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Fernández-Carballido C, Jovaní V, Catalán EB, Moreno-Ramos MJ, Sanz Sanz J, Gallego A, García Vivar ML, Rodríguez-Heredia JM, Sanabra C, Sastré C. Disease activity indexes might not capture the same disease aspects in males and females with ankylosing spondylitis: A real-world nationwide analysis. Front Med (Lausanne) 2022; 9:1078325. [PMID: 36619648 PMCID: PMC9811117 DOI: 10.3389/fmed.2022.1078325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background To evaluate gender differences in disease activity and health status (HS) in patients with radiographic axial spondyloarthritis (r-axSpA)/ankylosing spondylitis (AS). Methods Ancillary analysis of the MIDAS study, an observational, non-interventional, cross-sectional and retrospective multicenter nationwide study to assess disease activity and its relationship with HS in clinical practice. Adult patients with AS diagnosis, fulfilling ASAS and modified New York criteria, treated for ≥3 months upon study inclusion according to clinical practice were included. The primary outcome was "disease control" assessed by the percentage of patients in remission and low disease activity (BASDAI and ASDAS-CRP scores). HS was evaluated using the ASAS health index (ASAS-HI). Patients' responses and characteristics were analyzed by gender. Results We analyzed 313 patients with AS, 237 (75.7%) males and 76 (24.3%) females. A total of 202 (64.5%) patients had adequate disease control (BASDAI < 4); 69.2% of males [mean (SD) BASDAI 2.9 (2.1)] and 50.0% of females [mean (SD) BASDAI 3.8 (2.4); p = 0.01]. According to ASDAS-CRP, 57.5% of patients were adequately controlled (ASDAS-ID +ASDAS-LDA); 138 (58.2%) males and 42 (55.3%) females. The mean (SD) ASDAS-CRP was 1.9 (1.1); being 1.9 (1.0) in males and 2.0 (1.1) in females. Overall, the impact of AS on HS was low to moderate [mean (SD) ASAS-HI 5.8 (4.4)]; being 5.5 (4.4) for males and 6.8 (4.2) for females (p = 0.02). Conclusion This study showed a higher proportion of females with AS and active disease using the BASDAI definition. When using the ASDAS-CRP definition these differences by gender were less pronounced. The impact of disease activity on HS appears to be higher in females than males.
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Affiliation(s)
- Cristina Fernández-Carballido
- Department of Rheumatology, Hospital Universitario San Juan de Alicante, Alicante, Spain,*Correspondence: Cristina Fernández-Carballido ✉
| | - Vega Jovaní
- Department of Rheumatology, Hospital General Universitario Dr. Balmis, Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | | | | | - Jesús Sanz Sanz
- Department of Rheumatology, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Adela Gallego
- Department of Rheumatology, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain
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Prieto-Peña D, Loricera J, Castañeda S, Moriano C, Bernabéu P, Vela-Casasempere P, Narváez J, Aldasoro V, Maíz O, Fernández-López C, Freire González M, Melero R, Villa-Blanco I, González-Alvarez B, Solans-Laqué R, Callejas-Rubio JL, Fernández-Díaz C, Rubio Romero E, García Morillo S, Minguez M, Fernández-Carballido C, De Miguel E, Sanchez-Martin J, Fernández E, Melchor S, Salgado-Pérez E, Bravo B, Romero-Yuste S, Galíndez-Agirregoikoa E, Sivera F, Ferraz-Amaro I, Hidalgo C, Romero-Gómez C, Galisteo C, Moya P, Alvarez-Rivas N, Mendizabal J, Nieto González JC, De Dios JR, Andreu JL, Pérez de Pedro I, Revenga M, Alonso Valdivieso JL, Rosa RM, De la Morena I, Fernández-Llanio N, Labrador E, Roman-Ivorra JA, Ortiz-Sanjuán F, García-Valle A, Gallego A, Iñiguez C, Garrido-Puñal N, De la Torre R, López-González R, Collado P, Raya E, Navarro F, Mas AJ, Ordás C, Boquet MD, Velloso Feijoo ML, Campos Fernández C, Rúa-Figueroa I, Conesa A, Manrique Arija S, González-Gay MA, Blanco R. POS0804 TOCILIZUMAB IN LARGE-VESSEL GIANT CELL ARTERITIS AND TAKAYASU ARTERITIS: MULTICENTRIC OBSERVATIONAL COMPARATIVE STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundTocilizumab (TCZ) has shown to be effective for large vessel vasculitis including giant cell arteritis (GCA) and Takayasu arteritis (TAK) (1-5). However, LVV-GCA and TAK show different demographic and clinical features that may influence on TCZ therapeutic response.ObjectivesTo compare the effectiveness of TCZ in patients with LVV-GCA and patients with TAK.MethodsObservational multicenter study of patients with LVV-GCA and TAK who received TCZ. Outcome variables were: a) proportion of patients who achieved complete clinical improvement along with normalization of laboratory markers (CRP ≤0.5mg/dL and/or ESR ≤ 20 mm/1st hour) at 12 months b) complete improvement in imaging techniques. A comparative study between patients with LVV-GCA and TAK was performed.ResultsWe evaluated 70 LVV-GCA and 57 TAK patients who received TCZ. Main clinical and demographic characteristic are described in Table 1. Patients with TAK were younger, had longer disease duration, had received more commonly previous biologic therapy and were receiving higher doses of prednisone at baseline. TCZ intravenous administration was more common in TAK patients (80.7% vs 48.6%; p<0.01). Follow-up time after TCZ onset was similar in both groups. At 12 months, about 75% of patients achieved complete clinical improvement and ESR/CRP normalization in both groups. A follow-up imaging technique was performed in 37 LVV-GCA patients after a mean time of 12.9±6.0 months and 38 TAK patients after 9.5±5.0 months. Complete improvement in imaging techniques was only observed in 18.9% and 21.1% of patients with LVV-GCA and TAK, respectively (Figure 1).Table 1.LVV-GCA (n=70)TAK (n=57)pGeneral featuresAge (years), mean ± SD67.2 ± 10.540.5 ± 16.3< 0.01Sex (female), n (%)51 (72.9)49 (86)0.07Disease evolution before TCZ onset (months), median [IQR]5 [2-15]12 [3-37]<0.01Baseline laboratory parametersESR (mm/1st hour), median [IQR]32 [12.5-54.7]31 [10-52]0.82CRP (mg/dL), median [IQR]1.4 [0.5-2.4]1.4 [0.5-3.5]0.41Baseline prednisone dose (mg/day), median [IQR]15 [10-20]30 [15-50]< 0.01Previous therapyConventional DMARDs, n(%)45 (64.3)44(77.2)0.51Biologic therapy, n (%)0(0)12 (21.1)<0.01TCZ therapyIntravenous, n (%)34 (48.6)46 (80.7)< 0.01Combined with MTX, n(%)24 (34.3)24 (42.1)0.37Follow-up time after TCZ onset, median [IQR]20 [10-36]18 [7-41]0.73Complete clinical improvement and ESR/CRP normalization at 12 months, n/N (%)35/47 (74.4)30/39 (76.9)0.79Complete improvement in imaging techniques, n/N(%)7/37 (18.9)8/38 (21.1)0.85CRP: C-reactive protein; DMARDs: Disease-modifying anti-rheumatic drugs ESR: erythrocyte sedimentation rate; GCA: giant cell arteritis; IQR: interquartile range; LVV: large vessel; MTX: methotrexate; n: Number of patients; N: total number of patients: TCZ: tocilizumab; TAK:takayasuFigure 1.ConclusionThe effectiveness of TCZ was similar in patients with LVV-GCA and TAK, despite a more refractory disease in TAK patients. A discordance between clinical and imaging activity improvement was observed in both LVV-GCA and TAK, as reported in previous studies (3).References[1]Calderón-Goercke M, et al. Semin Arthritis Rheum 2019; 49:126-35. https://doi.org/10.1016/j.semarthrit.2019.01.003[2]Prieto-Peña D et al. Ther Adv Musculoskelet Dis. 2021;13:175. PMID: 34211589.[3]Prieto Peña D et al. Clin Exp Rheumatol. 2021;39 Suppl 129:69-75. PMID: 33253103.[4]González-Gay MA, et al. Expert Opin Biol Ther. 2019;19:65-72. doi: 10.1080/14712598.2019.1556256.[5]Prieto-Peña D, et al. Semin Arthritis Rheum. 2019;48(4):720-727. doi: 10.1016/j.semarthrit.2018.05.007Disclosure of InterestsNone declared
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Corredor H, Sandoval-Salinas C, Saffon J, Gallego A, Uribe O. Effectiveness and safety of the radial pressure waves for the treatment of erectile dysfunction. A randomized clinical trial. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.366] [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: 11/24/2022]
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Gallego A, Fuentes S, Martín S, Maesa J, León A. M164 Evaluation of two methods for fecal calprotectin testing: Chemiluminiscence and ELISA. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.046] [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: 11/25/2022]
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Garcia-Cuesta J, Viñal D, Gomez-Barreda M, Gallego A, Higuera O, Ruiz-Giménez L, Sanchez D, Rodríguez-Salas N. P-84 Genotype-fenotype correlation in patients with Lynch syndrome and colorectal cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.139] [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: 10/20/2022] Open
