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García-Fulgueiras A, García-Pina R, Morant C, de Larrea-Baz NF, Alvarez E. Burden of disease related to hepatitis C and hepatitis B in Spain: a methodological challenge of an unfolding health problem. J Viral Hepat 2011; 18:e453-60. [PMID: 21914063 DOI: 10.1111/j.1365-2893.2011.01467.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Most previous studies of burden of disease (BoD) in the area of transmissible diseases have assessed the burden of hepatitis C and B without including the end stages of the disease and using an incident approach. We aimed to assess the disability-adjusted life years (DALYs) related to hepatitis C and B in Spain in 2006 taking into account related cirrhosis and liver cancer. A prevalence approach was used to estimate current years lived with disability (YLD) because of viral hepatitis contracted years/decades before. We added years of life lost (YLL) to obtain DALYs. Around 76,000 DALYs were attributed to hepatitis C virus (HCV) and 15,323 to hepatitis B virus (HBV) when calculated without applying social values. Applying the discount rate and age-weighting used in the Global Burden Disease study, the BoD nearly halved. In any case, the burden related to hepatitis C including long-term outputs becomes the leading cause of DALYs among transmissible diseases in Spain. The mortality component (YLL) represents more than 90% of the BoD in both HCV and HBV. The findings emphasize the need to provide good surveillance systems not only concerning acute viral hepatitis, but also chronic and end-stage consequences to allow a reliable assessment of the prevention and public health control policies.
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Sánchez-Conde M, Montes Ramírez ML, Bellón Cano JM, Caminoa A, Alvarez Rodríguez F, González Garcia J, Miralles Martín P, Bernardino de la Serna I, Bernardo de Quirós JCL, Arribas López JR, Cosín Ochaíta J, Pascual Pareja JF, Alvarez E, Berenguer JB. Impact of liver steatosis on the correlation between liver stiffness and fibrosis measured by transient elastography in patients coinfected with human immunodeficiency virus and hepatitis C virus. J Viral Hepat 2011; 18:e278-83. [PMID: 21129129 DOI: 10.1111/j.1365-2893.2010.01407.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
We assessed the effect of different hepatic conditions such as fibrosis, steatosis and necroinflammatory activity on liver stiffness as measured by transient elastography in HIV/HCV-coinfected patients. We studied all consecutive HIV/HCV-coinfected patients who underwent liver biopsy and elastography between January 2007 and December 2008. Liver fibrosis was staged following METAVIR Cooperative Study Group criteria. Steatosis was categorized according to the percentage of affected hepatocytes as low (≤10%), moderate (<25%) and severe (≥25%). A total of 110 patients were included. Fibrosis was distributed by stage as follows: F0, n = 13; F1, n = 47; F2, n = 29; F3, n = 18; and F4, n = 3. Liver biopsy revealed the presence of hepatic steatosis in 68 patients (low to moderate, n = 53; and severe n = 15). By univariate regression analysis, fibrosis, necroinflammatory activity, and the degree of steatosis were correlated with liver stiffness. However, in a multiple regression analysis, steatosis and fibrosis were the only independent variables significantly associated with liver stiffness. With a cut-off of 9.5 kPa to distinguish patients with F ≤ 2 from F ≥ 3, elastography led to a significantly higher number of misclassification errors (25%vs 5%; P = 0.014), most of which were false positives for F ≥ 3. Our study suggests that the correlation between liver stiffness and fibrosis as estimated by transient elastography may be affected by the presence of hepatic steatosis in HIV/HCV-coinfected patients.
