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Serra J, Marques-Dos-Santos C, Marinheiro J, Cruz S, Cameira MR, de Vries W, Dalgaard T, Hutchings NJ, Graversgaard M, Giannini-Kurina F, Lassaletta L, Sanz-Cobeña A, Quemada M, Aguilera E, Medinets S, Einarsson R, Garnier J. Assessing nitrate groundwater hotspots in Europe reveals an inadequate designation of Nitrate Vulnerable Zones. CHEMOSPHERE 2024; 355:141830. [PMID: 38552801 DOI: 10.1016/j.chemosphere.2024.141830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/07/2024] [Accepted: 03/26/2024] [Indexed: 04/02/2024]
Abstract
Monitoring networks show that the European Union Nitrates Directive (ND) has had mixed success in reducing nitrate concentrations in groundwater. By combining machine learning and monitored nitrate concentrations (1992-2019), we estimate the total area of nitrate hotspots in Europe to be 401,000 km2, with 47% occurring outside of Nitrate Vulnerable Zones (NVZs). We also found contrasting increasing or decreasing trends, varying per country and time periods. We estimate that only 5% of the 122,000 km2 of hotspots in 2019 will meet nitrate quality standards by 2040 and that these may be offset by the appearance of new hotspots. Our results reveal that the effectiveness of the ND is limited by both time-lags between the implementation of good practices and pollution reduction and an inadequate designation of NVZs. Substantial improvements in the designation and regulation of NVZs are necessary, as well as in the quality of monitoring stations in terms of spatial density and information available concerning sampling depth, if the objectives of EU legislation to protect groundwater are to be achieved.
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Sousa AS, Serra J, Estevens C, Costa R, Ribeiro AJ. Leveraging a multivariate approach towards enhanced development of direct compression extended release tablets. Int J Pharm 2023; 646:123432. [PMID: 37739095 DOI: 10.1016/j.ijpharm.2023.123432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023]
Abstract
Extended release formulations play a crucial role in the pharmaceutical industry by maintaining steady plasma levels, reducing side effects, and improving therapeutic efficiency and compliance. One commonly used method to develop extended release formulations is direct compression, which offers several advantages, such as simplicity, time savings, and cost-effectiveness. However, successful direct compression-based extended release formulations require careful assessment and an understanding of the excipients' attributes. The scope of this work is the characterization of the compaction behavior of some matrix-forming agents and diluents for the development of extended release tablets. Fifteen excipients commonly used in extended release formulations were evaluated for physical, compaction and tablet properties. Powder properties (e.g., particle size, flow properties, bulk density) were evaluated and linked to the tablet's mechanical properties in a fully integrated approach, and data were analyzed by constructing a principal component analysis (PCA). Significant variability was observed among the various excipients. The present work successfully demonstrates the applicability of PCA as an effective tool for comparative analysis, pattern and clustering recognition and correlations between excipients and their properties, facilitating the development and manufacturing of direct compressible extended release formulations.
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González-Rodríguez L, Pérez-Davila S, Lama R, López-Álvarez M, Serra J, Novoa B, Figueras A, González P. 3D printing of PLA:CaP:GO scaffolds for bone tissue applications. RSC Adv 2023; 13:15947-15959. [PMID: 37260570 PMCID: PMC10227527 DOI: 10.1039/d3ra00981e] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/11/2023] [Indexed: 06/02/2023] Open
Abstract
Graphene oxide (GO) has attracted increasing interest for biomedical applications owing to its outstanding properties such as high specific surface area, ability to bind functional molecules for therapeutic purposes and solubility, together with mechanical resistance and good thermal conductivity. The combination of GO with other biomaterials, such as calcium phosphate (CaP) and biodegradable polymers, presents a promising strategy for bone tissue engineering. Presently, the development of these advanced biomaterials benefits from the use of additive manufacturing techniques, such as 3D printing. In this study, we develop a 3D printed PLA:CaP:GO scaffold for bone tissue engineering. First, GO was characterised alone by XPS to determine its main bond contributions and C : O ratio. Secondly, we determined the GO dose which ensures the absence of toxicity, directly exposed in vitro (human osteoblast-like cells MG-63) and in vivo (zebrafish model). In addition, GO was microinjected in the zebrafish to evaluate its effect on immune cells, quantifying the genetic expression of the main markers. Results indicated that the GO tested (C : O of 2.14, 49.50% oxidised, main bonds: C-OH, C-O-C) in a dose ≤0.25 mg mL-1 promoted MG63 cells viability percentages above 70%, and in a dose ≤0.10 mg mL-1 resulted in the absence of toxicity in zebrafish embryos. The immune response evaluation reinforced this result. Finally, the optimised GO dose (0.10 mg mL-1) was combined with polylactic acid (PLA) and CaP to obtain a 3D printed PLA:CaP:GO scaffold. Physicochemical characterisation (SEM/EDS, XRD, FT-Raman, nano-indentation) was performed and in vivo tests confirmed its biocompatibility, enabling a novel approach for bone tissue-related applications.
