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Vaquer A, Adrover-Jaume C, Clemente A, Viana J, Rodríguez R, Rojo-Molinero E, Oliver A, de la Rica R. OriPlex: Origami-enabled multiplexed detection of respiratory pathogens. Biosens Bioelectron 2024; 257:116341. [PMID: 38677019 DOI: 10.1016/j.bios.2024.116341] [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: 03/06/2024] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 04/29/2024]
Abstract
Origami biosensors leverage paper foldability to develop total analysis systems integrated in a single piece of paper. This capability can also be utilized to incorporate additional features that would be difficult to achieve with rigid substrates. In this article, we report a new design for 3D origami biosensors called OriPlex, which leverages the foldability of filter paper for the multiplexed detection of bacterial pathogens. OriPlex immunosensors detect pathogens by folding nanoparticle reservoirs containing different types of nanoprobes. This releases antibody-coated nanoparticles in a central channel where targets are captured through physical interactions. The OriPlex concept was demonstrated by detecting the respiratory pathogens Pseudomonas aeruginosa (PA) and Klebsiella pneumoniae (KP) with a limit of detection of 3.4·103 cfu mL-1 and 1.4·102 cfu mL-1, respectively, and with a turn-around time of 25 min. Remarkably, the OriPlex biosensors allowed the multiplexed detection of both pathogens spiked into real bronchial aspirate (BAS) samples at a concentration of 105 cfu mL-1 (clinical infection threshold), thus demonstrating their suitability for diagnosing lower tract respiratory infections. The results shown here pave the way for implementing OriPlex biosensors as a screening test for detecting superbugs requiring personalized antibiotics in suspected cases of nosocomial pneumonia.
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Affiliation(s)
- Andreu Vaquer
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain; Department of Chemistry, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Cristina Adrover-Jaume
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain; Department of Chemistry, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Antonio Clemente
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III Madrid, Spain.
| | - Julia Viana
- Microbiology Department, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma, Spain
| | - Rocío Rodríguez
- Microbiology Department, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma, Spain
| | - Estrella Rojo-Molinero
- Microbiology Department, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III Madrid, Spain
| | - Antonio Oliver
- Microbiology Department, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III Madrid, Spain
| | - Roberto de la Rica
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III Madrid, Spain.
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Berman-Riu M, Cunill V, Clemente A, López-Gómez A, Pons J, Ferrer JM. Dysfunctional mitochondria, disrupted levels of reactive oxygen species, and autophagy in B cells from common variable immunodeficiency patients. Front Immunol 2024; 15:1362995. [PMID: 38596676 PMCID: PMC11002182 DOI: 10.3389/fimmu.2024.1362995] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/04/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction Common Variable Immunodeficiency (CVID) patients are characterized by hypogammaglobulinemia and poor response to vaccination due to deficient generation of memory and antibody-secreting B cells. B lymphocytes are essential for the development of humoral immune responses, and mitochondrial function, hreactive oxygen species (ROS) production and autophagy are crucial for determining B-cell fate. However, the role of those basic cell functions in the differentiation of human B cells remains poorly investigated. Methods We used flow cytometry to evaluate mitochondrial function, ROS production and autophagy processes in human naïve and memory B-cell subpopulations in unstimulated and stimulated PBMCs cultures. We aimed to determine whether any alterations in these processes could impact B-cell fate and contribute to the lack of B-cell differentiation observed in CVID patients. Results We described that naïve CD19+CD27- and memory CD19+CD27+ B cells subpopulations from healthy controls differ in terms of their dependence on these processes for their homeostasis, and demonstrated that different stimuli exert a preferential cell type dependent effect. The evaluation of mitochondrial function, ROS production and autophagy in naïve and memory B cells from CVID patients disclosed subpopulation specific alterations. Dysfunctional mitochondria and autophagy were more prominent in unstimulated CVID CD19+CD27- and CD19+CD27+ B cells than in their healthy counterparts. Although naïve CD19+CD27- B cells from CVID patients had higher basal ROS levels than controls, their ROS increase after stimulation was lower, suggesting a disruption in ROS homeostasis. On the other hand, memory CD19+CD27+ B cells from CVID patients had both lower ROS basal levels and a diminished ROS production after stimulation with anti-B cell receptor (BCR) and IL-21. Conclusion The failure in ROS cell signalling could impair CVID naïve B cell activation and differentiation to memory B cells. Decreased levels of ROS in CVID memory CD19+CD27+ B cells, which negatively correlate with their in vitro cell death and autophagy, could be detrimental and lead to their previously demonstrated premature death. The final consequence would be the failure to generate a functional B cell compartment in CVID patients.
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Affiliation(s)
- Maria Berman-Riu
- Department of Immunology, Son Espases University Hospital, Palma, Spain
- Human Immunopathology Research Laboratory, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Vanesa Cunill
- Department of Immunology, Son Espases University Hospital, Palma, Spain
- Human Immunopathology Research Laboratory, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Antonio Clemente
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio López-Gómez
- Department of Immunology, Son Espases University Hospital, Palma, Spain
- Human Immunopathology Research Laboratory, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Jaime Pons
- Department of Immunology, Son Espases University Hospital, Palma, Spain
- Human Immunopathology Research Laboratory, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Joana M. Ferrer
- Department of Immunology, Son Espases University Hospital, Palma, Spain
- Human Immunopathology Research Laboratory, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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Gharbieh S, Milbrandt J, Reig B, Mercier D, Allain M, Clemente A. Design of a binary programmable transmitarray based on phase change material for beam steering applications in D-band. Sci Rep 2024; 14:2966. [PMID: 38316832 DOI: 10.1038/s41598-024-53150-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/29/2024] [Indexed: 02/07/2024] Open
Abstract
This paper introduces the design of a reconfigurable transmitarray operating within the D-band frequency range (110-170 GHz). The transmitarray unit cell is composed of three metal layers and two quartz dielectric substrates. It achieves a 1-bit phase shift resolution through the alternating states of two innovative switches integrated into the active transmitting patch of the unit cell. To address the challenge of miniaturization in the D-band, compact switches compatible with the proposed unit cell dimensions are introduced. These switches are constructed using phase change materials (PCM) that change between amorphous and crystalline states when exposed to heat. The paper includes a full-wave simulation of the unit cell, demonstrating an insertion loss below 1.5 dB across a wide frequency band of 27%. Additionally, a 10 [Formula: see text] 10 elements transmitarray is synthesized using a numerical tool and its theoretical results are compared to full-wave electromagnetic simulations for validation purposes. The results indicate that by incorporating the proposed switches into the unit cell, the transmitarray achieves promising reconfiguration capabilities within the D-band. Moreover, the paper presents the architecture of a command line designed to bias the PCM switches. Notably, this command line represents a novel approach, as it enables individual biasing of each PCM switch using direct current (DC). The influence of these command lines on the transmitarray's performance is thoroughly investigated. Although there is a compromise in the 1-dB gain bandwidth, the overall behavior of the transmitarray remains encouraging.
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Affiliation(s)
| | | | - Bruno Reig
- Univ. Grenoble Alpes, CEA, Leti, 38000, Grenoble, France
| | - Denis Mercier
- Univ. Grenoble Alpes, CEA, Leti, 38000, Grenoble, France
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Caputo M, Daffara T, Ferrero A, Romanisio M, Monti E, Mele C, Zavattaro M, Tricca S, Siani A, Clemente A, Palumbo C, De Cillà S, Carriero A, Volpe A, Marzullo P, Aimaretti G, Prodam F. Tumor enlargement in adrenal incidentaloma is related to glaucoma: a new prognostic feature? J Endocrinol Invest 2024; 47:377-387. [PMID: 37466811 PMCID: PMC10859343 DOI: 10.1007/s40618-023-02154-9] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE The uncertainty on the management of small adrenal incidentalomas (AIs) still represents a challenge in real clinical practice. Considering the lack of knowledge on risk factors implicated in tumour enlargement, the aim of this study was to identify risk factors for morphological changes during follow-up of adrenal incidentalomas (AIs). METHODS We retrospectively evaluated demographic, clinical, radiological and biochemical parameters of 153 AIs (2007-2021). Patients with histological diagnosis of metastases or pheochromocytoma were excluded. To detect risk factors for tumor enlargement, diseases associated with AIs were included if their prevalence was higher than 2%. Patients were divided into two groups (A: radiological stability; B: tumor enlargement defined as > 5 mm/year in the main diameter). RESULTS Group A: 89.5% and group B: 10.5%, mean follow-up 38.6 ± 6.9 months (range 6-240). Tumor enlargement when occurred was within 36 months of follow-up. In group B high body weight (p < 0.03), dehydroepiandrosterone sulfate (DHEAS) (p < 0.05) and direct renin concentration (DRC) (p < 0.04) were higher than group A, while aldosterone levels were lower; moreover, considering comorbidities, glaucoma and dysglycemia (p < 0.01 for both) had higher prevalence in group B. Glaucoma and dysglycemia were independent predictors of enlargement. Patients affected by glaucoma, atrial fibrillation, dysglycemia had a lower dimensional change-free survival than non-affected. CONCLUSIONS Glaucoma might be a novel risk factor for AI enlargement. If subtle undetectable cortisol hypersecretion has a role is a topic for further research.
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Affiliation(s)
- M Caputo
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy.
- Department of Health Sciences, Università del Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy.
| | - T Daffara
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy
| | - A Ferrero
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy
| | - M Romanisio
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy
| | - E Monti
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy
| | - C Mele
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy
| | - M Zavattaro
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy
| | - S Tricca
- Department of Diagnostic and Interventional Radiology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - A Siani
- Department of Diagnostic and Interventional Radiology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - A Clemente
- Ophthalmology Unit, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - C Palumbo
- Division of Urology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - S De Cillà
- Ophthalmology Unit, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - A Carriero
- Department of Diagnostic and Interventional Radiology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - A Volpe
- Division of Urology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - P Marzullo
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy
| | - G Aimaretti
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy
| | - F Prodam
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy
- Department of Health Sciences, Università del Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy
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Adrover-Jaume C, Clemente A, Rodríguez-Urretavizcaya B, Vilaplana L, Marco MP, Rojo-Molinero E, Oliver A, de la Rica R. A paper biosensor for overcoming matrix effects interfering with the detection of sputum pyocyanin with competitive immunoassays. Mikrochim Acta 2023; 190:441. [PMID: 37845505 PMCID: PMC10579119 DOI: 10.1007/s00604-023-06017-1] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/25/2023] [Indexed: 10/18/2023]
Abstract
Detecting sputum pyocyanin (PYO) with a competitive immunoassay is a promising approach for diagnosing Pseudomonas aeruginosa respiratory infections. However, it is not possible to perform a negative control to evaluate matrix-effects in competitive immunoassays, and the highly complex sputum matrix often interferes with target detection. Here, we show that these issues are alleviated by performing competitive immunoassays with a paper biosensor. The biosensing platform consists of a paper reservoir, which contains antibody-coated gold nanoparticles, and a substrate containing a competing recognition element, which is a piece of paper modified with an albumin-antigen conjugate. Detection of PYO with a limit of detection of 4.7·10-3 µM and a dynamic range between 4.7·10-1 µM and 47.6 µM is accomplished by adding the sample to the substrate with the competing element and pressing the reservoir against it for 5 min. When tested with patient samples, the biosensor was able to qualitatively differentiate spiked from non-spiked samples, whereas ELISA did not show a clear cut-off between them. Furthermore, the relative standard deviation was lower when determining sputum with the paper-based biosensor. These features, along with a mild liquefaction step that circumvents the use of harsh chemicals or instruments, make our biosensor a good candidate for diagnosing Pseudomonas infections at the bedside through the detection of sputum PYO.
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Affiliation(s)
- Cristina Adrover-Jaume
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma, Spain
- Department of Chemistry, University of the Balearic Islands, Palma, Spain
| | - Antonio Clemente
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma, Spain.
- Department of Chemistry, University of the Balearic Islands, Palma, Spain.
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
| | - Bárbara Rodríguez-Urretavizcaya
- Nanobiotechnology for Diagnostics (Nb4D), Department of Surfactants and Nanobiotechnology, Institute for Advanced Chemistry of Catalonia (IQAC), Barcelona, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | - Lluïsa Vilaplana
- Nanobiotechnology for Diagnostics (Nb4D), Department of Surfactants and Nanobiotechnology, Institute for Advanced Chemistry of Catalonia (IQAC), Barcelona, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | - M Pilar Marco
- Nanobiotechnology for Diagnostics (Nb4D), Department of Surfactants and Nanobiotechnology, Institute for Advanced Chemistry of Catalonia (IQAC), Barcelona, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | - Estrella Rojo-Molinero
- Microbiology Department, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Oliver
- Microbiology Department, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Roberto de la Rica
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Delgado-Cano D, Clemente A, Adrover-Jaume C, Vaquer A, López M, Martínez R, Roig IM, Iglesias A, Cosío BG, de la Rica R. Facemask analyses for the non-invasive detection of chronic and acute P. aeruginosa lung infections using nanoparticle-based immunoassays. Analyst 2023; 148:4837-4843. [PMID: 37622408 DOI: 10.1039/d3an00979c] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Pseudomonas aeruginosa (P. aeruginosa) is a pathogen that persistently colonizes the respiratory tract of patients with chronic lung diseases. The risk of acquiring a chronic P. aeruginosa infection can be minimized by rapidly detecting the pathogen in the patient's airways and promptly administrating adequate antibiotics. However, the rapid detection of P. aeruginosa in the lungs involves the analysis of sputum, which is a highly complex matrix that is not always available. Here, we propose an alternative diagnosis based on analyzing breath aerosols. In this approach, nanoparticle immunosensors identify bacteria adhered to the polypropylene layer of a surgical facemask that was previously worn by the patient. A polypropylene processing protocol was optimized to ensure the efficient capture and analysis of the target pathogen. The proposed analytical platform has a theoretical limit of detection of 105 CFU mL-1 in aerosolized mock samples, and a dynamic range between 105 and 108 CFU mL-1. When tested with facemasks worn by patients, the biosensors were able to detect chronic and acute P. aeruginosa lung infections, and to differentiate them from respiratory infections caused by other pathogens. The results shown here pave the way to diagnose Pseudomonas infections at the bedside, as well as to identify the progress from chronic to acute infection.
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Affiliation(s)
- David Delgado-Cano
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain.
| | - Antonio Clemente
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain.
- Department of Chemistry, University of the Balearic Islands, Palma de Mallorca, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III Madrid, Spain
| | - Cristina Adrover-Jaume
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain.
- Department of Chemistry, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Andreu Vaquer
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain.
- Department of Chemistry, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Meritxell López
- Inflamación, Reparación y Cáncer en Enfermedades Respiratorias (i-RESPIRE), Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Respiratory Medicine, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Rocío Martínez
- Inflamación, Reparación y Cáncer en Enfermedades Respiratorias (i-RESPIRE), Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Department of Respiratory Medicine, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Isabel M Roig
- Department of Respiratory Medicine, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Amanda Iglesias
- Inflamación, Reparación y Cáncer en Enfermedades Respiratorias (i-RESPIRE), Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Borja G Cosío
- Inflamación, Reparación y Cáncer en Enfermedades Respiratorias (i-RESPIRE), Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Respiratory Medicine, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Roberto de la Rica
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain.