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De Miguel E, Gratacos-Masmitja J, Cacheda AP, Rodríguez-Heredia JM, Gallego A, Beltrán E, Font Ramos B, Sastré C, Sanabra C. POS0978 DISEASE CONTROL IN PSORIATIC ARTHRITIS PATIENTS WITH OR WITHOUT AXIAL MANIFESTATIONS IN REAL CLINICAL PRACTICE IN SPAIN: RESULTS FROM THE MIDAS STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:MIDAS study assessed the disease activity in psoriatic arthritis (PsA) patients treated in clinical practice in Spain.Objectives:This sub-analysis compared disease activity between PsA patients with or without axial manifestations.Methods:MIDAS is an observational, non-interventional, cross-sectional, multicenter study conducted in Spain. Patients included were ≥18 years old with ≥6 months since diagnosis, were classified by CASPAR criteria and had initiated treatment ≥3 months. Disease activity was measured by Disease Activity in Psoriatic Arthritis (DAPSA) and Minimal Disease Activity (MDA). Axial involvement was defined according to the presence of inflammatory back pain assessed by rheumatologist.Results:312 evaluable PsA patients were included in this analysis, 12.2% of which presented with axial involvement. PsA patients with axial manifestations reported longer time from onset of symptoms to diagnosis and disease duration, higher presence of concomitant diseases, HLA-B*27+ status, C-reactive protein (CRP) levels, perception of uncontrolled disease and presence of swollen and tender joints compared to patients without axial involvement. A higher proportion of PsA patients with axial manifestations were treated with a biologic compared with those without axial involvement 68.4% vs 57.3% (Table 1). Patients with axial involvement showed a higher impairment of their quality of life compared to those without axial manifestations by a worse higher mean (SD) Psoriatic Arthritis Impact of Disease 12-item questionnaire (PSAID12) score (5.0 [2.4] vs 2.7 [2.2], respectively). In terms of disease control more patients with axial manifestations presented with moderate to high disease activity (DAPSA>14: 65.7% vs 36.8%, respectively) and did not meet the MDA criteria for remission (89.5% vs 42.7%, respectively) (Figure 1).Conclusion:PsA patients with axial manifestations presented with a higher burden of disease and showed a worse disease control compared to those without axial involvement.Table 1.Baseline demographic and clinical characteristicsWith axial manifestations(n=38)Without axial manifestations (n=274)PsA(n=312)Age (years), mean (SD)53.1 (10.4)54.1 (12.4)54.0 (12.2)Sex (male), n (%)17 (44.7%)153 (55.8%)170 (54.5%)Time since diagnosis (years), mean (SD)13.6 (10.1)10.1 (8.8)10.5 (9.0)Time from onset of symptoms to diagnosis (years), mean (SD)4.3 (6.1)2.8 (4.8)3.0 (5.0)Presence of concomitant diseases, mean (SD)26 (68.4%)166 (60.6%)192 (61.5%)Anemia, n (%)3 (7.9%)7 (2.6%)7 (2.2%)Anxiety, n (%)6 (15.8%)9 (3.3%)1 (0.3%)Asthma, n (%)2 (5.3%)7 (2.6%)1 (0.3%)Depression, n (%)6 (15.8%)1 (0.4%)1 (0.3%)Dyslipidemia, n (%)3 (7.9%)8 (2.9%)9 (2.9%)Hypertension, n (%)3 (7.9%)7 (2.6%)9 (2.9%)Others (excluding skin psoriasis, uveitis, or IBD), n (%)3 (7.9%)17 (6.2%)19 (6.1%)Presence of HLA-B*27+, n (%)6 (15.8%)28 (10.2%)34 (10.9%)CRP levels (mg/l), mean (SD)7.3 (11.3)4.6 (6.5)4.9 (7.3)Patient perceived disease control (PASS), n (%)30 (78.9%)228 (83.5%)258 (83.0%)Presence of swollen (SJC≥1), n (%)22 (57.9%)117 (42.7%)139 (44.6%)Presence of tender joints (TJC≥1), n (%)14 (36.8%)74 (27.0%)88 (28.2%)Patients treated with biological26 (68.4%)157 (57.3%)183 (58.7%)COPD, chronic obstructive pulmonary disease; CRP, C-reactive protein; HLA-B*27, human leukocyte antigen B27; IBD, inflammatory bowel disease; PASS, patient acceptable symptom state; PsA, psoriatic arthritis; SD, standard deviation; SJC, swollen joint counts; TJC, tender joint counts.Figure 1.Disease status according to clinical phenotype of PSA A) Disease activity according to DAPSA B) Disease activity according to MDA DAPSA, Disease Activity in Psoriatic Arthritis; MDA, Minimal Disease Activity; PsA, psoriatic arthritis.Acknowledgements:We thank to MIDAS group investigators and patients included in the study.Disclosure of Interests:Eugenio de Miguel Speakers bureau: AbbVie, Novartis, Pfizer, MSD, BMS, UCB, Roche, Grunental, Janssen, Sanofi., Paid instructor for: Janssen, Novartis, Roche, Consultant of: AbbVie, Novartis, Pfizer, Galapagos, Grant/research support from: Abbvie, Novartis, Pfizer, Jordi Gratacos-Masmitja Speakers bureau: During the course of the year I have received funding in relation to courses and / or conferences, and / or have participated as a speaker or in advisory boards from: MSD, Pfizer, AbbVie, Janssen Cilag, Novartis, Lilly and Amgen., Consultant of: During the course of the year I have received funding in relation to courses and / or conferences, and / or have participated as a speaker or in advisory boards from: MSD, Pfizer, AbbVie, Janssen Cilag, Novartis, Lilly and Amgen., Grant/research support from: During the course of the year I have received a private grand from Pfizer.I have not received any private influence in the elaboration of the contents of this talk., Ana Paula Cacheda: None declared, José M. Rodríguez-Heredia Speakers bureau: Amgen, Novartis, Sanofi, Consultant of: Amgen, Biogen, Fresenius, MSD, Janssen, Roche, Novartis, Pfizer, Sanofi, Adela Gallego Speakers bureau: During the course of the year I have received funding in relation to courses and / or conferences, and / or have participated as a speaker or in advisory boards from: MSD, Pfizer, AbbVie, Janssen, Novartis, Lilly, Amgen and Sanofi.I have not received any private influence in the elaboration of the contents of this talk., Grant/research support from: During the course of the year I have received funding in relation to courses and / or conferences, and / or have participated as a speaker or in advisory boards from: MSD, Pfizer, AbbVie, Janssen, Novartis, Lilly, Amgen and Sanofi.I have not received any private influence in the elaboration of the contents of this talk., Emma Beltrán Speakers bureau: Abbvie, Bristol, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Roche and UCB, Consultant of: Abbvie, Bristol, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Roche and UCB, Beatriz Font Ramos Employee of: Novartis employee, Carlos Sastré Employee of: Novartis employee, Cristina Sanabra Employee of: Novartis employee.
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Sanchez-Bilbao L, Loricera J, Aldasoro V, Valdivieso-Achá JP, Villa-Blanco I, Maiz O, Melero R, Moriano C, Sánchez J, De Miguel E, Perez-Pampín E, De Dios JR, Nieto González JC, Galíndez-Agirregoikoa E, Moya P, Sivera F, Andréu Sánchez JL, Pinillos V, García-Valle A, Vela-Casasempere P, Alvarez-Rivas N, Revenga M, Manrique Arija S, Fernández-López C, Raya E, Hidalgo C, López-González R, Campos Fernández C, Juan-Mas A, Arca B, Rua-Figueroa I, Boquet MD, García A, Gallego A, Salgado-Pérez E, González-Gay MA, Blanco R. OP0064 TOCILIZUMAB IN CRANIAL AND EXTRACRANIAL REFRACTORY GIANT CELL ARTERITIS: A MULTICENTER STUDY OF 312 CASES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Giant cell arteritis (GCA) may be divided into cranial, and extracranial GCA. Tocilizumab (TCZ) has shown efficacy and safety in GCA and other large-vessel vasculitis (LVV) (1-5).Objectives:To compare the efficacy of TCZ in cranial and extracranial GCA.Methods:Multicenter observational study of 312 patients with GCA treated with TCZ. They were divided into 3 groups a) only cranial (cGCA), b) only extracranial (ecGCA), c) mixed affection (mixGCA). GCA was diagnosed by a) ACR criteria, and/or b) positive temporal artery biopsy, and/or c) LVV by imaging. Remission and sustained remission was defined according to EULAR definitions (1). In ecGCA and mixGCA we also studied the improvement (complete or partial) by imaging techniques.Results:We studied 312 patients (218 females; mean age, 73.4±9.6 years). TABLE shows the main features of the 3 groups. Remission at month 6 was higher in cGCA, as well as the sustained remission at month12 (FIGURE). At 18 and 24months, were similar in the 3 groups. Improvement by imaging techniques was partial/complete at 6,12,18 and 24 months, in 50%/0%,71%/0%, 61%/15% and 67%/17% respectively, in ecGCA, and in 75%/0%,53%/18%, 64%/12% and 50%/28% in mixGCA.Table 1.Main features of 312 patients at TCZ onset.Cranial GCA(n=152)Extracranial GCA(n=49)Mixed GCA(n=111)Cranial vs Extracranial GCApAge at TCZ onset, years, mean± SD76.0±8.265.4±12.273.5±8.10.000*Sex, female/male, n (% female)105/47 (69)33/16 (67)80/31 (72)0.960Time from diagnosis to TCZ onset (months, median [IQR]6 [2-21]7 [2-20]9 [3-25]0.765Biopsy-proven GCA, n (%)87/128 (68)0 (0)50/87 (57)0.000*Systemic manifestations at TCZ onset109 (72)32 (65)84 (76)0.501Fever, n (%)18 (12)1 (2)8 (7)0.048*Constitutional syndrome, n (%)52 (34)16 (33)47 (42)0.933PmR, n (%)88 (58)29 (59)71 (64)0.999Ischemic manifestations at TCZ onset117 (77)0 (0)70 (63)0.000*Visual involvement, n (%)31 (20)0 (0)16 (14)0.000*Headache, n (%)103 (85)0 (0)63 (57)0.000*Jaw claudication, n (%)39 (26)0 (0)21 (19)0.000*Acute phase reactantsESR, mm/1st hour, median [IQR]28 [9-53]24 [10-43]28 [15-48]0.462CRP, mg/dL, median [IQR]1.2 [0.3-3.4]0.7 [0.4-1.8]1.6 [0.4-3.8]0.153Prednisone dose at TCZ onset, mean ± SD26.2±17.615.4±14.220.1±14.90.000*TCZmono/TCZcombo, n (% TCZ mono)116/36 (76)26/23 (53)69/42 (62)0.003*Follow-up (months), mean ± SD27.3±21.132.7±23.327.9±22.00.143Figure 1.Remission and sustained remission of cGCA, ecGCA and mixGCA according to EULAR (1). In the first 3 months we only could assess cGCA because in ecGCA and mixGCA a control imaging was not performedConclusion:TCZ seems to be effective in all phenotypes but it is faster in cGCA in reaching remission. However, improvement by imaging techniques was partial and very rarely complete in ecGCA and mixGCA.References:[1]Hellmich B, et al. Ann Rheum Dis. 2020; 79: 19-30.