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Lalueza A, López-Medrano F, del Palacio A, Alhambra A, Alvarez E, Ramos A, Pérez A, Lizasoain M, Meije Y, García-Reyne A, Aguado JM. Cladosporium macrocarpum brain abscess after endoscopic ultrasound-guided celiac plexus block. Endoscopy 2011; 43 Suppl 2 UCTN:E9-10. [PMID: 21271535 DOI: 10.1055/s-0030-1255804] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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De la Haba J, Rodriguez-Lescure A, Baena JM, Martin Liberal J, Morales S, Chacon JI, Lopez-Vega JM, Fernandez I, Aguiar D, Garcia-Palomo A, Llorente RM, Barea JL, Alvarez E, Blancas I, Fernandez Y, Sanchez Rovira P, Vinyes G. Final analysis of dose density with zoledronic acid treatment in metastatic breast cancer patients: ZARAS study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Calvo F, Serrano J, Lozano M, Gomez-Espi M, Botella S, Munoz M, del Valle E, Garcia-Sabrido J, Alvarez E, Herranz R. 39 poster PRESACRAL EVOLUTIVE EVENTS AFTER POST-NEOADJUVANT INTRAOPERATIVE PRESACRAL RADIATION BOOST FOR RECTAL CANCER. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70162-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Pezzano SC, Torres C, Fainboim HA, Bouzas MB, Schroder T, Giuliano SF, Paz S, Alvarez E, Campos RH, Mbayed VA. Hepatitis B virus in Buenos Aires, Argentina: genotypes, virological characteristics and clinical outcomes. Clin Microbiol Infect 2011; 17:223-31. [PMID: 20545965 DOI: 10.1111/j.1469-0691.2010.03283.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Hepatitis B virus (HBV) is classified into eight major genotypes, A-H, which are geographically distributed worldwide. The aim of this work was to describe the clinical characteristics associated with the HBV genotypes circulating in Buenos Aires city. The study included 139 patients infected with HBV, whose clinical courses were classified as acute symptomatic self-limiting hepatitis, inactive carrier state and chronic active hepatitis (HBV e-antigen (HBeAg)-positive and HBeAg-negative). The HBV genotypes were determined in 128 patients by PCR-restriction fragment length polymorphism and phylogenetic analysis. Biochemical, virological, clinical and histological features were analysed. A differential distribution of genotypes between acute symptomatic and chronic infections was found. Among the acute cases, genotype F was predominant (65.2%, 30/46) and genotype D was rare (4.3%, 2/46), whereas among the chronic infections, a homogeneous distribution of genotypes A (26.8%, 22/82), D (31.7%, 26/82) and F (36.6%, 30/82), with an unusual presence of genotypes B (1.2%, 1/82) and C (3.7%, 3/82), was observed. Regarding the liver histology of chronically infected patients, genotype F tended to display higher histological activity indexes. Mutations related to HBV surface antigen immunoreactivity, antiviral resistance and HBeAg-negative status were studied. This work constitutes, to our knowledge, the first description of the clinical characteristics related to HBV genotypes in Argentina, where the distribution of genotypes in patients with acute infection has not been reported previously. Finally, it was established that genotype F is the prevalent genotype among the acute symptomatic infections in Buenos Aires city, and that it shows a tendency to cause an adverse disease outcome among the chronic cases.
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Rodiño-Janeiro BK, Salgado-Somoza A, Teijeira-Fernández E, González-Juanatey JR, Alvarez E, Eiras S. Receptor for advanced glycation end-products expression in subcutaneous adipose tissue is related to coronary artery disease. Eur J Endocrinol 2011; 164:529-37. [PMID: 21282351 DOI: 10.1530/eje-10-0904] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Obesity, a risk factor for coronary artery disease (CAD), is associated with inflammation and reactive oxygen species (ROS) production, while advanced glycation end-products, through their receptor (AGER or RAGE), play an important role on these processes. The aim of this study was to analyze the expression levels of RAGE, NADPH oxidase subunits, and catalase in adipose tissue in relation with CAD. DESIGN AND METHODS Patients undergoing heart surgery were included in two groups: with and without CAD. Epicardial adipose tissue (EAT) and subcutaneous adipose tissue (SAT) biopsies were analyzed for gene expression by RT-quantitative PCR, immunohistochemistry, or western blot. RESULTS RAGE mRNA and protein expression in SAT from patients with CAD was lower than in patients without CAD. However, there was no change in EAT from patients with or without CAD. P22-PHOX and RAGE gene expression were higher in EAT than in SAT, whereas catalase mRNA levels were lower. NADPH oxidase subunits and catalase mRNA expression were not influenced by CAD. Whereas NADPH oxidase-dependent oxidative response of SAT and EAT to lipid circulating levels could be different; glycemic levels were not related with the analyzed genes expression. CONCLUSIONS This study demonstrates that RAGE expression in SAT, but not in EAT, is down-regulated in patients with CAD with respect to those without CAD. Although changes were not observed for NADPH oxidase subunits or catalase expression between CAD and non-CAD patients, a possible relationship between ROS production and RAGE expression in adipose tissues cannot be ruled out.