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Opdam F, Heymach J, Barve M, Tu HY, Wu YL, Gibson N, Sadrolhefazi B, Serra J, Yoh K, Yamamoto N. 40P Updated data from the phase I Beamion Lung 1 trial of BI 1810631, a HER2 TKI, in patients (pts) with advanced solid tumours with HER2 aberrations. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00294-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Sousa AS, Serra J, Estevens C, Costa R, Ribeiro AJ. A quality by design approach in oral extended release drug delivery systems: where we are and where we are going? JOURNAL OF PHARMACEUTICAL INVESTIGATION 2022. [DOI: 10.1007/s40005-022-00603-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Opdam F, Heymach J, Barve M, Gibson N, Sadrolhefazi B, Serra J, Yamamoto N, Yoh K, Wu YL. EP08.02-049 A Phase I Trial of the HER2 Exon 20 Inhibitor, BI 1810631, In Patients With Advanced Solid Tumors With HER2 Aberrations. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Schol J, Wauters L, Dickman R, Drug V, Mulak A, Serra J, Enck P, Tack J. United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis. United European Gastroenterol J 2022; 9:883-884. [PMID: 35099124 DOI: 10.1002/ueg2.12090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Ioaquín AB, Piedra A, Mosquera J, Riudavets M, Gomez-Randulfe M, Campelo MG, Sullivan I, Serra J, Aguado M, Tarruella MM. 131P Predictive factors of response to PD-(L)1 inhibitors in patients with advanced non-small cell lung (NSCLC) and high PD-L1 expression. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01973-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Clemente V, Allen-Gomes A, Tavares D, Azevedo C, Marques D, Serra J. How severe insomnia is (as measured by the insomnia severity index) depending on whether patients are using versus not using sleeping medication? Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Garcia-Garcia C, Rueda F, Vila J, De Diego O, Oliveras T, Labata C, Serra J, Ferrer M, El Ouaddi N, Cediel G, Elosua R, Lupon J, Bayes-Genis A. P1729Cardiogenic shock in ST elevation myocardial infarction: prevalence, management and acute phase and one-year mortality over the last three decades. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiogenic shock (CS) is an ominous complication of ST elevation myocardial infarction (STEMI). However, the widespread use of reperfusion therapies and invasive management could have reduced the prevalence of CS and improved the prognosis of these patients in the last decades.
Purpose
The aim is to analyze the changes over last three decades in the prevalence, management and acute phase prognosis and 1-year mortality of STEMI patients complicated with CS.
Method
Between February 1989 and December 2017, 7,589 STEMI patients were consecutively admitted in the Coronary Care Unit of a University Hospital and were included in a prospective registry. Depending on the year of admission, patients were classified in five groups: 1989–1994: n=1,337, period 1; 1995–1999: n=960, period 2; 2000–2004: n=1,059, period 3; 2005–2009: n=1,535, period 4 and 2010–2015: n=2,698, period 5). We analyze the trend in prevalence of CS, management and 28-day and 1-year mortality over these five periods.
