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García-Mateo S, Martínez-Domínguez SJ, Gargallo-Puyuelo CJ, Gallego B, Alfambra E, Aso MC, Martinez-Micaelo N, Amigó N, Martínez-García J, Baptista PM, Sanz B, Ballesta S, Espinosa J, Tejero C, Gomollón F. Cardiovascular risk assessment in inflammatory bowel disease with metabolic dysfunction-associated steatotic liver disease. Med Clin (Barc) 2024; 162:409-416. [PMID: 38423940 DOI: 10.1016/j.medcli.2023.11.032] [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: 09/05/2023] [Revised: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND AND AIMS Inflammatory bowel disease (IBD) has been reported to increase the risk of early atherosclerosis even in young patients. Moreover, metabolic dysfunction-associated steatotic liver disease (MASLD), which has been linked to IBD, is a well-recognized but underdiagnosis entity related to cardiovascular risk. We analyze the impact of MASLD in IBD patients' cardiovascular risk through both advanced lipoprotein profile sorted by nuclear magnetic resonance spectroscopy, and carotid artery intima-media thickness (CIMT). METHODS Cross-sectional cohort study which involves 941 IBD adult outpatients. Of them, 50 patients with IBD who met criteria for MASLD and 50 with IBD without MASLD, matched by sex and age were included. Alterations in CIMT were evaluated considering abnormal measures above the 75th percentile adjusted for sex and age. Specific advanced lipoprotein profile was also carried out. RESULTS Most of the patients had an abnormal CIMT (58%). MASLD (OR=5.05, CI 95%=1.71-14.92) and female sex (OR=3.32, CI 95%=1.03-10) were significantly associated with CIMT alterations. Dense LDL particles (with high cholesterol composition in general cohort (OR=3.62, 95% CI=1.07-12.19) and high triglycerides density in young subgroup (OR=6.25, 95% CI=1.04-50) but not total LDL cholesterol were associated with CIMT alterations. CONCLUSIONS MASLD and female sex are associated with early atherosclerosis in IBD patients. Dense LDL particle in combination with vascular imaging findings should be evaluated as non-invasive tools in the management of cardiovascular risk in IBD patients.
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Affiliation(s)
- Sandra García-Mateo
- Department of Gastroenterology, "Lozano Blesa" University Clinical Hospital, 50009 Zaragoza, Spain; Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain.
| | - Samuel J Martínez-Domínguez
- Department of Gastroenterology, "Lozano Blesa" University Clinical Hospital, 50009 Zaragoza, Spain; Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
| | - Carla J Gargallo-Puyuelo
- Department of Gastroenterology, "Lozano Blesa" University Clinical Hospital, 50009 Zaragoza, Spain; Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
| | - Beatriz Gallego
- Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
| | - Erika Alfambra
- Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
| | - María C Aso
- Department of Gastroenterology, "Lozano Blesa" University Clinical Hospital, 50009 Zaragoza, Spain; Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain
| | | | - Nuria Amigó
- School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain; Biosfer Teslab, Plaça del Prim 10, 2on 5a, 43201 Reus, Spain
| | - Javier Martínez-García
- Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain; University of Zaragoza, Department of Multiscale in Mechanical and Biological Engineering, Spain
| | - Pedro M Baptista
- Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain; CIBER Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain
| | - Borja Sanz
- Department of Endocrinology, Manises Hospital, 46940 Valencia, Spain
| | - Sara Ballesta
- Department of Neurology, Lozano Blesa University Hospital, 50009 Zaragoza, Spain
| | - Judith Espinosa
- Department of Neurology, Lozano Blesa University Hospital, 50009 Zaragoza, Spain
| | - Carlos Tejero
- Department of Neurology, Lozano Blesa University Hospital, 50009 Zaragoza, Spain
| | - Fernando Gomollón
- Department of Gastroenterology, "Lozano Blesa" University Clinical Hospital, 50009 Zaragoza, Spain; School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
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Castellarnau S, Gaya JM, Espinosa J, Sierra P, Huguet J, Palou J, Hernando D, Sabaté S, Breda A. Clinical impact of the suspension of the ERAS protocol on patients undergoing radical cystectomy during the COVID-19 pandemic. Actas Urol Esp 2023:S2173-5786(23)00014-8. [PMID: 36842706 PMCID: PMC9957335 DOI: 10.1016/j.acuroe.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/20/2023] [Indexed: 02/28/2023]
Abstract
INTRODUCTION During the beginning of the COVID-19 pandemic in our center, neither prehabilitation nor multimodal rehabilitation could be applied due to the excessive patient load on the health system and to reduce SARS-CoV-2 transmission. The objective of our study was to analyze the evolution, complications, and survival up to one year of patients who underwent radical cystectomy in our hospital from March 1st to May 31st, 2020 (period of the first wave COVID-19 pandemic in Spain). We also compared the results with cystectomized patients outside the pandemic period and with application of the ERAS (Enhanced Recovery After Surgery) protocol. MATERIAL AND METHODS Single-center, retrospective cohort study of patients scheduled for radical cystectomy from March 1st, 2020 to May 31st, 2020. They were matched with previously operated patients using a 1:2 propensity matching score. The matching variables were demographic data, preoperative and intraoperative clinical conditions. RESULTS A total of 23 radical cystectomies with urinary diversion were performed in the period described. In none of the cases the prehabilitation or the follow-up of our ERAS protocol could be applied, and this was the only difference we found between the 2 groups. Although the minimally invasive approach was more frequent in the pandemic group, the difference was not statistically significant. Three patients were diagnosed with COVID-19 during their admission, presenting severe respiratory complications and high in-hospital mortality. Apart from respiratory complications secondary to SARS-CoV-2, we also found statistically significant differences in other postoperative complications. The hospital stay increased by 3 days in the pandemic group. CONCLUSIONS Patients who underwent radical cystectomy at our center during the first wave of the COVID-19 pandemic had a higher number and severity of respiratory and non-respiratory complications. Discontinuation of the ERAS protocol was the main difference in treatment between groups.
