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García-Cruz E, Piqueras M, Gosálbez D, Pérez-Márquez M, Peri L, Izquierdo L, Franco A, Luque P, Corral J, Alvarez-Vijande R, Alcaraz A. [Erectile dysfunction and its severity are related to the number of cardiovascular risk factors]. Actas Urol Esp 2012; 36:291-5. [PMID: 22266257 DOI: 10.1016/j.acuro.2011.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 11/28/2011] [Accepted: 11/29/2011] [Indexed: 10/28/2022]
Abstract
AIM Erectile dysfunction (ED) is a very common condition in the general population. ED is closely related to Hypertension (HT), Diabetes Mellitus (DM), Dyslipidemia (DLP) and Metabolic Syndrome (MS). This study has aimed to clarify whether the presence and severity of ED are related to the presence and number of cardiovascular risk factors (CVRF). MATERIAL AND METHODS We retrospectively analyzed the characteristics of 242 males referred to our center for a prostate biopsy from September 2007 to December 2009. The following variables were collected prospectively: age, height, weight, body mass index (BMI), AHT, DM, DLP and obesity (BMI<30 kg/m(2)). The Erection Hardness Score Questionnaire was used to assess erectile function. We analyzed the relation between the presence and severity of ED and the presence of HT, DM, DLP and obesity. We analyzed the clinical variables based on the presence or absence of ED and in relationship to its severity. RESULTS The presence of ED was related to HT (OR: 1.805 [1.128-2.887]; p=0.013), DM (OR 3.585 [1.613-7.966]; p=0.001) and Dyslipidemia (OR: 1.928 [1.062-3.500]; p=0.029). Erectile function was not related to Obesity (OR: 0.929 [0.522-1.632]; p=0.795). Patients with ED were more likely to have more CVRF (p=0.009) and the severity of ED was related to the presence of HT (p<0.001), DM (p<0.001), DLP (p=0.001) and the number of CVRF (p<0.001). CONCLUSIONS The presence and severity of ED correlate with the presence of HT, DM, Dyslipidemia and the number of DVRF.
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García-Cruz E, Piqueras M, Gosálbez D, Pérez-Márquez M, Peri L, Izquierdo L, Franco A, Luque P, Corral J, Alvarez-Vijande R, Alcaraz A. Erectile dysfunction and its severity are related to the number of cardiovascular risk factors. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.acuroe.2012.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Garcia-Cruz E, Piqueras M, Huguet J, Perez-Marquez M, Gosalbez D, Peri L, Izquierdo L, Luque P, Ribal MJ, Alcaraz A. Hypertension, dyslipidemia and overweight are related to lower testosterone levels in a cohort of men undergoing prostate biopsy. Int J Impot Res 2012; 24:110-3. [PMID: 22258063 DOI: 10.1038/ijir.2011.55] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Testosterone deficiency syndrome (TDS) is a clinical and biochemical entity related to sexual and cardiovascular health. Hypertension, diabetes mellitus (DM), dyslipidemia and overweight are four clinical factors strongly related to cardiovascular illnesses. The aim of our study was to determine if the presence and number of cardiovascular risk factors was related to total testosterone levels and the presence of biochemical TDS. We retrospectively analyzed 384 patients referred to our center for prostate biopsy between September 2007 and December 2009. Variables age, height, weight, body mass index (BMI), tobacco use, alcohol intake, hypertension, DM, dyslipidemia (hypercholesterolemia/hypertriglyceridemia) and overweight (BMI>25) were recorded prospectively. Hormonal profile was determined as part of our clinical protocol. We used 231 and 346 ng dl(-1) as total testosterone cut-points (8-12 nmol l(-1)) for diagnosis of biochemical TDS, following ISA-ISSAM-EAU Guidelines. We analyzed the relationship between testosterone levels and the presence of hypertension, DM, dyslipidemia and overweight, and with the number of these cardiovascular risk factors. Mean age was 66 ± 8 years. Prevalence of TDS was 6.5% within the 231 ng ml(-1) cutoff point and 28.4% for the 346 ng dl(-1) cutoff point. Levels of testosterone were related to hypertension (P=0.007), dyslipidemia (P=0.013), overweight (P=0.036) and the number of cardiovascular risk factors (P=0.018). The prevalence of TDS in our population is comparable to data from international studies. Testosterone levels decrease as the number of cardiovascular risk factors rise.