Results
The global prevalence of CS was 6.1% (466 patients), mean age was 67.7 (SD 11.7) years and 68.7% were men. Prevalence of CS in STEMI decreased from period 1 to 5 (7.3%, 6.4%, 5.5%, 5.8%, 6.0%, p<0.001), although it has been reduced more in women (10.1% in period 1 vs 8.3%, period 5, p<0.001) than in men (6.5% vs 5.4%, period 1 vs 5, respectively (p<0.001). Reperfusion therapy increased from 25.8% in period 1 (all with thrombolysis) vs 83.8% in period 5 (all with primary angioplasty). Intra-aortic balloon contrapulsation was only available from period 3 to 5, and it's used were firstly increased (20.7%, 36% and 37.9%, respectively, p<0.001). Ventricular assistance device (Impella CP) it was only available in 2017 and it was implanted in 10.5% of CS due to STEMI. Although 28-day case fatality is very high (60.7%, 283 patients), it has been reduced from period 1 to 5 (69.6%, 77.3%, 64.7%, 55.9% and 57.8%, respectively, p=0.012). This reduction in 28-day case fatality was higher in women (75.5% in period 1 vs 58.6% in period 5, p=0.12) than in men (66.8% vs 57.3, period 1–5, p=0.019). One-year mortality has been reduced between periods 1–5 (73.7% vs 61.8%, p=0.012). After multivariate adjustment, both 28-day (HR 0.63, 95% CI: 0.45–0.89, p=0.008) and 1-year mortality (HR 0.64, 95% CI: 0.45–0.90, p=0.010) have declined in the last period.
Kaplan-Meier curves, 1-year mortality
Conclusions
Cardiogenic shock development in STEMI patients has been reduced from 7.3% to 6.1% in the last three decades. The whole improvement in management of these patients achieves a 37% of reduction in 28-day case fatality and 1-year all-cause mortality. Despite this improvement, acute phase (28-day) case fatality of STEMI complicated with CS remains over 57% in the primary angioplasty era.
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Riudavets M, Mosquera J, Campelo RG, Serra J, Anguera G, Gallardo P, Sullivan I, Barba A, Majem M. P2.04-52 Impact of Corticosteroids and Antibiotics on Efficacy of Immune-Checkpoint Inhibitors in Patients with Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Riudavets M, Mosquera J, Campelo RG, Serra J, Anguera G, Gallardo P, Sullivan I, Barba A, Majem M. P1.04-19 Association Between Efficacy and irAEs in Patients with Advanced Non-Small Cell Lung Cancer Receiving Immune-Checkpoint Inhibitors. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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El Ouaddi N, Garcia-Garcia C, De Diego O, Labata C, Rueda F, Oliveras T, Camara ML, Serra J, Berastegui E, Ferrer M, Munoz C, Bayes-Genis A. P865Mechanical Complications in ST elevation myocardial infarction: Trends in prevalence, acute phase prognosis and one-year mortality after the onset of reperfusion network. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The development of mechanical complications (MC) following an ST elevation myocardial infarction (STEMI) is associated with a high acute phase and long-term mortality. However, the widespread use of reperfusion therapies with primary angioplasty (pPCI) and surgical management could have reduced the prevalence of MC and improved the prognosis of these patients in the last years.
Purpose
The aim is to analyze the changes in the prevalence, management and acute phase prognosis and 1-year mortality of STEMI patients complicated with MC between two periods, before and after the onset of pPCI reperfusion network.
Method
We included all STEMI patients in a single centre prospective registry. Between 1990 and 2000, 2,251 STEMI patients were consecutively admitted in the Coronary Care Unit of a University Hospital (pre-pPCI period). In 2007, pPCI reperfusion program was onset in our centre. Between 2007 and 2017, 3,783 consecutive STEMI patients were included in the registry (post-pCI period). We analyze the prevalence of MC, management (reperfusion therapies, surgery ...) and 28-day and 1-year mortality among these two periods.
Results
A total of 6,034 STEMI patients were included in the registry (men 78.8%, mean age 61.7 years, SD 12.8). Patients admitted in the post-PCI period were older (62.4 vs 60.4 years, p<0.001) and have more prevalence of hypertension and dyslipidemia. Reperfusion therapy increased in post-pPCI period (89.1% vs 49.7%, p<0.001), due to widespread use of pPCI. A total of 105 patients (1.7%) develop any mechanical complication: 35 with ventricular septal rupture (VSR), 22 with papillary muscle rupture (PMR) and 48 patients with free wall rupture (FWR). Prevalence of MC has not been change between both periods. VSR occurred in 0.6% pre-PCI and 0.6% post-pPCI, p=0.98; PMR 0.3% vs 0.4% post-PCI, p=0.33; and FWR 1% vs 0.7% post-PCI, p=0.22). Overall 28-day STEMI mortality has been reduced in post-pPCI period (5.9% vs 10.1%, p<0.001 in acute phase). This 28-day mortality remains very high and without significant changes when MC appears: VSR: post-pPCI 77.3% vs 58.0%, p=0.25; PMR: 25.0% post-PCI vs 58.3%, p=0.69; and FWR: 66.4% post-PCI vs 73.7%, p=0.84). One-year mortality has not been changed between both periods and stays in a very high ratio (65.7% for VRS, 45.4% for PMR and 66.7% for FWR).