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III Madrid, Spain
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Russo A, Clemente A, Massè A, Burastero G. Medial gastrocnemius rotational flap for the reconstruction of extensor mechanism disruption in periprosthetic knee infections: a retrospective series with minimum two year follow-up. Int Orthop 2023; 47:983-993. [PMID: 36752846 DOI: 10.1007/s00264-023-05716-x] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/27/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE Extensor mechanism disruption following total knee arthroplasty has a prevalence ranging from 0.3 to 3%. Its management is challenging, especially in case of associated infection of the prosthetic implant. Surgical options are limited due to the septic process, and the use of allograft or synthetic mesh are not recommended. The aim of this study was to report clinical outcomes, complications, survival, and surgical technique of medial gastrocnemius flap for the treatment of extensor mechanism disruptions associated with periprosthetic knee infection. METHODS This is a retrospective study from a prospectively collected arthroplasty registry from 2012 to 2019. Patients who received the gastrocnemius flap in the setting of a two-stage knee replacement for periprosthetic infection were included. Results of physical examination, Knee Society Score, Oxford Knee Score, and measurement of the range of motion registered pre-operatively were compared to those obtained at last follow-up. Survival was analysed through Kaplan-Meier curve. RESULTS A total of 15 patients were included, with a mean age of 63.4 years (range 36-77). The reconstruction of the extensor mechanism demonstrated a success rate of 73.3%. The mean extension lag at final follow-up was 7.5° (range, 0-30). The mean Knee Society Score and Oxford Knee Score improved from 29.0 (range, 21-36) and 17.5 (range, 13-22) respectively, to 82.9 (range, 74-89) and 36.0 (range, 33-39). CONCLUSION Medial gastrocnemius rotational flap is a reliable option for joint and limb salvage in case of periprosthetic knee infection associated with wide soft tissue degeneration and extensor mechanism disruption. The technique and surgical protocol presented in this study are reproducible and guaranteed good clinical outcomes and infection control.
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Affiliation(s)
- Antonio Russo
- Department of Surgical Sciences, University of Turin, Corso Dogliotti 24, 10126, Turin, Italy
| | - Antonio Clemente
- Department of Surgical Sciences, University of Turin, Corso Dogliotti 24, 10126, Turin, Italy
| | - Alessandro Massè
- Department of Surgical Sciences, University of Turin, Corso Dogliotti 24, 10126, Turin, Italy
| | - Giorgio Burastero
- IRCCS Ospedale Galeazzi-Sant'Ambrogio, Via Cristina Belgioioso 173, 20157, Milan, Italy.
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Santopolo G, Clemente A, González-Freire M, Russell SM, Vaquer A, Barón E, Aranda M, Socias A, Del Castillo A, Borges M, de la Rica R. Plasma-induced nanoparticle aggregation for stratifying COVID-19 patients according to disease severity. Sens Actuators B Chem 2022; 373:132638. [PMID: 36124254 PMCID: PMC9476366 DOI: 10.1016/j.snb.2022.132638] [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] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/06/2022] [Indexed: 06/15/2023]
Abstract
Stratifying patients according to disease severity has been a major hurdle during the COVID-19 pandemic. This usually requires evaluating the levels of several biomarkers, which may be cumbersome when rapid decisions are required. In this manuscript we show that a single nanoparticle aggregation test can be used to distinguish patients that require intensive care from those that have already been discharged from the intensive care unit (ICU). It consists of diluting a platelet-free plasma sample and then adding gold nanoparticles. The nanoparticles aggregate to a larger extent when the samples are obtained from a patient in the ICU. This changes the color of the colloidal suspension, which can be evaluated by measuring the pixel intensity of a photograph. Although the exact factor or combination of factors behind the different aggregation behavior is unknown, control experiments demonstrate that the presence of proteins in the samples is crucial for the test to work. Principal component analysis demonstrates that the test result is highly correlated to biomarkers of prognosis and inflammation that are commonly used to evaluate the severity of COVID-19 patients. The results shown here pave the way to develop nanoparticle aggregation assays that classify COVID-19 patients according to disease severity, which could be useful to de-escalate care safely and make a better use of hospital resources.
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Key Words
- AST, aspartate aminotransferaseALT, alanine aminotransferase
- Alb, albumin
- C1.75, protein concentration 1.75 × 10-4 g·dL-1
- CPImin, protein concentration at PImin
- CRP, C-reactive protein
- Colorimetric
- Creat, creatinine
- D-D, D-dimer
- Ferr, ferritin
- GGT, gamma-glutamyl transferase
- Glu, glucose
- Gold
- Hb, hemoglobin
- ICU, intensive care unit
- INR, international normalized ratio (prothrombin time)
- LDH, lactate dehydrogenase
- LSPR, localized surface plasmon resonance
- MCV, mean corpuscular volume
- MPV, mean platelet volume
- Mono, monocytes
- NIR, near-infrared
- NLR, neutrophil-to-lymphocyte ratio
- NTA, nanoparticle tracking analysis
- PDW, platelet distribution width
- PI, pixel intensity
- PI1.75, pixel intensity at C1.75
- PIdil, pixel intensity at plasma dilution 1:31250
- PImin, minimum value of pixel intensity
- PLR, platelet-to-lymphocyte ratio
- Plasmonic
- RBC, red blood cells
- RDW, red cell distribution width
- SARS-CoV-2
- Sepsis
- TG, triglycerides
- TotProt, total protein concentration
- WBC, white blood cells
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Affiliation(s)
- Giulia Santopolo
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- University of the Balearic Islands (UIB), Chemistry Department, 07122 Palma, Spain
| | - Antonio Clemente
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Marta González-Freire
- Translational Research In Aging and Longevity (TRIAL) group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Steven M Russell
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Andreu Vaquer
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- University of the Balearic Islands (UIB), Chemistry Department, 07122 Palma, Spain
| | - Enrique Barón
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - María Aranda
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, 07198 Palma, Spain
| | - Antonia Socias
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, 07198 Palma, Spain
| | - Alberto Del Castillo
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, 07198 Palma, Spain
| | - Marcio Borges
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, 07198 Palma, Spain
| | - Roberto de la Rica
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), 28029 Madrid, Spain
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9
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Santopolo G, Clemente A, Rojo-Molinero E, Fernández S, Álvarez MC, Oliver A, de la Rica R. Improved cytometric analysis of untouched lung leukocytes by enzymatic liquefaction of sputum samples. Biol Proced Online 2022; 24:17. [PMID: 36396988 PMCID: PMC9673301 DOI: 10.1186/s12575-022-00181-z] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/02/2022] [Indexed: 11/19/2022] Open
Abstract
Background Phenotyping sputum-resident leukocytes and evaluating their functional status are essential analyses for exploring the cellular basis of pathological processes in the lungs, and flow cytometry is widely recognized as the gold-standard technique to address them. However, sputum-resident leukocytes are found in respiratory samples which need to be liquefied prior to cytometric analysis. Traditional liquefying procedures involve the use of a reducing agent such as dithiothreitol (DTT) in temperature-controlled conditions, which does not homogenize respiratory samples efficiently and impairs cell viability and functionality. Methods Here we propose an enzymatic method that rapidly liquefies samples by means of generating O2 bubbles with endogenous catalase. Sputum specimens from patients with suspected pulmonary infection were treated with DTT, the enzymatic method or PBS. We used turbidimetry to compare the liquefaction degree and cell counts were determined using a hemocytometer. Finally, we conducted a comparative flow cytometry study for evaluating frequencies of sputum-resident neutrophils, eosinophils and lymphocytes and their activation status after liquefaction. Results Enzymatically treated samples were better liquefied than those treated with DTT or PBS, which resulted in a more accurate cytometric analysis. Frequencies of all cell subsets analyzed within liquefied samples were comparable between liquefaction methods. However, the gentle cell handling rendered by the enzymatic method improves cell viability and retains in vivo functional characteristics of sputum-resident leukocytes (with regard to HLA-DR, CD63 and CD11b expression). Conclusion In conclusion, the proposed enzymatic liquefaction method improves the cytometric analysis of respiratory samples and leaves the cells widely untouched for properly addressing functional analysis of lung leukocytes. Supplementary Information The online version contains supplementary material available at 10.1186/s12575-022-00181-z.
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10
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Santopolo G, Clemente A, Rojo-Molinero E, Oliver A, Noé C, de la Rica R. Rapid Identification and Classification of Pathogens That Produce Carbapenemases and Cephalosporinases with a Colorimetric Paper-Based Multisensor. Anal Chem 2022; 94:9442-9449. [PMID: 35748103 DOI: 10.1021/acs.analchem.2c01724] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Infections caused by bacteria that produce β-lactamases (BLs) are a major problem in hospital settings. The phenotypic detection of these bacterial strains requires culturing samples prior to analysis. This procedure may take up to 72 h, and therefore it cannot be used to guide the administration of the first antibiotic regimen. Here, we propose a multisensor for identifying pathogens bearing different types of β-lactamases above the infectious dose threshold within 90 min that does not require culturing samples. Instead, bacterial cells are preconcentrated in the cellulose scaffold of a paper-based multisensor. Then, 12 assays are performed in parallel to identify whether the pathogens produce carbapenemases and/or cephalosporinases, including metallo-β-lactamases, extended-spectrum β-lactamases (ESBLs), and AmpC enzymes. The multisensor generates an array of colored spots that can be quantified with image processing software and whose interpretation leads to the detection of the different enzymes depending on their specificity toward the hydrolysis of certain antibiotics, and/or their pattern of inhibition or cofactor activation. The test was validated for the diagnosis of urinary tract infections. The inexpensive paper platform along with the uncomplicated colorimetric readout makes the proposed prototypes promising for developing fully automated platforms for streamlined clinical diagnosis.
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Affiliation(s)
- Giulia Santopolo
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca 07120, Spain.,Department of Chemistry, University of the Balearic Islands, Palma de Mallorca 07122, Spain
| | - Antonio Clemente
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca 07120, Spain
| | - Estrella Rojo-Molinero
- Microbiology Department, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca 07120, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid 28029, Spain
| | - Antonio Oliver
- Microbiology Department, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca 07120, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid 28029, Spain
| | - Camilla Noé
- Dipartimento di Scienza Applicata e Tecnologia, Politecnico di Torino (POLITO), Torino 10129, Italy
| | - Roberto de la Rica
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca 07120, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid 28029, Spain
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11
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Morales-Arráez D, Ventura-Cots M, Altamirano J, Abraldes JG, Cruz-Lemini M, Thursz MR, Atkinson SR, Sarin SK, Kim W, Chavez-Araujo R, Higuera-de la Tijera MF, Singal AK, Shah VH, Kamath PS, Duarte-Rojo A, Charles EA, Vargas V, Jager M, Rautou PE, Rincon D, Zamarripa F, Restrepo-Gutiérrez JC, Torre A, Lucey MR, Arab JP, Mathurin P, Louvet A, García-Tsao G, González JA, Verna EC, Brown RS, Argemi J, Fernández-Carrillo C, Clemente A, Alvarado-Tapias E, Forrest E, Allison M, Bataller R. Correction to: The MELD Score Is Superior to the Maddrey Discriminant Function Score to Predict Short-Term Mortality in Alcohol-Associated Hepatitis: A Global Study. Am J Gastroenterol 2022; 117:818. [PMID: 35501978 DOI: 10.14309/ajg.0000000000001704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- D Morales-Arráez
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
- Department of Gastroenterology and Hepatology, Hospital Universitario de Canarias, Canarias, Spain
| | - M Ventura-Cots
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
| | - J Altamirano
- Department of Internal Medicine, Hospital Quironsalud, Barcelona, Spain
| | - J G Abraldes
- Division of Gastroenterology, Liver Unit, University of Alberta, Edmonton, Canada
| | - M Cruz-Lemini
- Women and Perinatal Research Group, Obstetrics and Gynecology Department, Sant Pau University Hospital, Barcelona, Spain, and Maternal and Child Health and Development Network (SAMID, RD16/0022/0015), Instituto de Salud Carlos III, Spanish Ministry of Health, Spain
| | - M R Thursz
- Department of Metabolism, Digestive Disease and Reproduction, Imperial College London, London, UK
| | - S R Atkinson
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
- Department of Metabolism, Digestive Disease and Reproduction, Imperial College London, London, UK
| | - S K Sarin
- Department of Hepatology, Institute of Liver & Biliary Sciences, New Delhi, India
| | - W Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - R Chavez-Araujo
- Hospital das Clinicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - A K Singal
- Division of Gastroenterology and Hepatology, the University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - V H Shah
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - P S Kamath
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - A Duarte-Rojo
- Division of Gastroenterology and Hepatology, Department of Medicine, the University of Arkansas for Medical Science, Little Rock, Arkansas, USA
| | - E A Charles
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
| | - V Vargas
- Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Universidad Autónoma, Barcelona, CIBERehd, Barcelona, Spain
| | - M Jager
- Service d'Hépatologie, Centre de Référence des Maladies Vasculaires du Foie, DHU Unity, Pôle des Maladies de l'Appareil Digestif, Hôpital Beaujon, AP-HP, Clichy, France
| | - P E Rautou
- Service d'Hépatologie, Centre de Référence des Maladies Vasculaires du Foie, DHU Unity, Pôle des Maladies de l'Appareil Digestif, Hôpital Beaujon, AP-HP, Clichy, France
- Inserm, UMR-970, Paris Cardiovascular Research Center, PARCC, Paris, France
| | - D Rincon
- Hepatology Department, Hospital General Universitario Gregorio Marañón, CIBERehd and Universidad Complutense, Madrid, Spain
| | - F Zamarripa
- Gastroenterology, Juarez Hospital, Mexico City, Mexico
| | - J C Restrepo-Gutiérrez
- Liver Transplant Program, Hospital Pablo Tobon Uribe, University of Antioquia, Medellin, Colombia
| | - A Torre
- Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - M R Lucey
- Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - J P Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - P Mathurin
- Service des Maladies de l'Appareil Digestif et de la Nutrition, CHU Lille, Lille, France
- LIRIC-Lille Inflammation Research International Center-U995, Univ. Lille, Inserm, CHU Lille, Lille, France
| | - A Louvet
- Service des Maladies de l'Appareil Digestif et de la Nutrition, CHU Lille, Lille, France
| | - G García-Tsao
- Section of Digestive Diseases, Yale University School of Medicine/VA-CT Healthcare System, New Haven/West Haven, Connecticut¸ USA
| | - J A González
- Gastroenterology Department, Hospital Universitario "Dr. José E González" Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - E C Verna
- Division of Digestive and Liver Diseases, Department of Medicine and Center for Liver Disease and Transplantation, Columbia University Irving Medical Center, New York, New York, USA
| | - R S Brown
- Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, New York, USA
| | - J Argemi
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
- Liver Unit, Clinica Universidad de Navarra, IdisNA, Pamplona, Spain
| | - C Fernández-Carrillo
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
| | - A Clemente
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
- Liver Unit and Digestive Department H.G.U. Gregorio Marañón, Madrid, Spain
- CIBERehd, Instituto de Salud Carlos III, Madrid, Spain
| | - E Alvarado-Tapias
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
| | - E Forrest
- Glasgow Royal Infirmary, Glasgow, UK
| | - M Allison
- Liver Unit, Cambridge Biomedical Research Centre, Cambridge, UK
| | - R Bataller
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
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12
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Navarro-Selma B, Clemente A, Nicolás JF, Crespo J, Carratalá A, Lucarelli F, Giardi F, Galindo N, Yubero E. Size segregated ionic species collected in a harbour area. Chemosphere 2022; 294:133693. [PMID: 35063561 DOI: 10.1016/j.chemosphere.2022.133693] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/22/2021] [Accepted: 01/17/2022] [Indexed: 06/14/2023]
Abstract
Water-soluble ions were analysed in size segregated aerosol samples collected in the port of Alicante (Southeastern Spain) during summer and winter using a multistage cascade impactor. Seasonal variations in the size distributions of the analysed components and the influence of bulk materials handling (loading/unloading and stockpiling) at the docks were investigated. The size distributions of SO42-, NH4+ and K+ were characterized by prominent peaks in the condensation and droplet modes, both in summer and winter, while those of Ca2+, Na+, Mg2+ and Cl- had a main peak centred at ∼4 μm. Although oxalate size distributions were similar during both seasons, the fraction of coarse-mode oxalate increased in summer most likely as a result of volatilization and repartition processes or reactions of oxalic acid with coarse alkaline particles. Nitrate size distributions were dominated by a coarse mode; however, during winter, modal peaks in the submicron size range were also observed due to favourable conditions for the formation of fine-mode NH4NO3. Harbour activities had a significant impact only on the concentrations of calcium, particularly in the coarse fraction, during both summer and winter.
