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Martin-Gorgojo A, Ramírez-Bellver JL, Ruiz-Rodríguez R, Pizarro Á. SARS-CoV-2 Spike-like Pigmented Peripheral Structures: A Dermoscopic Finding in Dysplastic Nevi and Incipient Melanomas. Actas Dermosifiliogr 2021:S1578-2190(21)00306-1. [PMID: 34785818 PMCID: PMC8579716 DOI: 10.1016/j.adengl.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The Publisher regrets that this article is an accidental duplication of an article that has already been published, https://doi.org/10.1016/j.ad.2021.07.015 . The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
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Affiliation(s)
| | | | | | - Á Pizarro
- Clínica Dermatológica Internacional, Madrid, Spain
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Ruiz-Carnicer Á, Garzón-Benavides M, Fombuena B, Segura V, García-Fernández F, Sobrino-Rodríguez S, Gómez-Izquierdo L, Montes-Cano MA, Rodríguez-Herrera A, Millán R, Rico MC, González-Naranjo C, Bozada-García JM, Díaz J, Coronel-Rodríguez C, Espín B, Romero-Gómez M, Cebolla Á, Sousa C, Comino I, Argüelles F, Pizarro Á. Negative predictive value of the repeated absence of gluten immunogenic peptides in the urine of treated celiac patients in predicting mucosal healing: new proposals for follow-up in celiac disease. Am J Clin Nutr 2020; 112:1240-1251. [PMID: 32692806 DOI: 10.1093/ajcn/nqaa188] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/15/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The treatment of celiac disease (CD) is a lifelong gluten-free diet (GFD). The current methods for monitoring GFD conformance, such as a dietary questionnaire or serology tests, may be inaccurate in detecting dietary transgressions, and duodenal biopsies are invasive, expensive, and not a routine monitoring technique. OBJECTIVES Our aim was to determine the clinical usefulness of urine gluten immunogenic peptides (GIP) as a biomarker monitoring GFD adherence in celiac patients and to evaluate the concordance of the results with the degree of mucosal damage. METHODS A prospective observational study was conducted involving 22 de novo CD patients, 77 celiac patients consuming a GFD, and 13 nonceliac subjects. On 3 d of the week, urine samples were collected and the GIP concentrations were tested. Simultaneously, anti-tissue transglutaminase antibodies, questionnaire results, clinical manifestations, and histological findings were analyzed. RESULTS Approximately 24% (18 of 76) of the celiac patients consuming a GFD exhibited Marsh II-III mucosal damage. Among this population, 94% (17 of 18) had detectable urine GIP; however, between 60% and 80% were asymptomatic and exhibited negative serology and appropriate GFD adherence based on the questionnaire. In contrast, 97% (31 of 32) of the celiac patients without duodenal damage had no detectable GIP. These results demonstrated the high sensitivity (94%) and negative predictive value (97%) of GIP measurements in relation to duodenal biopsy findings. In the de novo CD-diagnosed cohort, 82% (18 of 22) of patients had measurable amounts of GIP in the urine. CONCLUSIONS Determining GIP concentrations in several urine samples may be an especially convenient approach to assess recent gluten exposure in celiac patients and appears to accurately predict the absence of histological lesions. The introduction of GIP testing as an assessment technique for GFD adherence may help in ascertaining dietary compliance and to target the most suitable intervention during follow-up.
