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Ríos A, Ruiz-Pardo J, Balaguer-Román A, Puñal JA, Moreno P, Mercader E, Ferrero E, Morlán MA, Martín J, Durán M, Bravo JM, Casanova D, Salvador-Egea MP, Torregrosa NM, Exposito-Rodríguez A, Martínez-Fernández G, Carrión AM, Vidal O, Herrera F, Ruiz-Merino G, Rodríguez JM. Is unicentric familial papillary thyroid microcarcinoma different from multicentric? Endocrine 2023; 82:613-621. [PMID: 37490266 DOI: 10.1007/s12020-023-03455-y] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/13/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Familial papillary thyroid microcarcinoma (FPTMC) appears to be more aggressive than sporadic papillary thyroid microcarcinoma (SPTMC). However, there are authors who indicate that unicentric FPTMC has a similar prognosis to SPTMC. The objective is to analyze whether unicentric FPTMC has a better prognosis than multicentric FPTMC. DESIGN AND METHODS Type of study: National multicenter longitudinal analytical observational study. STUDY POPULATION Patients with FPTMC. STUDY GROUPS Two groups were compared: Group A (unicentric FPTMC) vs. Group B (multicentric FPTMC). STUDY VARIABLES It is analyzed whether between the groups there are: a) differentiating characteristics; and b) prognostic differences. STATISTICAL ANALYSIS Cox regression analysis and survival analysis. RESULTS Ninety-four patients were included, 44% (n = 41) with unicentric FPTMC and 56% (n = 53) with multicentric FPTMC. No differences were observed between the groups according to socio-familial, clinical or histological variables. In the group B a more aggressive treatment was performed, with higher frequency of total thyroidectomy (99 vs. 78%; p = 0.003), lymph node dissection (41 vs. 15%; p = 0.005) and therapy with radioactive iodine (96 vs. 73%; p = 0.002). Tumor stage was similar in both groups (p = 0.237), with a higher number of T3 cases in the group B (24 vs. 5%; p = 0.009). After a mean follow-up of 90 ± 68.95 months, the oncological results were similar, with a similar disease persistence rate (9 vs. 5%; p = 0.337), disease recurrence rate (21 vs. 8%; p = 0.159) and disease-free survival (p = 0.075). CONCLUSIONS Unicentric FPTMC should not be considered as a SPTMC due to its prognosis is similar to multicentric FPTMC.
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Affiliation(s)
- A Ríos
- Unidad de Cirugía Endocrina. Servicio de Cirugía General y de Aparato Digestivo. Instituto Murciano de Investigación Bio-Sanitaria (IMIB-Arrixaca). Hospital Clínico Universitario Virgen de la Arrixaca, Servicio Murciano de Salud, Murcia, Spain.
- Departamento de Cirugía, Pediatría y Obstetricia, y Ginecología, Universidad de Murcia, Murcia, Spain.
| | - J Ruiz-Pardo
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Torrecardenas, Almería, Spain
| | - A Balaguer-Román
- Unidad de Cirugía Endocrina. Servicio de Cirugía General y de Aparato Digestivo. Instituto Murciano de Investigación Bio-Sanitaria (IMIB-Arrixaca). Hospital Clínico Universitario Virgen de la Arrixaca, Servicio Murciano de Salud, Murcia, Spain
- Departamento de Cirugía, Pediatría y Obstetricia, y Ginecología, Universidad de Murcia, Murcia, Spain
| | - J A Puñal
- Servicio de Cirugía General y Aparato Digestivo. C.H.U, Santiago de Compostela, Spain
| | - P Moreno
- Cirugía Endocrina, Hospital Universitario de Bellvitge. L´Hospitalet de Llobregat, Barcelona, Spain
| | - E Mercader
- Sección de Cirugía Endocrino-Metabólica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - E Ferrero
- Servicio de Cirugía General, Aparato Digestivo y Trasplante de Órganos Abdominales, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M A Morlán
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Virgen de la Salud, Toledo, Spain
| | - J Martín
- Servicio de Cirugía General y Aparato digestivo, Hospital Universitario Severo Ochoa. Leganés, Madrid, Spain
| | - M Durán
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Rey Juan Carlos. Móstoles, Madrid, Spain
- Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos. Alcorcón, Madrid, Spain
| | - J M Bravo
- Servicio de Cirugía General y del Aparato Digestivo, Hospital de la Princesa, Madrid, Spain
| | - D Casanova
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - M P Salvador-Egea
- Servicio de Cirugía General y Digestiva, Complejo Hospitalario de Pamplona. Pamplona, Navarra, Spain
| | - N M Torregrosa
- Servicio de Cirugía General y del Aparato Digestivo, Hospital de Santa Lucia, Cartagena, Murcia, España
| | - A Exposito-Rodríguez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital de Basurto, Vizcaya, España
| | - G Martínez-Fernández
- Unidad de Cirugía Endocrina, Servicio de Cirugía General (Hospital Universitario de Cruces), Barakaldo (Bizkaia), Spain
| | - A M Carrión
- Servicio de Cirugía, Hospital General Universitario de Alicante, Alicante, Spain
| | - O Vidal
- Cirugía General y del Aparato Digestivo, Hospital Universitario de Burgos, Burgos, Spain
| | - F Herrera
- Servicio de Cirugía General, Hospital General Básico Santa Ana, Motril (Granada), Spain
| | - G Ruiz-Merino
- FFIS, Fundación para la Formación e Investigación Sanitarias de la Región de Murcia, Murcia, España
| | - J M Rodríguez
- Unidad de Cirugía Endocrina. Servicio de Cirugía General y de Aparato Digestivo. Instituto Murciano de Investigación Bio-Sanitaria (IMIB-Arrixaca). Hospital Clínico Universitario Virgen de la Arrixaca, Servicio Murciano de Salud, Murcia, Spain
- Departamento de Cirugía, Pediatría y Obstetricia, y Ginecología, Universidad de Murcia, Murcia, Spain
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Ríos A, Puñal-Rodríguez JA, Moreno P, Mercader-Cidoncha E, Ferrero-Herrero E, Durán M, Ruiz-Merino G, Ruiz-Pardo J, Rodríguez JM, Gutiérrez PR. Protocolization of multicenter clinical studies in the digital era. Is useful data centralization by a data-manager? Cir Esp 2023; 101:755-764. [PMID: 37866482 DOI: 10.1016/j.cireng.2023.02.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/21/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION In multicenter studies, the protocolization of data is a critical phase that can generate biases.The objective is to analyze the concordance and reliability of the data obtained in a clinical multicenter study between the protocolization in the center of origin and the centralized protocolization of the data by a data -manager. METHODS National multicenter clinical study about an infrequent carcinoma. A double protocolization of the data is carried out: (a) center of origin; and (b) centralized by a data manager: The concordance between the data is analyzed for the global data and for the two groups of the project: (a) study group (Familiar carcinoma, 30 researchers protocolize); (b) control group (Sporadic carcinoma, 4 people protocolize). Interobserver variability is evaluated using Cohen's kappa coefficient. RESULTS The study includes a total of 689 patients with carcinoma, 252 in the study group and 437 in the control group. Regarding the concordance analysis of the tumor stage, 2.5% of disagreements were observed and the concordance between people who protocolize was near perfect (Kappa = 0.931). Regarding the evaluation of the recurrence risk, disagreements occurred in 7% of the cases and the concordance was near perfect (Kappa = 0.819). Regarding the sonography evaluation (TIRADS), the disagreements were 6.9% and the concordance was near perfect (Kappa = 0.922). Also, 4.6% of transcription errors were detected. CONCLUSIONS In multicenter clinical studies, the centralized data protocolization o by a data-manager seems to present similar results to the direct protocolization in the database in the center of origin.
