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Triola M, Cobo J, González-Rodríguez A, Nieto L, Ochoa S, Usall J, García-Ribera C, Baños I, González B, Solanilla A, Massons C, Ruiz I, Ruiz AI, Oliva JC, Pousa E. Impact of Delusions and Hallucinations on Clinical Insight Dimensions in Schizophrenia Spectrum Disorders. Psychopathology 2024:1-10. [PMID: 38442692 DOI: 10.1159/000536360] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 01/07/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Insight in psychosis has been conceptualized as a continuous, dynamic, and multidimensional phenomenon. This study aims to determine the impact of delusions and hallucinations in different dimensions of clinical insight in schizophrenia spectrum disorders. METHODS Cross-sectional multicenter study including 516 patients (336 men) diagnosed with schizophrenia spectrum disorders. Based on dichotomized scores of Positive and Negative Syndrome Scale (PANSS) items P1 (delusions) and P3 (hallucinations), patients were assigned to four groups according to current clear presence of delusions (scores 4 or above 4 in PANSS item P1) and/or hallucinations (scores 4 or above 4 in PANNS item P3). Insight was assessed using the three main dimensions of the Scale of Unawareness of Mental Disorder (SUMD). RESULTS Around 40% of patients showed unawareness of illness; 30% unawareness of the need for treatment; and 45% unawareness of the social consequences of the disorder. Patients with current clear presence of delusions had higher overall lack of awareness, regardless of current clear presence of hallucinations. Similarly, the clear presence of delusions showed a greater predictive value on insight than the presence of hallucinations, although the implication of both in the prediction was modest. CONCLUSIONS Our results confirm that lack of insight is highly prevalent in schizophrenia spectrum disorders, particularly when patients experience delusions. This study adds insight-related data to the growing symptom-based research, where specific types of psychotic experiences such as hallucinations and delusions could form different psychopathological patterns, linking the phenomenology of delusions to a lack of clinical insight.
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Affiliation(s)
- Maria Triola
- Mental Health Department, Corporació Sanitària Parc Taulí - CIBERSAM - ISCIII - I3PT - CREA, Sabadell, Spain
| | - Jesus Cobo
- Mental Health Department, Corporació Sanitària Parc Taulí - CIBERSAM - ISCIII - I3PT - CREA, Sabadell, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Alexandre González-Rodríguez
- Department of Mental Health, Mutua Terrassa University Hospìtal, Terrassa, Spain
- University of Barcelona, CIBERSAM, Barcelona, Spain
| | - Lourdes Nieto
- Department of Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico D.F., Mexico
| | - Susana Ochoa
- Research and Development Unit, Parc Sanitari San Joan de Dèu, MERITT Group, Institut de Recerca Sant Joan de Déu - CIBERSAM - ISCIII, Sant Boi de Llobregat, Barcelona, Spain
| | - Judith Usall
- Research and Development Unit, Parc Sanitari San Joan de Dèu, MERITT Group, Institut de Recerca Sant Joan de Déu - CIBERSAM - ISCIII, Sant Boi de Llobregat, Barcelona, Spain
| | - Carles García-Ribera
- Department of Psychiatry, Hospital de La Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau, IIB-Sant Pau, CIBERSAM, Barcelona, Spain
| | - Iris Baños
- Research and Development Unit, Parc Sanitari San Joan de Dèu, MERITT Group, Institut de Recerca Sant Joan de Déu - CIBERSAM - ISCIII, Sant Boi de Llobregat, Barcelona, Spain
| | - Beatriz González
- Mental Health Department, Hospital Benito Menni, Sant Boi de Llobregat, Barcelona, Spain
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Ariadna Solanilla
- Mental Health Department, Corporació Sanitària Parc Taulí - CIBERSAM - ISCIII - I3PT - CREA, Sabadell, Spain
| | - Carmina Massons
- Mental Health Department, Corporació Sanitària Parc Taulí - CIBERSAM - ISCIII - I3PT - CREA, Sabadell, Spain
| | - Isabel Ruiz
- Department of Health and Clinical Psychology, Research Unit, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Ada I Ruiz
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | | | - Esther Pousa
- Department of Psychiatry, Hospital de La Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau, IIB-Sant Pau, CIBERSAM, Barcelona, Spain
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Mateu-Bosch A, Segur-Bailach E, García-Villoria J, Gea-Sorlí S, Ruiz I, Del Rey J, Camps J, Guitart-Mampel M, Garrabou G, Tort F, Ribes A, Fillat C. Modeling Glutaric Aciduria Type I in human neuroblastoma cells recapitulates neuronal damage that can be rescued by gene replacement. Gene Ther 2024; 31:12-18. [PMID: 37985879 DOI: 10.1038/s41434-023-00428-8] [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] [Received: 05/12/2023] [Revised: 10/26/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023]
Abstract
Glutaric Aciduria type I (GA1) is a rare neurometabolic disorder caused by mutations in the GDCH gene encoding for glutaryl-CoA dehydrogenase (GCDH) in the catabolic pathway of lysine, hydroxylysine and tryptophan. GCDH deficiency leads to increased concentrations of glutaric acid (GA) and 3-hydroxyglutaric acid (3-OHGA) in body fluids and tissues. These metabolites are the main triggers of brain damage. Mechanistic studies supporting neurotoxicity in mouse models have been conducted. However, the different vulnerability to some stressors between mouse and human brain cells reveals the need to have a reliable human neuronal model to study GA1 pathogenesis. In the present work we generated a GCDH knockout (KO) in the human neuroblastoma cell line SH-SY5Y by CRISPR/Cas9 technology. SH-SY5Y-GCDH KO cells accumulate GA, 3-OHGA, and glutarylcarnitine when exposed to lysine overload. GA or lysine treatment triggered neuronal damage in GCDH deficient cells. SH-SY5Y-GCDH KO cells also displayed features of GA1 pathogenesis such as increased oxidative stress vulnerability. Restoration of the GCDH activity by gene replacement rescued neuronal alterations. Thus, our findings provide a human neuronal cellular model of GA1 to study this disease and show the potential of gene therapy to rescue GCDH deficiency.
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Affiliation(s)
- A Mateu-Bosch
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - E Segur-Bailach
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - J García-Villoria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
- Section of Inborn Errors of Metabolism-IBC, Biochemial and Molecular Genetics Department, Hospital Clinic de Barcelona, Barcelona, Spain
- Inherited Metabolic Diseases and Muscle Disorders' Research Group, Barcelona, Spain
| | - S Gea-Sorlí
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - I Ruiz
- Unitat de Biologia Cel·lular i Genètica Mèdica, Departament de Biologia Cel·lular, Fisiologia i Immunologia, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, 08193, Spain
| | - J Del Rey
- Unitat de Biologia Cel·lular i Genètica Mèdica, Departament de Biologia Cel·lular, Fisiologia i Immunologia, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, 08193, Spain
| | - J Camps
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Unitat de Biologia Cel·lular i Genètica Mèdica, Departament de Biologia Cel·lular, Fisiologia i Immunologia, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, 08193, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - M Guitart-Mampel
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
- Inherited Metabolic Diseases and Muscle Disorders' Research Group, Barcelona, Spain
| | - G Garrabou
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
- Inherited Metabolic Diseases and Muscle Disorders' Research Group, Barcelona, Spain
| | - F Tort
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
- Inherited Metabolic Diseases and Muscle Disorders' Research Group, Barcelona, Spain
| | - A Ribes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
- Inherited Metabolic Diseases and Muscle Disorders' Research Group, Barcelona, Spain
| | - C Fillat
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain.
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Valentí V, Capdevila L, Ruiz I, Ramos J, Badía J, Blázquez S, Villuendas Ó, Pérez C, Fernández-Sender L, Córdoba M, Alonso-Villaverde C. Variation of Plasma Damage-Associated Molecular Patterns in Patients with Advanced Solid Tumors after Standard of Care Systemic Treatment. Cancer Invest 2023; 41:821-829. [PMID: 37975838 DOI: 10.1080/07357907.2023.2283458] [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: 07/25/2022] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Immunogenic cell death (ICD) is known for releasing damage-associated molecular patterns (DAMPs) from tumor cells. We aimed to find ICD signals by assessing the variation of plasmatic DAMPs (HMGB1, S100A8) before-after standard of care (SoC) systemic treatment in patients with advanced solid tumors. METHODS Patients scheduled to start a new line of systemic treatment were included. Plasmatic concentrations of HMGB1 and S100A8 were measured (ng/mL) before and after three months of treatment. RESULTS Fifty-two patients were included. Forty-four patients (85%) had metastases, and 8 (15%) were treated for stage III tumors. The most frequent tumor sites were colorectal (35%) and lung (25%). Forty-two patients (81%) received this treatment in the first-line setting. Thirty-six patients (69%) were treated chemotherapy (CT) alone, ten (19%) CT plus targeted therapy, two (3.8%) carboplatin-pemetrexed-pembrolizumab, three (5.8%) pembrolizumab alone and one (1.9%) cetuximab alone. Median plasmatic concentration of S100A8 was significantly higher before than after treatment in the whole population (3.78 vs. 2.91 ng/mL; p = 0.011) and more markedly in the subgroups of patients who experienced RECIST-assessed tumor response (5.70 vs. 2.63 ng/mL; p = 0.002). Median plasmatic concentration of HMGB1was not significantly different before and after treatment (10.23 vs. 11.85 ng/mL; p = 0.382) and did not differ depending on tumor response. Median PFS was not significantly different between patients whose plasma HMBG1 concentration decreased or increased (8.0 vs. 10.6 months; p = 0.29) after treatment. Median PFS was significantly longer in those patients in whom the plasma concentration of S100A8 decreased after treatment (12 vs. 4.7 months; p < 0.001). Median OS was not significantly different between patients whose plasma HMBG1 concentration decreased or increased (13.1 vs. 14.7 months; p = 0.46) after treatment. Median OS was significantly longer in those patients in whom the plasma concentration of S100A8 decreased after treatment (16.7 vs. 9.0 months; p < 0.001). CONCLUSIONS Signals of ICD were not observed. S100A8 behaves as an inflammatory marker with decreased concentration after treatment, mostly in RECIST-responders. PFS and OS were significantly prolonged in those patients who experienced a decrease of S100A8 compared with those patients who experienced increase of plasma S100A8 at three months.
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Affiliation(s)
| | - Laia Capdevila
- Medical Oncology, Hospital Santa Tecla, Tarragona, Spain
| | - Isabel Ruiz
- Medical Oncology, Hospital del Vendrell, El Vendrell, Spain
| | - Javier Ramos
- Medical Oncology, Hospital Santa Tecla, Tarragona, Spain
| | - Joan Badía
- Medical Oncology, Hospital Santa Tecla, Tarragona, Spain
| | | | | | - Cristina Pérez
- Medical Oncology, Hospital del Vendrell, El Vendrell, Spain
| | | | - Mónica Córdoba
- Internal Medicine, Hospital Santa Tecla, Tarragona, Spain
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Patriota P, Ruiz I, Rezzi S, Vidal PM, Borloz S, Bouthors T, Hauschild M. Vitamin D Levels, Obesity And Cardiovascular Risk Factors In Adolescents Attending A Reference Centre For The Treatment Of Obesity. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.320] [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: 03/28/2023]
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Bernet L, Hardisson D, Rodrigo M, Córdoba A, Sancho M, Peg V, Ruiz I, Godey F, Sánchez-Méndez JI, Prat A. OSNA Total Tumor Load for the Prediction of Axillary Involvement in Breast Cancer Patients: Should We use Different Thresholds According to the Intrinsic Molecular Subtype? MOTTO Study. Clin Pathol 2023; 16:2632010X231183693. [PMID: 37534372 PMCID: PMC10392164 DOI: 10.1177/2632010x231183693] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/05/2023] [Indexed: 08/04/2023]
Abstract
Aims To assess the impact of the molecular subtype (MS) on the total number of CK19 mRNA copies in all positive SLN (TTL) threshold, to predict non-SLN affectation, and to compare 5 years progression-free survival (PFS) according to the risk of recurrence (ROR) group by PAM50. Methods Cohort with infiltrating breast cancer with intra-operative metastatic SLN detected by one-step nucleic acid amplification (OSNA) assay who underwent subsequent ALND. Logistic regression was used to assess a possible interaction between TTL and MS(Triple Negative, Her-2-Enriched, Luminal A, or Luminal B), or hormone receptors (HR: positive or negative) by immunohistochemistry (IMH). Cox regression was used to compare PFS and OS in the 3 ROR groups (high, medium, or low). Results TTL was predictive of non-SLN affectation in both univariate (OR [95% CI]: 1.72 [1.43, 2.05], P < .001) and multivariate (1.55 [95% CI: 1.04, 2.32], P = .030) models, but MS-IMH or HR-IMH, and their interactions with TTL were not (best multivariate model: HR + main effect OR 1.16 [95% CI: 0.18, 7.64], P = .874; interaction OR: 1.04 [0.7, 1.55], P = .835; univariate model: HR + main effect OR: 1.44 [95% CI: 0.85, 2.44], P = .180). PFS was lower in the high-risk ROR group (81.1%) than in the low-risk group (93.9%) (HR: 3.68 [95 CI: 1.70, 7.94], P < .001). Conclusions our results do not provide evidence to support the utilization of subtype-specific thresholds for TTL values to make therapeutic decisions on the axilla. The ROR group was predictive of 5 years-PFS.
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Affiliation(s)
- L Bernet
- Department of Pathology, Hospital Universitario del Vinalopó, Elche, Spain
| | - D Hardisson
- Department of Pathology, Hospital Universitario La Paz, Madrid
- Hospital La Paz Institute for health Research (IdiPAZ), Universidad Autónoma de Madrid
| | - M Rodrigo
- Department of Pathology, Hospital Universitario de Burgos, Burgos, Spain
| | - A Córdoba
- Department of Pathology, Hospital Universitario de Navarra, Navarra, Spain
| | - M Sancho
- Department of Pathology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - V Peg
- Department of Pathology, Vall d’Hebron University Hospital, Barcelona, Spain
- Universidad Autónoma de Barcelona, Barcelona, Spain
- Spanish Biomedical Research Network Centre in Oncology (CIBERONC), Madrid, Spain
| | - I Ruiz
- Department of Pathology, Hospital Universitario de Donostia, Donostia, Spain
| | - F Godey
- Department of Pathology, Centre Eugène Marquis, Rennes, France
| | - JI Sánchez-Méndez
- Department of Ginecology and Obstetrics, Hospital Universitario La Paz, Madrid
- Hospital La Paz Institute for Health Research (IdiPAZ), Universidad Autónoma de Madrid
| | - A Prat
- Medical Oncology department, Hospital Clínic de Barcelona, Barcelona, Spain
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Sánchez M, Ramos DR, Fernández MI, Aguilar S, Ruiz I, Canle M, Soto M. Removal of emerging pollutants by a 3-step system: Hybrid digester, vertical flow constructed wetland and photodegradation post-treatments. Sci Total Environ 2022; 842:156750. [PMID: 35750172 DOI: 10.1016/j.scitotenv.2022.156750] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 03/23/2022] [Revised: 05/17/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
The removal of emerging pollutants from municipal wastewater was studied for the first time using a three-step pilot-scale system: 1) hybrid digester (HD) as first step, 2) subsurface vertical flow constructed wetland (VF) as second step, and 3) photodegradation (PD) unit as third step or post-treatment. The HD and VF units were built and operated in series with effluent recirculation at pilot scale. For the PD post-treatment, three alternatives were studied at lab-scale, i) UVC irradiation at 254 nm (0.5 h exposure time), ii) UVA irradiation at 365 nm using a TiO2-based photocatalyst and iii) sunlight irradiation using a TiO2-based photocatalyst, the last two for 1 and 2 h. Alternative iii) was also tested at pilot-scale. Degradation of nine compounds was evaluated: acetaminophen (ACE), caffeine (CAF), carbamazepine (CBZ), ketoprofen (KET), ibuprofen (IBU), diclofenac (DCL), clofibric acid (ACB), bisphenol A (BPA), and sotalol (SOT). Overall, the HD-VF-UVC system completely removed (>99.5 %) ACE, CAF, KET, IBU, DCL and ACB, and to a lesser extent SOT (98 %), BPA (83 %) and CBZ (51 %). On the other hand, the HD-VF-UVA/TiO2 system (at 2 h) achieved >99.5 % removal of ACE, CAF, KET, IBU and DCL while ACB, BPA, CBZ and SOT were degraded by 83 %, 81 %, 78 % and 68 %, respectively. Working also at 2 h of exposure time, in summer conditions, the HD-VF-Sol/TiO2 system achieved >99.5 % removal of ACE, CAF, KET, IBU, DCL and ACB, and to a minor extent BPA (80 %), SOT (74 %) and CBZ (69 %). Similar results, although slightly lower for SOT (60 %) and CBZ (59 %), were obtained in the pilot sunlight plus TiO2 catalyst unit. However, the use of sunlight irradiation with a TiO2-based photocatalyst clearly showed lower removal efficiency in autumn conditions (i.e., 47 % SOT, 31 % CBZ).