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Ciudin A, Huguet J, García-Larrosa A, Musquera M, Alvarez-Vijande JR, José Ribal M, Alcaraz A. [Delayed bleeding after partial nephrectomy. Management with selective embolization]. Actas Urol Esp 2011; 35:615-9. [PMID: 21764183 DOI: 10.1016/j.acuro.2011.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Accepted: 05/22/2011] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Bleeding after partial nephrectomy can be immediate or delayed and may have severe consequences. The incidence of this complication is low. The most frequent cause of delayed bleeding is arterial pseudoaneurysm. Superselective embolization is a feasible therapeutic option that has shown good results. OBJECTIVE To evaluate treatment and outcomes of delayed bleeding in our series of patients with partial nephrectomy. MATERIAL AND METHODS We performed a retrospective study of our database of partial nephrectomies. Patients who developed delayed bleeding (after discharge) were identified. Clinical histories were reviewed and data on presentation, diagnosis, treatment and outcomes were analyzed. RESULTS Among our series of patients undergoing partial nephrectomy, three developed delayed bleeding (1.3%). Symptom onset occurred 17 to 25 days after surgery and consisted of hematuria or lumbar pain. Diagnosis was provided through ultrasound, abdominal computed tomography and renal angiography. In all three patients, a complicated pseudoaneurysm was diagnosed and all patients underwent renal artery catheterization with selective renal artery embolization. In all patients, immediate control of bleeding was achieved. Outcome after a follow-up of 61 to 92 months was favorable. CONCLUSIONS Selective vascular embolization is the treatment of choice of renal pseudoaneurysm after partial nephrectomy in hemodynamically stable patients.
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Bermudo R, Abia D, Mozos A, García-Cruz E, Alcaraz A, Ortiz AR, Thomson TM, Fernández PL. Highly sensitive molecular diagnosis of prostate cancer using surplus material washed off from biopsy needles. Br J Cancer 2011; 105:1600-7. [PMID: 22009027 PMCID: PMC3242534 DOI: 10.1038/bjc.2011.435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction: Currently, final diagnosis of prostate cancer (PCa) is based on histopathological analysis of needle biopsies, but this process often bears uncertainties due to small sample size, tumour focality and pathologist's subjective assessment. Methods: Prostate cancer diagnostic signatures were generated by applying linear discriminant analysis to microarray and real-time RT–PCR (qRT–PCR) data from normal and tumoural prostate tissue samples. Additionally, after removal of biopsy tissues, material washed off from transrectal biopsy needles was used for molecular profiling and discriminant analysis. Results: Linear discriminant analysis applied to microarray data for a set of 318 genes differentially expressed between non-tumoural and tumoural prostate samples produced 26 gene signatures, which classified the 84 samples used with 100% accuracy. To identify signatures potentially useful for the diagnosis of prostate biopsies, surplus material washed off from routine biopsy needles from 53 patients was used to generate qRT–PCR data for a subset of 11 genes. This analysis identified a six-gene signature that correctly assigned the biopsies as benign or tumoural in 92.6% of the cases, with 88.8% sensitivity and 96.1% specificity. Conclusion: Surplus material from prostate needle biopsies can be used for minimal-size gene signature analysis for sensitive and accurate discrimination between non-tumoural and tumoural prostates, without interference with current diagnostic procedures. This approach could be a useful adjunct to current procedures in PCa diagnosis.
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Musquera M, Peri L, Izquierdo L, Campillo P, Ribal M, Alcaraz A. [Pioneer experience in Spain with LSSS nephrectomy in living donor]. Actas Urol Esp 2011; 35:559-62. [PMID: 21696861 DOI: 10.1016/j.acuro.2011.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Accepted: 04/16/2011] [Indexed: 12/28/2022]
Abstract
INTRODUCTION LESS surgery (Laparoendoscopic single site surgery) is a surgical technique that aims to perform intraabdominal surgery using a single site entry, allowing for reduction in the number and size of the incisions, achieving better esthetic results with at least the same functional outcomes as with the conventional laparoscopic surgery. MATERIAL AND METHODS We present the first experience of LESS living donor nephrectomy carried out by a totally European team. To perform it, a Quadport® device was placed through a 4 cm long paraumbilical incision. RESULTS The nephrectomy was performed using the standards of conventional laparoscopic surgery, with the use of a precurved instrument in the left hand and straight instruments in the right. After bagging the kidney, the artery and vein were sectioned after clipping, allowing for rapid extraction of the organ through the same incision, with warm ischemia of 3.30" and 2.47," respectively. CONCLUSION Living donor nephrectomy using the LESS technique is feasible and can be considered a good option for obtaining live donor kidney grafts in males. The application of said surgical in living kidney donor can increase the rate of donation, by reducing morbidity and improving the esthetic results with the same outcome for the donor as for the recipient.