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Affiliation(s)
- Antonio Ríos
- Unidad de Cirugía Endocrina, Servicio de Cirugía General y de Aparato Digestivo, Instituto Murciano de Investigación Bio-Sanitaria (IMIB-Arrixaca), Hospital Clínico Universitario Virgen de la Arrixaca, Servicio Murciano de Salud, Murcia, Spain; Departamento de Cirugía, Pediatría y Obstetricia, y Ginecología, Universidad de Murcia, Murcia, Spain.
| | | | - Pablo Moreno
- Cirugía Endocrina, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Enrique Mercader-Cidoncha
- Sección de Cirugía Endocrino-Metabólica, Hospital Universitario Gregorio Marañón, Instituto de Investigación Biosanitaria Gregorio Marañón, Madrid, Spain
| | - Eduardo Ferrero-Herrero
- Servicio de Cirugía General, Aparato Digestivo y Trasplante de Órganos Abdominales, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Manuel Durán
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain; Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Guadalupe Ruiz-Merino
- FFIS, Fundación para la Formación e Investigación Sanitarias de la Región de Murcia, Murcia, Spain
| | - José Ruiz-Pardo
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Torrecardenas, Almería, Spain
| | - José Manuel Rodríguez
- Unidad de Cirugía Endocrina, Servicio de Cirugía General y de Aparato Digestivo, Instituto Murciano de Investigación Bio-Sanitaria (IMIB-Arrixaca), Hospital Clínico Universitario Virgen de la Arrixaca, Servicio Murciano de Salud, Murcia, Spain; Departamento de Cirugía, Pediatría y Obstetricia, y Ginecología, Universidad de Murcia, Murcia, Spain
| | - Pedro Ramón Gutiérrez
- Servicio de Urología, Complejo Hospitalario Universitario de Canarias (CHUC), Santa Cruz de Tenerife, Spain; Departamento de Cirugía, Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
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Piñero-Madrona A, Cerezuela-Fuentes P, Ruiz-Merino G, Martínez-Barba E, Ortiz-Reina S, Martínez-Ortiz MJ, López-Ávila A, Frías-Iniesta JF, Viney A, Cabezas-Herrera J. Lower limb cutaneous melanoma surgery: location matters. Arch Dermatol Res 2023; 315:1971-1978. [PMID: 36862181 PMCID: PMC10366258 DOI: 10.1007/s00403-023-02571-z] [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: 10/26/2022] [Revised: 01/21/2023] [Accepted: 02/07/2023] [Indexed: 03/03/2023]
Abstract
The anatomical location of cutaneous melanoma is a relevant independent prognostic factor in melanoma. The aim of the study is to know the prognosis of lower limb cutaneous melanoma related to their location within the limb, regardless of the histological type, and if there are any other influencing variables. A real-world data observational study was developed. The lesions were divided depending on the location of the melanoma (thigh, leg and foot). Bivariate and multivariate analysis were performed, and melanoma-specific survival and disease-free survival rates were calculated. When these analysis were done, the results showed that, in melanomas of the lower limb, location on the foot presented a lower melanoma-specific survival rate compared to more proximal locations, and only the anatomical location presents statistical significance to discriminate cases with a higher mortality risk and a lower disease-free survival rate among distal melanomas (mainly on the foot). In conclusion, this study confirms that a more distal location of lower limb cutaneous melanoma is a relevant prognostic factor.Trial registration number NCT04625491 retrospectively registered.
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Affiliation(s)
- Antonio Piñero-Madrona
- Surgery Department, Hospital Clínico Universitario "Virgen de la Arrixaca", School of Medicine, University of Murcia, Campus de Ciencias de la Salud. Edificio Departamental, Office 4.27, 30120, Murcia, Spain.