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Affiliation(s)
- M Sánchez
- Dept. of Chemistry, Faculty of Sciences & CICA, University of A Coruña, E-15071 A Coruña, Galiza, Spain
| | - D R Ramos
- Dept. of Chemistry, Faculty of Sciences & CICA, University of A Coruña, E-15071 A Coruña, Galiza, Spain
| | - M I Fernández
- Dept. of Chemistry, Faculty of Sciences & CICA, University of A Coruña, E-15071 A Coruña, Galiza, Spain
| | - S Aguilar
- Dept. of Chemistry, Faculty of Sciences & CICA, University of A Coruña, E-15071 A Coruña, Galiza, Spain; Facultad de Ciencias Exactas y Naturales, Universidad Técnica Particular de Loja, Loja, Ecuador
| | - I Ruiz
- Dept. of Chemistry, Faculty of Sciences & CICA, University of A Coruña, E-15071 A Coruña, Galiza, Spain
| | - M Canle
- Dept. of Chemistry, Faculty of Sciences & CICA, University of A Coruña, E-15071 A Coruña, Galiza, Spain
| | - M Soto
- Dept. of Chemistry, Faculty of Sciences & CICA, University of A Coruña, E-15071 A Coruña, Galiza, Spain.
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Mora C, Sampedro I, Rodríguez-Caballero A, Martín-Láez R, Ortega-Roldán M, Venkatraghavan L, Fernández-Miera M, Varea M, Pajaron-Guerrero M, Esteban J, Moreno B, Manzano A, Ruiz I, Martino J, Zadeh G, Bernstein M, Velásquez C. Barriers and facilitators in the implementation of a telemedicine-based outpatient brain tumor surgery program. Neurosurg Focus 2022; 52:E8. [DOI: 10.3171/2022.3.focus2242] [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] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/21/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
Despite growing evidence on the benefits of outpatient oncological neurosurgery (OON), it is only performed in a few specialized centers and there are no previous descriptions of established OON programs in Europe. Moreover, increasing application of telemedicine strategies, especially after the start of the coronavirus disease 2019 (COVID-19) pandemic, is drastically changing neurosurgical management, particularly in the case of vulnerable populations such as neuro-oncological patients. In this context, the authors implemented an OON program in their hospital with telematic follow-up. Herein, they describe the protocol and qualitatively analyze the barriers and facilitators of the development process.
METHODS
An OON program was developed through the following steps: assessment of hospital needs, specific OON training, multidisciplinary team organization, and OON protocol design. In addition, the implementation phase included training sessions, a pilot study, and continuous improvement sessions. Finally, barriers and facilitators of the protocol’s implementation were identified from the feedback of all participants.
RESULTS
An OON protocol was successfully designed and implemented for resection or biopsy of supratentorial lesions up to 3 cm in diameter. The protocol included the patient’s admission to the day surgery unit, noninvasive anesthetic monitoring, same-day discharge, and admission to the hospital-at-home (HaH) unit for telematic and on-site postoperative care. After a pilot study including 10 procedures in 9 patients, the main barriers identified were healthcare provider resistance to change, lack of experience in outpatient neurosurgery, patient reluctance, and limitations in the recruitment of patients. Key facilitators of the process were the patient education program, the multidisciplinary team approach, and the HaH-based telematic postoperative care.
CONCLUSIONS
Initiating an OON program with telematic follow-up in a European clinical setting is feasible. Nevertheless, it poses several barriers that can be overcome by identifying and maximizing key facilitators of the process. Among them, patient education, a multidisciplinary team approach, and HaH-based postoperative care were crucial to the success of the program. Future studies should investigate the cost-effectiveness of telemedicine to assess potential cost savings, from reduced travel and wait times, and the impact on patient satisfaction.
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Affiliation(s)
- Carla Mora
- Department of Neurological Surgery, Hospital Universitario Marqués de Valdecilla
| | - Isabel Sampedro
- Hospital-at-Home Department, Hospital Universitario Marqués de Valdecilla
| | | | - Rubén Martín-Láez
- Department of Neurological Surgery, Hospital Universitario Marqués de Valdecilla
- Fundación Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Cantabria
| | - Marta Ortega-Roldán
- Ciencias Jurídicas y Empresariales, Universidad de Cantabria, Santander, Cantabria, Spain
- Medtronic Ibérica, Madrid, Spain
| | - Lashmi Venkatraghavan
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University of Toronto
| | | | - Mar Varea
- Hospital-at-Home Department, Hospital Universitario Marqués de Valdecilla
| | | | - Jesus Esteban
- Department of Neurological Surgery, Hospital Universitario Marqués de Valdecilla
| | - Blanca Moreno
- Hospital-at-Home Department, Hospital Universitario Marqués de Valdecilla
| | - Asunción Manzano
- Hospital-at-Home Department, Hospital Universitario Marqués de Valdecilla
| | - Isabel Ruiz
- Department of Anesthesiology, Hospital Universitario Marqués de Valdecilla
| | - Juan Martino
- Department of Neurological Surgery, Hospital Universitario Marqués de Valdecilla
- Fundación Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Cantabria
| | - Gelareh Zadeh
- Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Ontario, Canada
| | - Mark Bernstein
- Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Ontario, Canada
| | - Carlos Velásquez
- Department of Neurological Surgery, Hospital Universitario Marqués de Valdecilla
- Fundación Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Cantabria
- Department of Anatomy and Cell Biology, Universidad de Cantabria, Santander, Cantabria; and
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Valenti V, Capdevila L, Ruiz I, Badia J, Ramos Pascual FJ, Blázquez S, Villuendas Ó, Pérez C, Flores G, Córdoba M, Alonso C. Damage-associated molecular patterns (DAMPS) in patients with advanced cancer undergoing systemic treatment. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e14524] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14524 Background: Immunogenic cell death (ICD) is known for the release of DAMPS from tumor cells. We aimed to find signals of ICD by assessing the variation of plasma DAMPS (HMGB1 and S100A8) after vs. before standard of care (SoC) systemic treatment in patients with advanced solid tumors. Methods: Patients scheduled to start a new line of systemic treatment were included. Plasma concentrations of HMGB1 and S100A8 were measured (ng/mL) before and after three months of treatment. CD44 immunohistochemical (IHC) expression was determined in tumor tissue. After vs. before variation of paired median concentrations was analyzed with the Wilcoxon signed-rank test for the whole population and selected subgroups according to RECIST response, baseline plasmatic iron levels, CD44 expression, and platinum-based treatment. Results: Fifty-two patients were included. The most frequent tumor sites were colorectal (35%) and lung (25%). Forty-two patients (81%) received this treatment as first-line. Thirty-six patients (69%) received chemotherapy (CT) alone, ten (19%) CT plus targeted therapy (7 FOLFOX or XELOX plus bevacizumab, and one each FOLFOX plus cetuximab, FOLFOX plus panitumumab, docetaxel-trastuzumab-pertuzumab), two (3.8%) carboplatin-pemetrexed-pembrolizumab, three (5.8%) pembrolizumab alone and one (1.9%) cetuximab alone. Overall response rate (RECIST) was 42%, rate of patients with low baseline plasmatic iron levels was 53%, and CD44 expression was positive in 35% of the patients. Results on plasma concentration of DAMPS are shown in the table. Conclusions: Signals of ICD were not observed in these patients. HMGB1 variation was not significant while plasma concentration of S100A8 significantly decreased after treatment, more markedly in those patients who experienced tumor response.[Table: see text]
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Affiliation(s)
| | - Laia Capdevila
- Medical Oncology Department. Xarxa Sanitaria Santa Tecla, Tarragona, Spain
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Eremiev S, Espejo D, Florencia Pilia M, Sempere A, Teresa Martín-Góme M, Ojanguren I, Ruiz I. Pulmonary Cryptococcosis Mimicking Lung Cancer. Open Respiratory Archives 2022. [PMID: 37497319 PMCID: PMC10369628 DOI: 10.1016/j.opresp.2021.100154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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10
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Garrigós L, Saura C, Martinez-Vila C, Zambelli A, Bower M, Pistilli B, Lambertini M, Ottaviani D, Diamantis N, Lumsden A, Pernas S, Generali D, Seguí E, Viñas G, Felip E, Sanchez A, Rizzo G, Santoro A, Cortellini A, Perone Y, Chester J, Iglesias M, Betti M, Vincenzi B, Libertini M, Mazzoni F, Zoratto F, Berardi R, Guida A, Wuerstlein R, Loizidou A, Sharkey R, Aguilar Company J, Matas M, Saggia C, Chiudinelli L, Colomba-Blameble E, Galazi M, Mukherjee U, Van Hemelrijck M, Marin M, Strina C, Prat A, Pla H, Ciruelos EM, Bertuzzi A, del Mastro L, Porzio G, Newsom-Davis T, Ruiz I, Delany MB, Krengli M, Fotia V, Viansone A, Chopra N, Romeo M, Salazar R, Perez I, d’Avanzo F, Franchi M, Milani M, Pommeret F, Tucci M, Pedrazzoli P, Harbeck N, Ferrante D, Pinato DJ, Gennari A. COVID-19 in breast cancer patients: a subanalysis of the OnCovid registry. Ther Adv Med Oncol 2021; 13:17588359211053416. [PMID: 34777582 PMCID: PMC8573484 DOI: 10.1177/17588359211053416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 09/22/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Cancer patients are at higher risk of COVID-19 complications and mortality than the rest of the population. Breast cancer patients seem to have better prognosis when infected by SARS-CoV-2 than other cancer patients. METHODS We report a subanalysis of the OnCovid study providing more detailed information in the breast cancer population. RESULTS We included 495 breast cancer patients with a SARS-CoV-2 infection. Mean age was 62.6 years; 31.5% presented more than one comorbidity. The most frequent breast cancer subtype was luminal-like (n = 245, 49.5%) and 177 (35.8%) had metastatic disease. A total of 332 (67.1%) patients were receiving active treatment, with radical intent in 232 (47.6%) of them. Hospitalization rate was 58.2% and all-cause mortality rate was 20.3%. One hundred twenty-nine (26.1%) patients developed one COVID-19 complication, being acute respiratory failure the most common (n = 74, 15.0%). In the multivariable analysis, age older than 70 years, presence of COVID-19 complications, and metastatic disease were factors correlated with worse outcomes, while ongoing anticancer therapy at time of COVID-19 diagnosis appeared to be a protective factor. No particular oncological treatment was related to higher risk of complications. In the context of SARS-CoV-2 infection, 73 (18.3%) patients had some kind of modification on their oncologic treatment. At the first oncological reassessment (median time: 46.9 days ± 36.7), 255 (51.6%) patients reported to be fully recovered from the infection. There were 39 patients (7.9%) with long-term SARS-CoV-2-related complications. CONCLUSION In the context of COVID-19, our data confirm that breast cancer patients appear to have lower complications and mortality rate than expected in other cancer populations. Most breast cancer patients can be safely treated for their neoplasm during SARS-CoV-2 pandemic. Oncological treatment has no impact on the risk of SARS-CoV-2 complications, and, especially in the curative setting, the treatment should be modified as little as possible.
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Affiliation(s)
- Laia Garrigós
- Department of Medical Oncology, Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Cristina Saura
- Head Breast Cancer Unit, Vall d’Hebron University Hospital and Principal Investigator Breast Group, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebrón 119-129, 08035 Barcelona, Spain
| | | | | | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Barbara Pistilli
- Department of Medical Oncology, Institute Gustave-Roussy, Villejuif, France
| | - Matteo Lambertini
- Department of Medical Oncology, UOC Clinica di Oncologia Medica, IRCCS Policlinico San Martino Hospital, Genoa, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy
| | - Diego Ottaviani
- Cancer Division, University College London Hospitals, London, UK
| | | | - Ailsa Lumsden
- Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK
| | - Sonia Pernas
- Department of Medical Oncology, Catalan Institute of Oncology, L’Hospitalet, Spain
- Oncobell Program (IDIBELL), CIBERONC, Hospitalet de Llobregat, Barcelona, Spain
| | - Daniele Generali
- Multidisciplinary Breast Pathology and Translational Research Unit, ASST Cremona, Casalmaggiore, Italy
| | - Elia Seguí
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - Gemma Viñas
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Eudald Felip
- Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain
| | - Ana Sanchez
- Department Medical Oncology, Hospital XII de Octubre, Madrid, Spain
| | - Gianpiero Rizzo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Armando Santoro
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alessio Cortellini
- Department of Biotechnology and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
- Division of Surgery and Cancer, Hammersmith Hospital, Imperial College London, London, UK
| | - Ylenia Perone
- Medical Oncology, Velindre Cancer Centre, Cardiff, UK
| | - John Chester
- Medical Oncology, Velindre Cancer Centre, Cardiff, UK
| | - Maria Iglesias
- Department of Oncology, Hospital Universitario Son Llatzer, Palma de Mallorca, Spain
| | - Marta Betti
- Research Infrastructure, Research and Innovation Department, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Bruno Vincenzi
- Department of Oncology, University “Campus Bio-Medico”, Rome, Italy
| | - Michela Libertini
- Medical Oncology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Francesca Mazzoni
- Department of Oncology, Careggi University Hospital, Florence, Italy
| | | | - Rossana Berardi
- Oncology Clinic, Università Politecnica Delle Marche, Ospedali Riuniti Di Ancona, Ancona, Italy
| | - Annalisa Guida
- Struttura Complessa di Oncologia Medica e Traslazionale, Azienda Ospedaliera Santa Maria di Terni, Italy
| | - Rachel Wuerstlein
- Department of Gynecology and Obstetrics, Breast Center and Gynecological Cancer Center and CCC Munich, University Hospital Munich, Munich, Germany
| | - Angela Loizidou
- Department of Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Belgium
| | - Rachel Sharkey
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Juan Aguilar Company
- Department of Medical Oncology, Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
- Department of Infectious Diseases, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Marta Matas
- Department of Oncology, Hospital Althaia Manresa, Barcelona, Spain
| | - Chiara Saggia
- Department of Translational Medicine, University of Piemonte Orientale, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy
| | | | | | - Myria Galazi
- Cancer Division, University College London Hospitals, London, UK
| | - Uma Mukherjee
- Medical Oncology, Barts Health NHS Trust, London, UK
| | - Mieke Van Hemelrijck
- Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK
| | - Mar Marin
- Department of Medical Oncology, Catalan Institute of Oncology, L’Hospitalet (Barcelona), Spain
| | - Carla Strina
- Multidisciplinary Breast Pathology and Translational Research Unit, ASST Cremona, Casalmaggiore, Italy
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
- Translational Genomics and Targeted therapies Group, IDIBAPS, Barcelona, Spain
| | - Helena Pla
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | | | - Alexia Bertuzzi
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Lucia del Mastro
- Breast Unit, IRCCS Policlinico San Martino Hospital, Genoa, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy
| | | | - Thomas Newsom-Davis
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Isabel Ruiz
- Department of Infectious Diseases, Vall d’Hebron University Hospital, Barcelona, Spain
| | | | - Marco Krengli
- Division of Radiotherapy, Department of Translational Medicine, University of Eastern Piedmont and Hospital “Maggiore della Carità”, Novara, Italy
| | | | | | - Neha Chopra
- Cancer Division, University College London Hospitals, London, UK
| | - Margarita Romeo
- Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain
| | - Ramon Salazar
- Department of Medical Oncology, Catalan Institute of Oncology, L’Hospitalet (Barcelona), Spain
- Oncobell Program (IDIBELL), CIBERONC. Hospitalet de Llobregat, Spain
| | - Ignacio Perez
- Department of Oncology, Hospital Althaia Manresa, Barcelona, Spain
| | - Francesca d’Avanzo
- Department of Translational Medicine, University of Piemonte Orientale, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy
| | | | - Manuela Milani
- Multidisciplinary Breast Pathology and Translational Research Unit, ASST Cremona, Casalmaggiore, Italy
| | - Fanny Pommeret
- Department of Medical Oncology, Institute Gustave-Roussy, Villejuif, France
| | - Marco Tucci
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Nadia Harbeck
- Department of Gynecology and Obstetrics, Breast Center and Gynecological Cancer Center and CCC Munich, University Hospital Munich, Munich, Germany
| | - Daniela Ferrante
- Department of Translational Medicine, Unit of Medical Statistics, University of Piemonte Orientale and Cancer Epidemiology, CPO Piemonte, Novara, Italy
| | - David J. Pinato
- Division of Surgery and Cancer, Hammersmith Hospital, Imperial College London, London, UK
- Department of Translational Medicine, University of Piemonte Orientale, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy
| | - Alessandra Gennari
- Department of Translational Medicine, University of Piemonte Orientale, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy
- Department of Surgery and Cancer, Imperial College London, London, UK
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Carballeira T, Ruiz I, Soto M. Improving the performance of vertical flow constructed wetlands by modifying the filtering media structure. Environ Sci Pollut Res Int 2021; 28:56852-56864. [PMID: 34080115 DOI: 10.1007/s11356-021-14389-1] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/10/2021] [Indexed: 06/12/2023]
Abstract
The aim of this research was to study the influence of the bed media configuration and particle size on the treatment efficiency of subsurface vertical flow (VF) constructed wetlands (CWs) treating municipal wastewater. Two outdoor pilot units (VF1 and VF2, planted with Phragmites australis) with the configuration C1 were operated in parallel for 2 years at similar surface loading rates of 9.7 ± 3.2 (VF1) and 10.1 ± 3.3 (VF2) g biological oxygen demand (BOD5)/m2·day (19.5 ± 6.4 (VF1) and 20.4 ± 6.2 (VF2) g chemical oxygen demand (COD)/m2·day). A different configuration C2 was used during the third year at 16.9 ± 4.6 (VF1) and 18.2 ± 3.0 (VF2) g BOD5/m2·day and 26.0 ± 7.2 (VF1) and 28.0 ± 4.7 (VF2) g COD/m2·day. Two different filtering materials (1-3-mm sand for VF1 and 2-6-mm fine gravel for VF2) were used for configuration C1. The same units were modified after 2 years of operation by adding a 10-cm layer of fine sand (0-2 mm) on the top (configuration C2). In C1 conditions, the unit with the coarse material VF2 showed significantly (p < 0.05) lower removal efficiencies of total suspended solids (TSS) and BOD5 than VF1, and both units failed to meet the BOD5 discharge limit. In C2 conditions, removal efficiencies reached 82% TSS, 97% BOD5, 76-81% ammonia, and 60-66% TN, without significant differences between VF1 and VF2 units. Removal efficiencies were significantly higher for configuration C2 than that for C1, due to the positive effect of the upper fine sand layer. The presence of this fine sand layer doubled the water retention time and increased the removal rates, while the infiltration rates were high enough for an operation free of clogging.