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Gomez Veiga F, Alcaraz A, Bellmunt J, Rodriguez A, Solsona E. 642 A CONSENSUS DEFINITION FOR CASTRATION-RESISTANT PROSTATE CANCER. “DELPHI STUDY”. J Urol 2011. [DOI: 10.1016/j.juro.2011.02.1544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Alcaraz A. Comentario a: "Linfadenectomía retroperitoneal laparoscópica primaria para el tumor testicular de células germinales no seminomatoso en estadio clínico I". Actas Urol Esp 2011. [DOI: 10.4321/s0210-48062011000100008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Alcaraz A. Comentario a: “Linfadenectomía retroperitoneal laparoscópica primaria para el tumor testicular de células germinales no seminomatoso en estadio clínico I”. Actas Urol Esp 2011. [DOI: 10.1016/j.acuro.2010.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Alcaraz A. [Comment to: "Primary laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ-cell testis tumor"]. Actas Urol Esp 2011; 35:29-30. [PMID: 21322830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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López ML, García-Giménez E, Aguilella VM, Alcaraz A. Critical assessment of OmpF channel selectivity: merging information from different experimental protocols. JOURNAL OF PHYSICS. CONDENSED MATTER : AN INSTITUTE OF PHYSICS JOURNAL 2010; 22:454106. [PMID: 21339594 DOI: 10.1088/0953-8984/22/45/454106] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The ion selectivity of a channel can be quantified in several ways by using different experimental protocols. A wide, mesoscopic channel, the OmpF porin of the outer membrane of E. coli, serves as a case study for comparing and analysing several measures of the channel cation-anion permeability in chlorides of alkali metals (LiCl, NaCl, KCl, CsCl). We show how different insights can be gained and integrated to rationalize the global image of channel selectivity. To this end, reversal potential, channel conductance and bi-ionic potential (two different salts with a common anion on each side of the channel but with the same concentration) experiments are discussed in light of an electrodiffusion model based on the Poisson-Nernst-Planck formalism. Measurements and calculations based on the atomic crystal structure of the channel show that each protocol displays a particular balance between the different sources of selectivity.
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Izquierdo L, Peri L, Álvarez-Vijande R, Alcaraz A. Audit of an Initial 100 Cases of Laparoscopic Live Donor Nephrectomy. Transplant Proc 2010; 42:3437-9. [DOI: 10.1016/j.transproceed.2010.06.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Revised: 04/23/2010] [Accepted: 06/10/2010] [Indexed: 11/26/2022]
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Izquierdo L, Peri L, Piqueras M, Revuelta I, Alvarez-Vijande R, Musquera M, Oppenheimer F, Alcaraz A. Third and Fourth Kidney Transplant: Still a Reasonable Option. Transplant Proc 2010; 42:2498-502. [DOI: 10.1016/j.transproceed.2010.04.064] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Revised: 03/11/2010] [Accepted: 04/01/2010] [Indexed: 01/16/2023]
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Alcaraz A, Musquera M, Peri L, Molina A, Campillo P. 332 FIRST EXPERIENCE OF TRANSVAGINALLY NOTES-ASSISTED LAPAROSCOPIC LIVING DONOR NEPHRECTOMY. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s1569-9056(10)60330-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Izquierdo L, Truán D, Alvarez-Vijande R, Alcaraz A. Carcinoma urotelial de tracto urinario superior: 114 casos con largo seguimiento. Actas Urol Esp 2010. [DOI: 10.4321/s0210-48062010000300003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Izquierdo L, Truán D, Alvarez-Vijande R, Alcaraz A. [Large series of 114 cases with long-term follow-up of upper urinary tract urothelial tumors]. Actas Urol Esp 2010; 34:232-237. [PMID: 20416239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