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Affiliation(s)
- B Navarro-Selma
- Atmospheric Pollution Laboratory (LCA), Department of Applied Physics, Miguel Hernández University, Avenida de la Universidad S/N, 03202, Elche, Spain
| | - A Clemente
- Atmospheric Pollution Laboratory (LCA), Department of Applied Physics, Miguel Hernández University, Avenida de la Universidad S/N, 03202, Elche, Spain
| | - J F Nicolás
- Atmospheric Pollution Laboratory (LCA), Department of Applied Physics, Miguel Hernández University, Avenida de la Universidad S/N, 03202, Elche, Spain
| | - J Crespo
- Atmospheric Pollution Laboratory (LCA), Department of Applied Physics, Miguel Hernández University, Avenida de la Universidad S/N, 03202, Elche, Spain
| | - A Carratalá
- Department of Chemical Engineering, University of Alicante, P. O. Box 99, 03080, Alicante, Spain
| | - F Lucarelli
- Department of Physics and Astronomy, University of Florence and INFN, 50019, Florence, Italy
| | - F Giardi
- Department of Physics and Astronomy, University of Florence and INFN, 50019, Florence, Italy
| | - N Galindo
- Atmospheric Pollution Laboratory (LCA), Department of Applied Physics, Miguel Hernández University, Avenida de la Universidad S/N, 03202, Elche, Spain
| | - E Yubero
- Atmospheric Pollution Laboratory (LCA), Department of Applied Physics, Miguel Hernández University, Avenida de la Universidad S/N, 03202, Elche, Spain.
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13
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Russell SM, Alba-Patiño A, Vaquer A, Clemente A, de la Rica R. Improving the Quantification of Colorimetric Signals in Paper-Based Immunosensors with an Open-Source Reader. Sensors 2022; 22:s22051880. [PMID: 35271026 PMCID: PMC8914853 DOI: 10.3390/s22051880] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 02/01/2023]
Abstract
Measuring the colorimetric signals produced by the biospecific accumulation of colorimetric probes and recording the results is a key feature for next-generation paper-based rapid tests. Manual processing of these tests is time-consuming and prone to a loss of accuracy when interpreting faint and patchy signals. Proprietary, closed-source readers and software companies offering automated smartphone-based assay readings have both been criticized for interoperability issues. Here, we introduce a minimal reader prototype composed of open-source hardware and open-source software that has the benefits of automatic assay quantification while avoiding the interoperability issues associated with closed-source readers. An image-processing algorithm was developed to automate the selection of an optimal region of interest and measure the average pixel intensity. When used to quantify signals produced by lateral flow immunoassays for detecting antibodies against SARS-CoV-2, results obtained with the proposed algorithm were comparable to those obtained with a manual method but with the advantage of improving the precision and accuracy when quantifying small spots or faint and patchy signals.
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Affiliation(s)
- Steven M. Russell
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain; (A.A.-P.); (A.V.); (R.d.l.R.)
- Correspondence: (S.M.R.); (A.C.)
| | - Alejandra Alba-Patiño
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain; (A.A.-P.); (A.V.); (R.d.l.R.)
- Chemistry Department, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
| | - Andreu Vaquer
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain; (A.A.-P.); (A.V.); (R.d.l.R.)
- Chemistry Department, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
| | - Antonio Clemente
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain; (A.A.-P.); (A.V.); (R.d.l.R.)
- Correspondence: (S.M.R.); (A.C.)
| | - Roberto de la Rica
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain; (A.A.-P.); (A.V.); (R.d.l.R.)
- CIBER de Enfermedades Infecciosas (CIBERINFEC), 28029 Madrid, Spain
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14
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Morales-Arráez D, Ventura-Cots M, Altamirano J, Abraldes JG, Cruz-Lemini M, Thursz MR, Atkinson SR, Sarin SK, Kim W, Chavez-Araujo R, Higuera-de la Tijera MF, Singal AK, Shah VH, Kamath PS, Duarte-Rojo A, Charles EA, Vargas V, Jager M, Rautou PE, Rincon D, Zamarripa F, Restrepo-Gutiérrez JC, Torre A, Lucey MR, Arab JP, Mathurin P, Louvet A, García-Tsao G, González JA, Verna EC, Brown RS, Argemi J, Fernández-Carrillo C, Clemente A, Alvarado-Tapias E, Forrest E, Allison M, Bataller R. The MELD Score Is Superior to the Maddrey Discriminant Function Score to Predict Short-Term Mortality in Alcohol-Associated Hepatitis: A Global Study. Am J Gastroenterol 2022; 117:301-310. [PMID: 34962498 PMCID: PMC8999152 DOI: 10.14309/ajg.0000000000001596] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 10/27/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Several scoring systems predict mortality in alcohol-associated hepatitis (AH), including the Maddrey discriminant function (mDF) and model for end-stage liver disease (MELD) score developed in the United States, Glasgow alcoholic hepatitis score in the United Kingdom, and age, bilirubin, international normalized ratio, and creatinine score in Spain. To date, no global studies have examined the utility of these scores, nor has the MELD-sodium been evaluated for outcome prediction in AH. In this study, we assessed the accuracy of different scores to predict short-term mortality in AH and investigated additional factors to improve mortality prediction. METHODS Patients admitted to hospital with a definite or probable AH were recruited by 85 tertiary centers in 11 countries and across 3 continents. Baseline demographic and laboratory variables were obtained. The primary outcome was all-cause mortality at 28 and 90 days. RESULTS In total, 3,101 patients were eligible for inclusion. After exclusions (n = 520), 2,581 patients were enrolled (74.4% male, median age 48 years, interquartile range 40.9-55.0 years). The median MELD score was 23.5 (interquartile range 20.5-27.8). Mortality at 28 and 90 days was 20% and 30.9%, respectively. The area under the receiver operating characteristic curve for 28-day mortality ranged from 0.776 for MELD-sodium to 0.701 for mDF, and for 90-day mortality, it ranged from 0.773 for MELD to 0.709 for mDF. The area under the receiver operating characteristic curve for mDF to predict death was significantly lower than all other scores. Age added to MELD obtained only a small improvement of AUC. DISCUSSION These results suggest that the mDF score should no longer be used to assess AH's prognosis. The MELD score has the best performance in predicting short-term mortality.
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Affiliation(s)
- D Morales-Arráez
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
- Department of Gastroenterology and Hepatology, Hospital Universitario de Canarias, Canarias, Spain
| | - M Ventura-Cots
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
| | - J Altamirano
- Department of Internal Medicine, Hospital Quironsalud, Barcelona, Spain
| | - J G Abraldes
- Division of Gastroenterology, Liver Unit, University of Alberta, Edmonton, Canada
| | - M Cruz-Lemini
- Women and Perinatal Research Group, Obstetrics and Gynecology Department, Sant Pau University Hospital, Barcelona, Spain, and Maternal and Child Health and Development Network (SAMID, RD16/0022/0015), Instituto de Salud Carlos III, Spanish Ministry of Health, Spain
| | - M R Thursz
- Department of Metabolism, Digestive disease and Reproduction, Imperial College London, UK
| | - S R Atkinson
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
- Department of Metabolism, Digestive disease and Reproduction, Imperial College London, UK
| | - S K Sarin
- Department of Hepatology, Institute of Liver & Biliary Sciences, New Delhi, India
| | - W Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - R Chavez-Araujo
- Hospital das Clinicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - A K Singal
- Division of Gastroenterology and Hepatology, the University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - V H Shah
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - P S Kamath
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - A Duarte-Rojo
- Division of Gastroenterology and Hepatology, Department of Medicine, the University of Arkansas for Medical Science, Little Rock, Arkansas, USA
| | - E A Charles
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
| | - V Vargas
- Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Universidad Autónoma, Barcelona, CIBERehd, Barcelona, Spain
| | - M Jager
- Service d'Hépatologie, Centre de Référence des Maladies Vasculaires du Foie, DHU Unity, Pôle des Maladies de l'Appareil Digestif, Hôpital Beaujon, AP-HP, Clichy, France
| | - P E Rautou
- Service d'Hépatologie, Centre de Référence des Maladies Vasculaires du Foie, DHU Unity, Pôle des Maladies de l'Appareil Digestif, Hôpital Beaujon, AP-HP, Clichy, France
- Inserm, UMR-970, Paris Cardiovascular Research Center, PARCC, Paris, France
| | - D Rincon
- Hepatology Department, Hospital General Universitario Gregorio Marañón, CIBERehd and Universidad Complutense, Madrid, Spain
| | - F Zamarripa
- Gastroenterology, Juarez Hospital, Mexico City, Mexico
| | - J C Restrepo-Gutiérrez
- Liver Transplant Program, Hospital Pablo Tobon Uribe, University of Antioquia, Medellin, Colombia
| | - A Torre
- Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - M R Lucey
- Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - J P Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - P Mathurin
- Service des Maladies de l'Appareil Digestif et de la Nutrition, CHU Lille, Lille, France
- LIRIC-Lille Inflammation Research International Center-U995, Univ. Lille, Inserm, CHU Lille, Lille, France
| | - A Louvet
- Service des Maladies de l'Appareil Digestif et de la Nutrition, CHU Lille, Lille, France
| | - G García-Tsao
- Section of Digestive Diseases, Yale University School of Medicine/VA-CT Healthcare System, New Haven/West Haven, Connecticut¸ USA
| | - J A González
- Gastroenterology Department, Hospital Universitario "Dr. José E González" Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - E C Verna
- Division of Digestive and Liver Diseases, Department of Medicine and Center for Liver Disease and Transplantation, Columbia University Irving Medical Center, New York, New York, USA
| | - R S Brown
- Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, New York, USA
| | - J Argemi
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
- Liver Unit, Clinica Universidad de Navarra, IdisNA. Pamplona, Spain
| | - C Fernández-Carrillo
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
| | - A Clemente
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
- Liver Unit and Digestive Department H.G.U. Gregorio Marañón, Madrid, Spain
- CIBERehd, Instituto de Salud Carlos III, Madrid, Spain
| | - E Alvarado-Tapias
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
| | - E Forrest
- Glasgow Royal Infirmary, Glasgow, UK
| | - M Allison
- Liver Unit, Cambridge Biomedical Research Centre, Cambridge, UK
| | - R Bataller
- Division of Gastroenterology, Hepatology and Nutrition, Pittsburgh Liver Research Center, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
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Alessio-Mazzola M, Clemente A, Russo A, Mertens P, Burastero G, Formica M, Felli L. Clinical radiographic outcomes and survivorship of medial pivot design total knee arthroplasty: a systematic review of the literature. Arch Orthop Trauma Surg 2022; 142:3437-3448. [PMID: 34633511 PMCID: PMC9522696 DOI: 10.1007/s00402-021-04210-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 09/29/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Total knee arthroplasty is a reliable procedure able to reduce pain and disability in patients suffering from osteoarthritis. However, a considerable percentage of patients still experiences unsatisfactory results. Medial pivot total knee arthroplasty has been introduced in the clinical practice to overcome problems related with classic design implants and better mimic native knee kinematics. The aim of this study was to analyze survivorship and clinical and radiographic outcomes of medial pivot implants. METHODS A systematic research was conducted in eight different databases. Thirty-four studies met the inclusion criteria and were included in the analysis. Data on objective and patients-reported outcomes, radiographic alignment, and survivorship were collected and analyzed. Revision rate was expressed as revision per 100 components years. RESULT A total of 3377 procedures were included. Mean follow-up was 85.7 months (range, 12-182). The revision per 100 components years was 0.19, which corresponds to a revision rate of 1.9% after 10 years. Mean post-operative range of motion was 117.3 ± 0.4°. Mean clinical and functional Knee Society Score were, respectively, 85.9 ± 1.1 and 84.7 ± 3.5 at final follow-up. Post-operative femorotibial alignment was 177.1 ± 0.5°. Alfa and beta angles were 95.7 ± 0.1° and 89.2 ± 0.1°, respectively. Gamma and delta angles were 2.3 ± 0.6° and 86.7 ± 0.4°. CONCLUSION Medial pivoting implants provided excellent survivorship and low revision rate, as well as good-to-excellent results in term of objective and patient-reported clinical outcomes, and reliable correction of radiographic parameters. More high-quality studies with long-term follow-up are needed to clarify the role of medial pivoting implants.
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Affiliation(s)
- Mattia Alessio-Mazzola
- Orthopedic Clinic, Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy.
- Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Viale Benedetto XV 6, 16132, Genoa, Italy.
| | - Antonio Clemente
- Orthopedic Clinic, Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Viale Benedetto XV 6, 16132, Genoa, Italy
| | - Antonio Russo
- Orthopedic Clinic, Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Viale Benedetto XV 6, 16132, Genoa, Italy
| | - Peter Mertens
- Orthopaedics and Traumatology Department, ZNA Middelheim, Antwerp, Belgium
| | - Giorgio Burastero
- Centro di Chirurgia Protesica, Istituto Ortopedico Galeazzi IRCCS, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Matteo Formica
- Orthopedic Clinic, Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Viale Benedetto XV 6, 16132, Genoa, Italy
| | - Lamberto Felli
- Istituto Ortopedico Galeazzi IRCCS Chirurgia Articolare Sostitutiva e Chirurgia Ortopedica, Via Riccardo Galeazzi 4, 20161, Milan, Italy
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Santopolo G, Clemente A, Aranda M, Socias A, del Castillo A, Chica A, Borges M, de la Rica R. Colorimetric Detection of Sepsis-Derived Hyperdegranulation with Plasmonic Nanosensors. ACS Sens 2021; 6:4443-4450. [PMID: 34793672 DOI: 10.1021/acssensors.1c01884] [Citation(s) in RCA: 3] [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] [Indexed: 12/16/2022]
Abstract
Hyperdegranulation of neutrophilic granulocytes is a common finding in sepsis that directly contributes to the heightened immune response leading to organ dysfunction. Currently, cell degranulation is detected by flow cytometry, which requires large infrastructure that is not always available at the point of care. Here, we propose a plasmonic assay for detecting the degranulation status of septic cells colorimetrically. It is based on triggering the aggregation of gold nanoparticles with cationic granule proteins. Cells from septic patients contain fewer granules and therefore release less cationic proteins than healthy cells. This results in red-colored assays than can be easily detected by eye. The assay can selectively detect cationic granule proteins even in the presence of an excess of unrelated proteins, which is key to detect degranulation with high specificity. Coupling this signal generation mechanism with a magnetic purification step enabled the identification of septic cells with the same performance as flow cytometry. This makes the proposed method a promising alternative for diagnosing sepsis in decentralized healthcare schemes.
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Affiliation(s)
- Giulia Santopolo
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Chemistry Department, University of the Balearic Islands (UIB), 07122 Palma, Spain
| | - Antonio Clemente
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Maria Aranda
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, 07198 Palma, Spain
| | - Antonia Socias
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, 07198 Palma, Spain
| | - Alberto del Castillo
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, 07198 Palma, Spain
| | - Aniceta Chica
- Immunology Department, Son Espases University Hospital, 07120 Palma, Spain
| | - Marcio Borges
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, 07198 Palma, Spain
| | - Roberto de la Rica
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
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Clemente A, Alba-Patiño A, Santopolo G, Barón E, Rojo-Molinero E, Oliver A, Pérez-Bárcena J, Merino de Cos P, Aranda M, Del Castillo A, Socias A, Borges M, de la Rica R. Optimized detection of lung IL-6 via enzymatic liquefaction of low respiratory tract samples: application for managing ventilated patients. Analyst 2021; 146:6537-6546. [PMID: 34581315 DOI: 10.1039/d1an00763g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Lung IL-6 is a promising biomarker for predicting respiratory failure during pulmonary infections. This biomarker is found in respiratory samples which need to be liquefied prior to analysis. Traditional liquefying methods use reducing agents such as dithiothreitol (DTT). However, DTT impairs immunodetection and does not liquefy highly viscous samples. We propose an enzymatic method that liquefies samples by means of generating O2 bubbles with endogenous catalase. Low respiratory tract specimens from 48 mechanically ventilated patients (38 with SARS-CoV-2 infection) were treated with DTT or with the enzymatic method. We used turbidimetry to compare the liquefaction degree and IL-6 was quantified with ELISA. Finally, we used AUC-ROC, time-to-event and principal component analysis to evaluate the association between respiratory compromise or local inflammation and IL-6 determined with both methods. Enzymatically treated samples were better liquefied than those reduced by DTT, which resulted in higher ELISA signals. Lung IL-6 levels obtained with the enzymatic procedure were negatively correlated with the oxygenation index (PaO2/FiO2) and the time of mechanical ventilation. The proposed enzymatic liquefaction method improves the sensitivity for lung IL-6 detection in respiratory samples, which increases its predictive power as a biomarker for evaluating respiratory compliance.