[2]Stone JH, et al. N Engl J Med. 2017; 377: 317-28.[3]Calderón-Goercke M, et al. Semin Arthritis Rheum 2019; 49:126-35. https://doi.org/10.1016/j.semarthrit.2019.01.003.[4]Prieto Peña D et al. Clin Exp Rheumatol 2020 Nov 27. PMID: 33253103.[5]Loricera J, et al. Clin Exp Rheumatol 2016; 34:S44-53. PMID: 27050507Disclosure of Interests:Lara Sanchez-Bilbao: None declared, Javier Loricera: None declared, Vicente Aldasoro: None declared, Juan Pablo Valdivieso-Achá: None declared, Ignacio Villa-Blanco: None declared, Olga Maiz: None declared, Rafael Melero: None declared, Clara Moriano: None declared, Julio Sánchez: None declared, Eugenio de Miguel: None declared, Eva Perez-Pampín: None declared, Juan Ramón De Dios: None declared, Juan Carlos Nieto González: None declared, Eva Galíndez-Agirregoikoa: None declared, Patricia Moya: None declared, Francisca Sivera: None declared, José Luis Andréu Sánchez: None declared, Valvanera Pinillos: None declared, Andrea García-Valle: None declared, Paloma Vela-Casasempere: None declared, Noelia Alvarez-Rivas: None declared, Marcelino Revenga: None declared, Sara Manrique Arija: None declared, Carlos Fernández-López: None declared, Enrique Raya: None declared, Cristina Hidalgo: None declared, Ruth López-González: None declared, Cristina Campos Fernández: None declared, Antonio Juan-Mas: None declared, Beatriz Arca: None declared, Iñigo Rua-Figueroa: None declared, María Dolors Boquet: None declared, Antonio García: None declared, Adela Gallego: None declared, Eva Salgado-Pérez: None declared, Miguel A González-Gay Speakers bureau: Abbvie, Pfizer, Roche, Sanofi, Lilly, Celgene and MSD, Grant/research support from: Abbvie, MSD, Jansen and Roche, Ricardo Blanco Speakers bureau: Abbvie, Lilly, Pfizer, Roche, Bristol-Myers, Janssen, UCB Pharma and MSD, Grant/research support from: Abbvie, MSD and Roche
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Martín-Varillas JL, Calvo-Río V, Sanchez-Bilbao L, González-Mazón I, Adan A, Hernanz Rodríguez I, Gallego A, Beltrán E, Castro S, Fanlo P, García Martos A, Torre-Salaberri I, Cordero-Coma M, De Dios-Jiménez Aberásturi J, García-Aparicio Á, Hernández-Garfella M, Sanchez-Andrade A, García-Valle A, Maiz O, Miguélez R, Rodríguez Montero S, Urruticoechea-Arana A, Veroz Gonzalez R, Conesa A, Fernández-Carballido C, Jovani V, Martínez González O, Moya P, Romero-Yuste S, Rubio Muñoz P, Peña Sainz-Pardo E, González-Gay MA, Hernández JL, Blanco R. POS1340 MULTICENTER STUDY OF 71 PATIENTS WITH REFRACTORY UVEITIS RELATED TO IMMUNE-MEDIATED INFLAMMATORY DISEASES ON CERTOLIZUMAB PEGOL TREATMENT. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Prognosis of non-infectious refractory uveitis has improved markedly with biologic therapy (BT) (1-5). Most data are with monoclonal anti-TNF drugs, especially Adalimumab (ADA) and Infliximab (IFX). However, there is not enough evidence for the use of Certolizumab Pegol (CZP).Objectives:To evaluate the efficacy and safety of CZP in refractory uveitis secondary to Immune-Mediated Inflammatory Diseases (IMID).Methods:Multicenter study of 71 patients with uveitis due to IMID refractory to glucocorticoids and conventional immunosuppressants. Efficacy was assessed with the following ocular parameters: best corrected visual acuity (BCVA), anterior chamber cells, vitritis, macular thickness and presence of retinal vasculitis. These outcomes were compared between baseline, 1st week, 1st and 6th month, and 1st and 2nd year. Statistical analysis was performed with IBM SPSS Statistics v.23.Results:71 patients/100 affected eyes (29 men/42 women) with mean age of 40.0±11.3 years were studied. Underlying IMIDs were: spondyloarthritis (n=38), Behçet (10), psoriatic arthritis (8), Crohn disease (3), sarcoidosis (2), JIA (1), reactive arthritis (1), rheumatoid arthritis (1), relapsing polychondritis (1), TINU (1), pars planitis (1), Birdshot (1) and idiopathic uveitis (3). Uveitis pattern was anterior (n=55), posterior (6), panuveitis (6) and intermediate (4).Prior to CZP, patients had received: methotrexate (37), sulfasalazine (26), azathioprine (14), cyclosporine (10), leflunomide (3), mycophenolate mofetil (3) and cyclophosphamide (1). Previous BT was administered in 48 (67.6%) patients, with a mean of 1.4±1.3 drugs per patient as follows: ADA (n=56), IFX (27), golimumab (14), tocilizumab (5) and etanercept (3). Pregnancy was the reason for prescribing CZP in 19 patients. CZP was administered in monotherapy (n=39) or combined with conventional immunosuppressants (n=32).After a mean follow-up of 27.1±21.1 months, most of the ocular variables showed a rapid and significantly improvement (Table 1). A decrease in the median number [IQR] of flares of uveitis before and after CZP, (3 [1-4] vs. 0 [0-1], p<0.001) was observed. CZP was discontinued in 15 patients due to remission (n=2), ocular insufficient response (2) and incomplete response of extraocular manifestations (11). No serious adverse events were reported.Conclusion:CZP seems to be effective and safe in patients with refractory uveitis due to IMID.References:[1]Martín-Varillas JL, et al. Ophthalmology 2018; 125:1444-1451. doi: 10.1016/j.ophtha.2018.02.020.[2]Atienza-Mateo B, et al. Arthritis Rheumatol 2019; 71:2081-2089. doi: 10.1002/art.41026.[3]Santos-Gómez M, et al. Clin Exp Rheumatol 2016; 34(6 Suppl 102):S34-S40. PMID: 27054359[4]Vegas-Revenga N, et al. Am J Ophthalmol 2019; 200:85-94. doi: 10.1016/j.ajo.2018.12.019[5]Calvo-Río V, et al. Clin Exp Rheumatol. 2014; 32 (4 Suppl 84):S54-7. PMID: 25005576Table 1.Baseline1stweek1stMonth6thMonth1styear2ndyearBCVA (mean±SD)0.68±0.270.72±0.27*0.79±0.25*0.84±0.24*0.85±0.25*0.87±0.22*Improvement in AC Cells, n (%)Patients with AC cells at baseline (n=48)-21 (43.7)30 (62.5)*41 (85.4)*48 (100)*48 (100)*Improvement in Vitritis, n (%)Patients with vitritis at baseline (n=13)-3 (23.1)8 (61.5)*11 (84.6)*13 (100)*13 (100)*OCT (µ) (mean±SD)292.5±47.7294±47.4286.7±41.9*274.7±38.7*272.8±38.9*266.31±36.2*Choroiditis; affected eyes, n, (%)3 (4.2)3 (4.2)2 (2.8)2 (2.8)1 (1.4)0 (0)Retinal Vasculitis; affected eyes, n, (%)2 (2.8)0 (0)1 (1.4)0 (0)0 (0)0 (0)*p<0.001Disclosure of Interests:None declared
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Limay K, Jimenez N, Gallego A, Zatarain E, Sousa I, Alarcon A, Calahorra L, Sarmiento E, Carbone J. B Cell Abnormalities and Cancer Development in Heart Recipients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.578] [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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10
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McGrath M, Davies K, Gallego A, Laszczak P, Tang J, Zahedi S, Moser D. Using a Sweating Residuum/socket Interface Simulator for the Evaluation of Sweat Management Liners in Lower Limb Prosthetics. Can Prosthet Orthot J 2021; 4:35213. [PMID: 37614936 PMCID: PMC10443463 DOI: 10.33137/cpoj.v4i1.35213] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 12/04/2020] [Accepted: 03/10/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Lab-based simulators can help to reduce variability in prosthetics research. However, they have not yet been used to investigate the effects of sweating at the residuum-liner interface. This work sought to create and validate a simulator to replicate the mechanics of residual limb perspiration. The developed apparatus was used to assess the effects of perspiration and different liner designs. METHODOLOGY By scanning a cast, an artificial residuum was manufactured using a 3D-printed, transtibial bone model encased in silicone, moulded with pores. The pores allowed water to emit from the residuum surface, simulating sweating. Dry and sweating cyclic tests were performed by applying compressive and tensile loading, while measuring the displacement of the residuum relative to the socket. Tests were conducted using standard and perforated liners. FINDINGS Although maximum displacement varied between test setups, its variance was low (coefficient of variation <1%) and consistent between dry tests. For unperforated liners, sweating increased the standard deviation of maximum displacement approximately threefold (0.04mm v 0.12mm, p<0.001). However, with the perforated liner, sweating had little effect on standard deviation compared to dry tests (0.04mm v 0.04mm, p=0.497). CONCLUSIONS The test apparatus was effective at simulating the effect of perspiration at the residual limb. Moisture at the skin-liner interface can lead to inconsistent mechanics. Perforated liners help to remove sweat from the skin-liner interface, thereby mitigating these effects.