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Olivares J, Carrasco J, Alvarez E, Pérez M, López-Gómez V, Vilardaga I, Rejas J. Effect of pregabalin on generalized anxiety disorder patients with severe symptoms of anxiety and depression refractory to duloxetin. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)71884-3] [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: 11/30/2022] Open
Abstract
PurposeThe purpose of this research was to analyse the effect of adding Pregabalin (PGB) on severe symptoms of anxiety and depression in patients with Generalized Anxiety Disorder refractory to duloxetin in daily medical practice in Spain.MethodsThis is a post-hoc analysis of a 6-month multicentre, prospective and observational study carried out in outpatient psychiatric clinics in Spain. Men and women, above 18 years, with a diagnosis of GAD according with DSM-IV-TR criteria, pregabalin naïve and refractory to a previous course of duloxetin (3 months or more) and severe symptoms of anxiety (HAM-A ≥ 24) and depression (MADRS ≥ 35) were considered eligible for analysis.ResultsA total of twenty-five patients [76% women, mean age; 49.3 (11.8) years, 82% with a comorbid depressive disorder] fulfilled criteria for analysis, and were previously exposed to duloxetin [mean dose: 71.7 (26.7) mg/day] for an average of 6.7 (3.7) months. Adding pregabalin [mean dose: 172.8 (75.5) mg/day], during 5.2 (1.8) months, reduced both anxiety and depressive symptoms by a mean of, respectively in HAM-A and MADRS scales, 54.1% (from 36.5 ± 4.3 pts to 16.6 ± 9.1 pts; p < 0.001, effect size: 4.63) and 52.8% (from 40.4 ± 4.6 pts to 19.0 ± 11.0 pts; p < 0.001, effect size: 4.65). As a result, the percentages of patients without symptoms of either anxiety or depression were 30% and 24%, respectively.ConclusionDespite small sample, adding pregabalin had a meaningful and significant effect on severe symptoms of anxiety and depressive symptoms in patients with severe GAD and concomitant depressive disorder resistant to duloxetin.
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Scanderbeg D, Saenz C, Plaxe S, McHale M, Alvarez E, Yashar C. Novel brachytherapy device design for treatment of cervical and uterine carcinoma. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Alvarez E, Carrasco J, Olivares J, Pérez M, López-Gómez V, Vilardaga I, Rejas J. Broadening diagnostic criteria of generalized anxiety disorders from DSM-IV: The impact on patient level of disability. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)71883-1] [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: 11/16/2022] Open
Abstract
PurposeTo explore the consequences of broadening DSM-IV criteria for Generalized Anxiety Disorder (GAD) on patient's disability.MethodsA multicentre and observational study was carried-out in outpatient psychiatric clinics in Spain between years 2007 and 2008. Naïve diagnosed patients with GAD according to DSM-IV criteria or with anxiety symptoms fulfilling broadened criteria were compared. At least 1-month of excessive or non-excessive worry along with only two of the associated symptoms listed on DSM-IV for GAD were considered as broadened GAD criteria. Socio-demographic data, medical history and functional outcome measures were recorded.ResultsA total of 3,549 patients were systematically recruited, 12.8% excluded because not found eligible for inclusion in analysis; 1,815 in the DSM-IV group (DG) and 1,264 in the broadening criteria group (BG). Both groups were similar on their sociodemographic characteristics. Total disability score in the WHO-DAS II scale was slightly, but statistically significant, higher in DG; 41.9 (17.1) versus 38.9 (16.0) points, p < 0.05. These weak differences were observed in all of the scale domains but mainly in domains “Getting around” [34.5 (23.6) versus 29.4 (22.8), p< 0.05] and “Life activities” [55.5 (27.1) versus 52.1 (26.2), p< 0.05], since differences in the other domains, even statistically significant, were negligible.ConclusionPatients with standard DSM-IV criteria for GAD appears to show slightly, but significant, worst level of disability than subjects with broadening diagnostic GAD criteria. Life-activities and participation in society domains seems to be the functional domains most impacted by symptoms of anxiety.