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Affiliation(s)
- S Castellarnau
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - J M Gaya
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Espinosa
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - P Sierra
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Huguet
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Palou
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - D Hernando
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Sabaté
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Breda
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
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Castellarnau S, Gaya JM, Espinosa J, Sierra P, Huguet J, Palou J, Hernando D, Sabaté S, Breda A. [CLINICAL IMPACT OF THE SUSPENSION OF THE ERAS PROTOCOL ON PATIENTS UNDERGOING RADICAL CYSTECTOMY DURING THE COVID-19 PANDEMIC.]. Actas Urol Esp 2023; 47:S0210-4806(23)00012-8. [PMID: 36776227 PMCID: PMC9905094 DOI: 10.1016/j.acuro.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/20/2023] [Indexed: 02/10/2023]
Abstract
INTRODUCTION During the beginning of the COVID-19 pandemic in our center, neither prehabilitation nor multimodal rehabilitation could be applied due to the excessive patient load on the health system and to reduce SARS-CoV-2 transmission. The objective of our study was to analyze the evolution, complications, and survival up to one year of patients who underwent radical cystectomy in our hospital from March 1st to May 31st, 2020 (period of the first wave COVID-19 pandemic in Spain). We also compared the results with cystectomized patients outside the pandemic period and with application of the ERAS (Enhanced Recovery After Surgery) protocol. MATERIAL AND METHODS Single-center, retrospective cohort study of patients scheduled for radical cystectomy from March 1st,2020 to May 31st, 2020. They were matched with previously operated patients using a 1:2 propensity matching score. The matching variables were demographic data, preoperative and intraoperative clinical conditions. RESULTS A total of 23 radical cystectomies with urinary diversion were performed in the period described. In none of the cases the prehabilitation or the follow-up of our ERAS protocol could be applied, and this was the only difference we found between the 2 groups. Although the minimally invasive approach was more frequent in the pandemic group, the difference was not statistically significant. Three patients were diagnosed with COVID-19 during their admission, presenting severe respiratory complications and high in-hospital mortality. Apart from respiratory complications secondary to SARS-CoV-2, we also found statistically significant differences in other postoperative complications. The hospital stay increased by 3 days in the pandemic group. CONCLUSIONS Patients who underwent radical cystectomy at our center during the first wave of the COVID-19 pandemic had a higher number and severity of respiratory and non-respiratory complications. Discontinuation of the ERAS protocol was the main difference in treatment between groups.