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Affiliation(s)
- M McGrath
- Blatchford Group, Unit D Antura, Bond Close, Basingstoke, UK
| | - K.C. Davies
- Blatchford Group, Unit D Antura, Bond Close, Basingstoke, UK
| | - A Gallego
- Blatchford Group, Unit D Antura, Bond Close, Basingstoke, UK
| | - P Laszczak
- Blatchford Group, Unit D Antura, Bond Close, Basingstoke, UK
| | - J Tang
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, UK
| | - S Zahedi
- Blatchford Group, Unit D Antura, Bond Close, Basingstoke, UK
| | - D Moser
- Blatchford Group, Unit D Antura, Bond Close, Basingstoke, UK
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Prieto-Peña D, Calderón-Goercke M, Adán A, Chamorro-López L, Maíz-Alonso O, De Dios-Jiménez Aberásturi JR, Veroz R, Blanco S, Martín-Santos JM, Navarro F, Gallego A, González-Suárez S, Conesa A, García-Valle A, Cordero-Coma M, Pardiñas-Barón N, Demetrio R, Calvo-Río V, Martínez-Taboada VM, Castañeda S, Hernández JL, González-Gay MA, Blanco R. Efficacy and safety of certolizumab pegol in pregnant women with uveitis. Recommendations on the management with immunosuppressive and biologic therapies in uveitis during pregnancy. Clin Exp Rheumatol 2021; 39:105-114. [DOI: 10.55563/clinexprheumatol/j9ysbm] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/16/2020] [Indexed: 11/13/2022]
Affiliation(s)
- Diana Prieto-Peña
- Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Mónica Calderón-Goercke
- Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Alfredo Adán
- Clinic Institute of Ophthalmology (ICOF), Hospital Clinic of Barcelona, Spain
| | | | - Olga Maíz-Alonso
- Rheumatology, Hospital Universitario de Donostia, San Sebastián, Spain
| | | | | | | | | | - Francisco Navarro
- Rheumatology, Hospital General Universitario de Elche, Alicante, Spain
| | - Adela Gallego
- Rheumatology, Hospital Universitario de Badajoz, Spain
| | | | - Arantxa Conesa
- Rheumatology, Hospital General Universitari de Castelló, Castellón de la Plana, Spain
| | | | | | | | - Rosalía Demetrio
- Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Vanesa Calvo-Río
- Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Víctor M. Martínez-Taboada
- Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, and University of Cantabria, School of Medicine, Santander, Spain
| | - Santos Castañeda
- Rheumatology, Hospital Universitario de la Princesa, IIS-Princesa, Madrid, Spain
| | - José L. Hernández
- Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Miguel A. González-Gay
- Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, University of Cantabria, School of Medicine, Santander, Spain, and Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Ricardo Blanco
- Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.
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Gutierrez-Sainz L, Martinez-Marin V, Viñal D, Martinez-Perez D, Pedregosa J, Garcia-Cuesta JA, Villamayor J, Zamora P, Pinto A, Redondo A, Castelo B, Cruz P, Higuera O, Custodio A, Gallego A, Sanchez-Cabrero D, de Castro-Carpeño J, Espinosa E, Feliu J. Incidence of venous thromboembolic events in cancer patients receiving immunotherapy: a single-institution experience. Clin Transl Oncol 2020; 23:1245-1252. [PMID: 33231859 DOI: 10.1007/s12094-020-02515-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 06/15/2020] [Accepted: 10/18/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cancer and cancer therapies have been associated with an increased incidence of venous thromboembolic events (VTE). However, the incidence of VTE in patients on immunotherapy has not been well characterized. The aim of this study was to assess the incidence of VTE in cancer patients receiving immunotherapy and ascertain its prognostic utility. MATERIALS AND METHODS We conducted a single-institution retrospective study, including all cancer patients treated with anti-Programmed cell Death 1 (PD-1), anti-Programmed cell Death Ligand-1 (PD-L1), anti-Cytotoxic T-Lymphocyte-Associated Protein 4 (CTLA4), a combination of anti-PD-1/anti-PD-L1 and anti-CTLA4 or a combination including any of these drugs with chemotherapy, antiangiogenic agents or both between June 2013 and April 2019 at La Paz University Hospital, Madrid (Spain). RESULTS We selected 229 patients. VTE occurred in 16 of 229 patients (7%). VTE occurred more frequently in patients with lung cancer followed by melanoma. Female sex and melanoma were independently associated with an increased risk of VTE. 12 of 16 VTE (75%) were symptomatic. Progressive disease to immunotherapy [HR 31.60 (95% CI 11.44-87.22), p = 0.00], lung cancer [HR 2.55 (95% CI 1.34-4.86), p = 0.00] and melanoma [HR 2.42 (1.20-4.86), p = 0.01] were independently associated with shorter OS. VTE occurrence was not independently associated with shorter OS [HR 1.33 (95% CI 0.63-2.80), p = 0.44]. CONCLUSIONS The incidence of VTE in cancer patients receiving immunotherapy in our study appeared to be similar to the incidence previously reported in other series of cancer patients treated with systemic therapies. VTE occurrence did not correlate with the prognosis. Further and prospective studies are needed to derive definitive conclusions.
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Affiliation(s)
- L Gutierrez-Sainz
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain.
| | - V Martinez-Marin
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain.,Translational Oncology Group, IdiPAZ, Madrid, Spain.,Cancer & Thrombosis Section, Spanish Society of Medical Oncology (SEOM), Madrid, Spain
| | - D Viñal
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - D Martinez-Perez
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - J Pedregosa
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - J A Garcia-Cuesta
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - J Villamayor
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - P Zamora
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain.,Translational Oncology Group, IdiPAZ, Madrid, Spain.,Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - A Pinto
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain.,Translational Oncology Group, IdiPAZ, Madrid, Spain
| | - A Redondo
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain.,Translational Oncology Group, IdiPAZ, Madrid, Spain.,Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,Cátedra UAM-AMGEN, Madrid, Spain
| | - B Castelo
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain.,Translational Oncology Group, IdiPAZ, Madrid, Spain.,Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,Cátedra UAM-AMGEN, Madrid, Spain
| | - P Cruz
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - O Higuera
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - A Custodio
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain.,Translational Oncology Group, IdiPAZ, Madrid, Spain
| | - A Gallego
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - D Sanchez-Cabrero
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - J de Castro-Carpeño
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain.,Translational Oncology Group, IdiPAZ, Madrid, Spain.,Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,CIBERONC, Madrid, Spain.,Cátedra UAM-AMGEN, Madrid, Spain
| | - E Espinosa
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain.,Translational Oncology Group, IdiPAZ, Madrid, Spain.,Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,CIBERONC, Madrid, Spain.,Cátedra UAM-AMGEN, Madrid, Spain
| | - J Feliu
- Medical Oncology Department, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, Madrid, 28046, Spain.,Translational Oncology Group, IdiPAZ, Madrid, Spain.,Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,CIBERONC, Madrid, Spain.,Cátedra UAM-AMGEN, Madrid, Spain
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Gallego A, Ramon-Patino J, Brenes J, Mendiola M, Berjon A, Casado G, Castelo B, Espinosa E, Hernandez A, Hardisson D, Feliu J, Redondo A. Bevacizumab in recurrent ovarian cancer: could it be particularly effective in patients with clear cell carcinoma? Clin Transl Oncol 2020; 23:536-542. [PMID: 32651885 DOI: 10.1007/s12094-020-02446-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 05/25/2020] [Accepted: 06/27/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Treatment of recurrent ovarian carcinoma is a challenge, particularly for the clear cell (CCC) subtype. However, there is a preclinical rationale that these patients could achieve a benefit from antiangiogenic therapy. To assess this hypothesis, we used the growth modulation index (GMI), which represents an intrapatient comparison of two successive progression-free survival (PFS). METHODS We conducted a retrospective real-world study performed on 34 patients with recurrent ovarian cancer, treated with bevacizumab-containing regimens from January 2009 to December 2017. The primary endpoint was GMI. An established cut-off > 1.33 was defined as a sign of drug activity. RESULTS 73.5% of patients had high-grade serous ovarian carcinoma (HGSOC), and 17.7% had CCC; 70.6% of patients received carboplatin/gemcitabine/bevacizumab, and 29.4% received weekly paclitaxel/bevacizumab. According to histological subtype, the overall response rate and median PFS were 52% and 14 months for HGSOC and 83.3% and 20 months for CCC, respectively. The overall population median GMI was 0.99; it was 0.95 and 2.36 for HGSOC and CCC, respectively. CCC subtype was significantly correlated with GMI > 1.33 (odds ratio 41.67; 95% confidence interval 3.6-486.94; p = .03). CONCLUSION Adding bevacizumab to chemotherapy in recurrent CCC is associated with a remarkable benefit in this cohort. The efficacy of antiangiogenic drugs in CCC warrants further prospective evaluation.
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Affiliation(s)
- A Gallego
- Department of Medical Oncology, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain.,Translational Oncology Research Laboratory, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - J Ramon-Patino
- Translational Oncology Research Laboratory, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - J Brenes
- Department of Medical Oncology, Instituto Catalán de Oncología, Hospitalet de Llobregat, Barcelona, Spain
| | - M Mendiola
- Molecular Pathology and Therapeutic Targets Group, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.,Center for Biomedical Research in the Cancer Network (Centro de Investigación Biomédica en Red de Cáncer, CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - A Berjon
- Molecular Pathology and Therapeutic Targets Group, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.,Department of Pathology, Hospital Universitario La Paz, Madrid, Spain
| | - G Casado
- Department of Pharmacy, Hospital Universitario La Paz, Madrid, Spain
| | - B Castelo
- Department of Medical Oncology, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain.,Translational Oncology Research Laboratory, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.,Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain.,Cátedra Universidad Autónoma de Madrid UAM-Amgen, Madrid, Spain
| | - E Espinosa
- Department of Medical Oncology, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain.,Translational Oncology Research Laboratory, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.,Center for Biomedical Research in the Cancer Network (Centro de Investigación Biomédica en Red de Cáncer, CIBERONC), Instituto de Salud Carlos III, Madrid, Spain.,Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain.,Cátedra Universidad Autónoma de Madrid UAM-Amgen, Madrid, Spain
| | - A Hernandez
- Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain.,Department of Gynecology, Hospital Universitario La Paz, Madrid, Spain
| | - D Hardisson
- Molecular Pathology and Therapeutic Targets Group, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.,Center for Biomedical Research in the Cancer Network (Centro de Investigación Biomédica en Red de Cáncer, CIBERONC), Instituto de Salud Carlos III, Madrid, Spain.,Department of Pathology, Hospital Universitario La Paz, Madrid, Spain.,Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - J Feliu
- Department of Medical Oncology, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain.,Translational Oncology Research Laboratory, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.,Center for Biomedical Research in the Cancer Network (Centro de Investigación Biomédica en Red de Cáncer, CIBERONC), Instituto de Salud Carlos III, Madrid, Spain.,Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain.,Cátedra Universidad Autónoma de Madrid UAM-Amgen, Madrid, Spain
| | - A Redondo
- Department of Medical Oncology, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain. .,Translational Oncology Research Laboratory, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain. .,Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain. .,Cátedra Universidad Autónoma de Madrid UAM-Amgen, Madrid, Spain.