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Affiliation(s)
- Antonio Clemente
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain.
| | - Alejandra Alba-Patiño
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain. .,Balearic Islands University, Chemistry Department, Palma de Mallorca, Spain
| | - Giulia Santopolo
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain. .,Balearic Islands University, Chemistry Department, Palma de Mallorca, Spain
| | - Enrique Barón
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain.
| | - Estrella Rojo-Molinero
- Microbiology Department, Son Espases University Hospital, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Antonio Oliver
- Microbiology Department, Son Espases University Hospital, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Jon Pérez-Bárcena
- Intensive Care Department, Son Espases University Hospital, Palma de Mallorca, Spain
| | | | - María Aranda
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, Palma de Mallorca, Spain
| | - Alberto Del Castillo
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, Palma de Mallorca, Spain
| | - Antonia Socias
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, Palma de Mallorca, Spain
| | - Marcio Borges
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain. .,Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, Palma de Mallorca, Spain
| | - Roberto de la Rica
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain. .,Balearic Islands University, Chemistry Department, Palma de Mallorca, Spain
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18
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Vaquer A, Alba-Patiño A, Adrover-Jaume C, Russell SM, Aranda M, Borges M, Mena J, Del Castillo A, Socias A, Martín L, Arellano MM, Agudo M, Gonzalez-Freire M, Besalduch M, Clemente A, Barón E, de la Rica R. Nanoparticle transfer biosensors for the non-invasive detection of SARS-CoV-2 antigens trapped in surgical face masks. Sens Actuators B Chem 2021; 345:130347. [PMID: 34188360 PMCID: PMC8225299 DOI: 10.1016/j.snb.2021.130347] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/07/2021] [Accepted: 06/22/2021] [Indexed: 05/08/2023]
Abstract
Detecting SARS-CoV-2 antigens in respiratory tract samples has become a widespread method for screening new SARS-CoV-2 infections. This requires a nasopharyngeal swab performed by a trained healthcare worker, which puts strain on saturated healthcare services. In this manuscript we describe a new approach for non-invasive COVID-19 diagnosis. It consists of using mobile biosensors for detecting viral antigens trapped in surgical face masks worn by patients. The biosensors are made of filter paper containing a nanoparticle reservoir. The nanoparticles transfer from the biosensor to the mask on contact, where they generate colorimetric signals that are quantified with a smartphone app. Sample collection requires wearing a surgical mask for 30 min, and the total assay time is shorter than 10 min. When tested in a cohort of 27 patients with mild or no symptoms, an area under the receiving operating curve (AUROC) of 0.99 was obtained (96.2 % sensitivity and 100 % specificity). Serial measurements revealed a high sensitivity and specificity when masks were worn up to 6 days after diagnosis. Surgical face masks are inexpensive and widely available, which makes this approach easy to implement anywhere. The excellent sensitivity, even when tested with asymptomatic patient samples, along with the mobile detection scheme and non-invasive sampling procedure, makes this biosensor design ideal for mass screening.
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Affiliation(s)
- Andreu Vaquer
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
| | - Alejandra Alba-Patiño
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
- University of the Balearic Islands, Chemistry Department, Palma de Mallorca, Spain
| | - Cristina Adrover-Jaume
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
- University of the Balearic Islands, Chemistry Department, Palma de Mallorca, Spain
| | - Steven M Russell
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
| | - María Aranda
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llatzer University Hospital, Spain
| | - Marcio Borges
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llatzer University Hospital, Spain
| | - Joana Mena
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llatzer University Hospital, Spain
| | - Alberto Del Castillo
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llatzer University Hospital, Spain
| | - Antonia Socias
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llatzer University Hospital, Spain
| | - Luisa Martín
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
- Emergency Department, Son Llatzer University Hospital, Spain
| | - María Magdalena Arellano
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
- Emergency Department, Son Llatzer University Hospital, Spain
| | - Miguel Agudo
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
- Emergency Department, Son Llatzer University Hospital, Spain
| | - Marta Gonzalez-Freire
- Translational Research In Aging and Longevity (TRIAL) Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
| | - Manuela Besalduch
- Servicio de Prevención de Riesgos Laborales, Servei de Salut Illes Balears, Spain
| | - Antonio Clemente
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
| | - Enrique Barón
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
| | - Roberto de la Rica
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
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Romeo MR, Baroni M, Berti S, Bianchi G, Margaryan R, Solinas M, Clemente A, Chiappino D, Bevilacqua S, Megaro M. Primary mitral valve regurgitation scheduled for cardiac surgery: no longer need for coronary angiography? A clinical retrospective & HTA analysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
In patients (pts) undergoing cardiac surgery for primary mitral regurgitation (PMR), coronary angiography (CA) is always scheduled shortly before surgery to rule out significant coronary artery disease (CAD), despite this population is often young and with relatively low risk for CAD. Computed Tomography Coronary Angiography (CTCA) could be an alternative approach to evaluate coronary arteries, at least ruling out significant CAD in selected pts, due to its high negative predictive value.
Purpose
A safer, more appropriate and efficient clinical and diagnostic pathway for patients undergoing cardiac surgery for PMR by stratifying patients prior cardiac surgery according to pretest probability score (PTP) and therefore shifting imaging of epicardial coronary arteries from invasive to noninvasive in specific patients subsets.
Methods
A retrospective analysis (Jan 2014–Dec 2020) was carried out through the extraction of 7343 electronic medical records of pts who underwent cardiac valve surgery. In 1556 pts with PMR (1195 with no-CAD and 361 with CAD) a PTP was retrospectively calculated according to Genders, 2012, to stratify their risk of CAD.
A Decision oriented Health Technology Assessment (DoHTA) and a cost analysis were also performed to support the analysis results. A survey was distributed to a team of experts with a multidisciplinary background to analyze the most significant evaluation areas (Economic Aspects, Clinical Effectiveness, Safety, Innovation) and the sub-criteria related to them.
Following the Core Model Eunethta as a guideline, a Rapid Report HTA has been drawn up to identify the best solution.
Results
Patients characteristics are listed in Picture 1. Pts with normal coronary arteries showed a PTP low-to intermediate while pts with high PTP had CAD and therefore had a real pretest need for a CA (average 11 percent ± 9 in noCAD group vs 20 percent ± 14 in the CAD group). In two thirds of PMR population coronary angiography could have been avoided according to a PTP score <15 percent.
The cost analysis results were significantly lower in CTCA (1,315.00 EUR vs 180.00 EUR, CA vs CTCA respectively), The Decision Oriented HTA conducted by a multidisciplinary team showed a relevant preference for the new pathway (Picture 2) with a score of 70.23 percent of preference among the Team.
Conclusions
This new pathway, already proposed for selected pts in ESC guidelines on valve diseases (class IIA, LOE C) could be always adopted in PMR pts with low-to intermediate PTP score undergoing cardiac surgery. It could improve workflow efficiency and reduce LOS, and last but not least, avoid an invasive test, reduce radiation exposure and AKI risk in in a relatively young population
The DoHTA provided a more effective and efficient support to the decision-making process.
Funding Acknowledgement
Type of funding sources: None. Picture 1. Patients characteristics (noCAD-CAD)Picture 2. HTA Score CTCA vs CA
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Affiliation(s)
- M R Romeo
- Fondazione Toscana Gabriele Monasterio, HTA Innovation Lab, Pisa, Italy
| | - M Baroni
- Fondazione Toscana Gabriele Monasterio, Clinical Risk Management, Pisa, Italy
| | - S Berti
- Fondazione Toscana Gabriele Monasterio, Invasive Cardiology Unit, Pisa, Italy
| | - G Bianchi
- Fondazione Toscana Gabriele Monasterio, Cardiac Surgery Dpt, Pisa, Italy
| | - R Margaryan
- Fondazione Toscana Gabriele Monasterio, Cardiac Surgery Dpt, Pisa, Italy
| | - M Solinas
- Fondazione Toscana Gabriele Monasterio, Cardiac Surgery Dpt, Pisa, Italy
| | - A Clemente
- Fondazione Toscana Gabriele Monasterio, Radiology Dpt, Pisa, Italy
| | - D Chiappino
- Fondazione Toscana Gabriele Monasterio, Radiology Dpt, Pisa, Italy
| | - S Bevilacqua
- Fondazione Toscana Gabriele Monasterio, Management Control, Pisa, Italy
| | - M Megaro
- Fondazione Toscana Gabriele Monasterio, Management Control, Pisa, Italy
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Caselli C, De Caterina R, Smit JEFF, El Mahdiui M, Ragusa R, Clemente A, Sampietro T, Clerico A, Liga R, Pelosi G, Rocchiccioli S, Parodi O, Scholte A, Knuuti J, Neglia D. Elevated triglycerides and low HDL cholesterol predict coronary heart disease risk in patients with stable angina. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): The EVINCI study was supported by a grant from the European Union FP7-CP-FP506 2007 project (GA 222915). The SMARTool study was supported by a grant from the European Union H2020-PHC-30-2015 (GA 689068). This study was also partially supported by a grant from AMGEN (Protocol N. 20167781, 2017).
Background. High triglycerides (TG) and low high-density lipoprotein cholesterol (HDL-C) characterize an atherosclerotic cardiovascular disease (CAD) risk condition defined as atherogenic dyslipidemia.
Aim. To assess whether atherogenic dyslipidemia defined by TG/HDL-C ratio predicts CAD related outcomes in patients with stable angina, independently of other risk factors and treatments.
Methods. We studied 355 patients (60 ± 9 y, 211m) with stable angina from the EVINCI Outcome study. Patients were characterized for clinical, bio-humoral and imaging profiles, managed clinically, and followed for 4.5 ± 0.9 years. A computed tomography angiography (CTA) coronary risk score was obtained at baseline in all patients, and at follow-up in 154 of them. The primary composite outcome was all-cause mortality and non-fatal myocardial infarction. CTA scan was repeated at follow-up in 154 patients to assess CAD progression.
Results. The median value of TG/HDL-C ratio was 2.095 (2.079IQR). At baseline, the proportion of males, smoking, diabetes and metabolic syndrome, as well as circulating bio-markers of abnormal glucose metabolism and myocardial damage progressively increased across quartiles of TG/HDL-C ratio. The CTA score was significantly higher in the IV quartile of the TG/HDL-C ratio and both were the only independent predictors of the primary (CTA Score: HR 1.06, 95%CI 1.03-1.09, p = 0.001; TG/HDL-C IV quartile: HR 2.85, 95%CI 1.30-6.26, p < 0.01). In the 154 patients re-evaluated at follow-up, TG/HDL-C ratio associated cardio-metabolic disorder, systemic inflammation and CTA risk score progressed over time despite increased use of lipid-lowering drugs, anti-diabetics and other cardioactive medications and reduction in LDL-C levels.
Conclusions. In patients with stable angina, the TG/HDL-C ratio expresses a cardio-metabolic atherogenic disorder which is progressive over time and is associated with CAD related outcomes independently of LDL-C levels and treatments.
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Affiliation(s)
- C Caselli
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - R De Caterina
- Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - JEFF Smit
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - M El Mahdiui
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - R Ragusa
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - A Clemente
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - T Sampietro
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - A Clerico
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - R Liga
- Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - G Pelosi
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | | | - O Parodi
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - A Scholte
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - J Knuuti
- University of Turku, Turku, Finland
| | - D Neglia
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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Russo A, Cavagnaro L, Chiarlone F, Clemente A, Romagnoli S, Burastero G. Clinical outcomes and survivorship of two-stage total hip or knee arthroplasty in septic arthritis: a retrospective analysis with a minimum five-year follow-up. Int Orthop 2021; 45:1683-1691. [PMID: 33774699 PMCID: PMC8266791 DOI: 10.1007/s00264-021-05013-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/17/2021] [Indexed: 11/26/2022]
Abstract
Purpose Septic arthritis of the native joint is challenging for orthopedic surgeons because it may lead to wide bone defects and severe impairment of joint function. This study aimed to analyze clinical functional outcomes, the rate of infection eradication, and survival of implants of patients who underwent two-stage arthroplasty for septic arthritis of the hip and knee. Methods A retrospective single-centre analysis was conducted of patients treated for septic arthritis of the hip and knee joints through a two-stage surgery between 2012 and 2015. Clinical and radiological records were gathered from the prospectively collected Institutional Arthroplasty Registry. Patients’ pre-operative Harris hip scores and Knee Society scores were compared with those obtained at the latest follow-up. Kaplan–Meier curves were generated to assess survival of implants. Results Forty-seven patients were included. The mean follow-up was 85.2 ± 15.4 months. The Harris hip score improved from 39.4 ± 9.9 to 84.5 ± 10.8 points (p < 0.001). The Knee Society score improved from 40.7 ± 8.4 to 86.0 ± 7.8 points (p < 0.001). Knee Society score-function increased from 25.7 ± 14.2 to 85.4 ± 23.4 points (p < 0.001). The infection eradication rates were 92.0% and 90.9% in patients who underwent hip and knee operation, respectively (p = 0.891). Overall survivorship of implants after the second stage was 93.6%. Conclusions Two-stage arthroplasty provides good to excellent clinical outcomes in cases of active septic arthritis of the hip and the knee, high rates of infection control, and implant survival.
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Affiliation(s)
- Antonio Russo
- Orthopaedic Clinic, Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genova, Italy.
- Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Viale Benedetto XV 6, 16132, Genoa, Italy.
| | - Luca Cavagnaro
- Joint Arthroplasty Unit, Orthopaedic and Traumatology 2, Santa Corona Hospital, Viale 25 Aprile 38, 17027, Pietra Ligure, Italy
| | - Francesco Chiarlone
- Joint Arthroplasty Unit, Orthopaedic and Traumatology 2, Santa Corona Hospital, Viale 25 Aprile 38, 17027, Pietra Ligure, Italy
| | - Antonio Clemente
- Department of Orthopedics and Traumatology, CTO Hospital, University of Turin, Via G. Zuretti 29, 10126, Turin, Italy
| | - Sergio Romagnoli
- Prosthetic Surgery Centre, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Giorgio Burastero
- Prosthetic Surgery Centre, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy
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Clemente A, Alba-Patiño A, Santopolo G, Rojo-Molinero E, Oliver A, Borges M, Aranda M, del Castillo A, de la Rica R. Immunodetection of Lung IgG and IgM Antibodies against SARS-CoV-2 via Enzymatic Liquefaction of Respiratory Samples from COVID-19 Patients. Anal Chem 2021; 93:5259-5266. [DOI: 10.1021/acs.analchem.1c00251] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Antonio Clemente
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca 07120, Spain
| | - Alejandra Alba-Patiño
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca 07120, Spain
- Chemistry Department, University of the Balearic Islands, Palma de Mallorca 07122, Spain
| | - Giulia Santopolo
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca 07120, Spain
- Chemistry Department, University of the Balearic Islands, Palma de Mallorca 07122, Spain
| | - Estrella Rojo-Molinero
- Microbiology Department, Son Espases University Hospital, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca 07120, Spain
| | - Antonio Oliver
- Microbiology Department, Son Espases University Hospital, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca 07120, Spain
| | - Marcio Borges
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca 07120, Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, Palma de Mallorca 07198, Spain
| | - María Aranda
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca 07120, Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, Palma de Mallorca 07198, Spain
| | - Alberto del Castillo
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca 07120, Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, Palma de Mallorca 07198, Spain
| | - Roberto de la Rica
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca 07120, Spain
- Chemistry Department, University of the Balearic Islands, Palma de Mallorca 07122, Spain
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23
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Adrover-Jaume C, Alba-Patiño A, Clemente A, Santopolo G, Vaquer A, Russell SM, Barón E, González Del Campo MDM, Ferrer JM, Berman-Riu M, García-Gasalla M, Aranda M, Borges M, de la Rica R. Paper biosensors for detecting elevated IL-6 levels in blood and respiratory samples from COVID-19 patients. Sens Actuators B Chem 2021; 330:129333. [PMID: 33519090 PMCID: PMC7833127 DOI: 10.1016/j.snb.2020.129333] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 05/05/2023]
Abstract
Decentralizing COVID-19 care reduces contagions and affords a better use of hospital resources. We introduce biosensors aimed at detecting severe cases of COVID-19 in decentralized healthcare settings. They consist of a paper immunosensor interfaced with a smartphone. The immunosensors have been designed to generate intense colorimetric signals when the sample contains ultralow concentrations of IL-6, which has been proposed as a prognosis biomarker of COVID-19. This is achieved by combining a paper-based signal amplification mechanism with polymer-filled reservoirs for dispensing antibody-decorated nanoparticles and a bespoken app for color quantification. With this design we achieved a low limit of detection (LOD) of 10-3 pg mL-1 and semi-quantitative measurements in a wide dynamic range between 10-3 and 102 pg mL-1 in PBS. The assay time is under 10 min. The low LOD allowed us to dilute blood samples and detect IL-6 with an LOD of 1.3 pg mL-1 and a dynamic range up to 102 pg mL-1. Following this protocol, we were able to stratify COVID-19 patients according to different blood levels of IL-6. We also report on the detection of IL-6 in respiratory samples (bronchial aspirate, BAS) from COVID-19 patients. The test could be easily adapted to detect other cytokines such as TNF-α and IL-8 by changing the antibodies decorating the nanoparticles accordingly. The ability of detecting cytokines in blood and respiratory samples paves the way for monitoring local inflammation in the lungs as well as systemic inflammation levels in the body.
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Affiliation(s)
- Cristina Adrover-Jaume
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120, Palma de Mallorca, Spain
- University of the Balearic Islands, Chemistry Department, Cra. de Valldemossa km 7.5, 07122, Palma de Mallorca, Spain
| | - Alejandra Alba-Patiño
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120, Palma de Mallorca, Spain
- University of the Balearic Islands, Chemistry Department, Cra. de Valldemossa km 7.5, 07122, Palma de Mallorca, Spain
| | - Antonio Clemente
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120, Palma de Mallorca, Spain
| | - Giulia Santopolo
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120, Palma de Mallorca, Spain
- University of the Balearic Islands, Chemistry Department, Cra. de Valldemossa km 7.5, 07122, Palma de Mallorca, Spain
| | - Andreu Vaquer
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120, Palma de Mallorca, Spain
| | - Steven M Russell
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120, Palma de Mallorca, Spain
| | - Enrique Barón
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120, Palma de Mallorca, Spain
| | - María Del Mar González Del Campo
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120, Palma de Mallorca, Spain
| | - Joana M Ferrer
- Immune Response in Human Pathology Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
- Immunology Department, Son Espases University Hospital, Spain Son Espases University Hospital, 07120, Palma de Mallorca, Spain
| | - María Berman-Riu
- Immune Response in Human Pathology Group, Health Research Institute of the Balearic Islands (IdISBa), Spain
| | - Mercedes García-Gasalla
- Infectious Diseases-HIV Group, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120, Palma de Mallorca, Spain
| | - María Aranda
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120, Palma de Mallorca, Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, 07198, Palma de Mallorca, Spain
| | - Marcio Borges
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120, Palma de Mallorca, Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, 07198, Palma de Mallorca, Spain
| | - Roberto de la Rica
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital, 07120, Palma de Mallorca, Spain
- University of the Balearic Islands, Chemistry Department, Cra. de Valldemossa km 7.5, 07122, Palma de Mallorca, Spain
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Pugliese NR, Buechel R, Coceani M, Clemente A, Kaufmann PA, Marzullo P, Gimelli A. Myocardial perfusion scintigraphy for risk stratification of patients with coronary artery disease: the AMICO registry. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
onbehalf
AMICO registry
Background. Clinical evidence promotes therapy titration based on patient risk stratification in coronary artery disease (CAD).
Purpose. We assessed the prognostic value of myocardial perfusion scintigraphy (MPS) with cadmium-zinc-telluride in addition to clinical and coronary anatomy analysis.
Methods and Results. We prospectively enrolled 1464 patients (26% females, 69.5 ± 10.4 years) referred for stress-rest MPS. All the patients underwent invasive coronary angiography (1171, 80%) or coronary computed tomography angiography (293, 20%). We defined a composite endpoint of cardiovascular death and non-fatal MI. After a median follow-up of 3.5 years (interquartile range 2 – 6 years), we observed 127 events (Table). Summed stress score (SSS) had the highest accuracy in predicting primary endpoint with a ROC-derived cut-off of SSS > 8 (>10% myocardium). SSS > 8 portended the lowest survival probability at Kaplan–Meier analysis (p < 0.0001; Figure A). The Cox-regression analysis indicated SSS as an independent predictor of the composite endpoint, along with fasting blood glucose and total cholesterol and contrary to coronary anatomy parameters. Patients with SSS > 8 treated with optimal medical therapy (OMT) had the largest area of necrosis, the lower ischemic burden, the most compromised LV systo-diastolic function and the highest LV mass, but received a less aggressive treatment in comparison to early revascularized patients. Survival analysis revealed patients with SSS ≤ 8 had the greater freedom from events, irrespective of the treatment strategy, while the group with SSS > 8 and OMT had the worst outcome, followed by patients with SSS > 8 and early revascolarization (log-rank test: all p < 0.0001). Plotting the estimates from proportional-hazard modelling against SSS (reference level: SSS = 4) shows a risk curve for the primary endpoint that increase for SSS > 4 and reach a plateau for values >12 (Figure B).
Conclusion. The extension of stress perfusion abnormalities constitutes a robust independent predictor of future adverse events after adjustment for multiple clinical parameters and coronary anatomy analysis. MPS could help refine risk stratification of patients with known or suspected CAD.
Primary and secondary endpoints Variable Total population (n = 1464) SSS > 8 (n = 591) SSS ≤ 8 (n = 873) Hazard Ratio (95% CI)* P-value* Primary endpoint 127 (9) 85 (14) 42 (5) 3.25 (2.25 - 4.70) <0.0001 Cardiovascular death 50 (3) 37 (6) 13 (1) 4.53 (2.41 - 8.51) <0.0001 Non-fatal MI 84 (6) 53 (9) 31 (4) 2.71 (1.75 - 4.22) <0.0001 *The hazard ratio is for the SSS > 8 group as compared with the summed stress score (SSS)≤8 group, and P-values were calculated by the log-rank test and are unadjusted for multiple variables. Abstract Figure
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Affiliation(s)
- NR Pugliese
- Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - R Buechel
- University Hospital Zurich, Zurich, Switzerland
| | - M Coceani
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - A Clemente
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - PA Kaufmann
- University Hospital Zurich, Zurich, Switzerland
| | - P Marzullo
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - A Gimelli
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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Adrover-Jaume C, Rojo-Molinero E, Clemente A, Russell SM, Arranz J, Oliver A, de la Rica R. Mobile origami immunosensors for the rapid detection of urinary tract infections. Analyst 2021; 145:7916-7921. [PMID: 33020772 DOI: 10.1039/d0an01218a] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Urinary tract infections (UTI) have a high prevalence and can yield poor patient outcomes if they progress to urosepsis. Here we introduce mobile origami biosensors that detect UTIs caused by E. coli at the bedside in less than 7 minutes. The origami biosensors are made of a single piece of paper that contains antibody-decorated nanoparticles. When the urine sample contains E. coli, the biosensors generate colored spots on the paper strip. These are then quantified with a mobile app that calculates the pixel intensity in real time. The tests are highly specific and do not cross-react with other common uropathogens. Furthermore, the biosensors only yielded one false negative result when queried with a panel containing 57 urine samples from patients, which demonstrates that they have excellent sensitivity and specificity. This, along with the rapid assay time and smartphone-based detection, makes them useful for aiding in the diagnosis of UTIs at the point of care.
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Affiliation(s)
- Cristina Adrover-Jaume
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain.
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Clemente A, Alba-Patiño A, Rojo-Molinero E, Russell SM, Borges M, Oliver A, de la Rica R. Rapid Detection of Pseudomonas aeruginosa Biofilms via Enzymatic Liquefaction of Respiratory Samples. ACS Sens 2020; 5:3956-3963. [PMID: 33232131 DOI: 10.1021/acssensors.0c01618] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Respiratory infections caused by multi-drug-resistant Pseudomonas aeruginosa often yield poor outcomes if not detected right away. However, detecting this pathogen in respiratory samples with a rapid diagnostic test is challenging because the protective biofilms created by the pathogen are themselves surrounded by a high-viscosity sputum matrix. Here, we introduce a method for liquefying respiratory samples and disrupting bacterial biofilms on the spot within a minute. It relies on the generation of oxygen bubbles by bacterial catalase through the addition of hydrogen peroxide. When coupled with a mobile biosensor made of paper, the resulting diagnostic kit was able to detect P. aeruginosa infections in sputa from patients with excellent sensitivity and specificity within 8 min. The quick turnaround time along with few infrastructure requirements make this method ideal for the rapid screening of P. aeruginosa infections at the point of care.
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Affiliation(s)
- Antonio Clemente
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Alejandra Alba-Patiño
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Estrella Rojo-Molinero
- Servicio de Microbiología, Hospital Son Espases, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Steven M. Russell
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Marcio Borges
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Multidisciplinary Sepsis Unit, ICU, Son Llàtzer University Hospital, 07198 Palma de Mallorca, Spain
| | - Antonio Oliver
- Servicio de Microbiología, Hospital Son Espases, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Roberto de la Rica
- Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
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Chiappino S, Della Latta D, Martini N, Ripoli A, Aimo A, Piagneri V, Susini C, Clemente A, Emdin M, Zanetti V, Battipaglia E, Chiappino D. Artificial intelligence applied to non-contrast-enhanced cardiac computed tomography for the prediction of cardiovascular events. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Non-contrast-enhanced cardiac computed tomography (CT) may provide two measures that are emerging as independent predictors of cardiovascular events: coronary calcium score (CCS) and the volume of epicardial fat, a metabolically and immunologically active tissue surrounding the coronary arteries. The quantification of epicardial fat volume (EFV) is not routinely performed in clinical practice for the long time required for image reconstruction and the intra- and inter-observer variability.
Purpose
We evaluated if artificial intelligence (AI) might prove a valuable tool to interpret the CT data-set, and to better understand the relative prognostic value of CCS and EFV compared to “traditional” cardiovascular risk factors.
Methods
The Montignoso HEart and Lung Project is a community-based study carried out in a small town of Northern Tuscany (Italy). Starting from 2009, asymptomatic individuals from the general population underwent a baseline screening including a non-contrast cardiac CT, and were followed-up. For the present study, CCS and EFV were automatically measured from CT scans through a deep learning (DL) strategy based on convolutional neural networks. Because of the low incidence of the primary endpoint (myocardial infarction [MI]), the observed cardiac events were predicted with a random forest model built using a subsampling approach.
Results
Study participants (n=1528; 48% males, age 40 to 77 years) experienced 47 MI events (3%) over 5.5±1.5 years. CCS and EFV independently predicted this endpoint (p values <0.001 and 0.005, respectively) in a model including other predictors, namely weight, age, male gender, and hypertension. The model displayed a good prognostic performance, with an out-of-bag accuracy of 80.43% (accuracy on non-event prediction: 81.17%; performance on event prediction: 57,45%). The CCS emerged as the most important predictor, followed by EFV, weight and age. Interestingly, the incidence of cardiovascular events linked with CCS levels was associated with elevated EFV and the subjects with elevated CCS values but low EFV had no events (figure 1).
Conclusions
The tools of AI allow to perform an automated analysis of non-contrast-enhanced CT scans, with rapid and accurate measurement of CCS and EFV through a DL approach. In asymptomatic individuals from the general population, these features are more predictive of non-fatal MI than other variables related to the cardiovascular risk, as we can be demonstrated through an application of AI.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Chiappino
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - D Della Latta
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - N Martini
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - A Ripoli
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - A Aimo
- Sant'Anna School of Advanced Studies, Pisa, Italy
| | - V Piagneri
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - C.L Susini
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - A Clemente
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - M Emdin
- Gabriele Monasterio Foundation-CNR Region Toscana, Pisa, Italy
| | - V Zanetti
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - E Battipaglia
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - D Chiappino
- Fondazione Toscana Gabriele Monasterio, Massa, Italy
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Alessio-Mazzola M, Repetto I, Russo A, Clemente A, Ventura N, Formica M, Burastero G, Felli L. Permanent Spacers Are a Reliable Solution for Peri-prosthetic Shoulder Infection: A Systematic Review. HSS J 2020; 16:272-279. [PMID: 33082722 PMCID: PMC7534885 DOI: 10.1007/s11420-020-09755-7] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 02/06/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Peri-prosthetic shoulder infection (PSI), a highly disabling complication of shoulder arthroplasty, often requires additional surgery and prolonged antibiotic therapy. Of strategies proposed to manage this devastating condition, the use of cement spacers, perhaps even as a definitive treatment, is debated. QUESTIONS/PURPOSES We sought to systematically review the literature on antibiotic-loaded cement spacers as a viable, perhaps definitive, treatment for PSI, evaluating the eradication rates, mechanical reliability, and functional results related to its use. METHODS We conducted a systematic review of studies published from January 1, 1980, through September 1, 2019. Following the Cochrane Handbook of Systematic Reviews of Interventions and Preferred Reporting Items for Systematic Review and Meta-analysis, we searched for studies reporting functional and clinical outcomes in patients with PSI treated with a permanent spacer of the shoulder. Two independent reviewers searched eight databases, as well as reference lists of the retrieved articles. RESULTS After exclusion criteria were applied, 12 studies were included, involving a total of 143 patients. The mean age was 65.8 years; the mean follow-up was 37.4 months. A total of 133 patients (93%) were free from infection at latest follow-up. The mean post-operative active elevation of the shoulder ranged from 48.6 to 90°, the mean abduction ranged from 51 to 75°, and external rotation ranged from 3.6 to 29°. The mean Constant-Murley score ranged from 20.6 to 42 points (out of 100, from worst to best). CONCLUSION The use of a permanent cement spacer is a reliable solution to PSI in low-demand, older patients with comorbidities, a population in whom it is desirable to avoid additional surgery. Our review found a high rate of infection eradication and moderate-to-good objective and subjective results. However, the overall level of evidence of included studies was very low, and higher-quality studies are needed to clarify the role of permanent spacers in the treatment of PSI.