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Romero M, Monzón CG, Clemente G, Salcedo M, Bañares R, Alvarez E, Diego A, Santos L, Otero RM. Modulation of ICAM-1 tissue expression in patients with liver transplantation (LT) and acute rejection (AR) after glucocorticoid treatment. Transpl Int 2011. [DOI: 10.1111/j.1432-2277.2000.tb02083.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Vlaicu PC, Rusu LC, Ledesma A, Vicente M, Cuevas M, Zamorano M, Antolín-Amérigo D, Alvarez E, De La Hoz B. Cucumber anaphylaxis in a latex-sensitized patient. J Investig Allergol Clin Immunol 2011; 21:236-239. [PMID: 21548453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
We report the case of a 76-year-old woman who experienced dizziness, vomiting, dyspnea, thoracic erythema, and vaginal itching within 5 minutes of eating cucumber. She had been diagnosed 3 months earlier with papaya urticaria and latex sensitization. The results of skin prick tests were positive for cucumber, watermelon, papaya, and latex and negative for melon and profilin extracts. ImmunoCAP for latex-specific serum immunoglobulin (Ig) E was positive. Cucumber-specific serum IgE was negative. Immunoblot analysis using patient serum revealed a 30- to 32-kDa protein band in the cucumber (peel) and papaya extracts. Immunoblot inhibition with latex extract demonstrated inhibition of the band in both extracts. Immunoblot inhibition with cucumber-papaya and papaya-cucumber revealed inhibition of the same band in the cucumber and papaya extracts, respectively. We present a case of IgE-mediated allergy to cucumber and papaya. Our results strongly suggest that the allergen(s) implicated are associated with latex sensitization. To our knowledge, this is the first report of cucumber-latex and cucumber-papaya cross-reactivity.
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De La Mata M, Calvo F, Gomez Espi M, Alvarez E, Carreras J. Molecular Response to Neoadjuvant Oxaliplatin and Chemoradiation in Rectal Cancer: Molecular Imaging (FDG-PET/CT), VEGFR, and EGFR Expression and Histopathological Correlations. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Alvarez E, Jiménez J, Moleiro F, Rodríguez A. Characterizing atypical patterns of Heart Rate before Paroxysmal Ventricular Tachycardia. Med Eng Phys 2010; 32:1131-6. [PMID: 20869900 DOI: 10.1016/j.medengphy.2010.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Revised: 06/06/2010] [Accepted: 08/11/2010] [Indexed: 11/28/2022]
Abstract
Results of a comparative analysis between Heart Rate (HR) patterns occurring before the onset of Paroxysmal Ventricular Tachycardia (PVT) and from healthy subjects are shown. Two study groups were made after electrocardiographic dynamical monitoring (Holter) of volunteers. The first group includes 100h from 27 healthy control subjects, and the second group consists of 88h, ending with self-terminating episodes of PVT from 55 patients. Patterns are defined as sequences of consecutive RR intervals, while atypical patterns are defined as corresponding to unlikely behavior of Heart Rate in healthy subjects. We investigated spatial and temporal distributions of these patterns in order to find early signs of PVT. We found that they can be grouped on a reduced number of clusters, and the number of atypical patterns increases as we approach the onset of the episode.
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Vaidya C, Alvarez E, Vinciguerra J, Bruce DA, DesJardins JD. Reduction of Total Knee Replacement Wear with Vitamin E Blended Highly Cross-Linked Ultra-High Molecular Weight Polyethylene. Proc Inst Mech Eng H 2010; 225:1-7. [DOI: 10.1243/09544119jeim774] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Ultra-high molecular weight polyethylene (UHMWPE) is a common bearing component in total knee replacement (TKR) implants, and its susceptibility to wear continues to be the long-term limiting factor in the life of these implants. This study hypothesized that in TKR systems, a highly cross-linked (HXL) UHMWPE blended with vitamin E will result in reduced wear as compared to a direct compression-moulded (DCM) UHMWPE. A wear simulation study was conducted using an asymmetric lateral pivoting ‘3D Knee’ design to compare the two inserts. The highly cross-linked UHMWPE was aged prior to the testing and force-controlled wear testing was carried out for 5 million cycles using a load-controlled ISO-14243 standard at a frequency of 1Hz on both groups. Gravimetric measurements of DCM UHMWPE (4.4±3.0mg/million cycles) and HXL UHMWPE with vitamin E (1.9±1.9mg/ million cycles) showed significant statistical differences (p<0.01) between the wear rates. Wear modes and surface roughness for both groups revealed no significant dissimilarities.