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Prieto-Peña D, Calderón-Goercke M, Adan A, Chamorro-López L, Maiz O, De Dios-Jiménez Aberásturi J, Veroz Gonzalez R, Blanco S, Santos JM, Navarro F, Gallego A, González-Suárez S, Conesa A, García-Valle A, Cordero-Coma M, Pardiñas-Barón N, Demetrio-Pablo R, Calvo-Río V, Mora-Cuesta VM, Castañeda S, Hernández JL, González-Gay MA, Blanco R. AB1055 CERTOLIZUMAB PEGOL: A SAFE AND EFFICIENT TREATMENT IN PATIENTS WITH UVEITIS DURING PREGNANCY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Anti-TNFα agents are useful in uveitis(1-5).Certolizumab pegol (CZP) differs from other anti-TNFα agents due to its limited placental transfer.Objectives:To assess efficacy and safety of CZP in women with uveitis during pregnancy.Methods:Multicenter study of women with uveitis under CZP during pregnancy and their neonates.Results:14 women (23 eyes); mean age 34.3±5.5 yrs (TABLE 1). Pattern of uveitis: 10 anterior, 2 posterior, 1 intermediate, 1 panuveitis. Uveitis was bilateral in 9 and chronic in 7. CZP was started before conception in 10 patients and after in 4. All patients obtained or maintained ocular remission throughout pregnancy (FIGURE). Prednisone was reduced from a mean dose of 21.7±19.7 mg/day to 4.1±3.8 mg/day at 6 months (p=0.03), leading to complete discontinuation in 4. 15 healthy infants were born. Only 1 woman presented a mild infection. No infections or malformations were found in neonates after a follow-up of 6 months. 6 infants were breastfed and all received scheduled vaccinations without complications (TABLE 2).TABLE 1.AgeUnderlying diseaseImmunosuppressants before CZPCombined treatment134SpAMTX, AZA, ADAAZA237SpAMTX, AZA, IFX, ADA, GOLI339SpAAZA, ADAAZA446SpACyA, ETN, ADA, IFX, GOLI532SpASSZ, ADASSZ636SpAMTX, HCQ, ADA740SpAMTX, LFN, HCQ, IFX, ADA, GOLIHCQ831IdiopathicMTX, MMF, CyA, ADA933IdiopathicMTX, AZA, ADA, ETN1032RAMTXAZA1123Vogt-Koyanagi-HaradaAZA, ADAAZA1236Juvenil Idiopathic ArthritisADA1332Punctate inner choroidopathyADA1429BehcetCyA, IFX, ADAConclusion:CZP seems to be effective and safe in female patients with uveitis during pregnancy and neonates.References:[1]Llorenç V et al. Certolizumab Pegol, a New Anti-TNF-α in the Armamentarium against Ocular Inflammation. Ocul Immunol Inflamm. 2016;24(2):167-72. doi: 10.3109/09273948.2014.967779[2]Urruticoechea-Arana A et al. Efficacy and safety of biological therapy compared to synthetic immunomodulatory drugs or placebo in the treatment of Behçet’s disease associated uveitis: a systematic review. Rheumatol Int. 2019 Jan;39(1):47-58. doi: 10.1007/s00296-018-4193-z[3]Martín-Varillas JL et al. Successful Optimization of Adalimumab Therapy in Refractory Uveitis Due to Behçet’s Disease Ophthalmology. 2018 Sep;125(9):1444-1451. doi: 10.1016/j.ophtha.2018.02.020[4]Santos-Gómez M et al. The effect of biologic therapy different from infliximab or adalimumab in patients with refractory uveitis due to Behçet’s disease: results of a multicentre open-label study. Clin Exp Rheumatol. 2016. Sep-Oct;34(6 Suppl 102): S34-S40[5]Calvo-Río V et al. Golimumab in refractory uveitis related to spondyloarthritis. Multicenter study of 15 patients.Semin Arthritis Rheum. 2016 Aug;46(1):95-101. doi: 10.1016/j.semarthrit.2016.03.002Disclosure of Interests:D. Prieto-Peña: None declared, Monica Calderón-Goercke: None declared, Alfredo Adan: None declared, Lillian Chamorro-López: None declared, Olga Maiz: None declared, JR De Dios-Jiménez Aberásturi: None declared, Raul Veroz Gonzalez: None declared, Soledad Blanco: None declared, José M Santos: None declared, Francisco Navarro: None declared, Adela Gallego: None declared, Senen González-Suárez: None declared, Arantxa Conesa: None declared, Andrea García-Valle: None declared, Miguel Cordero-Coma: None declared, Nieves Pardiñas-Barón: None declared, Rosalía Demetrio-Pablo: None declared, Vanesa Calvo-Río Grant/research support from: MSD and Roche, Speakers bureau: AbbVie, Lilly, Celgene, Grünenthal, UCB Pharma, Victor Manuel Mora-Cuesta: None declared, Santos Castañeda: None declared, J. Luis Hernández: None declared, Miguel A González-Gay Grant/research support from: Pfizer, Abbvie, MSD, Speakers bureau: Pfizer, Abbvie, MSD, Ricardo Blanco Grant/research support from: AbbVie, MSD, Roche, Consultant of: Abbvie, Eli Lilly, Pfizer, Roche, Bristol-Myers, Janssen, UCB Pharma and MSD, Speakers bureau: Abbvie, Eli Lilly, Pfizer, Roche, Bristol-Myers, Janssen, UCB Pharma. MSD
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McGrath M, McCarthy J, Gallego A, Kercher A, Zahedi S, Moser D. The Influence of Perforated Prosthetic Liners on Residual Limb Wound Healing: a Case Report. Can Prosthet Orthot J 2019; 2:32723. [PMID: 37614809 PMCID: PMC10443507 DOI: 10.33137/cpoj.v2i1.32723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 05/23/2019] [Accepted: 07/29/2019] [Indexed: 11/23/2022] Open
Abstract
CASE DESCRIPTION Good residual limb skin health is vital to successful prosthetic prescription. Unnatural loading profiles and excessive sweating can lead to skin and soft tissue problems. Perforated liners allow the transport of moisture away from the skin and allow negative pressure (a condition that has been shown to aid wound healing) to act directly on the residuum surface. AIM Assess the effects of perforated prosthetic liner use, particularly with respect to wound healing. METHOD Three patient histories were retrospectively reviewed following prescription of perforated prosthetic liners due to excessive sweating or prolonged residual limb health concerns. Photographic records from patient files were used to document changes in residual limb condition. Patients also provided subjective feedback regarding their experiences. FINDINGS Two cases described active amputees with persistent blistering irritated during exercise. Another case described a patient of low mobility level with a history of residual limb skin infections. All saw their conditions heal and reported a reduction in problematic sweating. Two patients reported cancelling surgical interventions after substantial improvements with the perforated liner. DISCUSSION These findings provide evidence that the use of perforated prosthetic liners allow improvements in residual limb health, while still permitting prosthetic use.
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Affiliation(s)
- M. McGrath
- Blatchford Group, Unit D Antura, Bond Close, Basingstoke, RG24 8PZ, UK
| | - J. McCarthy
- Blatchford Group, Unit D Antura, Bond Close, Basingstoke, RG24 8PZ, UK
| | - A. Gallego
- Blatchford Group, Unit D Antura, Bond Close, Basingstoke, RG24 8PZ, UK
| | - A. Kercher
- Endolite North America, Miamisburg, OH, USA
| | - S. Zahedi
- Blatchford Group, Unit D Antura, Bond Close, Basingstoke, RG24 8PZ, UK
| | - D. Moser
- Blatchford Group, Unit D Antura, Bond Close, Basingstoke, RG24 8PZ, UK
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Castellon L, Gallego A, Mayorga J, Fuenzalida C, Jerez D. Tumor reconstruction in pediatric patients. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.419] [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: 11/30/2022]
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Castellon L, Jerez D, Gallego A, Mayorga J, Fuenzalida C. Microvascular Reconstruction of Maxillofacial Defects in Pediatric Patients. J Oral Maxillofac Surg 2018. [DOI: 10.1016/j.joms.2018.06.150] [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: 11/27/2022]
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Saffon J, Corredor H, Sandoval C, Martinez J, Gallego A. 318 Frequency of priapism and characterization of its management in patients with erectile dysfunction treatment. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.281] [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: 10/28/2022]
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Higuera O, Rodriguez A, Rodriguez-Salas N, Ruiz-Giménez L, Gallego A, Ghanem I, Custodio A, Sanchez D, Ostios L, Poma JM, Feliu J. Clinical and pathological features in colorectal cancer associated to Lynch syndrome. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.235] [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: 11/14/2022] Open
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Gallego A, Laurino Soulé J, Napolitano H, Rossi SL, Vescina C, Korol SE. Biodegradability of Chlorophenols in Surface Waters from the Urban Area of Buenos Aires. Bull Environ Contam Toxicol 2018; 100:541-547. [PMID: 29464279 DOI: 10.1007/s00128-018-2300-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 02/14/2018] [Indexed: 06/08/2023]
Abstract
Biodegradability of 2-Chlorophenol (2-CP), 3-Chlorophenol (3-CP), 4-Chlorophenol (4-CP), 2,4-Dichlorophenol (2,4-DCP) and 2,4,6 Trichlorophenol (2,4,6-TCP) has been tested in surface waters in the urban area of Buenos Aires. Samples were taken from the La Plata River and from the Reconquista and Matanza-Riachuelo basins, with a total amount of 18 sampling points. Water quality was established measuring chemical oxygen demand (COD), biochemical oxygen demand (BOD5), and both Escherichia coli and Enterococcus counts. Biodegradability was carried out by a respirometric method, using a concentration of 20 mg L-1 of chlorophenol, and the surface water as inoculum. Chlorophenols concentration in the same water samples were simultaneously measured by a solid phase microextraction (SPME) procedure followed by gas chromatography-mass spectrometry (GC-MS). 2,4-DCP was the most degradable compound followed by 2,4,6-TCP, 4-CP, 3-CP and 2-CP. Biodegradability showed no correlation with compound concentration. At most sampling points the concentration was below the detection limit for all congeners. Biodegradability does not correlate even with COD, BOD5, or fecal contamination. Biodegradability assays highlighted information about bacterial exposure to contaminants that parameters routinely used for watercourse characterization do not reveal. For this reason, they might be a helpful tool to complete the characterization of a site.