Conclusions
Although reperfusion therapy greatly increased with the onset of a pPCI reperfusion network, prevalence of MC has not been change over three decades in our series. Acute phase (28-day) and one-year mortality remains very high and without significant reduction in post-pPCI period.
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Calmeiro J, Carrascal M, Gomes C, Falcão A, Serra J, Cruz M, Neves B. Impact of different GMP media in the production of dendritic cells for next-generation cancer immunotherapy: Functional and metabolic characterization. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy485.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Caballero N, Marin I, Serra J. Gastric gas dynamics in healthy humans. Neurogastroenterol Motil 2018; 30:e13408. [PMID: 30043526 DOI: 10.1111/nmo.13408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 06/13/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND To cope with the daily increments of gastric gas, the stomach can propel gas to the small bowel or trigger the belching reflex. Our aim was to evaluate transit of free gastric gas in healthy humans, and its relationship with abdominal symptoms. METHODS In 24 healthy volunteers a gas mixture was infused into the stomach at 0 mL/min (sham infusion), 25 mL/min, 50 mL/min, and 100 mL/min (n = 6 each) up to 1500 mL. Belching, rectal gas evacuation, and abdominal perception were continuously recorded for 90 min. KEY RESULTS Sham infusion was associated to low rectal gas evacuation (187 ± 94 mL after 90 min), and belching (0 ± 0). In contrast, gastric gas infusion increased rectal gas evacuation (1198 ± 176 mL; P = .025) and belching (4 ± 1 belches; P = .0520) without differences between the infusion rates tested. Overall, there was a negative correlation between rectal gas evacuation and belching (r = -.72; P < .0001): 6 subjects had frequent belching (14 ± 2 belches) and minor rectal gas evacuation (330 ± 112 mL), whereas 12 subjects had virtually no belches (1 ± 1 belches) and greater rectal gas evacuation (1630 ± 147 mL; P < .001 vs belchers for both). Gas infusion induced lower abdominal symptoms in belchers (score increment 0.7 ± 0.3) than in rectal gas evacuators (score increment 1.7 ± 0.5; P = .033). CONCLUSIONS AND INFERENCES An excellent balance between belching and distal gastric empting allows the stomach to adapt to great variations in gas intake. In general, most gastric gas is emptied to distal intestinal segments, but in some circumstances gastric gas induces belching, a mechanism that may improve gas tolerance.
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Rodriguez-Gomez O, Sanabria A, Perez-Cordon A, Sanchez-Ruiz D, Abdelnour C, Valero S, Hernandez I, Rosende-Roca M, Mauleon A, Vargas L, Alegret M, Espinosa A, Ortega G, Guitart M, Gailhajanet A, Sotolongo-Grau O, Moreno-Grau S, Ruiz S, Tarragona M, Serra J, Martin E, Peleja E, Lomeña F, Campos F, Vivas A, Gomez-Chiari M, Tejero MA, Giménez J, Pesini P, Sarasa M, Martinez G, Ruiz A, Tarraga L, Boada M. FACEHBI: A Prospective Study of Risk Factors, Biomarkers and Cognition in a Cohort of Individuals with Subjective Cognitive Decline. Study Rationale and Research Protocols. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2018; 4:100-108. [PMID: 29186280 DOI: 10.14283/jpad.2016.122] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Long-term longitudinal studies with multimodal biomarkers are needed to delve into the knowledge of preclinical AD. Subjective cognitive decline has been proposed as a risk factor for the development of cognitive impairment. Thus, including individuals with SCD in observational studies may be a cost-effective strategy to increase the prevalence of preclinical AD in the sample. OBJECTIVES To describe the rationale, research protocols and baseline characteristics of participants in the Fundació ACE Healthy Brain Initiative (FACEHBI). DESIGN FACEHBI is a clinical trial (EudraCT: 2014-000798-38) embedded within a long-term observational study of individuals with SCD. SETTING Participants have been recruited at the memory clinic of Fundació ACE (Barcelona) from two different sources: patients referred by a general practitioner and individuals from an Open House Initiative. PARTICIPANTS 200 individuals diagnosed with SCD with a strictly normal performance in a comprehensive neuropsychological battery. MEASUREMENTS Individuals will undergo an extensive neuropsychological protocol, risk factor assessment and a set of multimodal biomarkers including florbetaben PET, structural and functional MRI, diffusion tensor imaging, determination of amyloid species in plasma and neurophthalmologic assessment with optical coherence tomography. RESULTS Two hundred individuals have been recruited in 15 months. Mean age was 65.9 years; mean MMSE was 29.2 with a mean of 14.8 years of education. CONCLUSIONS FACEHBI is a long-term study of cognition, biomarkers and lifestyle that has been designed upon an innovative symptom-based approach using SCD as target population. It will shed light on the pathophysiology of preclinical AD and the role of SCD as a risk marker for the development of cognitive impairment.