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Affiliation(s)
- Ángela Ruiz-Carnicer
- Department of Microbiology and Parasitology, Faculty of Pharmacy, University of Seville, Seville, Spain
| | - Marta Garzón-Benavides
- Digestive Disease Clinical Unit, Gastroenterology Division, Virgen del Rocío Hospital, Seville, Spain
| | - Blanca Fombuena
- Digestive Disease Clinical Unit, Gastroenterology Division, Virgen del Rocío Hospital, Seville, Spain
| | - Verónica Segura
- Department of Microbiology and Parasitology, Faculty of Pharmacy, University of Seville, Seville, Spain
| | | | | | | | - Marcos A Montes-Cano
- Institute of Biomedicine of Seville (IBiS), Seville, Spain; Faculty of Medicine, University of Seville, Seville, Spain
| | | | - Raquel Millán
- Digestive Disease Clinical Unit, Gastroenterology Division, Virgen del Rocío Hospital, Seville, Spain
| | - María C Rico
- Digestive Disease Clinical Unit, Gastroenterology Division, Virgen del Rocío Hospital, Seville, Spain
| | - Carmen González-Naranjo
- Digestive Disease Clinical Unit, Gastroenterology Division, Virgen del Rocío Hospital, Seville, Spain
| | - Juan M Bozada-García
- Endoscopy of Digestive Diseases Clinical Unit, Virgen del Rocío Hospital, Seville, Spain
| | - Jacobo Díaz
- Clinical Analysis Service, Hospital Universitario INGESA, Ceuta, Spain
| | | | - Beatriz Espín
- Pediatric, Gastroenterology, Hepatology and Nutrition Section, Virgen del Rocio Children's Hospital, Seville, Spain
| | - Manuel Romero-Gómez
- Digestive Disease Clinical Unit, Gastroenterology Division, Virgen del Rocío Hospital, Seville, Spain
| | | | - Carolina Sousa
- Department of Microbiology and Parasitology, Faculty of Pharmacy, University of Seville, Seville, Spain
| | - Isabel Comino
- Department of Microbiology and Parasitology, Faculty of Pharmacy, University of Seville, Seville, Spain
| | - Federico Argüelles
- Digestive Diseases Clinical Unit, Virgen Macarena Hospital, Seville, Spain
| | - Ángeles Pizarro
- Digestive Disease Clinical Unit, Gastroenterology Division, Virgen del Rocío Hospital, Seville, Spain
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Pizarro Á. Sentinel Lymph Node Biopsy in Melanoma Does Have Therapeutic Utility. Actas Dermo-Sifiliográficas (English Edition) 2020. [DOI: 10.1016/j.adengl.2019.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Pizarro Á. Sentinel Lymph Node Biopsy in Melanoma Does Have Therapeutic Utility. Actas Dermosifiliogr (Engl Ed) 2020; 111:536-537. [PMID: 32507284 DOI: 10.1016/j.ad.2019.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 11/22/2019] [Indexed: 01/14/2023] Open
Affiliation(s)
- Á Pizarro
- Unidad de Prevención y Diagnóstico Precoz de Melanoma, Clínica Dermatológica Internacional, Madrid, España.
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Mangas-Sanjuan C, Santana E, Cubiella J, Rodríguez-Camacho E, Seoane A, Alvarez-Gonzalez MA, Suárez A, Álvarez-García V, González N, Luè A, Cid-Gomez L, Ponce M, Bujanda L, Portillo I, Pellisé M, Díez-Redondo P, Herráiz M, Ono A, Pizarro Á, Zapater P, Jover R. Variation in Colonoscopy Performance Measures According to Procedure Indication. Clin Gastroenterol Hepatol 2020; 18:1216-1223.e2. [PMID: 31446179 DOI: 10.1016/j.cgh.2019.08.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 08/02/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Most fulfillment and benchmarking information for colonoscopy quality indicators has been obtained from studies of primary screening colonoscopies. We analyzed differences in the fulfillment of colonoscopy quality indicators based on the indication for endoscopy. METHODS We performed an observational, multicenter, cross-sectional study of 14,867 patients who underwent endoscopy procedures for gastrointestinal symptoms (40.3%), a positive result from a fecal immunochemical test (36.0%), postpolypectomy surveillance (15.3%), or primary screening (8.4%), from February 2016 through December 2017 at 14 centers in Spain. We evaluated rates of adequate colon cleansing, cecal intubation, adenoma detection, and colorectal cancer detection, among others. We used findings from primary screening colonoscopies as the reference standard. RESULTS Fewer than 90% of patients had adequate bowel preparation; 83.1% of patients with gastrointestinal symptoms had adequate bowel preparation (odds ratio [OR] compared with patients with primary screening colonoscopies, 0.62; 95% CI, 0.49-0.78) and 85.3% of patients receiving postpolypectomy surveillance had adequate bowel preparation (OR, 0.71; 95% CI, 0.55-0.91). The cecal intubation rate was also lower in patients with gastrointestinal symptoms (93.1%) (OR, 0.34; 95% CI, 0.22-0.52). The adenoma detection rate was higher in patients with a positive result from a fecal immunochemical test (46.4%) (OR, 2.01; 95% CI, 1.71-2.35) and in patients undergoing postpolypectomy surveillance (48.2%) (OR, 1.41; 95% CI, 1.20-1.67). The highest proportion of patients with colorectal cancer was in the gastrointestinal symptom group (5.1%) (OR, 5.24; 95% CI, 2.30-11.93) and the lowest was in patients undergoing surveillance (0.8%) (OR, 0.83; 95% CI, 0.32-2.14). CONCLUSIONS Fulfillment of colonoscopy performance measures varies substantially by indication. Policies addressing performance measures beyond colonoscopy screening procedures should be developed. Benchmarking recommendations could be adjusted according to colonoscopy indication.