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain.
| | - Pablo Cerezuela-Fuentes
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
- Medical Oncology Department, Hospital Clínico Universitario "Virgen de la Arrixaca", Murcia, Spain
| | - Guadalupe Ruiz-Merino
- Biostatistics Department, Fundación para la Formación e Investigación Sanitaria de la Región de Murcia, Murcia, Spain
| | - Enrique Martínez-Barba
- Pathology Department, Hospital Clínico Universitario "Virgen de la Arrixaca", Murcia, Spain
| | | | | | - Angel López-Ávila
- Dermatology Department, Complejo Hospitalario de Cartagena, Cartagena, Spain
| | - José F Frías-Iniesta
- Dermatology Department, Hospital Clínico Universitario "Virgen de la Arrixaca", Murcia, Spain
| | - Alice Viney
- Pharmacy Department, Complejo Hospitalario de Cartagena, Cartagena, Spain
| | - Juan Cabezas-Herrera
- Research Department, Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
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Ríos A, López-Gómez S, Belmonte J, Balaguer A, Gutiérrez PR, Ruiz-Merino G, Ayala-García MA, Ramírez P, López-Navas AI. The Roma population's fear of donating their own organs for transplantation. Cir Esp 2023; 101:350-358. [PMID: 35777627 DOI: 10.1016/j.cireng.2022.06.043] [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: 05/09/2022] [Accepted: 05/09/2022] [Indexed: 05/16/2023]
Abstract
BACKGROUND The refusal rate for donating organs among the Roma people is much higher than that of any other social group. OBJECTIVE To analyze the attitude towards the donation of one's own organs among the Roma population living in Spain. METHOD . TYPE OF STUDY Spanish national observational sociological study stratified by gender and age. STUDY POPULATION Roma population aged ≥15 years living in Spain. SAMPLE SIZE 1,253 respondents. Assessment instrument: Validated questionnaire on attitude towards organ donation for transplantation "PCID - DTO Ríos". Field work: Random selection based on stratification. Anonymous and self-administered completion. The collaboration of people of Roma ethnicity was required. STATISTICS Student's t test, χ2, Fisher's exact test and a logistic regression analysis. RESULTS The degree of completion was 18.2% (n = 228). Of those who completed the questionnaire, 42.1% (n = 96) were in favor of donation, 30.3% (n = 69) were undecided and the remaining 27.6% (n = 63) were against it. Of the 1,025 (81.8%) who declined to complete the questionnaire, 1,004 (98%) indicated that it was for fear of speaking about and filling in a questionnaire that raises the issue of death and organ donation after death. If those who did not complete the questionnaire due to fear of death and donating organs after death are considered not in favor, the results would be as follows: 7.8% (n = 96) in favor of donating their organs compared to 92.2% (n = 1166) not in favor (against or undecided). CONCLUSIONS A majority of the Roma population prefer not speak of death nor organ donation after death. These findings show that current campaigns to promote organ donation are not effective in this population group.
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Affiliation(s)
- Antonio Ríos
- Proyecto Colaborativo Internacional Donante, Murcia, Spain.
| | | | - Javier Belmonte
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Unidad de Trasplante. Servicio de Cirugía, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Andrés Balaguer
- Unidad de Trasplante. Servicio de Cirugía, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Pedro R Gutiérrez
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Servicio de Urología, Complejo Hospitalario Universitario de Canarias (CHUC), Departamento de Cirugía, Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - Guadalupe Ruiz-Merino
- Fundación para la Formación e Investigación Sanitarias de la Región de Murcia (FFIS), Murcia, Spain
| | - Marco Antonio Ayala-García
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Hospital Regional General Número 58 del Instituto Mexicano del Seguro Social (IMSS), Delegación de Guanajuato, Guanajuato. México
| | - Pablo Ramírez
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Departamento de Cirugía, Pediatría, Obstetricia y Ginecología, Universidad de Murcia, Murcia, Spain; Unidad de Trasplante. Servicio de Cirugía, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Ana Isabel López-Navas
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Departamento de Psicología, Universidad Católica San Antonio de Murcia (UCAM), Murcia, Spain
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5
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Ríos A, Rodríguez MA, Puñal JA, Moreno P, Mercader E, Ferrero E, Ruiz-Pardo J, Morlán MA, Martín J, Durán-Poveda M, Bravo JM, Casanova D, Egea MPS, Torregrosa NM, Exposito-Rodríguez A, Martínez-Fernández G, Carrión AM, Vidal O, Herrera F, Ruiz-Merino G, Rodríguez JM. Biological behavior of familial papillary thyroid microcarcinoma: Spanish multicenter study. Langenbecks Arch Surg 2022; 407:3631-3642. [PMID: 36251077 DOI: 10.1007/s00423-022-02704-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 10/05/2022] [Indexed: 10/24/2022]
Abstract
PURPOSE Familial papillary thyroid microcarcinoma (FPTMC) can present a more aggressive behavior than the sporadic microcarcinoma. However, few studies have analyzed this situation. The objective is to analyze the recurrence rate of FPTMC and the prognostic factors which determine that recurrence in Spain. METHODS Spanish multicenter longitudinal analytical observational study was conducted. Patients with FPTMC received treatment with curative intent and presented cure criteria 6 months after treatment. Recurrence rate and disease-free survival (DFS) were analyzed. Two groups were analyzed: group A (no tumor recurrence) vs. group B (tumor recurrence). RESULTS Ninety-four patients were analyzed. During a mean follow-up of 73.3 ± 59.3 months, 13 recurrences of FPTMC (13.83%) were detected and mean DFS was 207.9 ± 11.5 months. There were multifocality in 56%, bilateral thyroid involvement in 30%, and vascular invasion in 7.5%; that is to say, they are tumors with histological factors of poor prognosis in a high percentage of cases. The main risk factors for recurrence obtained in the multivariate analysis were the tumor size (OR: 2.574, 95% CI 1.210-5.473; p = 0.014) and the assessment of the risk of recurrence of the American Thyroid Association (ATA), both intermediate risk versus low risk (OR: 125, 95% CI 10.638-1000; p < 0.001) and high risk versus low risk (OR: 45.454, 95% CI 5.405-333.333; p < 0.001). CONCLUSION FPTMC has a recurrence rate higher than sporadic cases. Poor prognosis is mainly associated with the tumor size and the risk of recurrence of the ATA.