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Affiliation(s)
- Mattia Alessio-Mazzola
- grid.5606.50000 0001 2151 3065Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Viale Benedetto XV, 6, 2° piano, 16132 Genoa, Italy ,Orthopedic Clinic, Ospedale Policlinico San Martino, Genoa, Italy
| | - Ilaria Repetto
- grid.5606.50000 0001 2151 3065Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Viale Benedetto XV, 6, 2° piano, 16132 Genoa, Italy ,Orthopedic Clinic, Ospedale Policlinico San Martino, Genoa, Italy
| | - Antonio Russo
- grid.5606.50000 0001 2151 3065Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Viale Benedetto XV, 6, 2° piano, 16132 Genoa, Italy ,Orthopedic Clinic, Ospedale Policlinico San Martino, Genoa, Italy
| | - Antonio Clemente
- grid.5606.50000 0001 2151 3065Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Viale Benedetto XV, 6, 2° piano, 16132 Genoa, Italy ,Orthopedic Clinic, Ospedale Policlinico San Martino, Genoa, Italy
| | - Niccolò Ventura
- grid.5606.50000 0001 2151 3065Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Viale Benedetto XV, 6, 2° piano, 16132 Genoa, Italy ,Orthopedic Clinic, Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Formica
- grid.5606.50000 0001 2151 3065Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Viale Benedetto XV, 6, 2° piano, 16132 Genoa, Italy ,Orthopedic Clinic, Ospedale Policlinico San Martino, Genoa, Italy
| | - Giorgio Burastero
- Joint Replacement Unit, Azienda Ospedaliera Santa Corona, Pietra Ligure, Italy
| | - Lamberto Felli
- grid.5606.50000 0001 2151 3065Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Viale Benedetto XV, 6, 2° piano, 16132 Genoa, Italy ,Orthopedic Clinic, Ospedale Policlinico San Martino, Genoa, Italy
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Fania L, Clemente A, Sampogna F, Mazzanti C, Pallotta S, Panebianco A, Sordi D, Caggiati A, Cassotta G, Tiezzi A, Cristiano L, Zecchi V, Napolitano M, Abeni D. Intralesional ultrasound‐guided combined treatment with triamcinolone plus lincomycin in hidradenitis suppurativa: A pilot study. Dermatol Ther 2020; 33:e13901. [DOI: 10.1111/dth.13901] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/25/2020] [Accepted: 06/19/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Luca Fania
- First Dermatology Unit IDI‐IRCCS Rome Italy
| | - Antonio Clemente
- Department of Anesthesia and Intensive Care IDI‐IRCCS Rome Italy
| | | | | | | | | | | | | | | | | | - Lara Cristiano
- Department of Radiology IDI‐IRCCS Rome Italy
- Department of Radiology Fondazione Policlinico Universitario “A. Gemelli IRCCS”, UCSC Rome Italy
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Fania L, Moro F, Clemente A, Sordi D, Scarabello A, Mazzanti C, Caggiati A, Zecchi V, Panebianco A, Cassotta G, Abeni D. Successful treatment of Sapho syndrome and hidradenitis suppurativa: A therapeutic challenge. Dermatol Ther 2020; 33:e13453. [PMID: 32319137 DOI: 10.1111/dth.13453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/12/2020] [Accepted: 04/19/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Luca Fania
- First Dermatology Unit, IDI-IRCCS via dei Monti di Creta 104, 00167, Rome, Italy
| | - Francesco Moro
- First Dermatology Unit, IDI-IRCCS via dei Monti di Creta 104, 00167, Rome, Italy
| | - Antonio Clemente
- Anesthesia and Intensive Care Department, IDI-IRCCS via dei Monti di Creta 104, 00167, Rome, Italy
| | - Donatella Sordi
- First Dermatology Unit, IDI-IRCCS via dei Monti di Creta 104, 00167, Rome, Italy
| | | | - Cinzia Mazzanti
- First Dermatology Unit, IDI-IRCCS via dei Monti di Creta 104, 00167, Rome, Italy
| | - Alessio Caggiati
- Plastic Surgery Unit, IDI-IRCCS via dei Monti di Creta 104, 00167, Rome, Italy
| | - Viola Zecchi
- Radiology Department, IDI-IRCCS via dei Monti di Creta 104, 00167, Rome, Italy
| | | | - Gabriella Cassotta
- Plastic Surgery Unit, IDI-IRCCS via dei Monti di Creta 104, 00167, Rome, Italy
| | - Damiano Abeni
- Clinical Epidemiology Unit, IDI-IRCCS via dei Monti di Creta 104, 00167, Rome, Italy
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Nabais P, Oliveira J, Pina F, Teixeira N, de Freitas V, Brás NF, Clemente A, Rangel M, Silva AMS, Melo MJ. A 1000-year-old mystery solved: Unlocking the molecular structure for the medieval blue from Chrozophora tinctoria, also known as folium. Sci Adv 2020; 6:eaaz7772. [PMID: 32426456 PMCID: PMC7164948 DOI: 10.1126/sciadv.aaz7772] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 01/22/2020] [Indexed: 05/25/2023]
Abstract
The molecular structure of the medieval watercolor known as folium has finally been solved in the 21st century. The interdisciplinary approach taken was the key to producing extracts that had been prepared following medieval instructions, and shows the blue/purple chromophore as the major dye in Chrozophora tinctoria fruits (shell). A multi-analytical characterization of its structure was made using HPLC-DAD-MS, GC-MS, NMR (1H, 13C, COSY, HSQC, HMBC, INADEQUATE), and computational studies. The results demonstrate that the blue compound corresponds to 6'-hydroxy-4,4'-dimethoxy-1,1'-dimethyl-5'-{[3,4,5-trihydroxy-6-(hydroxymethyl)tetrahydro-2H-pyran-2-yl]oxy}-[3,3'-bipyridine]-2,2',5,6(1H,1'H)-tetraone, a hermidin derivative, which we named chrozophoridin. Experimental data and computational modeling studies show that this mono-glycosylated dimer is represented by two stable isomers (atropisomers). This is an indispensable piece of knowledge for the characterization of this medieval dye in works of art such as medieval manuscript illuminations and for testing its stability and contributes to the preservation of our cultural heritage.
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Affiliation(s)
- P. Nabais
- REQUIMTE–Laboratório Associado para a Química Verde, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Campus Caparica, 2829-516 Monte de Caparica, Portugal
| | - J. Oliveira
- REQUIMTE–Laboratório Associado para a Química Verde, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre, s/n, 4169-007 Porto, Portugal
| | - F. Pina
- REQUIMTE–Laboratório Associado para a Química Verde, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Campus Caparica, 2829-516 Monte de Caparica, Portugal
| | - N. Teixeira
- REQUIMTE–Laboratório Associado para a Química Verde, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre, s/n, 4169-007 Porto, Portugal
| | - V. de Freitas
- REQUIMTE–Laboratório Associado para a Química Verde, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre, s/n, 4169-007 Porto, Portugal
| | - N. F. Brás
- REQUIMTE–UCIBIO, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre, s/n, 4169-007 Porto, Portugal
| | - A. Clemente
- cE3c–Centre for Ecology, Evolution and Environmental Changes, Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal
| | - M. Rangel
- REQUIMTE–Laboratório Associado para a Química Verde, Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto
| | - A. M. S. Silva
- REQUIMTE–Laboratório Associado para a Química Verde, Departamento de Química, and QOPNA, University of Aveiro, 3810-193 Aveiro, Portugal
| | - M. J. Melo
- REQUIMTE–Laboratório Associado para a Química Verde, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Campus Caparica, 2829-516 Monte de Caparica, Portugal
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Galindo N, Yubero E, Clemente A, Nicolás JF, Navarro-Selma B, Crespo J. Insights into the origin and evolution of carbonaceous aerosols in a mediterranean urban environment. Chemosphere 2019; 235:636-642. [PMID: 31276876 DOI: 10.1016/j.chemosphere.2019.06.202] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 04/15/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 06/09/2023]
Abstract
Organic carbon (OC) and elemental carbon (EC) concentrations were measured in PM1 and PM10 daily samples collected at an urban station in Elche (southeastern Spain) from February 2015 to February 2018. The effect of seasonal weather conditions, traffic, and specific pollution events (Saharan dust outbreaks and local pollution episodes) on the variability of carbonaceous aerosol levels was studied in this work. The joint contribution of carbonaceous species to PM1 and PM10 mass concentrations was, respectively, 48% and 26%. Both OC and EC concentrations were higher in winter than in summer because of the poor dispersion conditions and lower temperatures leading to the condensation of semivolatile species. Secondary organic carbon (SOC), estimated using the EC tracer method, also exhibited higher concentrations during winter, indicating that the prevailing meteorological conditions during the cold season are more favorable for the formation of secondary organic aerosols. Our results suggest different formation pathways of secondary organic components during summer and winter. At the sampling site, EC was primarily derived from traffic emissions, independently of the season and the type of event, with a modest contribution from biomass burning (<20%). The estimated contribution from this source to OC levels was similar. Local pollution episodes lead to a significant increase in the concentrations of carbonaceous species, in particular of SOC, influencing its temporal variation. On average, African dust outbreaks showed a moderate impact on the levels of carbonaceous aerosols; however, the effect was significantly stronger during winter Saharan events.
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Affiliation(s)
- N Galindo
- Atmospheric Pollution Laboratory (LCA), Department of Applied Physics, Miguel Hernández University, Avenida de La Universidad, S/N, 03202, Elche, Spain.
| | - E Yubero
- Atmospheric Pollution Laboratory (LCA), Department of Applied Physics, Miguel Hernández University, Avenida de La Universidad, S/N, 03202, Elche, Spain
| | - A Clemente
- Atmospheric Pollution Laboratory (LCA), Department of Applied Physics, Miguel Hernández University, Avenida de La Universidad, S/N, 03202, Elche, Spain
| | - J F Nicolás
- Atmospheric Pollution Laboratory (LCA), Department of Applied Physics, Miguel Hernández University, Avenida de La Universidad, S/N, 03202, Elche, Spain
| | - B Navarro-Selma
- Atmospheric Pollution Laboratory (LCA), Department of Applied Physics, Miguel Hernández University, Avenida de La Universidad, S/N, 03202, Elche, Spain
| | - J Crespo
- Atmospheric Pollution Laboratory (LCA), Department of Applied Physics, Miguel Hernández University, Avenida de La Universidad, S/N, 03202, Elche, Spain
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Renzulli M, Capozzi N, Clemente A, Tovoli F, Cappabianca S, Golfieri R. What happened to my liver lesion (Hepatic Sclerosed Hemangioma)? Let's not forget (radiological) history. Acta Gastroenterol Belg 2019; 82:554-555. [PMID: 31950819 DOI: pmid/31950819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- M Renzulli
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant'Orsola Hospital, University of Bologna, Bologna, Italy
| | - N Capozzi
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant'Orsola Hospital, University of Bologna, Bologna, Italy
| | - A Clemente
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - F Tovoli
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - S Cappabianca
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - R Golfieri
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant'Orsola Hospital, University of Bologna, Bologna, Italy
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Renzulli M, Ricciardi D, Clemente A, Tovoli F, Cappabianca S, Golfieri R. Unexpected newborns in the liver : hemangiomatosis onset after hepatic resection of a giant cavernous hemangioma. Acta Gastroenterol Belg 2019; 82:454-455. [PMID: 31566341 DOI: pmid/31566341] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- M Renzulli
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant'Orsola Hospital, University of Bologna, Bologna, Italy
| | - D Ricciardi
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant'Orsola Hospital, University of Bologna, Bologna, Italy
| | - A Clemente
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania 'L. Vanvitelli', Naples, Italy
| | - F Tovoli
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - S Cappabianca
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania 'L. Vanvitelli', Naples, Italy
| | - R Golfieri
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant'Orsola Hospital, University of Bologna, Bologna, Italy
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Tribuna L, Clemente A, Teixeira T, Sa Couto P, Oliveira P, Agostinho P. P418Cine short-axis image quality optimisation on 3T cardiac MR. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez118.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L Tribuna
- Hospital da Luz Aveiro, Radiology, Aveiro, Portugal
| | - A Clemente
- Hospital da Luz Coimbra, Radiology, Coimbra, Portugal
| | - T Teixeira
- Centro Hospitalar do Baixo Vouga, Cardiology, Aveiro, Portugal
| | | | - P Oliveira
- University Hospitals of Coimbra, Radiology, Coimbra, Portugal
| | - P Agostinho
- Instituto Português de Oncologia de Coimbra, Radiology, Coimbra, Portugal
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Clemente A, Ait Ali L, Avogliero F, Pak V, Squarcia U, Festa P. Subaortic ventricular pouch in repaired tetralogy of Fallot mimicking right coronary artery aneurysm. Diagn Interv Imaging 2018; 99:413-414. [DOI: 10.1016/j.diii.2018.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 01/15/2018] [Accepted: 02/01/2018] [Indexed: 12/01/2022]
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Cunill V, Massot M, Clemente A, Calles C, Andreu V, Núñez V, López-Gómez A, Díaz RM, Jiménez MDLR, Pons J, Vives-Bauzà C, Ferrer JM. Relapsing-Remitting Multiple Sclerosis Is Characterized by a T Follicular Cell Pro-Inflammatory Shift, Reverted by Dimethyl Fumarate Treatment. Front Immunol 2018; 9:1097. [PMID: 29896193 PMCID: PMC5986897 DOI: 10.3389/fimmu.2018.01097] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 05/02/2018] [Indexed: 12/22/2022] Open
Abstract
Multiple sclerosis (MS) is considered a T cell-mediated autoimmune disease, although several evidences also demonstrate a B cell involvement in its etiology. Follicular T helper (Tfh) cells, a CXCR5-expressing CD4+ T cell subpopulation, are essential in the regulation of B cell differentiation and maintenance of humoral immunity. Alterations in circulating (c)Tfh distribution and/or function have been associated with autoimmune diseases including MS. Dimethyl fumarate (DMF) is a recently approved first-line treatment for relapsing-remitting MS (RRMS) patients whose mechanism of action is not completely understood. The aim of our study was to compare cTfh subpopulations between RRMS patients and healthy subjects and evaluate the impact of DMF treatment on these subpopulations, relating them to changes in B cells and humoral response. We analyzed, by flow cytometry, the distribution of cTfh1 (CXCR3+CCR6-), cTfh2 (CXCR3-CCR6-), cTfh17 (CXCR3-CCR6+), and the recently described cTfh17.1 (CXCR3+CCR6+) subpopulations of CD4+ Tfh (CD45RA-CXCR5+) cells in a cohort of 29 untreated RRMS compared to healthy subjects. CD4+ non-follicular T helper (Th) cells (CD45RA-CXCR5-) were also studied. We also evaluated the effect of DMF treatment on these subpopulations after 6 and 12 months treatment. Untreated RRMS patients presented higher percentages of cTfh17.1 cells and lower percentages of cTfh2 cells consistent with a pro-inflammatory bias compared to healthy subjects. DMF treatment induced a progressive increase in cTfh2 cells, accompanied by a decrease in cTfh1 and the pathogenic cTfh17.1 cells. A similar decrease of non-follicular Th1 and Th17.1 cells in addition to an increase in the anti-inflammatory Th2 subpopulation were also detected upon DMF treatment, accompanied by an increase in naïve B cells and a decrease in switched memory B cells and serum levels of IgA, IgG2, and IgG3. Interestingly, this effect was not observed in three patients in whom DMF had to be discontinued due to an absence of clinical response. Our results demonstrate a possibly pathogenic cTfh pro-inflammatory profile in RRMS patients, defined by high cTfh17.1 and low cTfh2 subpopulations that is reverted by DMF treatment. Monitoring cTfh subsets during treatment may become a biological marker of DMF effectiveness.