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Garcia-Garcia C, Oliveras T, Serra J, Rueda F, Labata C, Ferrer M, De Diego O, Aranyo J, Martinez MJ, Mauri J, Fernandez-Nofrerias E, Rodriguez-Leor O, Carrillo X, Abdul-Jawad O, Bayes-Genis A. P3618Early acute phase mortality and complications of STEMI patients: trends over the last three decades. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Ferrer M, Garcia-Garcia C, Labata C, De Diego O, Serra J, Rueda F, Oliveras T, Fadeuilhe E, Andres J, Bayes-Genis A. P833From coronary to critical cardiovascular care unit: cause of mortality and patients profile analysis over three decades. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Garcia-Garcia C, Rueda F, Oliveras T, Serra J, Labata C, Ferrer M, De Diego O, Cediel G, Rodriguez-Leor O, Carrillo X, Lupon J, Bayes-Genis A. P779Cardiogenic shock in STEMI patients:prevalence, management and acute phase mortality over the last three decades. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Garcia-Perez E, Schönberger T, Sumalla M, Stierstorfer B, Solà R, Doods H, Serra J, Gorodetskaya N. Behavioural, morphological and electrophysiological assessment of the effects of type 2 diabetes mellitus on large and small nerve fibres in Zucker diabetic fatty, Zucker lean and Wistar rats. Eur J Pain 2018; 22:1457-1472. [DOI: 10.1002/ejp.1235] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2018] [Indexed: 01/09/2023]
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Yee D, Sablin MP, Iwata H, Johnston EL, Bogenrieder T, Serra J, Hua H, Lo Russo P, Prat A. Abstract OT3-06-02: A phase Ib trial of xentuzumab and abemaciclib in patients with locally advanced or metastatic solid tumors, including hormone receptor-positive, HER2-negative breast cancer (plus endocrine therapy). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot3-06-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Resistance to endocrine therapy remains an important clinical problem in hormone receptor-positive (HR+), HER2-negative (HER2-) breast cancer (BC), necessitating alternative treatment options. The insulin-like growth factor (IGF) axis and cyclin D-cyclin-dependent kinase (CDK) 4/6-retinoblastoma pathway have been implicated in the pathogenesis and resistance mechanisms of a variety of cancers, including BC. Binding of IGF-I and -II to the IGF receptor results in upregulation of cyclin D1, and subsequent progression through the cell cycle, thus providing rationale for the simultaneous inhibition of IGF-I and -II and CDK4/6. This Phase Ib trial assesses the maximum-tolerated dose (MTD)/recommended phase II dose (RP2D), safety and preliminary efficacy of the IGF-ligand-neutralizing antibody, xentuzumab, in combination with abemaciclib, a selective, small-molecule inhibitor of both CDK4 and 6, in patients (pts) with solid tumors. The trial includes four dose finding cohorts followed by two expansion cohorts. Only those cohorts that will include pts with postmenopausal HR+, HER2- BC will be presented here.