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Affiliation(s)
- Carolina Mangas-Sanjuan
- Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria and Biomédica de Alicante, ISABIAL, Alicante, Spain
| | - Enrique Santana
- Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria and Biomédica de Alicante, ISABIAL, Alicante, Spain
| | - Joaquín Cubiella
- Department of Gastroenterology, Complexo Hospitalario de Ourense, Instituto de Investigación Biomédica de Ourense, Pontevedra y Vigo, Ourense, Spain
| | | | - Agustín Seoane
- Department of Gastroenterology, Parc de Salut Mar, Hospital del Mar, Barcelona, Spain
| | | | - Adolfo Suárez
- Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Natalia González
- Department of Gastroenterology, Hospital Universitario de Canarias, Instituto Universitario de Tecnologías Biomédicas and Centro de Investigación Biomédica de Canarias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - Alberto Luè
- Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Aragon Health Research Institute, Zaragoza, Spain
| | - Lucía Cid-Gomez
- Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Instituto de Investigación Biomédica, Xerencia de Xestión Integrada de Vigo, Vigo, Spain
| | - Marta Ponce
- Department of Gastroenterology, Hospital Universitario La Fe, Valencia, Spain
| | - Luis Bujanda
- Department of Gastroenterology, Biodonostia Medical Research Institute, San Sebastián, Spain
| | - Isabel Portillo
- BioCruces Health Research Institute, Colorectal Screening Program, Basque Health Service, Barakaldo, Spain
| | - María Pellisé
- Department of Gastroenterology, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Maite Herráiz
- Department of Gastroenterology, Clínica Universitaria and Medical School, University of Navarra, Navarra, Spain
| | - Akiko Ono
- Unidad de Gestión Clínica de Digestivo, Hospital Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria, Murcia, Spain
| | - Ángeles Pizarro
- Department of Gastroenterology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Pedro Zapater
- Unit of Clinical Pharmacology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL) Alicante, Spain
| | - Rodrigo Jover
- Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria and Biomédica de Alicante, ISABIAL, Alicante, Spain.
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Pizarro Á. Lymphadenectomy After a Positive Sentinel Lymph Node Biopsy in Melanoma: A Paradigm Shift. Actas Dermo-Sifiliográficas (English Edition) 2018. [DOI: 10.1016/j.adengl.2018.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Pizarro Á. Lymphadenectomy After a Positive Sentinel Lymph Node Biopsy in Melanoma: A Paradigm Shift. Actas Dermosifiliogr (Engl Ed) 2018; 109:298-302. [PMID: 29496198 DOI: 10.1016/j.ad.2018.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 01/13/2018] [Accepted: 01/21/2018] [Indexed: 11/25/2022] Open
Affiliation(s)
- Á Pizarro
- Unidad de Prevención y Diagnóstico Precoz de Melanoma, Clínica Dermatológica Internacional, Madrid, España.