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Affiliation(s)
- Vanesa Cunill
- Immunology Department, Hospital Universitari Son Espases, Palma, Spain.,Human Immunopathology Research Laboratory, Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma, Spain
| | - Margarita Massot
- Neurology Department, Hospital Universitari Son Espases, Palma, Spain
| | - Antonio Clemente
- Human Immunopathology Research Laboratory, Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma, Spain.,Clinical Trials and Methodology Support Platform, Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma, Spain
| | - Carmen Calles
- Neurology Department, Hospital Universitari Son Espases, Palma, Spain
| | - Valero Andreu
- Human Immunopathology Research Laboratory, Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma, Spain
| | - Vanessa Núñez
- Neurology Department, Hospital Universitari Son Espases, Palma, Spain
| | - Antonio López-Gómez
- Immunology Department, Hospital Universitari Son Espases, Palma, Spain.,Human Immunopathology Research Laboratory, Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma, Spain
| | - Rosa María Díaz
- Neurology Department, Hospital Universitari Son Espases, Palma, Spain
| | - María de Los Reyes Jiménez
- Immunology Department, Hospital Universitari Son Espases, Palma, Spain.,Human Immunopathology Research Laboratory, Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma, Spain
| | - Jaime Pons
- Immunology Department, Hospital Universitari Son Espases, Palma, Spain.,Human Immunopathology Research Laboratory, Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma, Spain
| | - Cristòfol Vives-Bauzà
- Research Unit, Institut d'Investigació Sanitària de les Illes Balears and Hospital Universitari Son Espases, Palma, Spain
| | - Joana Maria Ferrer
- Immunology Department, Hospital Universitari Son Espases, Palma, Spain.,Human Immunopathology Research Laboratory, Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma, Spain
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Singha S, Shao K, Yang Y, Clemente-Casares X, Solé P, Clemente A, Blanco J, Dai Q, Song F, Liu SW, Yamanouchi J, Umeshappa CS, Nanjundappa RH, Detampel P, Amrein M, Fandos C, Tanguay R, Newbigging S, Serra P, Khadra A, Chan WCW, Santamaria P. Peptide-MHC-based nanomedicines for autoimmunity function as T-cell receptor microclustering devices. Nat Nanotechnol 2017; 12:701-710. [PMID: 28436959 DOI: 10.1038/nnano.2017.56] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 03/06/2017] [Indexed: 05/23/2023]
Abstract
We have shown that nanoparticles (NPs) can be used as ligand-multimerization platforms to activate specific cellular receptors in vivo. Nanoparticles coated with autoimmune disease-relevant peptide-major histocompatibility complexes (pMHC) blunted autoimmune responses by triggering the differentiation and expansion of antigen-specific regulatory T cells in vivo. Here, we define the engineering principles impacting biological activity, detail a synthesis process yielding safe and stable compounds, and visualize how these nanomedicines interact with cognate T cells. We find that the triggering properties of pMHC-NPs are a function of pMHC intermolecular distance and involve the sustained assembly of large antigen receptor microclusters on murine and human cognate T cells. These compounds show no off-target toxicity in zebrafish embryos, do not cause haematological, biochemical or histological abnormalities, and are rapidly captured by phagocytes or processed by the hepatobiliary system. This work lays the groundwork for the design of ligand-based NP formulations to re-program in vivo cellular responses using nanotechnology.
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Affiliation(s)
- Santiswarup Singha
- Julia McFarlane Diabetes Research Centre (JMDRC) and Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Kun Shao
- Julia McFarlane Diabetes Research Centre (JMDRC) and Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Yang Yang
- Julia McFarlane Diabetes Research Centre (JMDRC) and Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Department of Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Xavier Clemente-Casares
- Julia McFarlane Diabetes Research Centre (JMDRC) and Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Patricia Solé
- Institut D'Investigacions Biomèdiques August Pi i Sunyer, Barcelona 08036, Spain
| | - Antonio Clemente
- Institut D'Investigacions Biomèdiques August Pi i Sunyer, Barcelona 08036, Spain
| | - Jesús Blanco
- Institut D'Investigacions Biomèdiques August Pi i Sunyer, Barcelona 08036, Spain
| | - Qin Dai
- Institute of Biomaterials and Biomedical Engineering, Departments of Chemistry, Chemical Engineering, and Materials Sciences and Engineering, Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, 164 College Street, Toronto, Ontario M5S 3G9, Canada
| | - Fayi Song
- Institute of Biomaterials and Biomedical Engineering, Departments of Chemistry, Chemical Engineering, and Materials Sciences and Engineering, Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, 164 College Street, Toronto, Ontario M5S 3G9, Canada
| | - Shang Wan Liu
- Department of Physiology, McGill University, McIntyre Medical Building, Montreal, Quebec H3G 1Y6, Canada
| | - Jun Yamanouchi
- Julia McFarlane Diabetes Research Centre (JMDRC) and Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Channakeshava Sokke Umeshappa
- Julia McFarlane Diabetes Research Centre (JMDRC) and Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Roopa Hebbandi Nanjundappa
- Julia McFarlane Diabetes Research Centre (JMDRC) and Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Pascal Detampel
- Departments of Cell Biology and Anatomy, and Pathology &Laboratory Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Matthias Amrein
- Departments of Cell Biology and Anatomy, and Pathology &Laboratory Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - César Fandos
- Institut D'Investigacions Biomèdiques August Pi i Sunyer, Barcelona 08036, Spain
| | - Robert Tanguay
- Environmental &Molecular Toxicology Sinnhuber Aquatic Research Laboratory, Oregon State University, Corvalis, Oregon 97333, USA
| | - Susan Newbigging
- Center for Modeling Human Disease, Toronto Centre for Phenogenomics, Lunenfeld Research Institute, 25 Orde Street, Toronto, Ontario M5T 3H7, Canada
| | - Pau Serra
- Institut D'Investigacions Biomèdiques August Pi i Sunyer, Barcelona 08036, Spain
| | - Anmar Khadra
- Department of Physiology, McGill University, McIntyre Medical Building, Montreal, Quebec H3G 1Y6, Canada
| | - Warren C W Chan
- Institute of Biomaterials and Biomedical Engineering, Departments of Chemistry, Chemical Engineering, and Materials Sciences and Engineering, Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, 164 College Street, Toronto, Ontario M5S 3G9, Canada
| | - Pere Santamaria
- Julia McFarlane Diabetes Research Centre (JMDRC) and Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Institut D'Investigacions Biomèdiques August Pi i Sunyer, Barcelona 08036, Spain
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Cunill V, Clemente A, Lanio N, Barceló C, Andreu V, Pons J, Ferrer JM. Follicular T Cells from smB - Common Variable Immunodeficiency Patients Are Skewed Toward a Th1 Phenotype. Front Immunol 2017; 8:174. [PMID: 28289412 PMCID: PMC5326800 DOI: 10.3389/fimmu.2017.00174] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 02/03/2017] [Indexed: 12/11/2022] Open
Abstract
Germinal center follicular T helper (GCTfh) cells are essential players in the differentiation of B cells. Circulating follicular T helper (cTfh) cells share phenotypic and functional properties with GCTfh cells. Distinct subpopulations of cTfh with different helper capabilities toward B cells can be identified: cTfh1 (CXCR3+CCR6−), cTfh2 (CXCR3−CCR6−), and cTfh17 (CXCR3−CCR6+). Alterations in cTfh function and/or distribution have been associated with autoimmunity, infectious diseases, and more recently, with several monogenic immunodeficiencies. Common variable immunodeficiency (CVID) disease is the commonest symptomatic primary immunodeficiency with a genetic cause identified in only 2–10% of patients. Although a heterogeneous disease, most patients show a characteristic defective B cell differentiation into memory B cells or antibody-secreting cells. We investigated if alterations in CVID cTfh cells frequency or distribution into cTfh1, cTfh2, and cTfh17 subpopulations and regulatory follicular T (Tfr) cells could be related to defects in CVID B cells. We found increased percentages of cTfh exhibiting higher programmed death-1 expression and altered subpopulations distribution in smB− CVID patients. In contrast to smB+ patients and controls, cTfh from smB− CVID patients show increased cTfh1 and decreased cTfh17 subpopulation percentages and increased CXCR3+CCR6+ cTfh, a population analogous to the recently described pathogenic Th17.1. Moreover, Tfr cells are remarkably decreased only in smB− CVID patients. In conclusion, increased cTfh17.1 and cTfh1/cTfh17 ratio in CVID patients could influence B cell fate in smB− CVID patients, with a more compromised B cell compartment, and the decrease in Tfr cells may lead to high risk of autoimmune conditions in CVID patients.
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Affiliation(s)
- Vanesa Cunill
- Immunology Department, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain; Human Immunopathology Research Laboratory, Institut d'Investigació Sanitària de Palma (IdISPa), Palma de Mallorca, Balearic Islands, Spain
| | - Antonio Clemente
- Immunology Department, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain; Human Immunopathology Research Laboratory, Institut d'Investigació Sanitària de Palma (IdISPa), Palma de Mallorca, Balearic Islands, Spain
| | - Nallibe Lanio
- Immunology Department, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain; Human Immunopathology Research Laboratory, Institut d'Investigació Sanitària de Palma (IdISPa), Palma de Mallorca, Balearic Islands, Spain
| | - Carla Barceló
- Immunology Department, Hospital Universitari Son Espases , Palma de Mallorca, Balearic Islands , Spain
| | - Valero Andreu
- Immunology Department, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain; Human Immunopathology Research Laboratory, Institut d'Investigació Sanitària de Palma (IdISPa), Palma de Mallorca, Balearic Islands, Spain
| | - Jaume Pons
- Immunology Department, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain; Human Immunopathology Research Laboratory, Institut d'Investigació Sanitària de Palma (IdISPa), Palma de Mallorca, Balearic Islands, Spain
| | - Joana M Ferrer
- Immunology Department, Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain; Human Immunopathology Research Laboratory, Institut d'Investigació Sanitària de Palma (IdISPa), Palma de Mallorca, Balearic Islands, Spain
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Moralejo E, Clemente A, Descals E, Belbahri L, Calmin G, Lefort F, Spies CF, McLeod A. Pythium recalcitranssp. nov. revealed by multigene phylogenetic analysis. Mycologia 2017. [DOI: 10.1080/15572536.2008.11832486] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - Enrique Descals
- Instituto Mediterráneo de Estudios Avanzados, IMEDEA (CSIC-UIB), Miquel Marquès 21, 07190, Esporles, Balearic Islands, Spain
| | | | | | - François Lefort
- Laboratory of Applied Genetics, School of Engineering of Lullier, University of Applied Sciences of Western Switzerland, 150 route de Presinge, 1254 Jussy, Switzerland
| | | | - Adele McLeod
- University of Stellenbosch, Department of Plant Pathology, Private Bag X1, Matieland 7602, South Africa
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Cunill V, Arboleya S, Jiménez MDLR, Campins A, Herbera P, Mestre LL, Clemente A, Barceló MI, Leyes M, Canellas F, Julià MR. Neuronal surface antibodies in HIV-infected patients with isolated psychosis. J Neuroimmunol 2016; 301:49-52. [PMID: 27836183 DOI: 10.1016/j.jneuroim.2016.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 07/20/2016] [Revised: 10/24/2016] [Accepted: 10/31/2016] [Indexed: 12/13/2022]
Abstract
Neuronal surface antibodies (NSA) involved in autoimmune encephalitis (AE) have been related to relapses in HVS encephalitis. Their role in non-encephalitic psychosis is controversial. We previously reported an HIV-infected patient, NSA-positive, only presenting psychosis. Therefore, we determined the NSA prevalence in a prospective cohort of 22 HIV-positive patients with psychosis and we analyzed the frequency of HIV infection among NSA tested patients due to AE suspicion. We found no NSA in the prospective cohort. In the retrospective analysis, 22% of NSA-positive versus 4.6% of negative patients were HIV-positive. Wider studies are required to clarify the relationship between NSA and HIV infection.
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Affiliation(s)
- Vanessa Cunill
- Department of Immunology, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120, Palma de Mallorca, Spain; Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain
| | - Susana Arboleya
- Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120, Palma de Mallorca, Spain; Faculty of Medicine, Universitat de Barcelona, Carrer de Casanova 143, 08036 Barcelona, Spain
| | - Maria de Los Reyes Jiménez
- Department of Immunology, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120, Palma de Mallorca, Spain; Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain.
| | - Antoni Campins
- Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain; Department of Internal Medicine, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120, Palma de Mallorca, Spain
| | - Patricia Herbera
- Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain; Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120, Palma de Mallorca, Spain
| | - LLuïsa Mestre
- Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain; Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120, Palma de Mallorca, Spain
| | - Antonio Clemente
- Department of Immunology, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120, Palma de Mallorca, Spain; Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain
| | - Maria Inés Barceló
- Department of Neurology, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120, Palma de Mallorca, Spain
| | - Maria Leyes
- Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain; Department of Internal Medicine, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120, Palma de Mallorca, Spain
| | - Francesca Canellas
- Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain; Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120, Palma de Mallorca, Spain
| | - Maria Rosa Julià
- Department of Immunology, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120, Palma de Mallorca, Spain; Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain
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Saceda-Corralo D, Grimalt R, Fernández-Crehuet P, Clemente A, Bernárdez C, García-Hernandez MJ, Arias-Santiago S, Rodrigues-Barata AR, Rodríguez-Pichardo A, García-Lora E, Jaén P, Camacho FM, Vañó-Galván S. Beard alopecia areata: a multicentre review of 55 patients. J Eur Acad Dermatol Venereol 2016; 31:187-192. [PMID: 27503140 DOI: 10.1111/jdv.13896] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 07/04/2016] [Indexed: 01/26/2023]
Abstract
BACKGROUND Alopecia areata on the beard area (BAA) is a common clinical manifestation, but there are no studies about its characteristics. OBJECTIVE To describe the epidemiology, comorbidities, clinical presentation, evolution, diagnostic findings and therapeutic choices in a series of patients with BAA. METHODS This retrospective multicentre review included patients diagnosed with BAA as the first and unique clinical manifestation with at least 12 months of follow-up. Diagnosis was performed based on the typical clinical features. Extra-beard involvement was monitored in all cases. RESULTS Overall, 55 male patients with a mean age of 39.1 years (range 20-74) were included. Twenty-five patients (45.5%) developed alopecia of the scalp during follow-up and more than 80% of cases appeared in the first 12.4 months. Clinical presentation of AA on the scalp was patchy AA (less than 5 patches) (52%), multifocal AA (28%), AA totalis (12%) and AA universalis (8%). Multivariate analysis revealed a trend of association between scalp involvement and family history of AA without statistical significance. CONCLUSIONS According to this study, BAA may progress to scalp AA in a significant number of patients (45.5% of the patients with a follow-up interval of at least 12 months). In the group of patients who developed scalp AA, 80% of them did it within the first 12 months, so follow-up of patients with BAA is highly encouraged.
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Affiliation(s)
| | - R Grimalt
- Dermatology Department, Universitat de Barcelona, Universitat Internacional de Catalunya, Madrid, Spain
| | - P Fernández-Crehuet
- Dermatology Department, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica (IMIBIC), Córdoba, Spain
| | - A Clemente
- Dermatology Department, Arrixaca-Murcia, Madrid, Spain
| | - C Bernárdez
- Dermatology Department, Fundación Jiménez Diaz-Madrid, Madrid, Spain
| | | | - S Arias-Santiago
- Dermatology Department, Complejo Hospitalario Universitario de Granada, Granada, Spain
| | - A R Rodrigues-Barata
- Dermatology Department, Ramon y Cajal Hospital, Madrid, Spain.,Dermatology Department, Grupo Pedro Jaén-Madrid, Madrid, Spain
| | | | - E García-Lora
- Dermatology Department, Hospital Virgen de las Nieves-Granada, Madrid, Spain
| | - P Jaén
- Dermatology Department, Ramon y Cajal Hospital, Madrid, Spain.,Dermatology Department, Grupo Pedro Jaén-Madrid, Madrid, Spain.,Department of Medicine and Medical Specialties, Faculty of Medicine, University of Alcala
| | - F M Camacho
- Dermatology Department, Hospital Virgen Macarena-Sevilla, Madrid, Spain
| | - S Vañó-Galván
- Dermatology Department, Ramon y Cajal Hospital, Madrid, Spain.,Dermatology Department, Grupo Pedro Jaén-Madrid, Madrid, Spain.,Department of Medicine and Medical Specialties, Faculty of Medicine, University of Alcala
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Arboleya S, Clemente A, Deng S, Bedmar M, Salvador I, Herbera P, Cunill V, Vives-Bauza C, Haro JM, Canellas F, Julià MR. Anti-NMDAR antibodies in new-onset psychosis. Positive results in an HIV-infected patient. Brain Behav Immun 2016; 56:56-60. [PMID: 26996305 DOI: 10.1016/j.bbi.2016.03.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 03/07/2016] [Accepted: 03/17/2016] [Indexed: 01/10/2023] Open
Abstract
The role of neuronal surface autoantibodies (NSAs) in non-encephalitic psychosis is of recent and controversial interest. Most of the studies relating NSAs with psychosis are retrospective and only focused on the N-methyl-d-aspartate glutamate receptor (NMDAR). Our goal was to evaluate the prevalence of IgG antibodies against the NMDAR NR1 subunit (NMDAR-Abs) along with five additional NSAs in 61 first psychotic episode patients and 47 matched controls. We found two patients positive for NMDAR-Abs (3.3%). One of them was eventually considered to have been misdiagnosed and reclassified as encephalitis. The other met the criteria for bipolar I disorder, presented no neurological symptoms and had a comorbid HIV infection of vertical transmission. This is the first reported case of an HIV-infected patient with psychosis associated with NSAs. This study shows that patients presenting with clinically incomplete forms of anti-NMDAR encephalitis, with predominant or isolated psychiatric symptoms, can remain undetected if no ancillary tests are performed. To improve patient diagnosis and treatment of individuals with a first psychotic episode, more detailed neurological examinations might be needed. Further studies are required to better clarify the role of NSAs in the neuropsychiatric effects of HIV infection.