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Affiliation(s)
- A Ríos
- Unidad de Cirugía Endocrina, Servicio de Cirugía General Y de Aparato Digestivo, Instituto Murciano de Investigación Bio-Sanitaria (IMIB-Arrixaca), Hospital Clínico Universitario Virgen de La Arrixaca, Servicio Murciano de Salud, Murcia, Spain. .,Departamento de Cirugía, Pediatría Obstetricia, Y Ginecología, Universidad de Murcia, Murcia, Spain.
| | - M A Rodríguez
- Departamento de Cirugía, Pediatría Obstetricia, Y Ginecología, Universidad de Murcia, Murcia, Spain
| | - J A Puñal
- Servicio de Cirugía General Y Aparato Digestivo, C.H.U, Santiago de Compostela, Spain
| | - P Moreno
- Cirugía Endocrina, Hospital Universitario de Bellvitge, L´Hospitalet de Llobregat, Barcelona, Spain
| | - E Mercader
- Sección de Cirugía Endocrino-Metabólica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - E Ferrero
- Servicio de Cirugía General, Aparato Digestivo Y Trasplante de Órganos Abdominales, Hospital Universitario, 12 de Octubre, Madrid, Spain
| | - J Ruiz-Pardo
- Servicio de Cirugía General Y del Aparato Digestivo, Hospital Universitario Torrecárdenas, Almeria, Spain
| | - M A Morlán
- Servicio de Cirugía General Y del Aparato Digestivo, Hospital Virgen de La Salud, Toledo, Spain
| | - J Martín
- Servicio de Cirugía General Y Aparato Digestivo, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - M Durán-Poveda
- Servicio de Cirugía General Y del Aparato Digestivo, Hospital Universitario Rey Juan Carlos. Móstoles, Madrid, Spain.,Facultad de Ciencias de La Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - J M Bravo
- Servicio de Cirugía General Y del Aparato Digestivo, Hospital de La Princesa, Madrid, Spain
| | - D Casanova
- Servicio de Cirugía General Y del Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - M P Salvador Egea
- Servicio de Cirugía General Y Digestiva, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - N M Torregrosa
- Servicio de Cirugía General Y del Aparato Digestivo, Hospital de Santa Lucia, Cartagena, Murcia, Spain
| | - A Exposito-Rodríguez
- Servicio de Cirugía General Y del Aparato Digestivo, Hospital de Basurto, Bizkaia, Spain
| | - G Martínez-Fernández
- Unidad de Cirugía Endocrina, Servicio de Cirugía General (Hospital Universitario de Cruces), Barakaldo, Bizkaia, Spain
| | - A M Carrión
- Servicio de Cirugía, Hospital General Universitario de Alicante, Alicante, Spain
| | - O Vidal
- Cirugía General Y del Aparato Digestivo, Hospital Universitario de Burgos, Burgos, Spain
| | - F Herrera
- Servicio de Cirugía General, Hospital General Básico Santa Ana, Motril, Granada, Spain
| | - G Ruiz-Merino
- FFIS, Fundación Para La Formación E Investigación Sanitarias de La Región de Murcia, Murcia, Spain
| | - J M Rodríguez
- Unidad de Cirugía Endocrina, Servicio de Cirugía General Y de Aparato Digestivo, Instituto Murciano de Investigación Bio-Sanitaria (IMIB-Arrixaca), Hospital Clínico Universitario Virgen de La Arrixaca, Servicio Murciano de Salud, Murcia, Spain.,Departamento de Cirugía, Pediatría Obstetricia, Y Ginecología, Universidad de Murcia, Murcia, Spain
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6
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Ríos A, López-Gómez S, Belmonte J, Balaguer A, Gutiérrez PR, Ruiz-Merino G, Ayala-García MA, Ramírez P, López-Navas AI. La población gitana tiene miedos sobre la donación de órganos propios para trasplante. Cir Esp 2022. [DOI: 10.1016/j.ciresp.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ríos A, López Navas AI, Rigabert M, Martínez-Alarcón L, Ayala-García MA, Ruiz-Merino G, de Moya M, Ramírez P. Usefulness of an organ donation opinion survey as a tool to promote organ donation among the adolescent population. Transpl Int 2021; 34:2138-2145. [PMID: 34486763 DOI: 10.1111/tri.14034] [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] [Received: 03/12/2021] [Revised: 08/13/2021] [Accepted: 08/31/2021] [Indexed: 01/29/2023]
Abstract
Opinion surveys on health issues are considered health promotion tools. However, no studies have confirmed this in deceased organ donation for transplantation. This study aimed to analyse the impact of completing an opinion questionnaire about deceased organ donation on the attitude towards organ donation among the adolescent population. This longitudinal study with repeated measurements of attitude towards deceased organ donation was conducted with an adolescent population. The measurement instrument was a validated questionnaire of the attitude towards organ donation (PCID-DTO-Ríos). The study process involved the application of the questionnaire at an initial time, 1 month later, and 6 months later. A total of 1374 adolescents participated in this study. The favourable attitude towards donation was 43.1%, which fell to 41.4% at 1 month (P = 0.145), and to 39.7% at 6 months (P = 0.019). Changes in the attitude were observed in all groups, both 1 and 6 months after the questionnaire was completed. There was no objective relationship between the adolescent's socio-family environment and the effect of completing the questionnaire on their attitude towards deceased organ donation. In conclusion, the opinion questionnaire was not useful for promoting organ donation and did not have a positive effect on adolescents' attitudes towards organ donation in the medium or long term.