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Calvo FA, De La Mata M, Gomez Espi M, Alvarez E, Carreras J. Molecular response to neoadjuvant oxaliplatin and chemoradiation in rectal cancer: Molecular imaging (FDG-PET/CT), VEGFR, and EGFR expression and histopathologic correlations. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pallí C, Beltran M, Barretina P, Alvarez E, Florensa A, Sala E, Vayreda J, Lluch J. Facing sexual difficulties: A psycho-oncology study with women affected by gynecologic cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e19563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Sánchez-Conde M, Montes-Ramírez ML, Miralles P, Alvarez JMC, Bellón JM, Ramírez M, Arribas JR, Gutiérrez I, López JC, Cosín J, Alvarez E, González J, Berenguer J. Comparison of transient elastography and liver biopsy for the assessment of liver fibrosis in HIV/hepatitis C virus-coinfected patients and correlation with noninvasive serum markers. J Viral Hepat 2010; 17:280-6. [PMID: 19732322 DOI: 10.1111/j.1365-2893.2009.01180.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Transient elastography (FibroScan) is a novel, rapid and noninvasive technique to assess liver fibrosis. Our objective was to compare transient elastography (TE) and other noninvasive serum indexes as alternatives to liver biopsy in HIV/hepatitis C virus (HCV)-coinfected patients. The fibrosis stage (METAVIR Score), TE, the aspartate aminotransferase-to-platelet ratio index, the Forns fibrosis index, FIB-4 and HGM-2 indexes were assessed in 100 patients between January 2007 and January 2008. The diagnostic values were compared by calculating the area under the receiver operating characteristic curves (AUROCs). Using TE, the AUROC (95% CI) of liver stiffness was 0.80 (0.72-0.89) when discriminating between F <or= 1 and F > 2, 0.93 (0.85-1.00) when discriminating between F <or= 2 and F > 3 and 0.99 (0.97-1.00) when discriminating between F <or= 3 and F4. For the diagnosis of F >or= 3, the AUROCs of TE were significantly higher than those obtained with the other four noninvasive indexes. Based on receiver operating characteristic curves, three cutoff values were chosen to identify F <or= 1 (<7 kPa), F >or= 3 (>or=11 kPa) and F4 (>or=14 kPa). Using these best cutoff scores, the negative predictive value and positive predictive value were 81.1% and 70.2% for the diagnosis of F <or= 1, 96.3% and 60% for the diagnosis of F >or= 3 and 100% and 57.1% for the diagnosis of F4. Thus, Transient elastography accurately predicted liver fibrosis and outperformed other simple noninvasive indexes in HIV/HCV-coinfected patients. Our data suggest that TE is a helpful tool for guiding therapeutic decisions in clinical practice.
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Inza A, Balda S, Alvarez E, Zárraga S, Gaínza FJ, Lampreabe I. Conversion to everolimus in kidney transplant recipients with decreased renal function. Transplant Proc 2010; 41:2134-6. [PMID: 19715854 DOI: 10.1016/j.transproceed.2009.05.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Whenever graft function is good and proteinuria is under control, many reports describe the efficacy and safety of the conversion to Everolimus (EVL) among stable kidney recepients, simultaneously withdrawing the calcineurin inhibitor (CNI). However, there are few publications that evaluate the role of EVL in patients with decreased renal function. We describe our experience with 22 stable renal transplant recipients whose serum creatinine concentrations were >2 mg/dL and proteinuria <1000 mg/24 h who underwent an abrupt switch from a CNI to EVL. Conversion was simple, well-tolerated, and safe using an initial dose of 1-3 mg/d that was sufficient to achieve the recommended levels of 3-8 ng/dL. The adverse events were expected; most of them were of medium intensity. Globally, over the 24 months follow-up, there was improved renal function despite the initial creatinine. The improvement was greater when the switch was performed during the first year after transplantation. Two patients lost their grafts after a dramatic evolution with development of nephrotic syndrome and increasing creatinine. In our experience, conversion to EVL is a safe alternative among patients with chronic allograft nephropathy or nephrotoxicity due to CNI, even in patients with significantly decreased renal function at the time of the switch.