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Affiliation(s)
- Tania Carballeira
- Department of Chemistry, University of A Coruña, Rúa da Fraga 10, 15008, A Coruña, Galiza, Spain
| | - Isabel Ruiz
- Department of Chemistry, University of A Coruña, Rúa da Fraga 10, 15008, A Coruña, Galiza, Spain
| | - Manuel Soto
- Department of Chemistry, University of A Coruña, Rúa da Fraga 10, 15008, A Coruña, Galiza, Spain.
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Ruiz I, Corona-García C, Santiago AA, Abatal M, Téllez Arias MG, Alfonso I, Vargas J. Synthesis, characterization, and assessment of novel sulfonated polynorbornene dicarboximides as adsorbents for the removal of heavy metals from water. Environ Sci Pollut Res Int 2021; 28:52014-52031. [PMID: 33997932 DOI: 10.1007/s11356-021-13757-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 03/29/2021] [Indexed: 06/12/2023]
Abstract
The occurrence of heavy metals in the natural aquatic systems arising from anthropogenic sources is an issue of global and environmental concern because of their extremely harmful effects to living beings even in rather low concentrations. The synthesis and ring-opening metathesis polymerization (ROMP) of novel norbornene dicarboximides bearing highly aromatic pendant groups, specifically, N-4-tritylphenyl-norbornene-5,6-dicarboximide (2a) and N-2,4,6-(triphenyl)phenyl-norbornene-5,6-dicarboximide (2b), their hydrogenation and further polymer sulfonation to render them adsorbents for the uptake of heavy metal ions from water is reported in this study. The macromolecules were characterized by means of FT-IR, 1H NMR, and thermal analysis, among others. A thoroughly kinetic and isothermal study of adsorption in single and ternary aqueous solutions of Pb2+, Cd2+, and Ni2+ was performed considering several experimental variables for instance initial metal concentration, contact time and solution pH. In general, the experimental data were adjusted more efficiently to the pseudo-second order kinetic model and to the Freundlich isotherm model, respectively. The maximum removal amounts were found to be 55.7 mg/g for Pb2+, 33.9 mg/g for Cd2+, and 10.2 mg/g for Ni2+ in the sulfonated trityl-bearing polymer 5a while those found for the sulfonated triphenyl-bearing polymer 5b were 31.5 mg/g for Pb2+, 26.6 mg/g for Cd2+, and 7.0 mg/g for Ni2+, respectively. The higher heavy metal removal capacity of polymer 5a was attributed to its also higher degree of sulfonation. The outcomes indicate that these novel sulfonic acid containing polymer-based adsorbents are effective for the uptake of heavy metallic elements from water.
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Affiliation(s)
- Isabel Ruiz
- Instituto de Investigaciones en Materiales, Unidad Morelia, Universidad Nacional Autónoma de México, Antigua Carretera a Pátzcuaro No. 8701, Col. Ex Hacienda de San José de la Huerta, C.P. 58190, Morelia, Michoacán, México
| | - Carlos Corona-García
- Instituto de Investigaciones en Materiales, Unidad Morelia, Universidad Nacional Autónoma de México, Antigua Carretera a Pátzcuaro No. 8701, Col. Ex Hacienda de San José de la Huerta, C.P. 58190, Morelia, Michoacán, México
| | - Arlette A Santiago
- Escuela Nacional de Estudios Superiores, Unidad Morelia, Universidad Nacional Autónoma de México, Antigua Carretera a Pátzcuaro No. 8701, Col. Ex Hacienda de San José de la Huerta, C.P. 58190, Morelia, Michoacán, México
| | - Mohamed Abatal
- Facultad de Ingeniería, Universidad Autónoma del Carmen, Avenida Central S/N Esq. con Fracc. Mundo Maya, C.P. 24115, Ciudad del Carmen, Campeche, México
| | - Mercedes Gabriela Téllez Arias
- Facultad de Ingeniería Química, Edif. M-CU, Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, C. P. 58060, México
| | - Ismeli Alfonso
- Instituto de Investigaciones en Materiales, Unidad Morelia, Universidad Nacional Autónoma de México, Antigua Carretera a Pátzcuaro No. 8701, Col. Ex Hacienda de San José de la Huerta, C.P. 58190, Morelia, Michoacán, México
| | - Joel Vargas
- Instituto de Investigaciones en Materiales, Unidad Morelia, Universidad Nacional Autónoma de México, Antigua Carretera a Pátzcuaro No. 8701, Col. Ex Hacienda de San José de la Huerta, C.P. 58190, Morelia, Michoacán, México.
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Gonzalo OG, Ruiz I, Soto M. Effect of different bypass rates and unit area ratio in hybrid constructed wetlands. Environ Sci Pollut Res Int 2020; 27:40355-40369. [PMID: 32666454 DOI: 10.1007/s11356-020-09982-9] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/01/2020] [Indexed: 06/11/2023]
Abstract
This study presents the performance of a hybrid constructed wetland (Bp(VF + HF)2:1) system which consists of an unsaturated vertical flow (VF) unit followed by a saturated down-flow unit simulating horizontal flow (HF) with HF/VF area ratio of 0.5 and influent bypass to the HF unit. Treating synthetic wastewater simulating municipal wastewater, optimum total nitrogen (TN) removal (57%) was reached at 39% bypass and surface loading rate (SLR) of 33 g BOD5/m2 day and 9.7 g TN/m2 day (overall system). On the other hand, treating actual municipal wastewater, the system reached 63% TN removal at 30% bypass and SLR of 18 g BOD5/m2 day and 4.7 g TN/m2 day. Surface removal rates reached 5.5 and 3.0 g TN/m2 day for synthetic and municipal wastewater. Surface nitrification rate in the VF unit was in the range of 5.0-7.4 and 3.6-3.8 g N/m2 day for synthetic and municipal wastewater, respectively, indicating a large effect of wastewater characteristics on the nitrification process. Infiltration rate in the VF unit remained high and far from clogging risk. Overall greenhouse gas emissions were 0.11 (N2O) and 0.41 (CH4) g/m2 day which corresponded to emissions factors (relative to total organic carbon and TN influent) of 0.7% (N2O) and 3.6% (CH4). Compared with a similar system with a different HF/VF area ratio of 2.0, organic matter and nitrogen removal efficiency was similar, but surface removal rates were about 3 times higher.
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Affiliation(s)
- Omar Gael Gonzalo
- Department of Chemistry, University of A Coruña, Rúa da Fraga 10, 15008, A Coruña, Galiza, Spain
| | - Isabel Ruiz
- Department of Chemistry, University of A Coruña, Rúa da Fraga 10, 15008, A Coruña, Galiza, Spain
| | - Manuel Soto
- Department of Chemistry, University of A Coruña, Rúa da Fraga 10, 15008, A Coruña, Galiza, Spain.
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García-Juárez I, Campos-Murguía A, Tovar-Méndez V, Gabutti A, Ruiz I. Unexpected better outcome in a liver transplant recipient with COVID-19: a beneficial effect of tacrolimus? Revista de Gastroenterología de México (English Edition) 2020. [PMCID: PMC7547645 DOI: 10.1016/j.rgmxen.2020.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Barranco P, Palao P, Ruiz I, Domínguez-Ortega J, Vilà-Nadal G, Pola B, Quirce S. Relationship Between IgE-Mediated Sensitization to Staphylococcus aureus Enterotoxin B, Asthma Severity, and Atopy. J Investig Allergol Clin Immunol 2020; 31:170-173. [PMID: 32694100 DOI: 10.18176/jiaci.0573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- P Barranco
- Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain.,CIBER of Respiratory Diseases, CIBERES, Madrid, Spain
| | - P Palao
- Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain.,Allergy Unit, Regional University Hospital, Malaga, Spain
| | - I Ruiz
- Department of Intensive Care, Gregorio Marañón University Hospital, Madrid, Spain
| | - J Domínguez-Ortega
- Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain.,CIBER of Respiratory Diseases, CIBERES, Madrid, Spain
| | - G Vilà-Nadal
- Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - B Pola
- Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - S Quirce
- Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain.,CIBER of Respiratory Diseases, CIBERES, Madrid, Spain
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Rubio MJ, Lecumberri MJ, Varela S, Alarcón J, Ortega ME, Gaba L, Espinós J, Calzas J, Barretina P, Ruiz I, Marquina G, Santaballa A. Efficacy and safety of trabectedin in metastatic uterine leiomyosarcoma: A retrospective multicenter study of the Spanish ovarian cancer research group (GEICO). Gynecol Oncol Rep 2020; 33:100594. [PMID: 32566719 PMCID: PMC7296187 DOI: 10.1016/j.gore.2020.100594] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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] [Received: 02/05/2020] [Revised: 05/26/2020] [Accepted: 05/31/2020] [Indexed: 02/06/2023] Open
Abstract
Trabectedin confers clinical benefit in patients with recurrent/metastatic uterine leiomyosarcoma. Our data are similar to those previously reported in clinical studies. Trabectedin is especially effective when administered in earlier lines. Trabectedin has a manageable safety profile.
Objective We assessed trabectedin in patients with advanced uterine leiomyosarcoma (uLMS) in real-life clinical practice given according to the marketing authorization. Methods Thirty-six women from 11 tertiary hospitals across Spain who received trabectedin after anthracycline-containing regimen/s were retrospectively analyzed. The primary endpoint was progression-free survival (PFS). Results Median PFS and overall survival (OS) since starting trabectedin treatment were 5.4 (95%CI: 3.5–7.3) and 18.5 months (95%CI: 11.5–25.6), respectively. Median OS was significantly higher (P = 0.028) in patients receiving trabectedin in ≤ 2nd line (25.3 months) than in ≥ 3rd (15.1 months) and with ECOG performance status ≤ 1 at trabectedin start (19.8 months) than ECOG 2–3 (6.0 months, P = 0.013). When calculating OS since diagnosis, patients had longer OS with localized disease at diagnosis (87.4 months) vs. locally advanced (30.0 months) or metastatic (44.0 months, P = 0.041); and patients who received adjuvant therapy (87.4 months) compared with those who did not (30.0 months, P = 0.003), especially when receiving radiochemotherapy (106.7 months, P = 0.027). One patient (2.8%) had a complete response (CR) and nine patients (25.0%) achieved a partial response (PR) for an objective response rate of 27.8% with median response duration of 11 months (range: 4–93). Eighteen patients (50.0%) had disease stabilization for a disease control rate (DCR) of 77.8%. More patients receiving trabectedin in 1st-line of advanced disease achieved CR (16.7%) and PR (50.0%) than those in ≥ 2nd line/s (0.0% and 20.0%), whereas the DCR was similar across treatment lines. Reversible neutropenia was the most common grade 3/4 laboratory abnormality (19.4%). Conclusions Trabectedin confers clinical benefit in patients with recurrent/metastatic uLMS, given after failure to an anthracycline-based regimen being comparable to those reported in clinical trials and with a manageable safety profile.
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Affiliation(s)
- María Jesús Rubio
- Hospital Universitario Reina Sofía, Córdoba, Spain
- Corresponding author at: Hospital Universitario Reina Sofía, Córdoba, Spain.
| | | | | | - Jesús Alarcón
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | | | - Lydia Gaba
- Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Julia Calzas
- Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Isabel Ruiz
- Hospital Universitario Sant Joan de Reus, Reus, Spain
| | | | - Ana Santaballa
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
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López-Sánchez C, Valcárcel D, Gómez V, López-Jiménez J, Serrano D, Rubio V, Solano C, Vázquez L, Ruiz I. Use of micafungin as antifungal prophylaxis in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) in Spain (GETH-MIC). Rev Esp Quimioter 2020; 33:110-115. [PMID: 32056418 PMCID: PMC7111230 DOI: 10.37201/req/094.2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Introduction The fungal infections remain an important problem in the allogeneic stem cell trasnsplantation (allo-SCT) setting and thus, anti-fungal prophylaxis is commonly used. The antifungal drug should offer activity, at least against Candida and Aspergillus spp., a good safety profile and low probability interactions. Micafungin could theoretically fulfill these requisites. The aim of the study was to describe the experience with micafungin as primary prophylaxis in patients undergoing allo-SCT in a cohort of Spanish centres, and to evaluate its efficacy and tolerability in this population. Material and methods Retrospective multicentre observational study including all consecutive adult patients admitted for allo-SCT in participating centres of the Grupo Español de Trasplante Hematopoyético (GETH), from January 2010 to December 2013, who received micafungin as primary prophylaxis during the neutropenic period. Results A total of 240 patients from 13 centres were identified and 159 patients were included for the analysis. Most patients (95.6%) received 50 mg/day of micafungin. During the follow-up, 7 (4.4%) patients developed breakthrough invasive fungal disease, 1 proven and 6 probable; one patient discontinued the drug because of serious drug interactions. Prophylaxis with micafungin was considered effective in 151 (94.9%) patients. Conclusions According to our experience, micafungin is an appropriate alternative for antifungal prophylaxis in patients undergoing an allo-HSCT, because its efficacy, its low profile of drug interactions and side-effects.