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Affiliation(s)
- Antonio Ríos
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain.,Department of Surgery, Paediatrics, Obstetrics y Gynaecology, University of Murcia, Murcia, Spain.,Transplant Unit, Surgery Service, IMIB - Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
| | - Ana Isabel López Navas
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain.,Department of Psychology, UCAM, Catholic University of San Antonio, Murcia, Spain
| | - Mariano Rigabert
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain.,Transplant Unit, Surgery Service, IMIB - Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
| | - Laura Martínez-Alarcón
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain.,Transplant Unit, Surgery Service, IMIB - Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
| | - Marco Antonio Ayala-García
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain.,General Regional Hospital Number 58 of the IMSS (Mexican Institute of Social Security), Guanajuato Delegation, Mexico
| | - Guadalupe Ruiz-Merino
- Statistics Unit, Foundation for Health Training and Research of the Murcia Region (FFIS), Murcia, Spain
| | - María de Moya
- Department of Psychology, UCAM, Catholic University of San Antonio, Murcia, Spain
| | - Pablo Ramírez
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain.,Department of Surgery, Paediatrics, Obstetrics y Gynaecology, University of Murcia, Murcia, Spain.,Transplant Unit, Surgery Service, IMIB - Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
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8
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Mansilla-Polo M, Ruiz-Merino G, Marín-Rodríguez P, Iborra-Lacal E, Guzmán-Aroca F, M Servet Pérez de Lema C, Marín-Hernández C, Polo-García L, Piñero-Madrona A. Cavity shaving for invasive breast cancer conservative surgery: Reduced specimen volume and margin positive rates. Surg Oncol 2021; 38:101632. [PMID: 34274752 DOI: 10.1016/j.suronc.2021.101632] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/01/2021] [Accepted: 07/11/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The cavity shaving (CS) technique was described in breast conserving surgery to reduce the rate of reoperation avoiding the need for intraoperative margin analysis. This study assesses differences in the rates of involvement of the surgical margin (requiring further surgery) and volume of surgical specimens, depending on the use or not of this technique. MATERIAL AND METHODS A retrospective cohort study was conducted in patients with breast carcinoma who underwent breast conserving surgery between 2013 and 2019. They were divided into two groups depending on whether the cavity shaving technique was used or not. Primary outcomes of the study included presence of final margin involvement, requiring need for further surgery, and the volume of excised tissue comparing the study groups. RESULTS A total of 202 cases were included: 92 in the control group and 110 in the cavity shaving group. Significant differences were found regarding involvement of the final margin (19.57% control group vs. 4.55% cavity shaving group; p = 0.010). The volume of additional surgical specimens were significantly greater in the traditional technique group than in the shaving technique (46.43 vs 13.32 cm3; p = 0.01) as was total specimen volume (143.40 vs 100.63 cm3; p = 0.022). CONCLUSIONS CS can reduce the positive margin and re-excision rates without larger-volume resections and should therefore be considered a routine technique in BCS for early-stage breast cancer.
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Affiliation(s)
- Miguel Mansilla-Polo
- Surgery Department. Hospital Clínico Universitario "Virgen de La Arrixaca". Murcia. Spain. Instituto Murciano de Investigación Biosanitaria (IMIB), Spain
| | - Guadalupe Ruiz-Merino
- Biostatistics Department. Fundación para la Formación e Investigación Sanitaria (FFIS), Murcia, Spain
| | - Pedro Marín-Rodríguez
- Surgery Department. Hospital Clínico Universitario "Virgen de La Arrixaca". Murcia. Spain. Instituto Murciano de Investigación Biosanitaria (IMIB), Spain
| | - Emma Iborra-Lacal
- Pathology Department. Hospital Clínico Universitario "Virgen de La Arrixaca", Murcia, Spain
| | | | | | - Caridad Marín-Hernández
- Surgery Department. Hospital Clínico Universitario "Virgen de La Arrixaca". Murcia. Spain. Instituto Murciano de Investigación Biosanitaria (IMIB), Spain
| | - Luis Polo-García
- Pathology Department. Hospital Clínico Universitario "Virgen de La Arrixaca", Murcia, Spain
| | - Antonio Piñero-Madrona
- Surgery Department. Hospital Clínico Universitario "Virgen de La Arrixaca". Murcia. Spain. Instituto Murciano de Investigación Biosanitaria (IMIB), Spain.
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9
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Alconchel F, Martínez-Insfran LA, Cascales-Campos PA, Febrero B, Martínez-Alarcón L, Ríos A, Fernández-Hernández JA, Rodríguez JM, Ruiz-Merino G, Royo-Villanova M, Pons JA, Robles-Campos R, Sánchez-Bueno F, Ramírez P, Parrilla P. Impact of Hepatic Artery Thrombosis on the Success of a Liver Transplant Because of Hepatocellular Carcinoma. Transplant Proc 2020; 52:559-561. [PMID: 32029319 DOI: 10.1016/j.transproceed.2019.11.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 11/06/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Hepatic artery thrombosis is one of the most serious complications after liver transplant. Our objective is to evaluate the impact of arterial thrombosis on the postoperative evolution of a series of patients who received transplants because of hepatocellular carcinoma. METHODS A retrospective study of 100 consecutive hepatocellular carcinoma liver transplants was performed from January 2011 to November 2017. RESULTS Of the 100 transplant recipients, we have observed hepatic artery thrombosis in 4 of them, 3 premature and 1 delayed. All of them received retransplants after diagnosis by hepatic artery ultrasonography and arteriography. The descriptive analysis showed a significant relationship between the appearance of hepatic artery thrombosis with variables of postoperative severity, such as arrhythmias, atelectasis, pleural effusion, hemodialysis requirement, acute kidney failure, and respiratory failure. Although patients with hepatic artery thrombosis had a longer mean hospital stay, this was not statistically significant. There was decreased graft survival and overall survival of patients who experienced hepatic artery thrombosis. CONCLUSION Although the incidence of hepatic artery thrombosis has been relatively low (4%), the early detection of risk factors, such as arterial anatomic anomalies that condition a complex anastomosis, should draw our attention, thus having at our disposal strict ultrasonography and arteriography surveillance protocols as well as prophylactic anticoagulation guidelines for receptors at risk.
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Affiliation(s)
- F Alconchel
- Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain.