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Affiliation(s)
- S Castellarnau
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - J M Gaya
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - J Espinosa
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - P Sierra
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - J Huguet
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - J Palou
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - D Hernando
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - S Sabaté
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - A Breda
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
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Castellarnau S, Espinosa J, Sierra P, Gaya J, Sabaté S, Hernando D. Impact of the COVID-19 pandemic in patients who underwent radical cystectomy during the first wave, one-year follow-up. Clin Nutr ESPEN 2022. [PMCID: PMC9519846 DOI: 10.1016/j.clnesp.2022.06.102] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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5
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Criado M, Espinosa J, Zapico D, Fernández M, Ferreras M, Benavides J, Pérez V. Immunohistochemical Study of the Inflammatory Cells Present at the Injection-site Granulomas INduced by Two Different Paratuberculosis Vaccines. J Comp Pathol 2022. [DOI: 10.1016/j.jcpa.2021.11.106] [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]
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Zapico D, Espinosa J, Criado M, Fernández M, Ferreras M, Benavides J, Perez V. Local Assessment of the Immunohistochemical Expression of Foxp3+ Regulatory T Lymphocytes in the Different Pathological Forms Associated with Bovine Paratuberculosis. J Comp Pathol 2022. [DOI: 10.1016/j.jcpa.2021.11.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Espinosa J, Vázquez S, Millán-Varela L, Prada I, Ferreras M, Pérez V. Severe Hypertrophy and Hyperplasia of Muscular and Serosal Layers Associated with Intestinal Lipogranulomatous Lymphangitis in Two Dogs. J Comp Pathol 2022. [DOI: 10.1016/j.jcpa.2021.11.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Madrigal J, Martín A, Chambel R, Guijarro M, Hernando C, Callejas M, Espinosa J, Climent J. Do cone age and heating mode determine the opening of serotinous cones during wildfires? A new bench scale approach applied to Pinus halepensis Mill. Sci Total Environ 2021; 763:144222. [PMID: 33383513 DOI: 10.1016/j.scitotenv.2020.144222] [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: 08/18/2020] [Revised: 11/25/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
Serotiny is a well-known fire adaptive trait in some species, as the Mediterranean conifer Pinus halepensis. However, information about cone opening mechanisms during wildfires and consequences on post fire dispersal is scarce. In addition, standardized methods allowing a realistic simulation of heating modes at bench-scale are not available. In this study, we address for the first time the interacting effects of radiation, convection and direct flame on the opening and seed release of serotinous cones, following a novel repeatable methodology. Using a Mass Loss Calorimeter (MLC) device and a wide range of heat exposures (between 5 and 75 kW m-2) with or without ignition, we intended to simulate realistic cone heating during surface and crown fires in laboratory conditions. Additionally, we included the effect of contrasting serotinous cone ages interacting with heating mode and considering the random individual variation. The proposed methodology has shown a high potential to simulate the complex process of crown fires in relation to cone opening under controlled conditions, detecting a threshold of heat exposure (25-30 kW m-2) for cone opening. We confirmed that heating mode had a highly significant effect in cone opening, interacting with cone age, while cone age effect on its own was marginal. Particularly, ignition significantly increased the efficacy of cone opening and seed release. Moreover, young and old cones behave differently in seed release, both in surface and crown fire simulations. Implementing and adjusting this methodology in other species will allow more realistic and reliable quantitative comparisons than previously attained.
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Affiliation(s)
- J Madrigal
- INIA, Forest Research Centre, Department of Forest Dynamics and Management, Forest Fire Laboratory, Ctra. Coruña Km 7,5, 28040 Madrid, Spain; iuFOR, University Institute for Sustainable Forest Management, UVA-INIA, Spain; ETSI Montes, Forestal y del Medio Natural, University Politechnic of Madrid (UPM), Ramiro de Maeztu s/n, 28040 Madrid, Spain.
| | - A Martín
- ETSI Montes, Forestal y del Medio Natural, University Politechnic of Madrid (UPM), Ramiro de Maeztu s/n, 28040 Madrid, Spain
| | - R Chambel
- INIA, Forest Research Centre, Department of Forest Ecology and Genetics, Genetics Laboratory, Ctra. Coruña Km 7,5, 28040 Madrid, Spain
| | - M Guijarro
- INIA, Forest Research Centre, Department of Forest Dynamics and Management, Forest Fire Laboratory, Ctra. Coruña Km 7,5, 28040 Madrid, Spain; iuFOR, University Institute for Sustainable Forest Management, UVA-INIA, Spain
| | - C Hernando
- INIA, Forest Research Centre, Department of Forest Dynamics and Management, Forest Fire Laboratory, Ctra. Coruña Km 7,5, 28040 Madrid, Spain; iuFOR, University Institute for Sustainable Forest Management, UVA-INIA, Spain
| | - M Callejas
- INIA, Forest Research Centre, Department of Forest Ecology and Genetics, Genetics Laboratory, Ctra. Coruña Km 7,5, 28040 Madrid, Spain