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Affiliation(s)
- A Gallego
- Cátedra de Salud Pública e Higiene Ambiental, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956 4ºPiso, Buenos Aires, Argentina.
| | - J Laurino Soulé
- Cátedra de Salud Pública e Higiene Ambiental, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956 4ºPiso, Buenos Aires, Argentina
| | - H Napolitano
- Jenk S.A. Alvarez Thomas 228, Buenos Aires, Argentina
| | - S L Rossi
- Cátedra de Salud Pública e Higiene Ambiental, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956 4ºPiso, Buenos Aires, Argentina
| | - C Vescina
- Cátedra de Química Analítica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956 4ºPiso, Buenos Aires, Argentina
| | - S E Korol
- Cátedra de Salud Pública e Higiene Ambiental, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956 4ºPiso, Buenos Aires, Argentina
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Carbone J, Gallego A, Fernandez Yañez J, Sousa I, Sarmiento E. Potential Immunomodulatory Role of Specific Anticytomegalovirus Intravenous Immunoglobulin in Heart Recipients. Transplant Proc 2017; 48:3027-3029. [PMID: 27932138 DOI: 10.1016/j.transproceed.2016.07.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 07/27/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Specific anticytomegalovirus (anti-CMV) intravenous immunoglobulin (IVIG) has the potential to influence the immune response, but its complex mode of action has not been well evaluated. METHODS An immunologic study of 6 CMV-seronegative heart transplant patients receiving anti-CMV prophylaxis with the use of ganciclovir and CMV-IVIG (150 mg/kg within 24 hours after transplantation and 100 mg/kg on days 2, 7, 14, 22, 35, 56, and 77 after transplantation) was performed in a single center. Lymphocyte subsets were evaluated by means of 4-color flow cytometry at the time of inclusion in the waiting list and at 3 months after transplantation. RESULTS High-risk heart recipients receiving CMV-IVIG showed a clear reduction in the frequency of activated CD4+CD38+DR+ T-helper cells at 3 months after transplantation compared with a group of 27 untreated control subjects who received only anti-CMV prophylaxis with the use of ganciclovir. In this study, an increase of CD19+CD27-IgM+IgD+ naïve B cells was also observed in seronegative recipients after prophylaxis with the use of CMV-IVIG but not in control subjects. None of the CMV-IVIG-treated recipients developed acute cellular rejection during the 1st 6 months after transplantation. CONCLUSIONS The immune modulation of activated CD4+ lymphocyte and of naïve B-cell subsets after CMV-IVIG use should be further evaluated in future prospective studies with higher numbers of patients.
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Affiliation(s)
- J Carbone
- Clinical Immunology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Microbiology I Department, Medicine Faculty, Complutense University, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - A Gallego
- Clinical Immunology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Microbiology I Department, Medicine Faculty, Complutense University, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - J Fernandez Yañez
- Cardiology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - I Sousa
- Cardiology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - E Sarmiento
- Clinical Immunology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Microbiology I Department, Medicine Faculty, Complutense University, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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Atiaga O, Gallego A, Escobar L, Bravo J, Fernández P. Determination of total arsenic in rice from Ecuador: A first assessment. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.07.353] [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: 10/20/2022]
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Carbone J, Gallego A, Lanio N, Calahorra L, Sousa I, Sarmiento E. Loss of Correlation Between Naive and Memory Class-Switched B-Cells in Heart Recipients with Acute Cellular Rejection. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.545] [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: 11/28/2022] Open
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Santos Gόmez M, Calvo-Río V, Blanco R, Rubio-Romero E, Cordero-Coma M, Gallego A, Atanes A, Francisco F, Riancho-Zarrabeitia L, Loricera J, González-Gay MΆ. AB0747 Golimumab in Refractory Uveitis Related to Spondyloarthritis. Multicenter Study of 9 Patients. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Gonzalo A, Gallego A, Rivera M, Orte L, Ortuño J. Least square regression analysis of arterial pressure estimators contributing to early renal failure in ADPKD. Contrib Nephrol 2015; 115:171-6. [PMID: 8585910 DOI: 10.1159/000424419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- A Gonzalo
- Servicio de Nefrologia, Hospital Ramón y Cajal y, Madrid, Spain
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Hernández Flόrez D, Valor L, de la Torre I, Gallego A, Chamizo E, del Río T, Martinez L, Gonzalez C, Lopez-Longo J, Monteagudo I, Naredo E, Montoro M, Salvat M, Carreño Perez L. AB0027 B-Cell Activating Factor (BAFF) Binding Receptors (BBR) on B Cells: Characterization in Patients with Rheumatoid Arthritis (RA) Receiving Biological Therapies: Anti-TNF, Anti-Il6r and Anti-Ctla4: A Longitudinal Study. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3191] [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: 11/03/2022]
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Lanio N, Sarmiento E, Gallego A, Navarro J, Palomo J, Fernandez-Yañez J, Ruiz M, Fernandez-Cruz E, Carbone J. Kinetics of functionally distinct T-lymphocyte subsets in heart transplant recipients after induction therapy with anti-CD25 monoclonal antibodies. Transpl Immunol 2013; 28:176-82. [DOI: 10.1016/j.trim.2013.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 04/13/2013] [Accepted: 04/15/2013] [Indexed: 12/18/2022]
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Valor L, Sarmiento E, Navarro J, Gallego A, Fernandez-Yañez J, Fernandez-Cruz E, Carbone J. Evaluation of Lymphoproliferative Responses by Carboxy Fluorescein Succinimidyl Ester Assay in Heart Recipients With Infections. Transplant Proc 2012; 44:2649-52. [DOI: 10.1016/j.transproceed.2012.09.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Sarmiento E, del Pozo N, Gallego A, Fernández-Yañez J, Palomo J, Villa A, Ruiz M, Muñoz P, Rodríguez C, Rodríguez-Molina J, Navarro J, Kotsch K, Fernandez-Cruz E, Carbone J. Decreased levels of serum complement C3 and natural killer cells add to the predictive value of total immunoglobulin G for severe infection in heart transplant recipients. Transpl Infect Dis 2012; 14:526-39. [DOI: 10.1111/j.1399-3062.2012.00757.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E. Sarmiento
- Clinical Immunology Department; University Hospital Gregorio Marañón; Madrid; Spain
| | - N. del Pozo
- Clinical Immunology Department; University Hospital Gregorio Marañón; Madrid; Spain
| | - A. Gallego
- Clinical Immunology Department; University Hospital Gregorio Marañón; Madrid; Spain
| | - J. Fernández-Yañez
- Cardiology Department; University Hospital Gregorio Marañón; Madrid; Spain
| | - J. Palomo
- Cardiology Department; University Hospital Gregorio Marañón; Madrid; Spain
| | - A. Villa
- Cardiology Department; University Hospital Gregorio Marañón; Madrid; Spain
| | - M. Ruiz
- Cardiovascular Surgery Department; University Hospital Gregorio Marañón; Madrid; Spain
| | - P. Muñoz
- Microbiology Department; University Hospital Gregorio Marañón; Madrid; Spain
| | - C. Rodríguez
- Biochemistry Department; University Hospital Gregorio Marañón; Madrid; Spain
| | - J. Rodríguez-Molina
- Clinical Immunology Department; University Hospital Gregorio Marañón; Madrid; Spain
| | - J. Navarro
- Clinical Immunology Department; University Hospital Gregorio Marañón; Madrid; Spain
| | - K. Kotsch
- Transplant Immunology Group; Immunology Institute; Universitätsmedizin Charité; Berlin; Germany
| | - E. Fernandez-Cruz
- Clinical Immunology Department; University Hospital Gregorio Marañón; Madrid; Spain
| | - J. Carbone
- Clinical Immunology Department; University Hospital Gregorio Marañón; Madrid; Spain
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Carbone J, Lanio N, Gallego A, Navarro J, Palomo J, Fernandez-Yañez J, Sarmiento E. 409 Dynamic Changes in the Immunophenotypic Maturation Status of CD19 B Lymphocytes in Patients with Acute Cellular Rejection after Heart Transplantation. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.419] [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: 11/28/2022] Open
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Carbone J, Del Pozo N, Gallego A, Lanio N, Rodriguez-Molina J, Navarro J, Palomo J, Fernandez-Yañez J, Villa A, Muñoz P, Ruiz M, Hortal J, Rodriguez C, Fernandez-Cruz E, Kotsch K, Sarmiento E. 476 Identification of Immune Profiles That Are Associated with Development of Severe Infection in Heart Recipients. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.487] [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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Castro FV, McGinn OJ, Krishnan S, Marinov G, Li J, Rutkowski AJ, Elkord E, Burt DJ, Holland M, Vaghjiani R, Gallego A, Saha V, Stern PL. 5T4 oncofetal antigen is expressed in high risk of relapse childhood pre-B acute lymphoblastic leukemia and is associated with a more invasive and chemotactic phenotype. Leukemia 2012; 26:1487-98. [PMID: 22266911 PMCID: PMC3378689 DOI: 10.1038/leu.2012.18] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Although the overall prognosis in childhood acute lymphoblastic leukemia (ALL) is good, outcome after relapse is poor. Recurrence is frequently characterized by the occurrence of disease at extramedullary sites, such as the central nervous system and testes. Subpopulations of blasts able to migrate to such areas may have a survival advantage and give rise to disease recurrence. Gene expression profiling of 85 diagnostic pre-B-ALL bone marrow samples revealed higher 5T4 oncofetal antigen transcript levels in cytogenetic high-risk subgroups of patients (P<0.001). Flow cytometric analysis determined that bone marrow from relapse patients have a significantly higher percentage of 5T4-positive leukemic blasts than healthy donors (P=0.005). The high-risk Sup-B15 pre-B-ALL line showed heterogeneity in 5T4 expression, and the derived, 5T4(+) (Sup5T4) and 5T4(-) (Sup) subline cells, displayed differential spread to the omentum and ovaries following intraperitoneal inoculation of immunocompromised mice. Consistent with this, Sup5T4 compared with Sup cells show increased invasion in vitro concordant with increased LFA-1 and VLA-4 integrin expression, adhesion to extracellular matrix and secretion of matrix metalloproteases (MMP-2/-9). We also show that 5T4-positive Sup-B15 cells are susceptible to 5T4-specific superantigen antibody-dependent cellular toxicity providing support for targeted immunotherapy in high-risk pre-B-ALL.