Trial design: In this phase Ib multicenter, non-randomized, open-label, dose escalation trial (BI 1280.18 [NCT03099174]), the key aims in the BC cohorts (Cohorts B–D, F) are to define the MTD or recommended phase 2 dose (RP2D), and to evaluate the preliminary efficacy, safety and tolerability of xentuzumab plus abemaciclib in combination with endocrine therapies. Eligible pts include adults ≥18 yrs (≥20 for Japan), with measurable or evaluable disease, adequate organ function, ECOG PS ≤1, and postmenopausal locally advanced or metastatic HR+, HER2- BC (Cohorts B–D, F). CDK4/6 inhibitor-naïve pts (Cohorts B–D) and pts who have received prior CDK4/6 inhibitors (palbociclib or ribociclib) plus aromatase inhibitors (Cohort F) are included. The MTD/RP2D of xentuzumab plus abemaciclib to be used in Cohorts B–D will be established in pts with solid tumors (Cohort A) who will receive xentuzumab (starting dose 1000mg weekly iv) plus abemaciclib (starting dose 150mg every 12 hours). CDK4/6 inhibitor-naïve pts with BC will receive xentuzumab plus abemaciclib at the RP2D determined in Cohort A in combination with letrozole (2.5mg/day; Cohort B), anastrozole (1mg/day; Cohort C), or fulvestrant (500mg/month; Cohort D). CDK4/6 inhibitor pre-treated pts with BC (Cohort F) will receive xentuzumab plus abemaciclib and fulvestrant at the RP2D determined in Cohort D. Primary endpoints in the BC cohorts are the MTD and/or RP2D of xentuzumab plus abemaciclib in combination with endocrine therapies, and the objective response (OR) in CDK4/6 inhibitor pre-treated pts with advanced BC (Cohort F); disease control (DC), duration of DC, time to OR, duration of OR, and progression-free survival (PFS) in Cohort F are secondary endpoints. Additionally, PK outcomes, safety and tolerability will be assessed in all cohorts. This study will be conducted in the US, Europe and Japan. Pt screening started in May 2017. Target enrolment is ˜88 pts, including ˜56 pts with advanced HR+, HER2- BC, of whom ˜20 had previously been treated with CDK 4/6 inhibitors.
Citation Format: Yee D, Sablin MP, Iwata H, Johnston EL, Bogenrieder T, Serra J, Hua H, Lo Russo P, Prat A. A phase Ib trial of xentuzumab and abemaciclib in patients with locally advanced or metastatic solid tumors, including hormone receptor-positive, HER2-negative breast cancer (plus endocrine therapy) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT3-06-02.
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Lages J, De Santis M, Serra J, Moita J. Obstructive sleep apnea and malignant melanoma – a clinical case. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Serra J, Almeida N, Moita J. Waking up to a sudden death or with panic attack?.. – A case report. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Yee D, Prat A, Sablin M, Iwata H, Johnston E, Bogenrieder T, Serra J, Hua H, LoRusso P. A phase Ib trial of xentuzumab and abemaciclib in patients with locally advanced or metastatic solid tumors, hormone receptor-positive (HR+), HER2-negative (HER2-) breast cancer (BC; +/- endocrine therapy), or non-small-cell lung cancer (NSCLC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx656.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
BACKGROUND Swallowed gas is an important source of abdominal gas, and aerophagia is often believed as a putative cause of gas-related abdominal symptoms. However, altered gas-swallow during meals has not been demonstrated. Our aim was to characterize the number of gas swallows during meals in patients complaining of excessive belching and gaseousness and a control group without abdominal symptoms during a 24-h period. METHODS A 24-h pH-impedance monitoring was performed in 10 patients with excessive belching, and 11 patients without digestive symptoms or reflux in the pH-impedance study. During the study, patients followed their daily routine and customary meals, without any specific limitation. In each patient the number and content of swallows and belches were analyzed. KEY RESULTS Total meal periods were similar in controls (75±26 min) and patients (79±21 min; P=.339), but the number of gaseous swallows was greater in patients (114±13 swallows) than controls (71±8 swallows; P=.007), due to a greater frequency of gaseous swallows during meals (15±2 swallows/10 min vs 10±1 swallows/10 min, respectively; P=.008). During the 24-h study period, 66±13 belches were recorded in patients, but only 13±3 belches in controls (P<.001), mainly gastric belches (80±4% and 92±2% of belches, patients, and controls, respectively) which showed a good correlation with the number of gaseous swallows performed during meals (r=.756; P=.011). CONCLUSION AND INFERENCES Gas is frequently swallowed during meals. Patients complaining of excessive belching have a different swallow pattern during meals, with an increased ingestion of gas that correlates with increased gastric belching events.
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