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Affiliation(s)
| | | | | | | | | | | | | | | | - I Ruiz
- Isabel Ruiz Camps, Infectious Diseases Department. University Hospital Vall d'Hebron. Paseo de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
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Schmid P, Zaiss M, Harper-Wynne C, Ferreira M, Dubey S, Chan S, Makris A, Nemsadze G, Brunt AM, Kuemmel S, Ruiz I, Perelló A, Kendall A, Brown J, Kristeleit H, Conibear J, Saura C, Grenier J, Máhr K, Schenker M, Sohn J, Lee KS, Shepherd CJ, Oelmann E, Sarker SJ, Prendergast A, Marosics P, Moosa A, Lawrence C, Coetzee C, Mousa K, Cortés J. Fulvestrant Plus Vistusertib vs Fulvestrant Plus Everolimus vs Fulvestrant Alone for Women With Hormone Receptor-Positive Metastatic Breast Cancer: The MANTA Phase 2 Randomized Clinical Trial. JAMA Oncol 2019; 5:1556-1564. [PMID: 31465093 PMCID: PMC6865233 DOI: 10.1001/jamaoncol.2019.2526] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Question Does the addition of vistusertib increase progression-free survival and other measures of antitumor activity of fulvestrant in postmenopausal women with estrogen receptor–positive advanced or metastatic breast cancer that progressed after prior therapy with aromatase inhibitors? Findings This randomized clinical trial in 333 patients failed to demonstrate a benefit of vistusertib plus fulvestrant vs fulvestrant alone. In addition, the outcomes in both vistusertib groups were inferior to those in the group treated with fulvestrant plus everolimus. Meaning The results suggest that dual mammalian target of rapamycin inhibition with vistusertib at the maximal tolerated doses is inferior to mammalian target of rapamycin complex 1 inhibition with the rapamycin analogue everolimus. Importance Randomized clinical trials have demonstrated a substantial benefit of adding everolimus to endocrine therapy. Everolimus inhibits the mammalian target of rapamycin complex 1 (mTORC1) complex but not mTORC2, which can set off an activating feedback loop via mTORC2. Vistusertib, a dual inhibitor of mTORC1 and mTORC2, has demonstrated broad activity in preclinical breast cancer models, showing superior activity to everolimus. Objective To evaluate the safety and efficacy of vistusertib in combination with fulvestrant compared with fulvestrant alone or fulvestrant plus everolimus in postmenopausal women with estrogen receptor–positive advanced or metastatic breast cancer. Design, Setting, and Participants The MANTA trial is an open-label, phase 2 randomized clinical trial in which 333 patients with estrogen receptor–positive breast cancer progressing after prior aromatase inhibitor treatment underwent randomization (2:3:3:2) between April 1, 2014, and October 24, 2016, at 88 sites in 9 countries: 67 patients were assigned to receive fulvestrant, 103 fulvestrant plus vistusertib daily, 98 fulvestrant plus vistusertib intermittently, and 65 fulvestrant plus everolimus. Treatment was continued until disease progression, development of unacceptable toxic effects, or withdrawal of consent. Analysis was performed on an intention-to-treat basis. Interventions Fulvestrant alone or in combination with vistusertib (continuous or intermittent dosing schedules) or everolimus. Main Outcomes and Measures The primary end point was progression-free survival (PFS). Results Among the 333 women in the study (median age, 63 years [range, 56-70 years]), median PFS was 5.4 months (95% CI, 3.5-9.2 months) with fulvestrant, 7.6 months (95% CI, 5.9-9.4 months) with fulvestrant plus daily vistusertib, 8.0 months (95% CI, 5.6-9.9 months) with fulvestrant plus intermittent vistusertib, and 12.3 months (95% CI, 7.7-15.7 months) with fulvestrant plus everolimus. There was no significant difference in PFS between those receiving fulvestrant plus daily or intermittent vistusertib and fulvestrant alone (hazard ratio, 0.88 [95% CI, 0.63-1.24]; P = .46; and hazard ratio, 0.79 [95% CI, 0.55-1.12]; P = .16). Conclusions and Relevance The combination of fulvestrant plus everolimus demonstrated significantly longer PFS compared with fulvestrant plus vistusertib or fulvestrant alone. The trial failed to demonstrate a benefit of adding the dual mTORC1 and mTORC2 inhibitor vistusertib to fulvestrant. Trial Registration ClinicalTrials.gov identifier: NCT02216786 and EudraCT number: 2013-002403-34
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Affiliation(s)
- Peter Schmid
- Barts Cancer Institute, Centre for Experimental Cancer Medicine, Queen Mary University of London, London, United Kingdom.,Oncology-Clinical, Barts Health National Health Service Trust, London, United Kingdom
| | - Matthias Zaiss
- Praxis fuer Interdisziplinaere Onkologie, Freiburg, Germany
| | - Catherine Harper-Wynne
- Kent Oncology Centre, Maidstone and Tunbridge Wells National Health Service Trust, Tunbridge Wells, United Kingdom
| | - Marta Ferreira
- Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal
| | - Sidharth Dubey
- Oncology, Derriford Hospital, Plymouth Hospitals National Health System Trust, Plymouth, United Kingdom
| | - Stephen Chan
- Oncology-Clinical, Nottingham University Hospitals National Health System Trust, Nottingham, United Kingdom
| | - Andreas Makris
- Mount Vernon Cancer Centre, East & North Herts National Health System Trust, London, United Kingdom
| | - Gia Nemsadze
- Institute of Clinical Oncology, Tbilisi, Republic of Georgia
| | - Adrian M Brunt
- Cancer Centre, University Hospitals of North Midlands National Health System Trust, Stoke-on-Trent, United Kingdom
| | | | - Isabel Ruiz
- Hospital Universitario Sant Joan De Reus, Tarragona, Spain
| | | | - Anne Kendall
- Cancer Services, Great Western Hospitals National Health System Foundation Trust, Swindon, United Kingdom
| | - Janet Brown
- Academic Unit of Clinical Oncology, University of Sheffield, Sheffield, United Kingdom
| | - Hartmut Kristeleit
- Medical Oncology, Queen Elizabeth Hospital, Woolwich, Lewisham and Greenwich National Health System Trust, London, United Kingdom
| | - John Conibear
- Oncology-Clinical, Barts Health National Health Service Trust, London, United Kingdom
| | - Cristina Saura
- Vall d'Hebron Institute of Oncology, SOLTI Breast Cancer Research Group, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | | | - Michael Schenker
- Sf Nectarie Oncology Center Societate cu Raspundere Limitata, Craiova, Dolj, Romania
| | - Joohyuk Sohn
- Yonsei University Health System, Seoul, Republic of Korea
| | - Keun Seok Lee
- National Cancer Center, Goyang-si Gyeonggi-do, Republic of Korea
| | - Christopher J Shepherd
- Oncology Translational Medicine Unit, Innovative Medicines and Early Drug Development Biotech Unit, AstraZeneca, Cambridge, United Kingdom
| | - Elisabeth Oelmann
- Oncology Translational Medicine Unit, Innovative Medicines and Early Drug Development Biotech Unit, AstraZeneca, Cambridge, United Kingdom
| | - Shah-Jalal Sarker
- Barts Cancer Institute, Centre for Experimental Cancer Medicine, Queen Mary University of London, London, United Kingdom
| | - Aaron Prendergast
- Barts Cancer Institute, Centre for Experimental Cancer Medicine, Queen Mary University of London, London, United Kingdom
| | - Patricia Marosics
- Barts Cancer Institute, Centre for Experimental Cancer Medicine, Queen Mary University of London, London, United Kingdom
| | - Atiyyah Moosa
- Barts Cancer Institute, Centre for Experimental Cancer Medicine, Queen Mary University of London, London, United Kingdom
| | - Cheryl Lawrence
- Barts Cancer Institute, Centre for Experimental Cancer Medicine, Queen Mary University of London, London, United Kingdom
| | - Carike Coetzee
- Barts Cancer Institute, Centre for Experimental Cancer Medicine, Queen Mary University of London, London, United Kingdom
| | - Kelly Mousa
- Barts Cancer Institute, Centre for Experimental Cancer Medicine, Queen Mary University of London, London, United Kingdom
| | - Javier Cortés
- Vall d'Hebron Institute of Oncology, SOLTI Breast Cancer Research Group, Vall d'Hebron University Hospital, Barcelona, Spain.,Ramon y Cajal University Hospital, Madrid, Spain.,Baselga Oncology Institute, Institute of Oncology, QuironGroup, Madrid, Spain
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Montero E, Puig-Pey I, Prado M, Huete L, Acemel D, Ruiz I, Banús C, Salas A, Laso J, Andreoni L. A case report: Acquired hemophilia A detected in the Laboratory of Hemostasia. Are the diagnostic algorithms necessary? Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.845] [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: 10/26/2022]
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Cruz-Hernández JJ, Ruiz I, Fernandez-Marcos A, Martin R, Aranda E, Carrato A, Díaz-Rubio E, Guillem V, Lopez R, Feyjoo M, Ferrer R, Gonzalez-Garcia N, Nieto-Librero A, Gonzalo-Gomez A, Camps C. Non-clinical needs of cancer patients in Spain under different perspectives: A comparative study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e18266] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e18266 Background: Patients with cancer and their caregivers express unmet needs beyond the clinical approach to cancer. The ECO Foundation (Quality and Excellence in Oncology) and the Spanish Association Against Cancer (AECC) have promoted a qualitative research study with the objective to compare the perceptions of newly diagnosed and 2-3 years after diagnosis cancer patients, caregivers, oncologists, nurses and social workers in relation to a set of non-clinical needs expressed by cancer patients and caregivers, and to obtain concrete and feasible proposals for improvement aimed at satisfying these needs. Methods: A multidisciplinary group of experts developed a questionnaire containing information processes for cancer patients and caregivers, shared decision-making, healthcare circuits, the architecture of consultations, psychological support, support of associations and hospital social workers. Fourteen Medical Oncology Services of Spanish hospitals have participated in this study collecting 310 forms. Data were statistically analyzed using Fisher's exact test. Results: Information processes. The opportunity to have a second opinion is positively valuated for 72.6% of patients and 70.2% of caregivers. However, although 62.5% of oncologists referred to offer this option to their patients, only 10.9% of patients reported having received it. Shared decision-making. For 58% of oncologists, patients are sufficiently trained to share decision-making, but only 24.6% of newly diagnosed patients consider being prepared. In addition, although 95.8% of oncologists report offering the participation of their patients in decision-making, only 45.8% of newly diagnosed patients and 64.4% of 2-3 years after diagnosis patients, consider having received this opportunity. Psychological support. Psychological assistance was considered positive for 94.2% of the patients, 97.4% of the caregivers, 85.4% of the oncologists and 97.1% of the nurses. However, only 21.3% of oncologists and 31.4% of nurses recognize offering such proffessional care given by psychologists to patients. Conclusions: Knowing the non-clinical needs, not only of patients and caregivers, but also from the health care professionals, is essential when designing health strategies that should align the perceptions of patients and health care professionals.
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Affiliation(s)
- Juan J. Cruz-Hernández
- ECO Foundation, Hospital Universitario de Salamanca,Universidad de Salamanca, Madrid, Spain
| | - Isabel Ruiz
- Complejo Asistencial de Palencia, Palencia, Spain
| | | | | | - Enrique Aranda
- Fundación ECO, Servicio de Oncología Médica, Hospital Reina Sofía de Córdoba, IMIBIC, CIBERONC, Universidad de Córdoba, Córdoba, Spain
| | - Alfredo Carrato
- Fundación ECO, Servicio de Oncología Médica, Hospital Ramón y Cajal, Madrid, Spain
| | - Eduardo Díaz-Rubio
- Fundación ECO, Vicepresidente de la Real Academia de Medicina; IdISCC; CIBERONC, Madrid, Spain
| | - Vicente Guillem
- ECO Foundation, Instituto Valenciano de Oncología, Madrid, Spain
| | - Rafael Lopez
- ECO Foundation, Hospital Clinico Santiago, Madrid, Spain
| | - Margarita Feyjoo
- Servicio de Oncología Médica, Hospital Universitario La Moraleja, Sanitas, Madrid, Spain
| | | | | | | | | | - Carlos Camps
- ECO Foundation, Medical Oncology Department, General University Hospital of Valencia, Valencia, Spain, Department of Medicine, Universitat de Valencia (CIBERONC), Madrid, Spain
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Ruiz I. Optimizing the treatment strategy to achieve hepatitis C virus elimination in Mexico. Rev Gastroenterol Mex (Engl Ed) 2019; 84:267-268. [PMID: 31053246 DOI: 10.1016/j.rgmx.2018.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 07/12/2018] [Indexed: 06/09/2023]
Affiliation(s)
- I Ruiz
- Department of Hepatology, Hôpital Henri Mondor, Université Paris-Est, Créteil, France; INSERM U955, Institut Mondor de Recherche Biomédicale, Créteil, France; National Reference Center for Viral Hepatitis B, C and D, Department of Virology, Hôpital Henri Mondor, Université Paris-Est, Créteil, France.
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Ruiz I. Optimizing the treatment strategy to achieve hepatitis C virus elimination in Mexico. Revista de Gastroenterología de México (English Edition) 2019. [DOI: 10.1016/j.rgmxen.2018.07.005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Gavilá J, Oliveira M, Pascual T, Perez-Garcia J, Gonzàlez X, Canes J, Paré L, Calvo I, Ciruelos E, Muñoz M, Virizuela JA, Ruiz I, Andrés R, Perelló A, Martínez J, Morales S, Marín-Aguilera M, Martínez D, Quero JC, Llombart-Cussac A, Prat A. Safety, activity, and molecular heterogeneity following neoadjuvant non-pegylated liposomal doxorubicin, paclitaxel, trastuzumab, and pertuzumab in HER2-positive breast cancer (Opti-HER HEART): an open-label, single-group, multicenter, phase 2 trial. BMC Med 2019; 17:8. [PMID: 30621698 PMCID: PMC6325829 DOI: 10.1186/s12916-018-1233-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 12/10/2018] [Indexed: 01/06/2023] Open
Affiliation(s)
- Joaquín Gavilá
- Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Mafalda Oliveira
- Vall d' Hebron University Hospital/Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Tomás Pascual
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Hospital Clínic, Barcelona, Spain.,SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - Jose Perez-Garcia
- Vall d' Hebron University Hospital/Vall d'Hebron Institute of Oncology, Barcelona, Spain.,Instituto Oncológico Baselga, Hospital Quirón, Barcelona, Spain
| | - Xavier Gonzàlez
- SOLTI Breast Cancer Research Group, Barcelona, Spain.,Institut Oncològic Rosell, Hospital General Catalunya, Barcelona, Spain
| | - Jordi Canes
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - Laia Paré
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Isabel Calvo
- Centro Integral Oncológico Clara Campal, Madrid, Spain
| | | | - Montserrat Muñoz
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Hospital Clínic, Barcelona, Spain
| | | | - Isabel Ruiz
- Hospital Universitario Sant Joan De Reus, Reus, Spain
| | - Raquel Andrés
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | | | | | | | - Débora Martínez
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | | | | | - Aleix Prat
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain. .,Hospital Clínic, Barcelona, Spain. .,SOLTI Breast Cancer Research Group, Barcelona, Spain.
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Porras-Segovia A, Valmisa E, Gutiérrez B, Ruiz I, Rodríguez-Barranco M, Cervilla J. Prevalence and correlates of major depression in Granada, Spain: Results from the GranadΣp study. Int J Soc Psychiatry 2018; 64:450-458. [PMID: 29843555 DOI: 10.1177/0020764018771405] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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] [Indexed: 12/16/2022]
Abstract
BACKGROUND Major depression is one of the world's leading causes of disability. Up-to-date information about the epidemiology of this disorder is key to health care planning. AIM The aim of our study is to report prevalence and correlates of current major depressive disorder (MDD) in the province of Granada, Southern Spain. METHODS The GranadΣp is a cross-sectional study based on a community-dwelling adult population living in the province of Granada, Southern Spain. Community-dwelling adults aged 18-80 years ( n = 810) were interviewed using the Mini-International Neuropsychiatric Interview (MINI). A variety of exposure assessments were also undertaken. RESULTS Point (2 weeks) prevalence of MDD in the Granada population was 5.6%. Positive family history of mental illness, high degree of neuroticism, high number of life threatening events (LTE), poor physical health status, cognitive impairment and cannabis use were independently associated with MDD in the multivariate regression model. Being female was also associated with MDD, but the significance disappeared after adjusting for neuroticism and physical health. CONCLUSION Prevalence of MDD in the Granada population is higher than expected. The effects of the financial crisis could be partially accountable for this excess in prevalence. Six variables were found to be independently associated with MDD. Association between female sex and depression may be partially explained by the confounding effect of neuroticism.