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Affiliation(s)
- F V Castro
- Cancer Research UK Immunology Group, Paterson Institute for Cancer Research, University of Manchester, Manchester, UK
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Demain DK, Gallego A, Jaworski A, Priede IG, Jones EG. Diet and feeding niches of juvenile Gadus morhua, Melanogrammus aeglefinus and Merlangius merlangus during the settlement transition in the northern North Sea. J Fish Biol 2011; 79:89-111. [PMID: 21722113 DOI: 10.1111/j.1095-8649.2011.02997.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A study on the feeding ecology of juvenile cod Gadus morhua, haddock Melanogrammus aeglefinus and whiting Merlangius merlangus during the pelagic to demersal transition was carried out on fishes sampled throughout their settlement season at a local nursery ground in the north-western North Sea, off the Scottish east coast. A comprehensive quantitative taxonomic analysis of the diets, as described in the paper, showed the emergence of distinctive feeding niches, minimizing the potential for competition between species and size categories. The diet of the juveniles changed with fish size, water depth, time of year and distance offshore. Small G. morhua were present in the study area earlier in the season, settled further inshore and ate a higher proportion of pelagic prey (copepods) and as size increased they moved into deeper waters and targeted larger, more benthic prey. As M. aeglefinus grew larger and moved into deeper waters, a diet of largely copepods, amphipods, pelagic Ammodytes spp., cyprids and pelagic gastropods evolved to one dominated predominantly by fishes and benthic invertebrates. In the case of M. merlangus, widespread ages and sizes throughout the sampling season, a consequence of their more protracted spawning season, resulted in dietary changes which were more likely to be influenced by seasonal changes in the prey field, in addition to developmental (size) changes, than the diets of the other two species.
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Affiliation(s)
- D K Demain
- Marine Scotland, Marine Laboratory, Aberdeen AB11 9DB, UK.
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Amo‐Ochoa P, Jiménez‐Aparicio R, Torres MR, Urbanos FA, Gallego A, Gómez‐García CJ. MMX Chains and Molecular Species Containing Rh
2
n+
(
n
= 4, 5, and 6) Units: Electrical Conductivity in Crystal Phase of MMX Polymers. Eur J Inorg Chem 2010. [DOI: 10.1002/ejic.201000741] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Pilar Amo‐Ochoa
- Departamento de Química Inorgánica, Facultad de Ciencias Químicas, Universidad Complutense de Madrid, Ciudad Universitaria, 28040 Madrid, Spain, Fax: +34‐1‐3944352
| | - Reyes Jiménez‐Aparicio
- Departamento de Química Inorgánica, Facultad de Ciencias Químicas, Universidad Complutense de Madrid, Ciudad Universitaria, 28040 Madrid, Spain, Fax: +34‐1‐3944352
| | - M. Rosario Torres
- Centro de asistencia a la investigación de rayos X, Facultad de Ciencias Químicas, Universidad Complutense de Madrid, Ciudad Universitaria, 28040 Madrid, Spain, Fax: +34‐1‐3944352
| | - Francisco A. Urbanos
- Departamento de Química Inorgánica, Facultad de Ciencias Químicas, Universidad Complutense de Madrid, Ciudad Universitaria, 28040 Madrid, Spain, Fax: +34‐1‐3944352
| | - A. Gallego
- Facultad de Ciencias Universidad Autónoma de Madrid, Campus de Cantoblanco 28049 Madrid, Spain, Fax: +34‐1‐4974833
| | - Carlos J. Gómez‐García
- Instituto de Ciencia Molecular, Universidad de Valencia, Parque Científico, 46980 Paterna, Spain, Fax: +34‐963543273
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Gallego A, Rossen A, Gemini V, Fortunato M, Rossi S, Pianes E, Korol S. Aerobic Reactors for Biotreatment of Polluted Waters and Synthetic Effluents Containing 3-Chlorobenzoic Acid. ACTA ACUST UNITED AC 2010. [DOI: 10.5132/jbse.2010.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Del Pozo N, Sarmiento E, Lanio N, Gallego A, Largo J, Carbone J. Immunophenotypic abnormalities of CD8+ T-cell subsets in a patient with unusual Good's Syndrome. Allergol Immunopathol (Madr) 2010; 38:102-5. [PMID: 20304549 DOI: 10.1016/j.aller.2009.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Accepted: 07/26/2009] [Indexed: 12/24/2022]
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Lanio N, Sarmiento E, Gallego A, Fernández-Yánez J, Palomo J, Pérez-Rojas J, Carbone J. The potential role of T-cell memory distribution as predisposing factor for rejection in heart transplant recipients. Transplant Proc 2010; 41:2480-4. [PMID: 19715957 DOI: 10.1016/j.transproceed.2009.06.043] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
CD4 T cells play a significant role in the pathogenesis of rejection, providing help to alloreactive CD8 and B cells, however, the exact contribution of each memory compartment in vivo has not been defined. They are also important for the maintenance of tolerance due to regulatory activity of specialized subsets. In this study, we assessed changes in frequencies of functionally distinct lymphocyte subsets of peripheral blood (PBLs) in 26 heart transplant recipients (HT) in association with rejection episodes. Patients who developed rejection (n = 7), namely Grade 3B (n = 1), 3A (n = 4), or 2 (n = 2), in comparison with those with stable graft function displayed at baseline (pre-HT) higher percentages of naive (CCR7+CD45RA+) CD4 T cells (median 48 vs 36.6%; P = .035) and lower percentages of central memory (CCR7+CD45RA-) CD4 T cells (33.3 vs 46.5%; P = .035). At 30 days post-HT, CD4/CD127(low)FoxP3+ T cells were significantly reduced among patients with rejection episodes (0.84 vs 2.15%; P = .042). CD8 final effector T cells were increased at 90 days post-HT among those patients who experienced rejection (TEM2: 60.8 vs 31.9%; P < .1), at the expense of shrinking CD8 central memory compartment (TCM: 8.6 vs 12.9%; P = .046). The potential role of T-cell memory distribution should be further evaluated in HT patients as possible markers to discriminate patients at risk for rejection.
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Affiliation(s)
- N Lanio
- Clinical Immunology Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Carbone J, Lanio N, Gallego A, Sarmiento E. [Lower levels of regulatory T-cells in a patient with HTLV-I associated myelopathy]. Rev Neurol 2009; 48:219-221. [PMID: 19226493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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41
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Gallego A, Sheldon J, García-Samaniego J, Margall N, Romero M, Hornillos P, Soriano V, Enrĺquez J. Evaluation of initial virological response to adefovir and development of adefovir-resistant mutations in patients with chronic hepatitis B. J Viral Hepat 2008; 15:392-8. [PMID: 18221300 DOI: 10.1111/j.1365-2893.2007.00966.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The aims of the present study were to assess initial virological response (IVR) to adefovir (ADV) treatment for chronic hepatitis B, to identify patients with suboptimal response and to determine the incidence of ADV-resistant mutants. All patients treated with ADV for at least 12 months were evaluated for virological response and ADV resistance. IVR was defined as a reduction > or = 4 log10 IU/mL in hepatitis B virus (HBV)-DNA at month 6. Forty-two patients were analysed. Mean treatment duration was 23 +/- 7 months; 50% had prior lamivudine (LAM) therapy (LAM resistance 62%); 88% were hepatitis B e antigen (HBeAg)-negative; and 76% carried genotype D. IVR was seen in 40.5% of patients. Higher baseline ALT level was the only factor associated with IVR (P = 0.043). Patients with IVR achieved undetectable HBV-DNA at month 12 in 77% of cases compared with only 5% of those without IVR (P < 0.001). Five (12%) patients developed ADV-resistant mutations: rtN236T in four cases and one case with an rtV207L change, which has not been previously reported. This mutation was accompanied by viral rebound and alanine aminotransferase (ALT) flare. The cumulative probability of ADV-resistant mutations at 12 and 24 months was 5% and 17% respectively. IVR defined as a reduction > or = 4 log10 IU/mL in HBV-DNA at month 6 is a useful tool to predict virological response at month 12 and to identify patients with suboptimal response to ADV. Cumulative probability of ADV resistance is higher than previously reported for nucleos(t)ide-naïve patients.
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Affiliation(s)
- A Gallego
- Gastroenterology Department, Hospital Sta. Creu i St. Pau, Barcelona
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Gallego A, Sheldon J, García-Samaniego J, Margall N, Romero M, Hornillos P, Soriano V, Enrĺquez J. Evaluation of initial virological response to adefovir and development of adefovir-resistant mutations in patients with chronic hepatitis B. J Viral Hepat 2008. [PMID: 18221300 DOI: 10.1111/j.1365-2893.2008.00966.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The aims of the present study were to assess initial virological response (IVR) to adefovir (ADV) treatment for chronic hepatitis B, to identify patients with suboptimal response and to determine the incidence of ADV-resistant mutants. All patients treated with ADV for at least 12 months were evaluated for virological response and ADV resistance. IVR was defined as a reduction > or = 4 log10 IU/mL in hepatitis B virus (HBV)-DNA at month 6. Forty-two patients were analysed. Mean treatment duration was 23 +/- 7 months; 50% had prior lamivudine (LAM) therapy (LAM resistance 62%); 88% were hepatitis B e antigen (HBeAg)-negative; and 76% carried genotype D. IVR was seen in 40.5% of patients. Higher baseline ALT level was the only factor associated with IVR (P = 0.043). Patients with IVR achieved undetectable HBV-DNA at month 12 in 77% of cases compared with only 5% of those without IVR (P < 0.001). Five (12%) patients developed ADV-resistant mutations: rtN236T in four cases and one case with an rtV207L change, which has not been previously reported. This mutation was accompanied by viral rebound and alanine aminotransferase (ALT) flare. The cumulative probability of ADV-resistant mutations at 12 and 24 months was 5% and 17% respectively. IVR defined as a reduction > or = 4 log10 IU/mL in HBV-DNA at month 6 is a useful tool to predict virological response at month 12 and to identify patients with suboptimal response to ADV. Cumulative probability of ADV resistance is higher than previously reported for nucleos(t)ide-naïve patients.