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Puigdemont D, Portella M, Pérez-Egea R, Radua J, de Diego-Adeliño J, Molet J, Gironell A, Alvarez E, Pérez V. FC01-03 - Deep brain stimulation of subcallosal cingulate gyrus for treatment resistant depression. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)70177-2] [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: 10/19/2022] Open
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Portella M, Puigdemont D, Pérez-Egea R, de Diego-Adeliño J, Molet J, Gironell A, Alvarez E, Pérez V. P01-84 - Deep brain stimulation, electroconvulsive therapy, or both? A two case report. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)70303-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Vispo E, Mena A, Maida I, Blanco F, Cordoba M, Labarga P, Rodriguez-Novoa S, Alvarez E, Jimenez-Nacher I, Soriano V. Hepatic safety profile of raltegravir in HIV-infected patients with chronic hepatitis C. J Antimicrob Chemother 2009; 65:543-7. [DOI: 10.1093/jac/dkp446] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Alvarez E, Moga E, Barquinero J, Sierra J, Briones J. Dendritic and tumor cell fusions transduced with adenovirus encoding CD40L eradicate B-cell lymphoma and induce a Th17-type response. Gene Ther 2009; 17:469-77. [PMID: 20010627 DOI: 10.1038/gt.2009.150] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Fusion of dendritic cells and tumor cells (FCs) constitutes a promising tool for generating an antitumor response because of their capacity to present tumor antigens and provide appropriate costimulatory signals. CD40-CD40L interaction has an important role in the maturation and survival of dendritic cells and provides critical help for T-cell priming. In this study, we sought to improve the effectiveness of FC vaccines in a murine model of B-cell lymphoma by engineering FCs to express CD40L by means of an adenovirus encoding CD40L (Adv-CD40L). Before transduction with Adv-CD40L, no CD40L expression was detected in FCs, DCs or tumor cells. The surface expression of CD40L in FC transduced with Adv-CD40L (FC-CD40L) ranged between 50 and 60%. FC-CD40L showed an enhanced expression of CD80, CD86, CD54 and MHC class II molecules and elicited a strong in vitro immune response in a syngeneic mixed lymphocyte reaction. Furthermore, FC-CD40L showed enhanced migration to secondary lymphoid organs. Splenocytes from mice treated with FC-CD40L had a dramatic increase in the production of IL-17, IL-6 and IFN-gamma, compared with controls. Treatment with the FC-CD40L vaccine induced regression of established tumors and increased survival. Our data demonstrate that FC transduced with Adv-CD40L enhances the antitumor effect of FC vaccines in a murine lymphoma model and this is associated with an increased Th17-type immune response.
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Roncero I, Sanz C, Alvarez E, Vázquez P, Barrio PA, Blázquez E. Glucokinase and glucokinase regulatory proteins are functionally coexpressed before birth in the rat brain. J Neuroendocrinol 2009; 21:973-81. [PMID: 19807849 DOI: 10.1111/j.1365-2826.2009.01919.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Our previous description of functional glucokinase (GK) isoforms and their interactions with glucokinase regulatory protein (GKRP) in adult rat and human brains suggested that both participate in glucose sensing in the central nervous system. To determine whether both proteins are coexpressed and active before birth or during early post-natal life, we characterised these molecules in the brains of foetal and post-natal pup rats. We found GK and GKRP mRNAs that were similar to those previously reported in the adult rat brain. Likewise, GK and GKRP gene expression gave rise to proteins of 52 and 69 kDa, respectively. Immunohistochemistry experiments showed the colocalisation of both GK and GKRP proteins in the same brain cells of 21-day-old rat foetuses. Furthermore, coprecipitation of GK and GKRP in the presence of fructose 6-phosphate suggests interactions between both proteins. The presence of GK phosphorylating activity was detected in different brain areas of 21-day-old foetuses with a contribution to the total glucose-phosphorylating activity of between 17.2 +/- 1.7% and 12.4 +/- 3.7%, with the hypothalamus being the region of maximum activity. The hypothalamic GK activity in 21-day-old foetuses has a high apparent K(m) for glucose and no product inhibition by glucose 6-phosphate. Our findings indicate that both proteins may be functionally active before birth and that they can act within a glucose sensor system involved in controlling food intake.
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Rosenfeld R, Campero J, Ramos C, Hinrichs A, Zambrano N, Alvarez E, Chiang H, Salgado G. VID-07.07: Partial Laparoscopic Nephrectomy in T1a Intrarenal Tumor. Urology 2009. [DOI: 10.1016/j.urology.2009.07.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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