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Affiliation(s)
| | | | - Blanca Gutiérrez
- 3 Department of Psychiatry, University of Granada, Granada, Spain
| | - Isabel Ruiz
- 4 Escuela Andaluza de Salud Pública, Granada, Spain
| | | | - Jorge Cervilla
- 1 International School for Postgraduate Studies, University of Granada, Granada, Spain.,3 Department of Psychiatry, University of Granada, Granada, Spain
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Giuntella O, Kone ZL, Ruiz I, Vargas-Silva C. Reason for immigration and immigrants' health. Public Health 2018; 158:102-109. [PMID: 29576228 DOI: 10.1016/j.puhe.2018.01.037] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [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: 06/14/2017] [Revised: 01/26/2018] [Accepted: 01/29/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The existing literature on the health trajectories of the UK immigrants has mainly focussed on the relationship between ethnicity and health. There is little information on the role of immigration status and no previous information on the role of reason for immigration to the country. This study fills this gap in the literature by analysing the heterogeneity of immigrant-native differences in health by reason for immigration. STUDY DESIGN Analysis of cross-sectional quarterly data from the UK Labour Force Survey covering the period of 2010 (quarter 1) to 2017 (quarter 2). The sample includes 345,086 observations. The dependent variables of interest include suffering from a long-lasting condition, the link between long-lasting conditions and labour market performance and the prevalence of 12 specific health conditions. METHODS Data were analysed using linear probability models to adjust for differences in age, education, gender, ethnicity, local authority of residence and year of survey. The analysis also explores the role of length of stay in the UK and the percentage of current lifetime spent in the UK (duration in the UK/age). RESULTS Results indicate that, in general, immigrants are less likely than natives to report suffering from a long-lasting (1 year or more) health problem. This pattern generally remains the same when we consider the specificity of the long-lasting health problem. However, there are key differences across the immigrant groups by reason for immigration. Those who migrated for employment, family and study reasons report better health outcomes than natives, while those who migrated to seek asylum report worse health outcomes than natives. There is convergence to natives' health outcomes over time for those who migrated for non-asylum reasons, but not for those who migrated to seek asylum. CONCLUSIONS The findings show that the prevalence of health problems differs not only between natives and immigrants but also across groups of immigrants who moved to the UK for different reasons.
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Affiliation(s)
| | - Z L Kone
- University of Oxford, United Kingdom.
| | - I Ruiz
- University of Oxford, United Kingdom.
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Fourati S, Guedj J, Chevaliez S, Nguyen THT, Roudot-Thoraval F, Ruiz I, Soulier A, Scoazec G, Varaut A, Poiteau L, Francois M, Mallat A, Hézode C, Pawlotsky JM. Viral kinetics analysis and virological characterization of treatment failures in patients with chronic hepatitis C treated with sofosbuvir and an NS5A inhibitor. Aliment Pharmacol Ther 2018; 47:665-673. [PMID: 29271114 DOI: 10.1111/apt.14478] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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] [Received: 10/13/2017] [Revised: 11/02/2017] [Accepted: 11/29/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND The combination of sofosbuvir (SOF) plus an NS5A inhibitor for 12 weeks is highly efficacious in patients with chronic hepatitis C. As the costs of generic production of sofosbuvir and NS5A inhibitor are rapidly decreasing, the combination of these DAAs will be the standard treatment in most low- to middle-income countries in the future. AIM To identify key predictors of response that can be used to tailor treatment decisions. METHODS A cohort of 216 consecutive patients infected with HCV genotype 1 (1a: n = 57; 1b: n = 77), 2 (n = 4), 3 (n = 33) or 4 (n = 44) were treated with sofosbuvir (SOF) + daclatasvir (n = 176) or SOF + ledipasvir (n = 40) for 12 weeks. The viral kinetics was analysed using the biphasic model and the cure boundary was used to predict time to clear HCV. RESULTS The overall SVR rate was high (94.4%; n = 204), regardless of the time to viral suppression or low-level viraemia at the end of treatment. The model-based predicted HCV RNA levels at the end of treatment could not differentiate patients who did from those who did not achieve SVR. The presence of NS5A resistance-associated substitutions [position 28 (OR = 70.3, P<.001) and/or 31 (OR = 61.6, P = .002)] at baseline was predictive of virological failure in cirrhotic patients but was not associated with on-treatment viral kinetics. CONCLUSION This real-world study confirms the excellent results of clinical trials with therapies based on a combination of SOF plus an NS5A inhibitor. It suggests that a personalized approach including baseline NS5A inhibitor resistance testing may inform treatment decisions in cirrhotic patients.
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Affiliation(s)
- S Fourati
- Department of Virology, Henri Mondor Hospital, National Reference Center for Viral Hepatitis B, C and D, University of Paris-Est, Créteil, France.,INSERM U955, Créteil, France
| | - J Guedj
- INSERM U1137, IAME, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - S Chevaliez
- Department of Virology, Henri Mondor Hospital, National Reference Center for Viral Hepatitis B, C and D, University of Paris-Est, Créteil, France.,INSERM U955, Créteil, France
| | | | - F Roudot-Thoraval
- Department of Public Health, Henri Mondor Hospital, University of Paris-Est, Créteil, France
| | - I Ruiz
- INSERM U955, Créteil, France.,Department of Hepatology, Henri Mondor Hospital, University of Paris-Est, Créteil, France
| | - A Soulier
- Department of Virology, Henri Mondor Hospital, National Reference Center for Viral Hepatitis B, C and D, University of Paris-Est, Créteil, France.,INSERM U955, Créteil, France
| | - G Scoazec
- Department of Hepatology, Henri Mondor Hospital, University of Paris-Est, Créteil, France
| | - A Varaut
- Department of Hepatology, Henri Mondor Hospital, University of Paris-Est, Créteil, France
| | - L Poiteau
- Department of Virology, Henri Mondor Hospital, National Reference Center for Viral Hepatitis B, C and D, University of Paris-Est, Créteil, France.,INSERM U955, Créteil, France
| | - M Francois
- Department of Hepatology, Henri Mondor Hospital, University of Paris-Est, Créteil, France
| | - A Mallat
- Department of Hepatology, Henri Mondor Hospital, University of Paris-Est, Créteil, France
| | - C Hézode
- Department of Hepatology, Henri Mondor Hospital, University of Paris-Est, Créteil, France
| | - J-M Pawlotsky
- Department of Virology, Henri Mondor Hospital, National Reference Center for Viral Hepatitis B, C and D, University of Paris-Est, Créteil, France.,INSERM U955, Créteil, France
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Undabeitia J, Torres-Bayona S, Samprón N, Arrázola M, Bollar A, Armendariz M, Torres P, Ruiz I, Caballero M, Egaña L, Querejeta A, Villanua J, Pardo E, Etxegoien I, Liceaga G, Urtasun M, Michan M, Emparanza J, Aldaz P, Matheu A, Úrculo E. Indirect costs associated with glioblastoma: Experience at one hospital. Neurología (English Edition) 2018. [DOI: 10.1016/j.nrleng.2016.05.009] [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] Open
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28
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Pousa E, Ochoa S, Cobo J, Nieto L, Usall J, Gonzalez B, Garcia-Ribera C, Pérez Solà V, Ruiz AI, Baños I, Cobo J, García-Ribera C, González B, Massons C, Nieto L, Monserrat C, Ochoa S, Pousa E, Ruiz AI, Ruiz I, Sanchez-Cabezudo D, Usall J. A deeper view of insight in schizophrenia: Insight dimensions, unawareness and misattribution of particular symptoms and its relation with psychopathological factors. Schizophr Res 2017; 189:61-68. [PMID: 28237605 DOI: 10.1016/j.schres.2017.02.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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: 11/25/2016] [Revised: 02/08/2017] [Accepted: 02/11/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE 1. To describe insight in a large sample of schizophrenia subjects from a multidimensional point of view, including unawareness of general insight dimensions as well as unawareness and misattribution of particular symptoms. 2. To explore the relationship between unawareness and clinical and socio-demographic variables. METHODS 248 schizophrenia patients were assessed with the Positive and Negative Syndrome Scale (PANSS, five factor model of Lindenmayer) and the full Scale of Unawareness of Mental Disorder (SUMD). Bivariate associations and multiple linear regression analyses were used to investigate the relationship between unawareness, symptoms and socio-demographic variables. RESULTS Around 40% of the sample showed unawareness of mental disorder, of the need for medication and of the social consequences. Levels of unawareness and misattribution of particular symptoms varied considerably. General unawareness dimensions showed small significant correlations with positive, cognitive and excitement factors of psychopathology, whereas these symptom factors showed higher correlations with unawareness of particular symptoms. Similarly, regression models showed a small significant predictive value of positive symptoms in the three general unawareness dimensions while a moderate one in the prediction of particular symptoms. Misattribution showed no significant correlations with any symptom factors. CONCLUSIONS Results confirm that insight in schizophrenia is a multi-phased phenomenon and that unawareness into particular symptoms varies widely. The overlap between unawareness dimensions and psychopathology is small and seems to be restricted to positive and cognitive symptoms, supporting the accounts from cognitive neurosciences that suggest that besides basic cognition poor insight may be in part a failure of self-reflection or strategic metacognition.
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Affiliation(s)
- Esther Pousa
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Salut Mental. Parc Taulí Sabadell, Hospital Universitari - UAB Universitat Autònoma de Barcelona, CIBERSAM, Campus d'Excel.lència Internacional. 08208 Sabadell, Barcelona, Spain.
| | - Susana Ochoa
- Research and Development Unit, Parc Sanitari San Joan de Dèu - CIBERSAM Sant Boi de Llobregat, Barcelona, Spain
| | - Jesús Cobo
- Salut Mental. Parc Taulí Sabadell, Hospital Universitari - UAB Universitat Autònoma de Barcelona, CIBERSAM, Campus d'Excel.lència Internacional. 08208 Sabadell, Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Spain
| | - Lourdes Nieto
- Department of Research; Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz.Calzada México-Xochimilco 101. 14370 San Lorenzo Huipulco - Tlalpan, México D. F. México
| | - Judith Usall
- Research and Development Unit, Parc Sanitari San Joan de Dèu - CIBERSAM Sant Boi de Llobregat, Barcelona, Spain
| | - Beatriz Gonzalez
- Research and Development Unit, Parc Sanitari San Joan de Dèu - CIBERSAM Sant Boi de Llobregat, Barcelona, Spain
| | - Carles Garcia-Ribera
- Servicio de Psiquiatría del Hospital de la Santa Creu i Sant Pau Barcelona, IIB-Sant Pau, Sant Quintí 89, 08025 Barcelona, Spain
| | - Victor Pérez Solà
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Spain; Servicio de Psiquiatría del Hospital de la Santa Creu i Sant Pau Barcelona, IIB-Sant Pau, Sant Quintí 89, 08025 Barcelona, Spain; Centro de Investigación Biomédica En Red de Salud Mental, CIBERSAM, Spain
| | - Ada-I Ruiz
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | - Iris Baños
- Research and Development Unit, Parc Sanitari San Joan de Dèu - CIBERSAM Sant Boi de Llobregat, Barcelona, Spain
| | - Jesús Cobo
- Salut Mental. Parc Taulí Sabadell, Hospital Universitari - UAB Universitat Autònoma de Barcelona, CIBERSAM, Campus d'Excel.lència Internacional. 08208 Sabadell, Barcelona, Spain; Salut Mental. Parc Taulí Sabadell, Hospital Universitari - UAB Universitat Autònoma de Barcelona, CIBERSAM, Campus d'Excel.lència Internacional. 08208 Sabadell, Barcelona, Spain
| | - Carles García-Ribera
- Servicio de Psiquiatría del Hospital de la Santa Creu i Sant Pau Barcelona, IIB-Sant Pau, Sant Quintí 89, 08025 Barcelona, Spain
| | - Beatriz González
- Mental Health Department, Hospital Benito Menni, Sant Boi de Llobregat, Barcelona, Spain
| | - Carmina Massons
- Salut Mental. Parc Taulí Sabadell, Hospital Universitari - UAB Universitat Autònoma de Barcelona, CIBERSAM, Campus d'Excel.lència Internacional. 08208 Sabadell, Barcelona, Spain
| | - Lourdes Nieto
- Department of Research; Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz.Calzada México-Xochimilco 101. 14370 San Lorenzo Huipulco - Tlalpan, México D. F. México
| | - Clara Monserrat
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Susana Ochoa
- Research and Development Unit, Parc Sanitari San Joan de Dèu - CIBERSAM Sant Boi de Llobregat, Barcelona, Spain
| | - Esther Pousa
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Salut Mental. Parc Taulí Sabadell, Hospital Universitari - UAB Universitat Autònoma de Barcelona, CIBERSAM, Campus d'Excel.lència Internacional. 08208 Sabadell, Barcelona, Spain
| | - Ada-Inmaculada Ruiz
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Isabel Ruiz
- Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Spain
| | | | - Judith Usall
- Research and Development Unit, Parc Sanitari San Joan de Dèu - CIBERSAM Sant Boi de Llobregat, Barcelona, Spain
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Torrijos V, Ruiz I, Soto M. Effect of step-feeding on the performance of lab-scale columns simulating vertical flow-horizontal flow constructed wetlands. Environ Sci Pollut Res Int 2017; 24:22649-22662. [PMID: 28812288 DOI: 10.1007/s11356-017-9925-1] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 08/07/2017] [Indexed: 06/07/2023]
Abstract
The effect of step-feeding (untreated wastewater by-pass) on the performance of lab-scale columns simulating a hybrid vertical flow (VF)-horizontal flow (HF) constructed wetland (CW) system was studied. Step-feeding strategies have been adopted in several kinds of CW, but this is the first report about the use of step-feeding in VF + HF hybrid systems treating domestic wastewater. Applied loading rates were 7-11 g BOD5/m2 day and 2.1-3.4 g TN/m2 day (overall system). Removal efficiency reached 98% TSS and COD and 99% BOD5 on average, whilst a 50% by-pass improved TN removal from 31 to 50%. Maximum surface nitrification rate (5.5 g N/m2 day) was obtained in VF unit, whilst maximum denitrification rate (1.8 g N/m2 day) was observed in HF unit. Referred to the overall system, maximum surface nitrification and denitrification rates were 2.2 and 1.6 g N/m2 day, respectively. However, potential nitrifying and denitrifying activities (batch assays) were 15.0 and 58.9 g N/m2 day, respectively. Even at 50% by-pass, operational conditions in HF unit (dissolved oxygen, redox, COD/TN ratio) were not suitable enough for denitrification. However, methane emissions were not observed and nitrous oxide emissions were relatively low.
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Affiliation(s)
- Verónica Torrijos
- Department of Chemistry, University of A Coruña, Rúa da Fraga 10, 15008, A Coruña, Galiza, Spain
| | - Isabel Ruiz
- Department of Chemistry, University of A Coruña, Rúa da Fraga 10, 15008, A Coruña, Galiza, Spain
| | - Manuel Soto
- Department of Chemistry, University of A Coruña, Rúa da Fraga 10, 15008, A Coruña, Galiza, Spain.