PURPOSE Upper urinary tract urothelial carcinoma (UUTUC) represents 5% of all urothelial tumors and has uncertain prognostic. Exist few series which describes clinical-pathological parameters of tumor progression. The aim of this study is to evaluate clinical and pathological parameters and determine their value as prognostic factors of tumor progression and cancer-specific survival. MATERIAL AND METHODS Retrospective analysis of 114 cases of radical nephroureterectomy or partial ureterectomy collected between 1991-2004. Variables analyzed were age, sex, pathological tumor stage, histological tumor grade, CIS, tumor localization, multiplicity, bladder cancer history, pathological nodes and adjuvant chemotherapy. Spearman test was used for correlations. The probabilities of progression free survival and cancer-specific survival were calculated using Kaplan-Meier curves. In the multivariate analysis forward stepwise Cox regression was performed. RESULTS Pathological stage was: 15 pTa, 25 pT1, 26 pT2, 32 pT3 and 16 pT4. There were 10 G1 (9%), 52 G2 (45.5%) and 52 G3 (45.5%). Fifteen patients presented pathological nodes at the moment of diagnosis. Fourteen percent of 114 patients received adjuvant treatment (Platin-based regimen). Mean follow-up: 74.8 months; 30.7% of the patients developed tumor progression. Death from the disease: 24.6%. Five-years overall and cancer-specific survival: 59.3% and 72.9%, respectively. Five-year progression-free survival: 68%. Mean time of tumor progression: 12.2 months and 23.3 months for cancer-specific death. In the multivariate analysis the independent predictive variables of death and tumor progression were histological grade and pathological stage. CONCLUSIONS We demonstrated that histological grade and pathological stage constitute independent prognostic factors of tumor progression and cancer-specific survival in UUTUC.
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Izquierdo L, Truán D, Alvarez-Vijande R, Alcaraz A. Carcinoma urotelial de tracto urinario superior: 114 casos con largo seguimiento. Actas Urol Esp 2010. [DOI: 10.1016/j.acuro.2009.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Alcaraz A, Burgos F, Cózar J, Gomez-Veiga F, Morote J, Solsona E, Unda M, Carballido J. UP-1.120: Prostate Cancer in Spain: From Guidelines to Clinical Practice. Urology 2009. [DOI: 10.1016/j.urology.2009.07.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mellado B, Font A, Alcaraz A, Aparicio LA, Veiga FJG, Areal J, Gallardo E, Hannaoui N, Lorenzo JRM, Sousa A, Fernandez PL, Gascon P. Phase II trial of short-term neoadjuvant docetaxel and complete androgen blockade in high-risk prostate cancer. Br J Cancer 2009; 101:1248-52. [PMID: 19755998 PMCID: PMC2768456 DOI: 10.1038/sj.bjc.6605320] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The low probability of curing high-risk prostate cancer (PC) with local therapy suggests the need to study modality of therapeutic approaches. To this end, a prospective phase II trial of neoadjuvant docetaxel (D) and complete androgen blockade (CAB) was carried out in high-risk PC patients. The primary end point was to detect at least 10% of pCRs after chemohormonal treatment. METHODS Patients with T1c-T2 clinical stage with prostate-specific antigen (PSA) >20 ng ml(-1) and/or Gleason score >or=7 (4+3) and T3 were included. Treatment consisted of three cycles of D 36 mg m(-2) on days 1, 8 and 15 every 28 days concomitant with CAB, followed by radical prostatectomy (RP). RESULTS A total of 57 patients were included. Clinical stage was T1c, 11 patients (19.3%); T2, 30 (52.6%) and T3, 16 (28%) patients. Gleason score was >or=7 (4+3) in 44 (77%) patients and PSA >20 ng ml(-1) in 15 (26%) patients. Treatment was well tolerated with 51 (89.9%) patients completing neoadjuvant therapy together with RP. The rate of pCR was 6% (three patients). Three (6%) additional patients had microscopic residual tumour (near pCR) in prostate specimen. With a median follow-up of 35 months, 18 (31.6%) patients presented PSA relapse. CONCLUSION Short-term neoadjuvant D and CAB induced a 6% pCR rate, which is close to what would be expected with ADT alone. The combination was generally well tolerated.