| | - L A Martínez-Insfran
- Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
| | - P A Cascales-Campos
- Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
| | - B Febrero
- Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
| | - L Martínez-Alarcón
- Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
| | - A Ríos
- Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
| | - J A Fernández-Hernández
- Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
| | - J M Rodríguez
- Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
| | - G Ruiz-Merino
- Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
| | - M Royo-Villanova
- Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain; Intensive Care Unit, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - J A Pons
- Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain; Department of Hepatology, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - R Robles-Campos
- Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
| | - F Sánchez-Bueno
- Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
| | - P Ramírez
- Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
| | - P Parrilla
- Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
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10
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Piñero-Madrona A, Ruiz-Merino G, Cerezuela Fuentes P, Martínez-Barba E, Rodríguez-López JN, Cabezas-Herrera J. Mitotic rate as an important prognostic factor in cutaneous malignant melanoma. Clin Transl Oncol 2019; 21:1348-1356. [PMID: 30783917 DOI: 10.1007/s12094-019-02064-4] [Citation(s) in RCA: 12] [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: 09/19/2018] [Accepted: 02/12/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Recently, the quantification of mitoses in cutaneous melanoma has been discharged from the main prognostic variables of the TNM classification. OBJECTIVE To investigate the prognostic value of the presence of mitoses in primary cutaneous melanoma and to establish the number of mitoses per mm2 that may have prognostic significance. METHODS A retrospective observational study was performed on 141 patients treated for cutaneous melanoma, who were assessed by the same pathologist, and who had a minimum follow-up of 2 years. Clinical, epidemiological, histopathological and follow-up variables were gathered and compared with the number of mitoses to distinguish the significance of differences by means of univariate, multivariate, and survival analyses. RESULTS The cut-off level related to a better sensitivity and specificity was 1.50 mitoses per mm2. The presence of two or more mitoses/mm2 showed a better relationship with prognostic variables and both the overall and disease-free survival than the presence of 1 or more mitoses/mm2. This happens especially in melanomas thicker than 0.8 mm and it could affect the staging in cases with Breslow between 1 and 2 mm. CONCLUSIONS A mitotic rate of two or more mitoses per mm2 in cutaneous melanoma should be considered as a more accurate prognostic factor than one or more mitoses per mm2, particularly in tumors equal or greater than 0.8 mm in thickness.
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Affiliation(s)
- A Piñero-Madrona
- Department of Surgery, Hospital Clínico Universitario "Virgen de La Arrixaca", Instituto Murciano de Investigación Biosanitaria (IMIB), El Palmar, 30120, Murcia, Spain.
| | - G Ruiz-Merino
- Department of Statistics, Hospital Clínico Universitario "Virgen de La Arrixaca", Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - P Cerezuela Fuentes
- Department of Oncology, Hospital Clínico Universitario "Virgen de La Arrixaca", Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - E Martínez-Barba
- Department of Pathology, Hospital Clínico Universitario "Virgen de La Arrixaca", Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - J N Rodríguez-López
- Department of Molecular Research, Hospital Clínico Universitario "Virgen de La Arrixaca", Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - J Cabezas-Herrera
- Department of Molecular Research, Hospital Clínico Universitario "Virgen de La Arrixaca", Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
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11
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Berná-Serna JD, Sánchez-Jiménez R, Velázquez-Marín F, Sainz de Baranda P, Guzmán-Aroca F, Fernández-Hernández C, Doménech-Abellán E, Abellán-Rivero D, Ruiz-Merino G, Madrid-Conesa J, Canteras-Jordana M. Acoustic radiation force impulse imaging for detection of liver fibrosis in overweight and obese children. Acta Radiol 2018; 59:247-253. [PMID: 28475023 DOI: 10.1177/0284185117707359] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Acoustic radiation force impulse (ARFI) is a non-invasive alternative to a liver biopsy for the evaluation of liver fibrosis (LF). Purpose To investigate the potential usefulness of acoustic radiation force impulse ARFI for detecting LF in overweight and obese children Material and Methods A cross-sectional study was conducted in 148 schoolchildren. A diagnosis of non-alcoholic fatty liver disease (NAFLD) and LF was based on ultrasound (US) and ARFI shear wave velocity (SWV). Results The laboratory parameters were normal in all the children. NAFLD was observed in 50 children (33.8%). The median SWV was 1.18 ± 0.28 m/s. Differences between ARFI categories and hepatic steatosis grades were observed (χ2 = 43.38, P = 0.0005). No fibrosis or insignificant fibrosis (SWV ≤ 1.60 m/s) was detected in 137 children (92.5%), and significant fibrosis (SWV > 1.60 m/s) in 11 children (7.5%), nine of whom had normal US or mild steatosis. Conclusion The present study is the first to evaluate the utility of the ARFI technique for detecting LF in overweight and obese children. The results of the study suggest that children with normal laboratory parameters such as normal liver ultrasound or mild steatosis may present with significant LF.
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Affiliation(s)
- Juan D Berná-Serna
- Department of Radiology, Virgen de la Arrixaca University Clinical Hospital- IMIB, Ctra. Madrid-Cartagena, 30120, El Palmar (Murcia), Spain
| | - Regina Sánchez-Jiménez
- Department of Radiology, Virgen de la Arrixaca University Clinical Hospital- IMIB, Ctra. Madrid-Cartagena, 30120, El Palmar (Murcia), Spain
| | - Francisca Velázquez-Marín
- Department of Radiology, Virgen de la Arrixaca University Clinical Hospital- IMIB, Ctra. Madrid-Cartagena, 30120, El Palmar (Murcia), Spain
| | | | - Florentina Guzmán-Aroca
- Department of Radiology, Virgen de la Arrixaca University Clinical Hospital- IMIB, Ctra. Madrid-Cartagena, 30120, El Palmar (Murcia), Spain
| | - Carmen Fernández-Hernández
- Department of Radiology, Virgen de la Arrixaca University Clinical Hospital- IMIB, Ctra. Madrid-Cartagena, 30120, El Palmar (Murcia), Spain
| | - Ernesto Doménech-Abellán
- Department of Radiology, Virgen de la Arrixaca University Clinical Hospital- IMIB, Ctra. Madrid-Cartagena, 30120, El Palmar (Murcia), Spain
| | - Dolores Abellán-Rivero
- Department of Radiology, Virgen de la Arrixaca University Clinical Hospital- IMIB, Ctra. Madrid-Cartagena, 30120, El Palmar (Murcia), Spain
| | | | - Juan Madrid-Conesa
- Department of Endocrinology and Nutrition, Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
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12
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Romero-Cara P, Torres-Moreno D, Pedregosa J, Vílchez JA, García-Simón MS, Ruiz-Merino G, Morán-Sanchez S, Conesa-Zamora P. A FCGR3A Polymorphism Predicts Anti-drug Antibodies in Chronic Inflammatory Bowel Disease Patients Treated With Anti-TNF. Int J Med Sci 2018; 15:10-15. [PMID: 29333082 PMCID: PMC5765734 DOI: 10.7150/ijms.22812] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 09/13/2017] [Accepted: 10/30/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The production of anti-drug antibodies (ADAs) against IgG monoclonal antibodies (mAbs) targeting tumour necrosis factor (TNF) is an important cause of loss of response to anti-TNF mAbs in patients with inflammatory bowel diseases (IBD) such as Crohn's disease (CD) and ulcerative colitis (UC). Since receptors for the Fc portion of IgG (FCGRs) are involved in the degradation of IgG complexes, we hypothesised that a polymorphism in FCGR3A (V158F; rs396991) gene could be involved in anti-TNF ADA generation and treatment resistance. MATERIAL AND METHODS A cohort of 103 IBD patients (80 CD, 23 UC) were genotyped and serum level of both anti-TNFs (infliximab or adalimumab) and ADA against them were measured. RESULTS No significant differences were observed between ADA occurrence or V158F genotype and type of disease or the kind of anti-TNF administrated. Interestingly, VV genotype correlated with patients producing ADA (VV: 37.5% vs. FV: 10.6% or FF: 5%; p=0.004) and was an independent predictor of this event after multivariate analysis. Moreover, VV genotype also correlated with those patients receiving anti-TNF dose intensification (p=0.03). CONCLUSION FCGR3A V158F polymorphism seems to be associated with ADA production against mAbs and it could be taken into account when considering the dose and type of anti-TNF in IBD patients.