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Mangas A, Yajeya J, González N, Ruiz I, Pernìa M, Geffard M, Coveñas R. Gemst: a taylor-made combination that reverts neuroanatomical changes in stroke. Eur J Histochem 2017; 61:2790. [PMID: 28735520 PMCID: PMC5452634 DOI: 10.4081/ejh.2017.2790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/12/2017] [Accepted: 05/12/2017] [Indexed: 01/25/2023] Open
Abstract
In a single transient middle cerebral artery occlusion model of stroke and using immunohistochemical techniques, the effects of a new therapeutic approach named Gemst (a member of the Poly-L-Lysine innovative therapies) have been studied in the rat brain. The expression of inflammatory (CD45, CD11b), oxidative (NO-tryptophan, NO2-tyrosine) and indoleamine 2, 3-dioxygenase pathway (kynurenic acid, 3-hydroxy anthranilic acid) markers has been evaluated in early and late phases of stroke. For this purpose, we have developed eight highly specific monoclonal antibodies directed against some of these markers. In the early phase (3 and 5 days of the stroke, we observed no effect of Gemst treatment (7.5 mg/day, subcutaneously for 3, 5 days). In the late phase (21 days) of stroke and exclusively in the ipsilateral side of non-treated animals an overexpression of kynurenic acid, 3-hydroxy anthranilic acid, CD45, CD11b, GFAP and ionized calcium-binding adapter molecule 1 (IBA-1) was found. In treated animals, the overexpression of the four former markers was completely abolished whereas the overexpression of the two latter ones was decreased down to normal levels. Gemst reversed the pathological conditions of stroke to normal situations. Gemst exerts a multifunctional action: down-regulates the indoleamine 2, 3-dioxygenase pathway and abolishes brain infiltration, microglial activation and gliosis. Moreover, Gemst has no effect on the expression of doublecortin, a protein involved in neuronal migration. Gemst could be a new drug for the treatment of stroke since it reverses the pathological findings of stroke and normalizes brain tissue conditions following the ischemic insult.
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Garcia Saenz JA, Ramos Vazquez M, Martin M, Ruiz A, Morales S, Bermejo B, Ruiz I, Cubedo R, Merino LDLC, Anton A, Carrasco EM, Kneissl M, Zohren F, Martinez N. A phase 2 study of investigational TORC1/2 inhibitor TAK-228 with fulvestrant in women with ER+/HER2–advanced or metastatic breast cancer (mBC) that has progressed during or after aromatase inhibitor (AI) therapy. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.tps1118] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS1118 Background: Antiestrogen therapy, including AI, is standard for ER+ tumors in the adjuvant and metastatic setting; however, resistance is common. These tumors may respond to alternative second-line anti-estrogen therapies such as fulvestrant but response durations are often short. Preclinical and clinical studies suggest that simultaneous inhibition of ER and PI3K/mTOR could prevent/delay the emergence of hormone-independent cancer cells, thereby improving patient (pt) outcomes. This study will test whether fulvestrant plus TAK-228, a dual TORC1/2 inhibitor, can overcome endocrine therapy resistance in ER+ mBC. This is an open-label, randomized, phase 2 study of continuous once-daily TAK-228 (4 mg) or once-weekly TAK-228 (30 mg) plus fulvestrant (per label), vs fulvestrant alone, in pts with ER+/HER2– advanced or mBC that has progressed during/after AI therapy (EudraCT 2015-003612-20). Methods: 153 pts will be randomized 1:1:1 and stratified (presence or absence of visceral metastasis, prior hormonal therapy sensitivity, and prior exposure to CDK 4/6 inhibitors). Pts will receive study drug(s) until progressive disease (PD), unacceptable toxicity, or consent withdrawal. Pts with histological confirmation of ER+/HER2– advanced or mBC with measureable disease, ECOG 0–1, PD during/after prior AI therapy (progression ≤12 mos after discontinuation of adjuvant therapy or ≤1 mo after discontinuation in the metastatic setting) and adequate organ function, but not prior therapy with mTOR, PI3K, dual PI3K-mTOR or AKT inhibitors, or fulvestrant, > 1 prior line of chemotherapy for mBC or recurrent or progressive disease on > 2 endocrine therapies for mBC are eligible. This study aims to determine the efficacy (primary endpoint: PFS; secondary endpoints: OS, TTP, ORR), safety and tolerability of TAK-228 plus fulvestrant vs fulvestrant alone. The primary hypothesis (TAK-228 plus fulvestrant can improve median PFS to 8 mos [hazard ratio, HR 0.5] vs fulvestrant-alone median PFS of 4 mos) is to be tested at the 0.10 significance level (2-sided; dropout rate 10%). To date, 24 pts have been enrolled. Clinical trial information: EudraCT 2015-003612-20.
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Affiliation(s)
| | | | - Miguel Martin
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Amparo Ruiz
- Instituto Valenciano de Oncología, Valencia, Spain
| | - Serafin Morales
- Medical Oncology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain
| | - Begona Bermejo
- Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | | | | | - Antonio Anton
- Hospital Universitario Miguel Servet, Zaragoza, Spain
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Gonzalo OG, Ruiz I, Soto M. Integrating pretreatment and denitrification in constructed wetland systems. Sci Total Environ 2017; 584-585:1300-1309. [PMID: 28189310 DOI: 10.1016/j.scitotenv.2017.01.217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/04/2016] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 06/06/2023]
Abstract
The aim of this work was to study the operational characteristics and the efficiency of a compact constructed wetland system for municipal wastewater treatment that integrates denitrification in the pre-treatment unit. The proposed system was simulated by two units in series with effluent recirculation, the first one being an anoxic digester, conceived as a hydrolytic up flow sludge bed for solids hydrolysis and denitrification, and the second one a sand column that simulated the operation of a vertical flow constructed wetland. The hybrid system consisted of two small columns of 4 and 10.2cm in diameter (anoxic digester and vertical flow unit, respectively). The unplanted system was operated successively with synthetic and real municipal wastewater over a period of 136days. Hydraulic loading rate ranged from 212 to 318mm/day and surface loading rate from 122 to 145g/m2·day of chemical oxygen demand and 10-15g/m2·day of total nitrogen for the overall system. The overall system reached removals of 91% to 99% for total suspended solids, chemical oxygen demand and biochemical oxygen demand whilst total nitrogen removal ranged from 43% to 61%. In addition to suspended solids removal (up to 78%), the anoxic digester provided high denitrification rates (3-12gN/m2·day) whilst the vertical flow unit provided high nitrification rates (8-15gN/m2·day). Organic matter was mainly removed in the anoxic digester (63-82% chemical oxygen demand) and used for denitrification. Final effluent concentration was lower for ammonia (7.4±2.4mgN/L on average) than for nitrate (19.8±4.4mgN/L), denitrification appearing as the limiting step in nitrogen removal in the system. CH4 or N2O emissions were not detected in any of the units of the system indicating very low greenhouse gas emissions.
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Affiliation(s)
- O G Gonzalo
- Department of Physical Chemistry and Chemical Engineering l, University of A Coruña, Rúa da Fraga 10, 15008 A Coruña, Spain.
| | - I Ruiz
- Department of Physical Chemistry and Chemical Engineering l, University of A Coruña, Rúa da Fraga 10, 15008 A Coruña, Spain.
| | - M Soto
- Department of Physical Chemistry and Chemical Engineering l, University of A Coruña, Rúa da Fraga 10, 15008 A Coruña, Spain.
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Gavilá J, Perez-Garcia J, Calvo I, Ciruelos E, Muñoz M, Virizuela JA, Ruiz I, Andrés R, Morales S, Perelló A, Sánchez P, Garcia-Saenz JA, Quero Guillen JC, González-Santiago S, Garau Llinas I, González-Martín A, Cantos Sánchez de Ibargüen B, Zaragoza K, de la Peña L, Llombart-Cussac A, Oliveira M. Abstract P4-21-05: Neoadjuvant non-pegylated liposomal doxorubicin plus paclitaxel, trastuzumab and pertuzumab in patients with HER2+ breast cancer – Final results of the SOLTI OPTI-HER HEART study. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-21-05] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
INTRODUCTION
Targeting HER2 by dual blockade with trastuzumab (T) and pertuzumab (P) in a taxane-based regimen is an active neoadjuvant treatment (NAT) of HER2+ early breast cancer (EBC). Addition of an anthracycline could further enhance this response, but potential cardiac toxicity is a concern. The Opti-HER HEART trial (NCT01669239) aims to optimize neoadjuvant treatment while minimizing cardiac risk, by combining T+P with a taxane and non-pegylated liposomal doxorubicin (NPLD).
MATERIAL AND METHODS
Phase II open-label, single-arm study of six 21-day cycles of NPLD (50mg/m2 D1), paclitaxel (80mg/m2 D1,8,15), T (4mg/kg C1D1, followed by 2mg/kg weekly), and P (840mg C1D1, followed by 420mg C2-6D1) as NAT for patients (pts) with stage II-IIIB HER2+ BC. Primary objective was to evaluate cardiac safety of the combination, measured by the incidence of type A (symptomatic congestive heart failure ) or type B [asymptomatic reduction of Left Ventricular Ejection Fraction (LVEF) value: ≥10% absolute decrease and LVEF<50%, LVEF<40% or any absolute decrease ≥20%] events, during NAT. Eighty-three pts were required to reject with 80% confidence the null hypothesis that the combination increases the incidence of cardiac events above the historical control of 18% (3% type A; 15% type B).
RESULTS
Between June 2013 and January 2015, 83 pts with HER2+ EBC (stage II 78%, stage III 22%) and adequate cardiac function (LVEF≥55%) were enrolled. Mean age was 50 years, N+ 47%, hormone receptor (HR) positive 71% and median baseline LVEF 66%. Eighty-five percent of pts completed 6 cycles of NAT, whereas 15% discontinued NAT due to toxicity. Adverse events (AEs) leading to dose adjustments/temporary interruptions and discontinuation of at least 1 drug occurred in 70% and 21% of pts, respectively. Primary objective was met with an incidence of cardiac events during NAT of 4% (95%CI 1-10, 3pts, all type B). Cardiac events until study completion (1 year) were 8% (all type B). All (but 2 cases with no follow-up data) were reversible and only 1 pt presented an asymptomatic LVEF<40%. Neutropenia (45%) was the most frequent hematological toxicity (G3/4 34%; febrile neutropenia 6%), less frequent in the 71% of pts that received primary G-CSF prophylaxis (G3/4 25% vs. 67%). Common non-hematological toxicities were diarrhea (74%; G3 7%), asthenia (78%; G3 11%) and neurotoxicity (52%; G3/4 10%). Pathological complete response (pCR) in breast+axilla (ypT0/is ypN0) was 60% (87% in HR-) and 69% in breast (91% in HR-).
TOTALHR-HR+% ypT0/is (95% CI)69 (58-79)91 (72-99)61 (47-74)% ypT0/is ypN0 (95% CI)60 (46-71)87 (66-97)50 (36-64)
CONCLUSIONS
The neoadjuvant combination of T+P, paclitaxel and NPLD does not increase the risk for cardiac events in HER2+ BC pts. Since cardiac toxicities may present later, long-term cardiac monitoring is essential. Efficacy in terms of pCR was remarkable, being higher to historical values of combinations with dual anti-HER2 blockade and one of the highest reported among HR-HER2+ BC. This regimen administered with primary G-CSF prophylaxis and cardiac function monitoring may be an effective and secure option for early and locally advanced HER2+ pts with good cardiac function.
Citation Format: Gavilá J, Perez-Garcia J, Calvo I, Ciruelos E, Muñoz M, Virizuela JA, Ruiz I, Andrés R, Morales S, Perelló A, Sánchez P, Garcia-Saenz JA, Quero Guillen JC, González-Santiago S, Garau Llinas I, González-Martín A, Cantos Sánchez de Ibargüen B, Zaragoza K, de la Peña L, Llombart-Cussac A, Oliveira M. Neoadjuvant non-pegylated liposomal doxorubicin plus paclitaxel, trastuzumab and pertuzumab in patients with HER2+ breast cancer – Final results of the SOLTI OPTI-HER HEART study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-21-05.
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Affiliation(s)
- J Gavilá
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - J Perez-Garcia
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - I Calvo
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - E Ciruelos
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - M Muñoz
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - JA Virizuela
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - I Ruiz
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - R Andrés
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - S Morales
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - A Perelló
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - P Sánchez
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - JA Garcia-Saenz
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - JC Quero Guillen
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - S González-Santiago
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - I Garau Llinas
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - A González-Martín
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - B Cantos Sánchez de Ibargüen
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - K Zaragoza
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - L de la Peña
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - A Llombart-Cussac
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - M Oliveira
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
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Mangas A, Yajeya J, González N, Ruiz I, Duleu S, Geffard M, Coveñas R. Overexpression of kynurenic acid in stroke: An endogenous neuroprotector? Ann Anat 2017; 211:33-38. [PMID: 28163204 DOI: 10.1016/j.aanat.2017.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 07/27/2016] [Revised: 11/08/2016] [Accepted: 01/04/2017] [Indexed: 10/20/2022]
Abstract
It is known that kynurenic acid (KYNA) exerts a neuroprotective effect against the neuronal loss induced by ischemia; acting as a scavenger, and exerting antioxidant action. In order to study the distribution of KYNA, a highly specific monoclonal antibody directed against KYNA was developed. This distribution was studied in control rats and in animals in which a middle cerebral artery occlusion (stroke model) was induced. By double immunohistochemistry, astrocytes containing KYNA and GFAP were exclusively found in the ipsilateral cerebral cortex and/or striatum, at 2, 5 and 21days after the induction of stroke. In control animals and in the contralateral side of the stroke animals, no immunoreactivity for KYNA was found. Under pathological conditions, the presence of KYNA is reported for the first time in the mammalian brain from early phases of stroke. The distribution of KYNA matches perfectly with the infarcted regions suggesting that, in stroke, this overexpressed molecule could be involved in neuroprotective/scavenger/antioxidant mechanisms.
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Affiliation(s)
- A Mangas
- Gemacbio, Saint Jean d'Illac, France; Institut pour le Développement de la Recherche en Pathologie Humaine et Thérapeutique (IDRPHT), Talence, France; Institute of Neurosciences of Castilla y León (INCYL), Laboratory of Neuroanatomy of the Peptidergic Systems, University of Salamanca, Salamanca, Spain.
| | - J Yajeya
- School of Medicine, Department of Physiology, University of Salamanca, Salamanca, Spain
| | - N González
- Gemacbio, Saint Jean d'Illac, France; Institut pour le Développement de la Recherche en Pathologie Humaine et Thérapeutique (IDRPHT), Talence, France
| | - I Ruiz
- Gemacbio, Saint Jean d'Illac, France
| | - S Duleu
- Institut pour le Développement de la Recherche en Pathologie Humaine et Thérapeutique (IDRPHT), Talence, France
| | - M Geffard
- Gemacbio, Saint Jean d'Illac, France; Institut pour le Développement de la Recherche en Pathologie Humaine et Thérapeutique (IDRPHT), Talence, France
| | - R Coveñas
- Institute of Neurosciences of Castilla y León (INCYL), Laboratory of Neuroanatomy of the Peptidergic Systems, University of Salamanca, Salamanca, Spain
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Llinares P, Ruiz I, Zaragoza R, Ferrer R, Rodríguez AH, Maseda E, Grau S. Erratum to "EPICO 3.0. Empirical antifungal therapy in critically-ill hematology patients" [Rev Iberoam Micol. 33 (4) (2016) 206-215]. Rev Iberoam Micol 2017; 34:62. [PMID: 28249672 DOI: 10.1016/j.riam.2017.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 02/06/2017] [Indexed: 10/20/2022] Open
Affiliation(s)
- Pedro Llinares
- Infectious Diseases Service, A Coruña University Complex Hospital, A Coruña, Spain
| | - Isabel Ruiz
- Infectious Diseases Service, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Rafael Zaragoza
- Intensive Care Medicine Service, Dr. Peset University Hospital, Valencia, Spain.
| | - Ricard Ferrer
- Intensive Care Medicine Service, Mutua de Terrassa University Hospital, Barcelona, Spain
| | | | - Emilio Maseda
- Anesthesiology Service, La Paz University Hospital, Madrid, Spain
| | - Santiago Grau
- Pharmacy Service, Hospital del Mar, Barcelona, Spain
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Grau S, Azanza JR, Ruiz I, Vallejo C, Mensa J, Maertens J, Heinz WJ, Barrueta JA, Peral C, Mesa FJ, Barrado M, Charbonneau C, Rubio-Rodríguez D, Rubio-Terrés C. Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spain. Clinicoecon Outcomes Res 2016; 9:39-47. [PMID: 28115858 PMCID: PMC5221484 DOI: 10.2147/ceor.s122177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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] [Indexed: 01/15/2023] Open
Abstract
Objective According to a recent randomized, double-blind clinical trial comparing the combination of voriconazole and anidulafungin (VOR+ANI) with VOR monotherapy for invasive aspergillosis (IA) in patients with hematologic disease or with hematopoietic stem cell transplant, mortality was lower after 6 weeks with VOR+ANI than with VOR monotherapy in a post hoc analysis of patients with galactomannan-based IA. The objective of this study was to compare the cost-effectiveness of VOR+ANI with VOR, from the perspective of hospitals in the Spanish National Health System. Methods An economic model with deterministic and probabilistic analyses was used to determine costs per life-year gained (LYG) for VOR+ANI versus VOR in patients with galactomannan-based IA. Mortality, adverse event rates, and life expectancy were obtained from clinical trial data. The costs (in 2015 euros [€]) of the drugs and the adverse event-related costs were obtained from Spanish sources. A Tornado plot and a Monte Carlo simulation (1,000 iterations) were used to assess uncertainty of all model variables. Results According to the deterministic analysis, for each patient treated with VOR+ANI compared with VOR monotherapy, there would be a total of 0.348 LYG (2.529 vs 2.181 years, respectively) at an incremental cost of €5,493 (€17,902 vs €12,409, respectively). Consequently, the additional cost per LYG with VOR+ANI compared with VOR would be €15,785. Deterministic sensitivity analyses confirmed the robustness of these findings. In the probabilistic analysis, the cost per LYG with VOR+ANI was €15,774 (95% confidence interval: €15,763–16,692). The probability of VOR+ANI being cost-effective compared with VOR was estimated at 82.5% and 91.9%, based on local cost-effectiveness thresholds of €30,000 and €45,000, respectively. Conclusion According to the present economic study, combination therapy with VOR+ANI is cost-effective as primary therapy of IA in galactomannan-positive patients in Spain who have hematologic disease or hematopoietic stem cell transplant, compared with VOR monotherapy.