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Alcaraz A, Peri L, Izquierdo L, Carmona F, Molina A, Ribal M. V20 HYBRID TRANSVAGINAL RADICAL NEPHRECTOMY. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s1569-9056(09)61037-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Domingo-Domenech J, Fernandez P, Filella X, Martinez-Fernandez A, Molina R, Fernandez E, Alcaraz A, Codony J, Gascon P, Mellado B. Serum HER2 extracellular domain predicts an aggressive clinical outcome and biological PSA response in hormone-independent prostate cancer patients treated with docetaxel. Ann Oncol 2008; 19:269-75. [DOI: 10.1093/annonc/mdm490] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gómez Veiga F, Sousa A, Alcaraz A, Areal J, Hannaoui N, Aparicio L, Mellado B, Gallardo E, Gascón P, Font A. POD-01.06: Phase II trial of weekly docetaxel and complete androgen blockade prior to radical prostatectomy in high-risk localized prostate cancer patients. Urology 2007. [DOI: 10.1016/j.urology.2007.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hernandez-Espinosa D, Alcaraz A, Miñano A, Mota R, Ordoñez A, Garcia-Estañ J, Vicente V, Ortiz M, Corral J. BILLIARY CIRRHOSIS: CONFORMATIONAL EFFECTS AND CONSEQUENCES OF THE OXIDATION OF HEPATIC SERPINS. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb03181.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Marín-Aguilera M, Alcaraz A. Reply to Tine Hajdinjak and Nadja Kokalj-Vokač’s Letter to the Editor re: Re: Mecedes Marín-Aguilera, Lourdes Mengual, María José Ribal et al. Utility of Fluorescence In Situ Hybridization as a Non-invasive Technique in the Diagnosis of Upper Urinary Tract Urothelial Carcinoma. Eur Urol 2007;51:409–15 and Alan M. Nieder, Mark S. Soloway and Harry W. Herr. Should We Abandon the FISH Test? Eur Urol 2007;51:1469–71. Eur Urol 2007;52:287–9. Eur Urol 2007. [DOI: 10.1016/j.eururo.2007.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Aguilar A, Alvarez-Vijande R, Capdevila S, Alcoberro J, Alcaraz A. Antioxidant Patterns (Superoxide Dismutase, Glutathione Reductase, and Glutathione Peroxidase) in Kidneys From Non–Heart-Beating-Donors: Experimental Study. Transplant Proc 2007; 39:249-52. [PMID: 17275515 DOI: 10.1016/j.transproceed.2006.10.212] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2005] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The evolution of renal antioxidant concentrations in the different phases of a non-heart-beating donor (NHBD) transplant after prolonged warm ischemia (40 and 90 minutes) and the effect of normothermic extracorporeal recirculation (37 degrees C) for 30 minutes were evaluated on antioxidant tissue concentrations in the kidney. METHODS Forty pairs of pigs, were divided into groups of 10 as follows: group 0, control donor with beating heart; group 1, 40 minutes of warm ischemia without recirculation by cardiopulmonary bypass pump (groups 2 and 3); group 2, 40 minutes of warm ischemia and recirculation for 30 minutes at 37 degrees C; and group 3, 90 minutes of warm ischemia and recirculation for 30 minutes at 37 degrees C. The concentrations of superoxide dismutase (SOD), glutathione peroxidase, and glutathione reductase were determined at the tissue level by biopsy at baseline the end of warm ischemia, the end of recirculation, at the end of cold ischemia, and 1 hour after reperfusion. RESULTS SOD was consumed at the end of the cold ischemia phase (P < .009) and increased during reperfusion (P < .02). Glutathione reductase was consumed during the cold ischemia phase (P < .04). In kidneys submitted to 40 minutes of warm ischemia, SOD was consumed during the cold ischemia phase (P < .04) and increased with reperfusion (P < .03). In kidneys undergoing 90 minutes of hot ischemia, SOD was consumed during cold ischemia (P < .04) and glutathione reductase during extracorporeal recirculation (P < .01). CONCLUSIONS Recirculation increased the tissue level of SOD at the end of the cold ischemia period.
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