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Affiliation(s)
- Patricia Romero-Cara
- Gastroenterology Department, Santa Lucía General University Hospital (HGUSL), C/ Mezquita sn, 30202 Cartagena, Spain
| | - Daniel Torres-Moreno
- Pathology Department, HGUSL, Cartagena, Spain.,Institute for Biohealth Research from Murcia (IMIB), Cartagena, Spain
| | - José Pedregosa
- Clinical Analysis Department, HGUSL. Instituto Murciano de Investigaciones Biosanitarias (IMIB-Arrixaca), Murcia, Spain
| | - Juan Antonio Vílchez
- Clinical Analysis Department, HGUSL. Instituto Murciano de Investigaciones Biosanitarias (IMIB-Arrixaca), Murcia, Spain
| | - María Sergia García-Simón
- Pharmacy Department, HGUSL, Cartagena, Spain.,Faculty of Health Sciences. Catholic University from Murcia (UCAM), Murcia, Spain
| | - Guadalupe Ruiz-Merino
- Institute for Biohealth Research from Murcia (IMIB), Cartagena, Spain.,Statistical Unit, Fundación para la Formación e Investigación Sanitarias (FFIS), C/ Luis Fontes Pagán 9, 30003 Murcia, Spain
| | - Senador Morán-Sanchez
- Gastroenterology Department, Santa Lucía General University Hospital (HGUSL), C/ Mezquita sn, 30202 Cartagena, Spain.,Faculty of Health Sciences. Catholic University from Murcia (UCAM), Murcia, Spain
| | - Pablo Conesa-Zamora
- Institute for Biohealth Research from Murcia (IMIB), Cartagena, Spain.,Clinical Analysis Department, HGUSL. Instituto Murciano de Investigaciones Biosanitarias (IMIB-Arrixaca), Murcia, Spain.,Pharmacy Department, HGUSL, Cartagena, Spain
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13
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Sánchez-Carrasco MA, Abellán JF, Qudsi-Sinclair S, Ruiz-Merino G, Carrillo-Juliá FJ, Bo-Rueda D. Comparison of Outcomes of Two Femoral Fixation Devices in Hamstring Anterior Cruciate Ligament Reconstruction. Indian J Orthop 2017; 51:487-492. [PMID: 28966371 PMCID: PMC5609369 DOI: 10.4103/ortho.ijortho_13_16] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Tear of the anterior cruciate ligament (ACL) is a common ligamentous injury of the knee. Reconstruction of this ligament is often required to restore functional stability of the knee. Outcome of ACL reconstruction is significantly affected by how the graft is fixed to the bone. This study is to determine if there is a different clinical outcome after cortical versus cortical-cancellous suspension femoral fixation in hamstring based anterior cruciate ligament (ACL) reconstruction. MATERIALS AND METHODS This is a retrospective comparative study conducted between 2006 and 2010. We enrolled patients who underwent arthroscopic ACL reconstruction. Sixty two patients met inclusion criteria and 41 agreed to come for followup assessment. Median age was of 28 years (range 18-39 years). Demographic baseline profile of both groups was similar. The femoral fixation devices were cortical (n = 16) and cortical-cancellous suspension techniques (n = 25). The average period of evolution at the time of assessment was 40 months (range 12-72 months). The patients were examined according to Lachman test (using Rolimeter knee tester), anterior drawer test, pivot shift test, International Knee Documentation Committee questionnaire, and Tegner-Lysholm knee scoring scale. RESULTS The objective evaluation of the patients (Lachman test) showed better results in terms of stability in the group of patients who underwent the cortical-cancellous suspension method. These differences were not reflected in the assessment of activity level (Tegner-Lysholm), where both groups showed the same results. CONCLUSIONS ACL reconstruction with both cortical and cortical-cancellous suspension femoral fixation techniques show the same clinical results at medium long followup. However, cortical-cancellous fixations seem to provide greater stability to the reconstruction.