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Affiliation(s)
- Santiago Grau
- Pharmacy Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona
| | - Jose Ramon Azanza
- Clinical Pharmacology Department, Clínica Universidad de Navarra, Pamplona
| | - Isabel Ruiz
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona
| | - Carlos Vallejo
- Hematology Department, Hospital Universitario Donostia, San Sebastián
| | - Josep Mensa
- Infectious Diseases Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Johan Maertens
- Hematology Department, University Hospital Gasthuisberg, Leuven, Belgium
| | - Werner J Heinz
- Hematology/Oncology Department, Medizinische Klinik und Poliklinik II, Universitätsklinikum, Würzburg, Germany
| | | | - Carmen Peral
- Economics and Outcomes Research Department, Pfizer S.L.U, Alcobendas
| | | | - Miguel Barrado
- Clinical Trials Department, Trial Form Support, Madrid, Spain
| | - Claudie Charbonneau
- Pharmacoeconomics Department, Pfizer International Operations, Paris, France
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Mangas A, Yajeya J, González N, Ruiz I, Geffard M, Coveñas R. 3-hydroxi-anthranilic acid is early expressed in stroke. Eur J Histochem 2016; 60:2709. [PMID: 28076933 PMCID: PMC5159783 DOI: 10.4081/ejh.2016.2709] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 11/22/2016] [Accepted: 11/27/2016] [Indexed: 12/14/2022] Open
Abstract
Using an immunohistochemical technique, we have studied the distribution of 3-OH-anthranilic acid (3-HAA) in the rat brain. Our study was carried out in control animals and in rats in which a stroke model (single transient middle cerebral artery occlusion) was performed. A monoclonal antibody directed against 3-HAA was also developed. 3-HAA was exclusively observed in the infarcted regions (ipsilateral striatum/cerebral cortex), 2, 5 and 21 days after the induction of stroke. In control rats and in the contralateral side of the stroke animals, no immunoreactivity for 3-HAA was visualized. Under pathological conditions (from early phases of stroke), we reported for the first time the presence of 3-HAA in the mammalian brain. By double immunohistochemistry, the coexistence of 3-HAA and GFAP was observed in astrocytes. The distribution of 3-HAA matched perfectly with the infarcted regions. Our findings suggest that, in stroke, 3-HAA could be involved in the tissue damage observed in the infarcted regions, since it is well known that 3-HAA exerts cytotoxic effects.
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Affiliation(s)
- A Mangas
- Gemacbio - Institute for the Development of Research in Human Pathology and Therapeutic (IDRPHT) - University of Salamanca.
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Llinares P, Ruiz I, Zaragoza R, Ferrer R, Rodríguez AH, Maseda E, Grau S. EPICO 3.0. Empirical antifungal therapy in critically-ill hematology patients. Rev Iberoam Micol 2016; 33:206-215. [PMID: 27751781 DOI: 10.1016/j.riam.2016.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/06/2016] [Accepted: 06/20/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Although in the past decade the management of invasive fungal infections has improved, a number of controversies persist regarding empirical antifungal treatment in critically-ill hematology patients. AIMS To identify key clinical knowledge to elaborate a set of recommendations, with a high level of consensus, necessary for the approach to fungal infections in critically-ill hematology patients. METHODS A Spanish prospective questionnaire, which measures consensus through the Delphi technique, was anonymously answered and e-mailed by 30 multidisciplinary national experts, all specialists in fungal invasive infections from six scientific national societies; intensivists, anesthesiologists, microbiologists, pharmacologists and specialists in infectious diseases. They responded to 10 questions prepared by the coordination group after a thorough review of the literature published in the last few years. For a category to be selected, the level of agreement among the experts in each category must be equal to or greater than 70%. In a second round, 73 specialists attended a face-to-face meeting held after extracting the recommendations from the chosen topics, and validated the pre-selected recommendations and derived algorithm. RESULTS Assess administering antifungal treatment to patients with high/medium risk factors and fever for over 4 days after onset of antibiotic therapy, and in the event of negative galactomannan or if no detection analysis has been performed and no relevant findings in the sinus and chest computed tomography (CT) have been detected, (1) in the case the patient did not receive prophylaxis, or was administered fluconazole, caspofungin treatment is recommended; (2) in the event the patient received prophylaxis with an azole with activity against filamentous fungi, the administration of liposomal amphotericin B is recommended and caspofungin as second choice therapy; (3) in the event that the prophylaxis received was an echinocandin, liposomal amphotericin B therapy is recommended and voriconazole as second choice. Assess administering antifungal treatment in patients with high/medium risk factors and fever for more than 4 days after onset of antibiotic therapy, and in the event of a positive galactomannan and/or sinus and chest CT suggests fungal infection caused by filamentous fungi, (1) in the event the patient did not receive antifungal prophylaxis or was administered fluconazole, the recommended treatment of choice is voriconazole or liposomal amphotericin B; (2) if the patient received prophylaxis with an azole with activity against filamentous fungi, the administration of liposomal amphotericin B with caspofungin is recommended and monotherapy with liposomal amphotericin B or the combination of voriconazole and anidulafungin are recommended as second choice therapies; (3) in the event an echinocandin was administered as prophylaxis, liposomal amphotericin B or voriconazole are the recommended treatments of choice. Consider the administration of antifungal treatment in patients with high/medium risk factors and fever for more than 4 days after onset of antibiotic therapy, and in the event of a negative galactomannan and the sinus and chest CT suggests fungal infection caused by filamentous fungi, (1) if the patient did not receive prophylaxis or was administered fluconazole, the recommended treatment of choice is liposomal amphotericin B or voriconazole; (2) in the case the patient received prophylaxis with an azole with activity against filamentous fungi, the administration of liposomal amphotericin B is recommended as first choice therapy and liposomal amphotericin B combined with caspofungin as second choice; (3) in the event an echinocandin was administered as prophylaxis, liposomal amphotericin B or voriconazole are the recommended treatments of choice. CONCLUSIONS The empirical antifungal approach in critically-ill hematology patients requires the application of the broad range of knowledge and skills described in our recommendations and algorithm. These recommendations, based on the DELPHI methodology, may help to identify potential patients, standardize their management and improve overall prognosis.
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Affiliation(s)
- Pedro Llinares
- Infectious Diseases Service, A Coruña University Complex Hospital, A Coruña, Spain.
| | - Isabel Ruiz
- Infectious Diseases Service, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Rafael Zaragoza
- Intensive Care Medicine Service, Dr. Peset University Hospital, Valencia, Spain
| | - Ricard Ferrer
- Intensive Care Medicine Service, Mutua de Terrassa University Hospital, Barcelona, Spain
| | | | - Emilio Maseda
- Anesthesiology Service, La Paz University Hospital, Madrid, Spain
| | - Santiago Grau
- Pharmacy Service, Hospital del Mar, Barcelona, Spain
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Torrijos V, Gonzalo OG, Trueba-Santiso A, Ruiz I, Soto M. Effect of by-pass and effluent recirculation on nitrogen removal in hybrid constructed wetlands for domestic and industrial wastewater treatment. Water Res 2016; 103:92-100. [PMID: 27441816 DOI: 10.1016/j.watres.2016.07.028] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [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: 04/30/2016] [Revised: 07/09/2016] [Accepted: 07/11/2016] [Indexed: 06/06/2023]
Abstract
Hybrid constructed wetlands (CWs) including subsurface horizontal flow (HF) and vertical flow (VF) steps look for effective nitrification and denitrification through the combination of anaerobic/anoxic and aerobic conditions. Several CW configurations including several configurations of single pass systems (HF + HF, VF + VF, VF + HF), the Bp(VF + HF) arrangement (with feeding by-pass) and the R(HF + VF) system (with effluent recirculation) were tested treating synthetic domestic wastewater. Two HF/VF area ratios (AR) were tested for the VF + HF and Bp(VF + HF) systems. In addition, a R(VF + VF) system was tested for the treatment of a high strength industrial wastewater. The percentage removal of TSS, COD and BOD5 was usually higher than 95% in all systems. The single pass systems showed TN removal below the threshold of 50% and low removal rates (0.6-1.2 g TN/m(2) d), except the VF + VF system which reached 63% and 3.5 g TN/m(2) d removal but only at high loading rates. Bp(VF + HF) systems required by-pass ratios of 40-50% and increased TN removal rates to approximately 50-60% in a sustainable manner. Removal rates depended on the AR value, increasing from 1.6 (AR 2.0) to 5.2 g TN/m(2) d (AR 0.5), both working with synthetic domestic wastewater. On real domestic wastewater the Bp (VF + HF) (AR 0.5 and 30% by-pass) reached 2.5 g TN/m(2) d removal rate. Effluent recirculation significantly improved the TN removal efficiency and rate. The R(HF + VF) system showed stable TN removals of approximately 80% at loading rates ranging from 2 to 8 g TN/m(2) d. High TN removal rates (up to 73% TN and 8.4 g TN/m(2) d) were also obtained for the R(VF + VF) system treating industrial wastewater.
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Affiliation(s)
- V Torrijos
- Department of Physical Chemistry and Chemical Engineering I, University of A Coruña, Rúa da Fraga 10, A Coruña 15008, Galiza, Spain
| | - O G Gonzalo
- Department of Physical Chemistry and Chemical Engineering I, University of A Coruña, Rúa da Fraga 10, A Coruña 15008, Galiza, Spain
| | - A Trueba-Santiso
- Department of Physical Chemistry and Chemical Engineering I, University of A Coruña, Rúa da Fraga 10, A Coruña 15008, Galiza, Spain
| | - I Ruiz
- Department of Physical Chemistry and Chemical Engineering I, University of A Coruña, Rúa da Fraga 10, A Coruña 15008, Galiza, Spain
| | - M Soto
- Department of Physical Chemistry and Chemical Engineering I, University of A Coruña, Rúa da Fraga 10, A Coruña 15008, Galiza, Spain.
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Cendejas-Bueno E, Forastiero A, Ruiz I, Mellado E, Gavaldà J, Gomez-Lopez A. Blood and tissue distribution of posaconazole in a rat model of invasive pulmonary aspergillosis. Diagn Microbiol Infect Dis 2016; 87:112-117. [PMID: 27889253 DOI: 10.1016/j.diagmicrobio.2016.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 09/08/2016] [Accepted: 10/05/2016] [Indexed: 12/31/2022]
Abstract
Posaconazole is the recommended prophylactic agent in patients at high risk of invasive fungal infection, since adequate drug levels seem to be reached in target sites despite the relatively low levels detected in blood. The objective of this study is to obtain pharmacokinetic (PK) information associated to blood and tissue distribution of posaconazole in an animal model of invasive pulmonary aspergillosis. The PK parameters in lung samples were systematically higher than in serum. After multiple-dose administration of posaconazole, a significant accumulation of the drug was evident in lung tissue. The PK behavior of posaconazole in this particular experimental model is similar to that observed in humans. Thus, we believe this model could be a valid tool to evaluate posaconazole exposure-response relationship.
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Affiliation(s)
- E Cendejas-Bueno
- Instituto de Salud Carlos III, Madrid, 28220, Spain; Clinical Microbiology Department, Hospital Universitario La Paz, Madrid, 28046, Spain
| | - A Forastiero
- Instituto de Salud Carlos III, Madrid, 28220, Spain
| | - I Ruiz
- Hospital Valld'Hebrón, Barcelona, 08035, Spain
| | - E Mellado
- Instituto de Salud Carlos III, Madrid, 28220, Spain
| | - J Gavaldà
- Hospital Valld'Hebrón, Barcelona, 08035, Spain
| | - A Gomez-Lopez
- Instituto de Salud Carlos III, Madrid, 28220, Spain.
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Cervilla JA, Ruiz I, Rodríguez-Barranco M, Rivera M, Ibáñez-Casas I, Molina E, Valmisa E, Carmona-Calvo J, Moreno-Küstner B, Muñoz-Negro JE, Ching-López A, Gutiérrez B. Protocolo y metodología del estudio epidemiológico de la salud mental en Andalucía: PISMA-ep. Revista de Psiquiatría y Salud Mental 2016; 9:185-194. [DOI: 10.1016/j.rpsm.2015.11.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 10/26/2015] [Accepted: 11/15/2015] [Indexed: 10/21/2022]
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Cobo J, Nieto L, Ochoa S, Pousa E, Usall J, Baños I, González B, Ruiz I, Ruiz AI. Insight and gender in schizophrenia and other psychoses. Psychiatry Res 2016; 243:268-77. [PMID: 27423634 DOI: 10.1016/j.psychres.2016.04.089] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 02/25/2015] [Revised: 12/30/2015] [Accepted: 04/25/2016] [Indexed: 12/24/2022]
Abstract
This study aimed to evaluate gender differences in the deficit of insight in psychosis and determine influences of clinical, functional, and sociodemographic variables. A multicenter sample of 401 adult patients with schizophrenia and other psychotic disorders who agreed to participate was evaluated in four centers of the metropolitan area of Barcelona (Catalonia). Psychopathological assessment was performed using the Positive and Negative Syndrome Scale Lindenmayers' Factors. Insight and its dimensions were assessed by means of the Scale of Unawareness of Mental Disorder. Significant differences were apparent neither between men and women in the three dimensions of insight, nor in the total awareness, nor in the total attribution subscales. However, statistically significant differences were found in awareness and attribution of particular symptoms. Women showed a worse awareness of thought disorder and alogia and a higher misattribution of apathy. Higher cognitive and positive symptoms, early stage of the illness, and having been married explained deficits of insight dimensions in women. In men, other variables such as lower functioning, higher age, other psychosis diagnosis, and, to a lower extent, higher scores in cognitive, positive, and excitative symptoms, explained deficits of insight dimensions. These data could help to design gender-specific preventive and therapeutic strategies.