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Affiliation(s)
- Susana Arboleya
- Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain; Faculty of Medicine, Universitat de Barcelona, C/Casanova 143, 08036 Barcelona, Spain.
| | - Antonio Clemente
- Department of Immunology, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain; Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain
| | - Savannah Deng
- Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain
| | - Marta Bedmar
- Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain
| | - Isabel Salvador
- Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain
| | - Patricia Herbera
- Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain
| | - Vanessa Cunill
- Department of Immunology, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain
| | - Cristòfol Vives-Bauza
- Research Unit, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain; Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu (PSSJD), CIBERSAM, C/Antoni Pujadas 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Faculty of Medicine, Universitat de Barcelona, C/Casanova 143, 08036 Barcelona, Spain
| | - Francesca Canellas
- Department of Psychiatry, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain; Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain
| | - Maria Rosa Julià
- Department of Immunology, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain; Institut d'Investigacio Sanitaria de Palma (IdISPa), Spain
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Scrimini S, Pons J, Agustí A, Clemente A, Sallán MC, Bauçà JM, Soriano JB, Cosio BG, Lopez M, Crespi C, Sauleda J. Expansion of myeloid-derived suppressor cells in chronic obstructive pulmonary disease and lung cancer: potential link between inflammation and cancer. Cancer Immunol Immunother 2015; 64:1261-70. [PMID: 26122358 PMCID: PMC11029165 DOI: 10.1007/s00262-015-1737-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 06/15/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a risk factor for lung cancer (LC). Myeloid-derived suppressor cells (MDSCs) down-regulate the T cell receptor ζ chain (TCR ζ) through L-arginine deprivation and lead to T cell dysfunction and deficient antitumor immunity. We hypothesized that abnormally high levels of MDSCs in COPD patients may alter tumor immunosurveillance. METHODS We compared the proportion of circulating MDSCs (Lin-HLA-DR-/CD33+/CD11b+) (by flow cytometry), arginase I (ARG I) serum levels (by ELISA), and expression levels of TCR ζ on circulating lymphocytes (by flow cytometry) in 28 patients with LC, 62 subjects with COPD, 41 patients with both LC and COPD, 40 smokers with normal spirometry and 33 non-smoking controls. T cell proliferation assays were performed in a subgroup of participants (CFSE dilution protocol). RESULTS We found that: (1) circulating MDSCs were up-regulated in COPD and LC patients (with and without COPD); (2) MDSCs expansion was associated with TCR ζ down-regulation in the three groups; (3) in LC patients, these findings were independent of COPD and tobacco smoking exposure; (4) TCR ζ down-regulation correlates with T cell hyporesponsiveness in COPD and LC patients. CONCLUSIONS These results suggest that tumor immunosurveillance might be impaired in COPD and may contribute to the increased risk of LC reported in these patients.
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Affiliation(s)
- Sergio Scrimini
- Instituto de Investigación Sanitaria de Palma, (IdISPa), Hospital Universitari Son Espases, C/Valldemossa 79, Planta 0, Mod. C, 07010 Palma de Mallorca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Palma de Mallorca, Spain
- Servicio de Neumología, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Jaume Pons
- Instituto de Investigación Sanitaria de Palma, (IdISPa), Hospital Universitari Son Espases, C/Valldemossa 79, Planta 0, Mod. C, 07010 Palma de Mallorca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Palma de Mallorca, Spain
- Servicio de Inmunología, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Alvar Agustí
- Instituto de Investigación Sanitaria de Palma, (IdISPa), Hospital Universitari Son Espases, C/Valldemossa 79, Planta 0, Mod. C, 07010 Palma de Mallorca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Palma de Mallorca, Spain
- Institut Clínic del Tòrax, Hospital Clinic, Institut D’investigacions Biomdiques August PI i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Antonio Clemente
- Instituto de Investigación Sanitaria de Palma, (IdISPa), Hospital Universitari Son Espases, C/Valldemossa 79, Planta 0, Mod. C, 07010 Palma de Mallorca, Spain
- Servicio de Inmunología, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Marta Crespí Sallán
- Instituto de Investigación Sanitaria de Palma, (IdISPa), Hospital Universitari Son Espases, C/Valldemossa 79, Planta 0, Mod. C, 07010 Palma de Mallorca, Spain
| | - Josep Miquel Bauçà
- Servicio de Análisis Clínicos, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Joan B. Soriano
- Instituto de Investigación Sanitaria de Palma, (IdISPa), Hospital Universitari Son Espases, C/Valldemossa 79, Planta 0, Mod. C, 07010 Palma de Mallorca, Spain
| | - Borja G. Cosio
- Instituto de Investigación Sanitaria de Palma, (IdISPa), Hospital Universitari Son Espases, C/Valldemossa 79, Planta 0, Mod. C, 07010 Palma de Mallorca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Palma de Mallorca, Spain
- Servicio de Neumología, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Meritxel Lopez
- Instituto de Investigación Sanitaria de Palma, (IdISPa), Hospital Universitari Son Espases, C/Valldemossa 79, Planta 0, Mod. C, 07010 Palma de Mallorca, Spain
- Servicio de Neumología, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Catalina Crespi
- Instituto de Investigación Sanitaria de Palma, (IdISPa), Hospital Universitari Son Espases, C/Valldemossa 79, Planta 0, Mod. C, 07010 Palma de Mallorca, Spain
| | - Jaume Sauleda
- Instituto de Investigación Sanitaria de Palma, (IdISPa), Hospital Universitari Son Espases, C/Valldemossa 79, Planta 0, Mod. C, 07010 Palma de Mallorca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Palma de Mallorca, Spain
- Servicio de Neumología, Hospital Universitari Son Espases, Palma de Mallorca, Spain
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Corzo N, Alonso JL, Azpiroz F, Calvo MA, Cirici M, Leis R, Lombó F, Mateos-Aparicio I, Plou FJ, Ruas-Madiedo P, Rúperez P, Redondo-Cuenca A, Sanz ML, Clemente A. [Prebiotics: concept, properties and beneficial effects]. NUTR HOSP 2015; 31 Suppl 1:99-118. [PMID: 25659062 DOI: 10.3305/nh.2015.31.sup1.8715] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Prebiotics are non-digestible food ingredients (oligosaccharides) that reach the colon and are used as substrate by microorganisms producing energy, metabolites and micronutrients used for the host; in addition they also stimulate the selective growth of certain beneficial species (mainly bifidobacteria and lactobacilli) in the intestinal microbiota. In this article, a multidisciplinary approach to understand the concept of prebiotic carbohydrates, their properties and beneficial effects in humans has been carried out. Definitions of prebiotics, reported by relevant international organizations and researchers, are described. A comprehensive description of accepted prebiotics having strong scientific evidence of their beneficial properties in humans (inulin-type fructans, FOS, GOS, lactulose and human milk oligosaccharides) is reported. Emerging prebiotics and those which are in the early stages of study have also included in this study. Taken into account that the chemical structure greatly influences carbohydrates prebiotic properties, the analytical techniques used for their analysis and characterization are discussed. In vitro and in vivo models used to evaluate the gastrointestinal digestion, absorption resistance and fermentability in the colon of prebiotics as well as major criteria to design robust intervention trials in humans are described. Finally, a comprehensive summary of the beneficial effects of prebiotics for health at systemic and intestinal levels is reported. The research effort on prebiotics has been intensive in last decades and has demonstrated that a multidisciplinary approach is necessary in order to claim their health benefits.
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Affiliation(s)
- N Corzo
- Departamento de Bioactividad y Análisis de Alimentos, Instituto de Investigación en Ciencias de la Alimentación, CIAL (CSIC-UAM) Madrid..
| | - J L Alonso
- Departamento de Ingeniería Química, Universidad de Vigo. Facultad de Ciencias, Campus de Ourense, Ourense
| | - F Azpiroz
- Servicio de Aparato Digestivo, Hospital Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona
| | - M A Calvo
- Grupo de investigación en Microbiología aplicada y medio-ambiental, Facultad de Veterinaria, Universidad Autónoma de Barcelona, Campus de Bellaterra, Barcelona
| | - M Cirici
- BENEO. Connecting nutrition and health, BENEO-Ibérica Barcelona
| | - R Leis
- Unidad de Gastroenterología, Hepatología y Nutrición Pediátrica, Dpto. Pediatría, Hospital Clínico Universitario de Santiago, Área de Gestión Integrada de Santiago, Universidad de Santiago de Compostela
| | - F Lombó
- Grupo de Investigación de Biotecnología y Terapia Experimental basada en Nutraceúticos (BITTEN), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Facultad de Medicina, Oviedo
| | - I Mateos-Aparicio
- Departamento de Nutrición y Bromatología II, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid
| | - F J Plou
- Grupo de Biocatálisis Aplicada, Instituto de Catálisis y Petroleoquímica, CSIC, Madrid
| | - P Ruas-Madiedo
- Departamento de Microbiología y Bioquímica de Productos Lácteos, Instituto de Productos Lácteos de Asturias - (IPLA-CSIC) Asturias
| | - P Rúperez
- Departamento de Metabolismo y Nutrición, Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC) Madrid
| | - A Redondo-Cuenca
- Departamento de Nutrición y Bromatología II, Bromatología, Facultad de Farmacia, Universidad Complutense de Madrid
| | - M L Sanz
- Departamento de Análisis Instrumental y Química Ambiental, Instituto de Química Orgánica General (CSIC), Madrid
| | - A Clemente
- Departamento de Fisiología y Bioquímica de la Nutrición Animal, Estación Experimental del Zaidin (CSIC), Granada. España
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Clemente A, Bergamin F, Surace C, Lepore E, Pugno N. Barbed suture vs conventional tenorrhaphy: biomechanical analysis in an animal model. J Orthop Traumatol 2015; 16:251-7. [PMID: 25628013 PMCID: PMC4559542 DOI: 10.1007/s10195-014-0333-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Accepted: 12/27/2014] [Indexed: 11/30/2022] Open
Abstract
Background The advantages of barbed suture for tendon repair could be to eliminate the need for a knot and to better distribute the load throughout the tendon so as to reduce the deformation at the repair site. The purpose of this study was to evaluate the breaking force and the repair site deformation of a new barbed tenorrhaphy technique in an animal model. Materials and methods Sixty porcine flexor tendons were divided randomly into three groups and repaired with one of the following techniques: a new 4-strand barbed technique using 2/0 polypropylene Quill™ SRS or 2/0 polydioxanone Quill™ SRS and a modified Kessler technique using 3/0 prolene. All tendons underwent mechanical testing to assess the 2-mm gap formation force, the breaking force and the mode of failure. The percentage change in tendon cross-sectional area before and after repair was calculated. Results The two-sample Student t-test demonstrated a significant increase in 2-mm gap formation force and in breaking force with barbed sutures, independently from suture material, when compared to traditional Kessler suture. Concerning the tendon profile, we registered less bunching at the repair site in the two barbed groups compared with the Kessler group. Conclusions This study confirms the promising results achieved in previous ex vivo studies about the use of barbed suture in flexor tendon repair. In our animal model, tenorrhaphy with Quill™ SRS suture guarantees a breaking force of repair that exceeds the 40–50 N suggested as sufficient to initiate early active motion, and a smoother profile at the repair site. Level of evidence Not applicable.
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Affiliation(s)
- A Clemente
- Department of Hand, Plastic and Reconstructive Surgery, Maria Vittoria Hospital, Turin, Italy
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Carli F, Clemente A. Regional anesthesia and enhanced recovery after surgery. Minerva Anestesiol 2014; 80:1228-1233. [PMID: 24492666] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Regional anesthesia is associated with recognized physiological advantages; however trials evaluating its impact on postoperative outcomes have shown contrasting results, probably because these effects have not been utilized in a multimodal perioperative care program. Enhanced recovery has attracted clinical interest because of its standardized, coordinated, multidisciplinary perioperative care plan that incorporates several evidenced-based interventions with positive influence on postoperative patient recovery. A critical analysis of the published evidence is here presented in order to understand the role of regional anesthesia and analgesia as part of the multidisciplinary components of the enhanced recovery program. Clearly, there are synergistic benefits derived from integrating specific regional anesthetic and analgesic techniques with other perioperative elements characteristic of a particular surgical procedure. This challenge requires a team approach in delivering such integrated care, ultimately providing the best cure for patient.
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Affiliation(s)
- F Carli
- Department of Anesthesia, McGill University Health Centre, Montreal, Canada -
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Canellas F, Lin L, Julià MR, Clemente A, Vives-Bauza C, Ollila HM, Hong SC, Arboleya SM, Einen MA, Faraco J, Fernandez-Vina M, Mignot E. Dual cases of type 1 narcolepsy with schizophrenia and other psychotic disorders. J Clin Sleep Med 2014; 10:1011-8. [PMID: 25142772 DOI: 10.5664/jcsm.4040] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Cases of narcolepsy in association with psychotic features have been reported but never fully characterized. These patients present diagnostic and treatment challenges and may shed new light on immune associations in schizophrenia. METHOD Our case series was gathered at two narcolepsy specialty centers over a 9-year period. A questionnaire was created to improve diagnosis of schizophrenia or another psychotic disorder in patients with narcolepsy. Pathophysiological investigations included full HLA Class I and II typing, testing for known systemic and intracellular/synaptic neuronal antibodies, recently described neuronal surface antibodies, and immunocytochemistry on brain sections to detect new antigens. RESULTS Ten cases were identified, one with schizoaffective disorder, one with delusional disorder, two with schizophreniform disorder, and 6 with schizophrenia. In all cases, narcolepsy manifested first in childhood or adolescence, followed by psychotic symptoms after a variable interval. These patients had auditory hallucinations, which was the most differentiating clinical feature in comparison to narcolepsy patients without psychosis. Narcolepsy therapy may have played a role in triggering psychotic symptoms but these did not reverse with changes in narcolepsy medications. Response to antipsychotic treatment was variable. Pathophysiological studies did not reveal any known autoantibodies or unusual brain immunostaining pattern. No strong HLA association outside of HLA DQB1*06:02 was found, although increased DRB3*03 and DPA1*02:01 was notable. CONCLUSION Narcolepsy can occur in association with schizophrenia, with significant diagnostic and therapeutic challenges. Dual cases maybe under diagnosed, as onset is unusually early, often in childhood. Narcolepsy and psychosis may share an autoimmune pathology; thus, further investigations in larger samples are warranted.
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Nogueira A, Mendes A, Ferreira D, Aragão J, Clemente A, Lopes M, Fonseca J, Ferreira R, Veríssimo M, Carvalho A. P415: The very elderly in the Emergency Department - a retrospective study. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70579-0] [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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Mendes A, Ferreira D, Lopes M, Clemente A, Fonseca J, Ferreira R, Pina P, Verissimo T, Carvalho S. P003: Elderly complexity: one complaint, several hypothesis, more than one cause. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70182-2] [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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