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Affiliation(s)
- Miguel Angel Sánchez-Carrasco
- Department of Orthopaedic Surgery and Traumatology, HGU Santa Lucia, Cartagena. Doctoral Program in Health Sciences. Catholic University of Murcia (UCAM), Murcia, Spain,Address for correspondence: Dr. Miguel Angel Sanchez-Carrasco, Secretaría de Traumatología, HGU Santa Lucía, C/Mezquita, s/n, Paraje Los Arcos, 30202, Cartagena, Murcia, Spain. E-mail:
| | - Juan Francisco Abellán
- Department of Orthopaedic Surgery and Traumatology, HGU José María Morales Meseguer, Murcia, Spain
| | | | - Guadalupe Ruiz-Merino
- Department of Statistics, Foundation for Training and Health Research in the Region of Murcia, Murcia, Spain
| | | | - David Bo-Rueda
- Department of Orthopaedic Surgery and Traumatology, HGU José María Morales Meseguer, Murcia, Spain
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14
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Qudsi-Sinclair S, Borrás-Rubio E, Abellan-Guillén JF, Padilla del Rey ML, Ruiz-Merino G. A Comparison of Genicular Nerve Treatment Using Either Radiofrequency or Analgesic Block with Corticosteroid for Pain after a Total Knee Arthroplasty: A Double-Blind, Randomized Clinical Study. Pain Pract 2016; 17:578-588. [DOI: 10.1111/papr.12481] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 02/09/2016] [Accepted: 06/03/2016] [Indexed: 01/02/2023]
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15
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Piñero-Madrona A, Ruiz-Merino G, Bernet L, Miguel-Martínez B, Vicente-García F, Viguri-Díaz MA, Giménez-Climent J. Tumoral load quantification of positive sentinel lymph nodes in breast cancer to predict more than two involved nodes. Breast 2014; 23:859-64. [PMID: 25283682 DOI: 10.1016/j.breast.2014.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 04/30/2014] [Revised: 09/09/2014] [Accepted: 09/12/2014] [Indexed: 11/16/2022] Open
Abstract
AIM One-Step Nucleic Acid Amplification (OSNA) can detect isolated tumour loads in axillary lymph nodes of breast cancer patients. We investigated the predictability of the non-sentinel lymph node (SLN) metastatic involvement (MI) based on the OSNA SLN assessment in surgical invasive breast cancer. METHODS We studied surgical breast invasive carcinoma patients, not taking neoadjuvant chemotherapy, having SLN positive by OSNA and having received axillary lymphadenectomy. Age, basic histopathological, immunohistochemical, SLN biopsy and lymphadenectomy data were compared between patients with or without MI of more than 2 non-SLN in both univariate and multivariate analyses. The discriminating capacity of the multivariate model was characterized by the ROC AUC. RESULTS 726 patients from 23 centers in Spain aged 55.3 ± 12.2 years were analysed. The univariate analysis comparing patients with or without MI of more than 2 non-SLN detected statistically significant differences in primary tumour size, multifocality, presence of lymphovascular infiltration, positive proliferation index with ki67, immunophenotype and logTTL (Tumour Total Load). The multivariate logistic analyses (OR (95% CI)) confirmed multifocality (2.16 (1.13-4.13), p = 0.019), lymphovascular infiltration (4.36 (2.43-7.82), p < 0.001) and logTTL (1.22 (1.10-1.35), p < 0.001) as independent predictors, and exhibit an AUC (95% CI) of 0.78 (0.72-0.83) with an overall fit (Hosmer-Lemeshow test) of 0.359. A change in the slope of both sensitivity and specificity is observed at about 10,000 copies/μL, without relevant changes in the Negative Predictive Values. CONCLUSIONS Using OSNA technique, the MI of more than 2 non-SLN can be reliably predicted.
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Affiliation(s)
- Antonio Piñero-Madrona
- Department of Surgery, "Virgen de la Arrixaca" University Hospital, 30120 Murcia, Spain.
| | - Guadalupe Ruiz-Merino
- Department of Statistics, FFIS-IMIB, Luis Fontes Pagán, 9, 1ª Planta, 30120 Murcia, Spain.
| | - Laia Bernet
- Department of Pathology, Hospital of Xátiva, Crtra de Xàtiva a Silla, Km 1, Valencia, Spain.
| | - Begoña Miguel-Martínez
- Department of Nuclear Medicine, University Hospital, Hijos de Santiago Rodriguez, 16, 09002 Burgos, Spain.
| | - Francisco Vicente-García
- Department of Surgery, Complejo Hospitalario de Navarra, La Arboleda, 4, Cizur Menor, 31190 Pamplona, Spain.
| | - María A Viguri-Díaz
- Department of Pathology, University Hospital Txagorritxu, Jose Atxotegui s/n, 01009 Vitoria, Spain.
| | - Julia Giménez-Climent
- Department of Surgery, Fundación Instituto Valenciano de Oncología, Prof. Beltrán Báguena, 8, 46009 Valencia, Spain.
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16
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López-Alvarez MR, Gómez-Mateo J, Ruiz-Merino G, Campillo JA, Miras M, García-Alonso AM, Sánchez-Bueno F, Parrilla P, Alvarez-López MR, Minguela A. Analysis of KIR2D receptors on peripheral blood lymphocytes from liver graft recipients. Transpl Immunol 2006; 17:51-4. [PMID: 17157216 DOI: 10.1016/j.trim.2006.09.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2006] [Accepted: 09/13/2006] [Indexed: 02/08/2023]
Abstract
KIR2D receptors are killer cell immunoglobulin-like receptors (KIRs) specific for HLA-C epitopes, that are expressed on NK cells as well as on minor peripheral blood T-cell subsets, and are able to control NK and T cells activity. The present work explores NK, and particularly CD8(+) T cells expressing KIR2D2L1/S1 (CD158a) or KIR2D2L2/3/S2 (CD158b) receptors in liver graft alloresponse. Flow cytometry was used to analyse peripheral blood mononuclear cells stained with anti-CD158a and anti-CD158b antibodies from 110 liver recipients and 46 healthy controls, previous to and along the first month after transplantation. Pre-transplantation data shows that both CD158a and CD158b molecules can be detected on NK and T cells from all patients and controls, but both KIR2D(+)NK cells are significantly under-represented in patients respect to controls (P<0.001), and CD3(+)CD8(+)CD158a(+) cells decreased particularly in patients suffering from acute rejection (4.03+/-1.33 cells/microL) compared with controls (7.8+/-2.4 cells/microL). Following transplantation, KIR2D(+)CD8(+) T-cell repertoires increased through the first month, mainly in recipients with a good graft acceptance. In summary, monitoring of KIR2D(+)CD8(+) T cells, particularly KIR2DL1/S1(+)CD8(+) T cells at pre-transplant, and both KIR2DL1/S1(+) and KIR2DL2/3/S2(+) T-cell subsets at early post-transplant period, could offer useful information for clinical follow-up of liver grafts.
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Affiliation(s)
- María R López-Alvarez
- Immunology Service, Hospital Universitario Virgen de la Arrixaca, 30120 Murcia, Spain
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