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Moreno MDL, Cebolla Á, Muñoz-Suano A, Carrillo-Carrion C, Comino I, Pizarro Á, León F, Rodríguez-Herrera A, Sousa C. Detection of gluten immunogenic peptides in the urine of patients with coeliac disease reveals transgressions in the gluten-free diet and incomplete mucosal healing. Gut 2017; 66:250-257. [PMID: 26608460 PMCID: PMC5284479 DOI: 10.1136/gutjnl-2015-310148] [Citation(s) in RCA: 203] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 09/23/2015] [Accepted: 09/25/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Gluten-free diet (GFD) is the only management for coeliac disease (CD). Available methods to assess GFD compliance are insufficiently sensitive to detect occasional dietary transgressions that may cause gut mucosal damage. We aimed to develop a method to determine gluten intake and monitor GFD compliance in patients with CD and to evaluate its correlation with mucosal damage. DESIGN Urine samples of 76 healthy subjects and 58 patients with CD subjected to different gluten dietary conditions were collected. A lateral flow test (LFT) with the highly sensitive and specific G12 monoclonal antibody for the most dominant gluten immunogenic peptides (GIP) and a LFT reader were used to quantify GIP in solid-phase extracted urines. RESULTS GIP were detectable in concentrated urines from healthy individuals previously subjected to GFD as early as 4-6 h after single gluten intake, and remained detectable for 1-2 days. The urine assay revealed infringement of the GFD in about 50% of the patients. Analysis of duodenal biopsies revealed that most of patients with CD (89%) with no villous atrophy had no detectable GIP in urine, while all patients with quantifiable GIP in urine showed incomplete intestinal mucosa recovery. CONCLUSION GIP are detected in urine after gluten consumption, enabling a new and non-invasive method to monitor GFD compliance and transgressions. The method was sensitive, specific and simple enough to be convenient for clinical monitoring of patients with CD as well as for basic and clinical research applications including drug development. TRIAL REGISTRATION NUMBER NCT02344758.
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Affiliation(s)
- María de Lourdes Moreno
- Facultad de Farmacia, Departamento de Microbiología y Parasitología, Universidad de Sevilla, Sevilla, Spain
| | | | | | | | - Isabel Comino
- Facultad de Farmacia, Departamento de Microbiología y Parasitología, Universidad de Sevilla, Sevilla, Spain
| | - Ángeles Pizarro
- Unidad Clínica de Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | | | - Carolina Sousa
- Facultad de Farmacia, Departamento de Microbiología y Parasitología, Universidad de Sevilla, Sevilla, Spain
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Pizarro Á, Santiago J, Santiago D. Dermoscopy in the Prevention and Early Diagnosis of Melanoma: A Biological Perspective. Actas Dermo-Sifiliográficas (English Edition) 2015. [DOI: 10.1016/j.adengl.2014.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Pizarro Á, Santiago JL, Santiago DI. Dermoscopy in the prevention and early diagnosis of melanoma: a biological perspective. Actas Dermosifiliogr 2014; 106:3-6. [PMID: 25109768 DOI: 10.1016/j.ad.2014.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Revised: 06/07/2014] [Accepted: 06/14/2014] [Indexed: 10/24/2022] Open
Affiliation(s)
- Á Pizarro
- Unidad de Prevención y Diagnóstico Precoz de Melanoma, Clínica Dermatológica Internacional, Clínica Ruber, Madrid, España.
| | - J L Santiago
- Servicio de Dermatología, Hospital General Universitario, Ciudad Real, España
| | - D I Santiago
- Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, España
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Feito-Rodríguez M, González-Beato M, Pizarro Á. Lesión nodular con patrón vascular dermatoscópico peculiar en un trasplantado renal. Actas Dermo-Sifiliográficas 2008. [DOI: 10.1016/s0001-7310(08)74682-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Pizarro Á. Why Does Sentinel Lymph Node Biopsy Not Increase Survival in Patients With Melanoma? Actas Dermo-Sifiliográficas (English Edition) 2008. [DOI: 10.1016/s1578-2190(08)70266-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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