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Affiliation(s)
- Jesus Cobo
- Mental Health Department, Corporació Sanitària Parc Taulí, Hospital Universitari - UAB Sabadell, Barcelona, Catalonia, Spain; Department of Psychiatry and Forensic Medicine. Universitat Autònoma de Barcelona Bellaterra, Barcelona, Catalonia, Spain; Research Workgroup on Womens' Mental Health, Catalan Society of Psychiatry & Mental Health Barcelona, Catalonia, Spain.
| | - Lourdes Nieto
- Research Workgroup on Womens' Mental Health, Catalan Society of Psychiatry & Mental Health Barcelona, Catalonia, Spain; Department of Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Susana Ochoa
- Research Workgroup on Womens' Mental Health, Catalan Society of Psychiatry & Mental Health Barcelona, Catalonia, Spain; Research and Development Unit, Parc Sanitari San Joan de Dèu - CIBERSAM Sant Boi de Llobregat, Barcelona, Catalonia, Spain
| | - Esther Pousa
- Mental Health Department, Corporació Sanitària Parc Taulí, Hospital Universitari - UAB Sabadell, Barcelona, Catalonia, Spain; Institut de Neuropsiquiatria i Addiccions, Hospital del Mar Barcelona, Catalonia, Spain
| | - Judith Usall
- Research Workgroup on Womens' Mental Health, Catalan Society of Psychiatry & Mental Health Barcelona, Catalonia, Spain; Research and Development Unit, Parc Sanitari San Joan de Dèu - CIBERSAM Sant Boi de Llobregat, Barcelona, Catalonia, Spain
| | - Iris Baños
- Research and Development Unit, Parc Sanitari San Joan de Dèu - CIBERSAM Sant Boi de Llobregat, Barcelona, Catalonia, Spain
| | - Beatriz González
- Mental Health Department, Hospital Benito Menni Sant Boi de Llobregat, Barcelona, Catalonia, Spain
| | - Isabel Ruiz
- Department of Health and Clinical Psychology - Research Unit. Universitat Autònoma de Barcelona Bellaterra, Barcelona, Catalonia, Spain
| | | | - Ada I Ruiz
- Research Workgroup on Womens' Mental Health, Catalan Society of Psychiatry & Mental Health Barcelona, Catalonia, Spain; Institut de Neuropsiquiatria i Addiccions, Hospital del Mar Barcelona, Catalonia, Spain; IMIM - Hospital del Mar Medical Research Institut Barcelona, Catalonia, Spain
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Undabeitia J, Torres-Bayona S, Samprón N, Arrázola M, Bollar A, Armendariz M, Torres P, Ruiz I, Caballero MC, Egaña L, Querejeta A, Villanua J, Pardo E, Etxegoien I, Liceaga G, Urtasun M, Michan M, Emparanza JI, Aldaz P, Matheu A, Úrculo E. Indirect costs associated with glioblastoma: Experience at one hospital. Neurologia 2016; 33:85-91. [PMID: 27449154 DOI: 10.1016/j.nrl.2016.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 11/12/2015] [Revised: 04/27/2016] [Accepted: 05/04/2016] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Glioblastoma is the most common primary brain tumour. Despite advances in treatment, its prognosis remains dismal, with a mean survival time of about 14 months. Many articles have addressed direct costs, those associated with the diagnosis and treatment of the disease. Indirect costs, those associated with loss of productivity due to the disease, have seldom been described. MATERIAL AND METHOD We conducted a retrospective study in patients diagnosed with glioblastoma at Hospital Universitario Donostia between January 1, 2010 and December 31, 2013. We collected demographics, data regarding the treatment received, and survival times. We calculated the indirect costs with the human capital approach, adjusting the mean salaries of comparable individuals by sex and age and obtaining mortality data for the general population from the Spanish National Statistics Institute. Past salaries were updated to 2015 euros according to the annual inflation rate and we applied a discount of 3.5% compounded yearly to future salaries. RESULTS We reviewed the records of 99 patients: 46 women (mean age 63.53) and 53 men (mean age 59.94); 29 patients underwent a biopsy and the remaining 70 underwent excisional surgery. Mean survival was 18.092 months for the whole series. The total indirect cost for the series was €11 080 762 (2015). Mean indirect cost per patient was €111 926 (2015). DISCUSSION Although glioblastoma is a relatively uncommon type of tumour, accounting for only 4% of all cancers, its poor prognosis and potential sequelae generate disproportionately large morbidity and mortality rates which translate to high indirect costs. Clinicians should be aware of the societal impact of glioblastoma and indirect costs should be taken into account when cost effectiveness studies are performed to better illustrate the overall consequences of this disease.
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Affiliation(s)
- J Undabeitia
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España.
| | - S Torres-Bayona
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España
| | - N Samprón
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España
| | - M Arrázola
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Departamento de Cirugía y Radiología y Medicina Física, Universidad del País Vasco, Donostia, España
| | - A Bollar
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España
| | - M Armendariz
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España
| | - P Torres
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España
| | - I Ruiz
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Anatomía Patológica, Hospital Universitario Donostia, Donostia, España
| | - M C Caballero
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Anatomía Patológica, Hospital Universitario Donostia, Donostia, España
| | - L Egaña
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Oncología Médica, Hospital Universitario Donostia, Donostia, España
| | - A Querejeta
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Oncología Radioterápica, Hospital Universitario Donostia, Donostia, España
| | - J Villanua
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Neurorradiología, Osatek, Hospital Universitario Donostia, Donostia, España
| | - E Pardo
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Radiología, Hospital Universitario Donostia, Donostia, España
| | - I Etxegoien
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Radiología, Hospital Universitario Donostia, Donostia, España
| | - G Liceaga
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Farmacología, Hospital Universitario Donostia, Donostia, España
| | - M Urtasun
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Neurología, Hospital Universitario Donostia, Donostia, España
| | - M Michan
- Servicio de Medicina Interna, Hospital Universitario Donostia, Donostia, España
| | - J I Emparanza
- Servicio de Epidemiología Clínica, Hospital Universitario Donostia, Donostia, España
| | - P Aldaz
- Grupo de Neuro-oncología, Instituto de Investigación Sanitaria Biodonostia, Donostia, España
| | - A Matheu
- Grupo de Neuro-oncología, Instituto de Investigación Sanitaria Biodonostia, Donostia, España
| | - E Úrculo
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Departamento de Cirugía y Radiología y Medicina Física, Universidad del País Vasco, Donostia, España
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de la Varga D, Ruiz I, Álvarez JA, Soto M. Methane and carbon dioxide emissions from constructed wetlands receiving anaerobically pretreated sewage. Sci Total Environ 2015; 538:824-833. [PMID: 26342902 DOI: 10.1016/j.scitotenv.2015.08.090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 04/23/2015] [Revised: 07/21/2015] [Accepted: 08/16/2015] [Indexed: 06/05/2023]
Abstract
The aim of this research was to determine methane and carbon dioxide emissions from a hybrid constructed wetland (CW) treating anaerobically pre-treated sewage. The CW was constituted of two horizontal flow (free water surface followed by a subsurface) units. A long-term study was carried out as both CW units were monitored for three campaigns in Period 1 (0.9-1.5years after start-up), and four campaigns in Period 2 (4.5-5.8years after start-up). The closed chamber method with collecting surfaces of 1810cm(2) was used. For this system, variability due to position in the transverse section of CW, plant presence or absence and recommended sampling period was determined. Overall methane emissions ranged from 96 to 966mgCH4m(-2) d(-1), depending on several factors as the operation time, the season of the year and the position in the system. Methane emissions increased from 267±188mgCH4m(-2)d(-1) during the second year of operation to 543±161mgCH4m(-2)d(-1) in the sixth year of operation. Methane emissions were related to the age of the CW and the season of the year, being high in spring and becoming lower from spring to winter. Total CO2 emissions ranged mostly from 3500 to 5800mgCO2m(-2)d(-1) during the sixth year of operation, while nitrous oxide emissions were below the detection limit of the method.
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Affiliation(s)
- D de la Varga
- Department of Physical Chemistry and Chemical Engineering I, University of A Coruña, Rúa da Fraga no 10, 15008 A Coruña, Galiza, Spain
| | - I Ruiz
- Department of Physical Chemistry and Chemical Engineering I, University of A Coruña, Rúa da Fraga no 10, 15008 A Coruña, Galiza, Spain
| | - J A Álvarez
- AIMEN Technology Center, C/. Relva, 27 A - Torneiros, Porriño, Pontevedra 36410, Spain
| | - M Soto
- Department of Physical Chemistry and Chemical Engineering I, University of A Coruña, Rúa da Fraga no 10, 15008 A Coruña, Galiza, Spain.
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Redondo M, Romance A, García Recuero I, Hinojosa J, Pascual B, Ruiz I, Sánchez Aniceto G. Metopic synostosis: our surgical experience. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.756] [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: 10/22/2022]
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Abstract
Hepatocellular carcinoma is the major complication of chronic liver diseases and particularly of cirrhosis whatever its etiology. Once encountered mainly in the endemic countries of hepatitis B and C, the incidence of hepatocellular carcinoma (6/100,000) is parallel to the global development of diabetes, overweight and alcohol consumption. Little progress has been made for this cancer, whose mortality is 100 % at 10 years. Liver transplantation is the only truly curative treatment (survival more than 50 % at 10 years) since it allows the eradication of hepatocellular carcinoma and its essential cause, cirrhotic liver. This is the only possible therapy when liver function is impaired. It has little impact since in the richest countries, less than 10 % of cases can be transplanted. Surgical resection and percutaneous destruction methods (uni- and multipolar radiofrequency, microwave, cryotherapy, electroporation) are the preferred treatments (survival less than 50 % at 5 years) but are only applicable for moderate tumour masses and in the absence of adjuvant therapy, are effective only in the medium term. Most patients received chemoembolization through hepatic artery, whose action is modest. Radiotherapy is widely used in Asia but almost non-existent in Western countries in this indication. Sorafenib is the only effective drug but its impact is modest. Therapies combining two modalities (embolization and radiotherapy; embolization and radiofrequency) seem promising and deserve wider testing. Screening and monitoring of cirrhosis is probably the major measure for potentially curative therapies.
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Affiliation(s)
- I Ruiz
- Service d'hépatologie, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; Équipe 18, Inserm U955, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - C Féray
- Service d'hépatologie, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; Équipe 18, Inserm U955, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
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Aguado JM, Cruz JJ, Virizuela JA, Aguilar M, Carmona A, Cassinello J, Gudiol C, Jiménez Fonseca P, Lizasoain M, Marco F, Ruiz I, Ruiz M, Salavert M, Vicente D, Carratalà J. Management of Infection and Febrile Neutropenia in Patients with Solid Cancer. Enferm Infecc Microbiol Clin 2015; 35:451-460. [PMID: 26279208 DOI: 10.1016/j.eimc.2015.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 05/14/2015] [Revised: 05/24/2015] [Accepted: 06/15/2015] [Indexed: 12/22/2022]
Abstract
A group of experts from the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Society of Medical Oncology (SEOM) have reviewed in this paper the main aspects to be considered in the evaluation of patients with solid cancer and infectious diseases. They have established a series of recommendations on the prevention of the most prevalent infections in these patients, the use of vaccines, the control measures of vascular catheter infection and prevention of infections before certain surgical procedures. Also the criteria for management of febrile neutropenia and the use of colony-stimulating factors were revised. Finally they provide a series of recommendations for the treatment of cancer patients with severe infection. The document is completed with a series of measures for the control of hospital infection.
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Affiliation(s)
- José María Aguado
- Unidad de Enfermedades Infecciosas, Hospital Universitario 12 de Octubre, Madrid, España.
| | - Juan Jesús Cruz
- Servicio de Oncología Médica, Hospital Clínico Universitario de Salamanca, Salamanca, España
| | - Juan Antonio Virizuela
- Servicio de Oncología Médica, Hospital Universitario Virgen de Macarena, Sevilla, España
| | - Manuela Aguilar
- Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Alberto Carmona
- Servicio de Oncología Médica, Hospital General Universitario Morales Meseguer, Murcia, España
| | - Javier Cassinello
- Servicio de Oncología Médica, Hospital Universitario de Guadalajara, Guadalajara, España
| | - Carlota Gudiol
- Servicio de Enfermedades Infecciosas, Hospital Universitari de Bellvitge, Barcelona, España
| | - Paula Jiménez Fonseca
- Servicio de Oncología Médica, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - Manuel Lizasoain
- Unidad de Enfermedades Infecciosas, Hospital Universitario 12 de Octubre, Madrid, España
| | - Francesc Marco
- Laboratori de Microbiologia, Centre de Diagnòstic Biomèdic (CDB), ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, España
| | - Isabel Ruiz
- Servicio de Enfermedades Infecciosas, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - Maribel Ruiz
- Servicio de Oncología Médica, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - Miguel Salavert
- Servicio de Enfermedades Infecciosas, Hospital Universitari i Politècnic La Fe, Valencia, España
| | - David Vicente
- Servicio de Oncología Médica, Hospital Universitario Virgen de Macarena, Sevilla, España
| | - Jordi Carratalà
- Servicio de Enfermedades Infecciosas, Hospital Universitari de Bellvitge, Barcelona, España
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Undabeitia J, Castle M, Arrazola M, Pendleton C, Ruiz I, Úrculo E. [Multiple extraneural metastasis of glioblastoma multiforme]. An Sist Sanit Navar 2015; 38:157-61. [PMID: 25963474 DOI: 10.23938/assn.0061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Glioblastoma multiforme is the most frequent primary tumor in the brain. Despite improvements in its surgical, chemotherapy and radiotherapy treatment, prognosis remains poor. Extracranial metastases of glioblastoma are a rare complication in this disease. Its appearance has been described in lung, liver, bone or lymph nodes. CASE REPORT We describe the case of a 20 year-old patient who complained of a subacute-onset headache. In the MRI an enhancing right temporal lesion was detected suggesting a high grade glioma as first diagnosis. Surgery was performed, obtaining a gross total resection of the lesion. Our patient underwent adjuvant radiotherapy and chemotherapy treatment, according to our hospital's protocol. Five months after initial surgery our patient complained of chest pain and a hacking cough. A thoracic-abdominal-pelvic CT scan was obtained, which showed bilateral lung infiltrates with pleural effusion, a pancreatic nodule and several vertebral lytic lesions. The lung lesions were biopsied. The pathologic diagnosis was metastatic glioblastoma multiforme. The patient died eight months after initial diagnosis. CONCLUSION Extracranial metastases of glioblastoma remain a rare event although its incidence is increasing, probably due to the improvement in survival among these patients and better imaging techniques. The mechanisms for extracranial dissemination of glioblastoma are not entirely known, as several theories exist in this regard. Physicians must be aware of this complication and keep it in mind as a differential diagnosis to improve the quality of life of our patients.
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Affiliation(s)
- J Undabeitia
- Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián, 20080, Spain.
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García-Cadenas I, Castillo N, Martino R, Barba P, Esquirol A, Novelli S, Orti G, Garrido A, Saavedra S, Moreno C, Granell M, Briones J, Brunet S, Navarro F, Ruiz I, Rabella N, Valcárcel D, Sierra J. Impact of Epstein Barr virus-related complications after high-risk allo-SCT in the era of pre-emptive rituximab. Bone Marrow Transplant 2015; 50:579-84. [PMID: 25581404 DOI: 10.1038/bmt.2014.298] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 11/08/2014] [Accepted: 11/16/2014] [Indexed: 01/14/2023]
Abstract
We monitored 133 high-risk allo-SCT recipients for 6 months after transplant for EBV reactivation by quantitative real-time PCR. Rituximab was given as pre-emptive therapy for viremia >1000 copies/mL. The 1-year cumulative incidence of EBV reactivation was 29.4% (95% confidence interval (CI): 18-40) in patients monitored due to initial high-risk characteristics (n=93) and 31.8% (95% CI: 19.7-44) in those followed because of the development of refractory GVHD (n=40). Overall response rate to Rituximab was 83%. Nine patients (9.6%) developed post-transplant lymphoproliferative disorder (PTLD) at a median of +62 days after SCT. Eight of them showed a concomitant CMV reactivation. Second SCT was the only risk factor associated with EBV infection and PTLD in multivariate analysis (hazard ratio (HR) 2.6 (95% CI: 1.1-6.4; P=0.04) and HR 6.4 (95%CI: 1.3-32; P=0.02)). The development of EBV reactivation was not associated with non-relapse mortality or OS (P=0.97 and P=0.84, respectively).
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Affiliation(s)
- I García-Cadenas
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Castillo
- Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R Martino
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - P Barba
- Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Esquirol
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Novelli
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - G Orti
- Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Garrido
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Saavedra
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Moreno
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Granell
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Briones
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Brunet
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - F Navarro
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Ruiz
- Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Rabella
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - D Valcárcel
- Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Sierra
- Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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