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Affiliation(s)
- A Gallego
- Gastroenterology Department, Hospital Sta. Creu i St. Pau, Barcelona
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Gallego A, Gemini VL, Koral SE. [Aerobic biological fixed film systems for wastewater biodegradation]. Rev Argent Microbiol 2006; 38:143. [PMID: 17152213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Affiliation(s)
- A Gallego
- Cátedra de Higiene y Sanidad, Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires, Junin 956 (1113) Ciudad Autónoma de Buenos Aires, Argentina
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Gallego A, Vargas JA, Castejón R, Citores MJ, Romero Y, Millán I, Durántez A. Production of intracellular IL-2, TNF-alpha, and IFN-gamma by T cells in B-CLL. Cytometry B Clin Cytom 2003; 56:23-9. [PMID: 14582134 DOI: 10.1002/cyto.b.10052] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Recent evidence indicates that the slowly expanding population of CD5(+) B cells that characterizes B-cell chronic lymphocytic leukemia (B-CLL) could be related to defects in the response to cytokine produced by T cells that regulate apoptosis. We studied the intracellular expressions of interleukin-2 (IL-2), tumor necrosis factor-alpha (TNF-alpha), and interferon-gamma (IFN-gamma) in T-helper 1 cells (Th1 response) of B-CLL. METHODS Peripheral blood mononuclear cells from 21 healthy individuals and purified T cells from 21 early-stage and 15 late-stage B-CLL patients were activated with phorbol myristate acetate and ionomycin. The Th1 cytoplasmic cytokines were evaluated in CD4(+) and CD8(+) T cells by flow cytometry. RESULTS The percentages of CD4(+) and CD8(+) T cells positive for IL-2 were significantly lower in B-CLL patients than in healthy individuals (P = 0.030 and 0.049, respectively). No significant differences in TNF-alpha or IFN-gamma intracellular expressions were found between patients and healthy individuals. TNF-alpha- and IFN-gamma-expressing CD8 T cells were disease stage dependent, being significantly higher in late-stage patients (P < 0.001 for both cytokines). CONCLUSIONS Our present observations suggested that Th1 cytokines may be of major importance in the pathogenesis of B-CLL.
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Affiliation(s)
- A Gallego
- Service of Internal Medicine I, Hospital Universitario Puerta de Hierro, Universidad Autónoma, Madrid, Spain
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Blanco C, López D, Andrés A, Schib J, Gallego A, Durán A, Sans-Coma V. CARTILAGE IN THE BULBUS ARTERIOSUS OF TELEOSTEAN FISHES. ACTA ACUST UNITED AC 2001. [DOI: 10.1163/156854201753247604] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Villanueva C, Miñana J, Ortiz J, Gallego A, Soriano G, Torras X, Sáinz S, Boadas J, Cussó X, Guarner C, Balanzó J. Endoscopic ligation compared with combined treatment with nadolol and isosorbide mononitrate to prevent recurrent variceal bleeding. N Engl J Med 2001; 345:647-55. [PMID: 11547718 DOI: 10.1056/nejmoa003223] [Citation(s) in RCA: 258] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND After an episode of acute bleeding from esophageal varices, patients are at high risk for recurrent bleeding and death. We compared two treatments to prevent recurrent bleeding--endoscopic ligation and combined medical therapy with nadolol and isosorbide mononitrate. METHODS We randomly assigned 144 patients with cirrhosis who were hospitalized with esophageal variceal bleeding to receive treatment with endoscopic ligation (72 patients) or the combined medical therapy (72 patients). Sessions of ligation were repeated every two to three weeks until the varices were eradicated. The initial dose of nadolol was 80 mg orally once daily, with adjustment according to the resting heart rate; isosorbide mononitrate was given in increasing doses, beginning at 20 mg once a day at bed time and rising over the course of one week to 40 mg orally twice a day, unless side effects occurred. The primary end points were recurrent bleeding, complications, and death. RESULTS The median follow-up period was 21 months. A total of 35 patients in the ligation group and 24 in the medication group had recurrent bleeding. The probability of recurrence was lower in the medication group, both for all episodes related to portal hypertension (P=0.04) and for recurrent variceal bleeding (P=0.04). There were major complications in nine patients treated with ligation (seven had bleeding esophageal ulcers and two had aspiration pneumonia) and two treated with medication (both had bradycardia and dyspnea) (P=0.05). Thirty patients in the ligation group died, as did 23 patients in the medication group (P=0.52). The probability of recurrent bleeding was lower for patients with a hemodynamic response to therapy, defined as a decrease in the hepatic venous pressure gradient of more than 20 percent from the base-line value or to less than 12 mm Hg (18 percent, vs. 54 percent in patients with no hemodynamic response at one year; P<0.001), and the probability of survival was higher (94 percent vs. 78 percent at one year, P=0.02). CONCLUSIONS Combined therapy with nadolol and isosorbide mononitrate is more effective than endoscopic ligation for the prevention of recurrent bleeding and is associated with a lower rate of major complications. A hemodynamic response to treatment is associated with a better long-term prognosis.
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Affiliation(s)
- C Villanueva
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
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Abstract
BACKGROUND The outcome for children with acute renal failure (ARF) may be poor. However, relatively few published studies have considered prognosis of these patients. METHODS We prospectively studied, from 1978 to 1998, 92 such children without heart disease to try to identify risk factors for mortality. RESULTS Forty five per cent of children with tumours, shock, and other causes died compared with none of those with a primary urinary tract related problem. ARF did not seem to be the cause of death in any case. Univariate analysis showed that in the non-primary urinary problem group (55 cases), patients with hypotension, high values of BUN or creatinine, or who needed mechanical ventilation or dialysis, had a poor outcome. Multivariate analysis showed that probability of death can be estimated using the following score: -0.02 + 0.28 (hypotension) + 0.19 (ventilation) + 0.27 (dialysis) + 0.01 (BUN). CONCLUSIONS Mortality of patients with ARF was related to aetiology, the need for dialysis and/or ventilator use, hypotension, and BUN values.
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Affiliation(s)
- N Gallego
- Servicio de Nefrología, Hospital Ramón y Cajal, Carretera de Colmenar Km 9.1, 28034 Madrid, Spain.
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Gallego A, Gómez CE, Fortunato MS, Cenzano L, Rossi S, Paglilla M, Goméz Hermida DG, Higa LE, Korol SE. Factors affecting biodegradation of 2-chlorophenol by Alcaligenes sp. in aerobic reactors. Environ Toxicol 2001; 16:306-313. [PMID: 11501279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The influence of variations in carbon source concentration, cell inocula, pH, presence of other substrates, and other organisms on the biodegradation of 2-chlorophenol (2-CP) was studied for Alcaligenes sp. isolated from natural sources. Assays of biodegradation were performed in batch and continuous-flow fluidized-bed aerobic reactors. Evaluation of biodegradation was performed by determining total phenols, chemical oxygen demand (COD), and 2-CP by ultraviolet (UV) spectrophotometry. Measurement of microbial growth was carried out by the plate count method. Bioassays of acute toxicity were performed to evaluate detoxification by using Daphnia magna. Results obtained show that under batch conditions with initial inocula of 10(6) cells/mL the strain grew exponentially with 100, 200, and 300 mg/L of 2-CP within 48 hr. A lag period was observed with low cell density inocula (10(5) cells/mL). The strain showed marked delay in the biodegradation of 2-CP at pH 5. Removal of target substrate from mixtures containing other carbon sources demonstrated the possibility of concurrent growth. Mineralization of 2-CP was assessed by gas chromatography carried out at the end of the batch assays and at the exit of the continuous-flow reactor. The presence of other organisms (bacteria, rotifers, ciliate, and algae) that developed in the fluidized-bed reactor did not affect the efficacy of the biodegradation of 2-CP. The removal of 2-CP in the two assayed systems was over 97% in all cases. Toxicity was not detected at the exit of the continuous reactor.
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Affiliation(s)
- A Gallego
- Faculty of Pharmacy and Biochemistry, University of Buenos Aires, Junín 956, CP 1113 Buenos Aires, Argentina
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Enríquez J, Gallego A, Torras X, Pérez-Olmeda T, Diago M, Soriano V, Luján MS, García-Samaniego J. Retreatment for 24 vs 48 weeks with interferon-alpha2b plus ribavirin of chronic hepatitis C patients who relapsed or did not respond to interferon alone. J Viral Hepat 2000; 7:403-8. [PMID: 11115050 DOI: 10.1046/j.1365-2893.2000.00243.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
We assessed the efficacy of interferon (IFN) plus ribavirin over 24 or 48 weeks for the retreatment of patients with chronic hepatitis C who had relapsed or did not respond to a previous course of IFN. One-hundred and twenty patients (69 non-responders and 51 relapsers) were randomly assigned to receive IFN-alpha2b (3 million units thrice weekly) plus ribavirin (1,000-1,200 mg per day) for 24 weeks (group A: 58 patients) or 48 weeks (group B: 62 patients). Treatment was discontinued at week 12 if the alanine aminotransferase (ALT) level remained elevated. The rate of sustained response was 15.5% in group A and 37.1% in group B (P = 0.013). Relapsers treated for 48 weeks had a sustained response rate of 66.6% compared with a sustained response rate of only 25% in those treated for 24 weeks (P = 0.004). Moreover, a sustained response was seen in 14.3% of non-responders treated for 48 weeks and in 8.8% of those treated for 24 weeks (P = 0.71). Fifty-three per cent of patients with a normal ALT level and undetectable hepatitis C virus (HCV) RNA at week 12 had a sustained response compared with 14% of those who were HCV RNA positive at week 12 (P < 0.001). Independent predictive factors of sustained response were: therapy for 48 weeks (P = 0.0026), relapse after IFN treatment (P = 0.0006), loss of HCV RNA at week 12 (P = 0.0008) and HCV genotype non-1 (P = 0.024). Hence, in patients with chronic hepatitis C who failed to respond to a previous course of IFN monotherapy, combination therapy with IFN plus ribavirin for 48 weeks seems to be more effective than IFN plus ribavirin for 24 weeks.
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Affiliation(s)
- J Enríquez
- Department of Gastroenterology, Hospital de la Sta Creu i St Pau, Barcelona, Spain
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