| | - J Espinosa
- INIA, Forest Research Centre, Department of Forest Dynamics and Management, Forest Fire Laboratory, Ctra. Coruña Km 7,5, 28040 Madrid, Spain; iuFOR, University Institute for Sustainable Forest Management, UVA-INIA, Spain
| | - J Climent
- iuFOR, University Institute for Sustainable Forest Management, UVA-INIA, Spain; INIA, Forest Research Centre, Department of Forest Ecology and Genetics, Genetics Laboratory, Ctra. Coruña Km 7,5, 28040 Madrid, Spain
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Gracia PV, Caballero LC, Sánchez J, Espinosa J, Campana S, Quintero A, Luo C, Ng J. Pregnancies recovered from SARS-CoV-2 infection in second or third trimester: obstetric evolution. Ultrasound Obstet Gynecol 2020; 56:777-778. [PMID: 32996648 PMCID: PMC7537281 DOI: 10.1002/uog.23134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 05/23/2023]
Affiliation(s)
- P. Vigil‐De Gracia
- Investigador distinguido del Sistema Nacional de InvestigaciónComplejo Hospitalario Dr. AAM Caja de Seguro Social, SENACYTPanamaPanama
| | - L. C. Caballero
- Ginecología y ObstetriciaHospital Luis “Chico Fábrega”, Santiago‐VeraguasPanama
| | - J. Sánchez
- Ginecología y ObstetriciaHospital Santo TomásPanamaPanama
| | - J. Espinosa
- Ginecología y ObstetriciaHospital Santo TomásPanamaPanama
| | - S. Campana
- Ginecología y ObstetriciaComplejo Hospitalario Dr. AAM Caja de Seguro Social, PanamaPanama
| | - A. Quintero
- Ginecología y ObstetriciaHospital José Domingo de ObaldíaDavidChiriquíPanama
| | - C. Luo
- Ginecología y ObstetriciaComplejo Hospitalario Dr. AAM Caja de Seguro Social, PanamaPanama
| | - J. Ng
- Ginecología y ObstetriciaComplejo Hospitalario Dr. AAM Caja de Seguro Social, PanamaPanama
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Orrego M, Besa P, Orrego F, Amenabar D, Vega R, Irribarra L, Espinosa J, Vial R, Phillips V, Irarrázaval S. Medial opening wedge high tibial osteotomy: more than ten years of experience with Puddu plate technique supports its indication. Int Orthop 2020; 44:2021-2026. [PMID: 32474719 DOI: 10.1007/s00264-020-04614-w] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/07/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe the short-term and long-term results of patients who underwent a medial opening wedge high tibial osteotomy (MOW-HTO) for unicompartmental medial knee joint osteoarthritis. METHODS A retrospective review was conducted of patients with MOW-HTO using a Puddu plate®, with more than ten year follow-up. The degree of correction, initial chondral damage, number of meniscal lesions, preoperative and 1-year postoperative functional scale scores (IKDC and Lysholm), and arthroplasty conversion rates at the ten year follow-up were registered. We assumed early indication when patients underwent the operation before they were 40 years old and delayed ≥ 40. Functional outcomes were analyzed by adjusting for pre-operative values. Fisher's exact test was used to study the association between the arthroplasty conversion rates and the timing of indication. RESULTS Fifty-five patients were included, 37 of whom were male (67%). Twenty-nine patients had early indications for surgery (53%). All patients completed ten year follow-up. All patients improved IKDC (p < 0.01) and Lysholm (p < 0.01) scores compared to their presurgical scores at the one year post-operative evaluation. We had six minor complications, none requiring revision surgery. We had three conversions to arthroplasty, all in the late indication group, not statistically significant different. Linear regression showed that early indication was associated with a higher IKDC score when adjusting for the Outerbridge chondral damage score, the number of meniscal lesions, and sex (p < 0.01). CONCLUSION All patients improved functional scores one year after surgery. Early indication (i.e., younger than 40 years of age) was independently associated with better functional outcomes than late indication at one year follow-up.
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Affiliation(s)
- M Orrego
- Department of Orthopedic Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - P Besa
- Department of Orthopedic Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - F Orrego
- School of Medicine, Universidad de Los Andes, Santiago, Chile
| | - D Amenabar
- Departament of Orthopedic Surgery, School of Medicine, Universidad de los Andes, Santiago, Chile
| | - R Vega
- Department of Orthopedic Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - L Irribarra
- Department of Orthopedic Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - J Espinosa
- Department of Orthopedic Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - R Vial
- Department of Orthopedic Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - V Phillips
- School of Medicine, Universidad de Los Andes, Santiago, Chile
| | - Sebastián Irarrázaval
- Department of Orthopedic Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Espinosa J, Pérez JM, Baéz–Bravo A, Fandos P, Cano–Manuel FJ, Soriguer RC, López–Olvera JR, Granados JE. Recommendations for the management of sarcoptic mange in free–ranging Iberian ibex populations. Anim Biodiv Conserv 2020. [DOI: 10.32800/abc.2020.43.0137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In recent decades, sarcoptic mange has become the main driver of demographic changes in Iberian ibex (Capra pyrenaica) populations in the Iberian Peninsula. Given this species’ economic and ecological importance, priority must be given to management measures aimed at limiting the effects of this disease. However, despite the wealth of research on sarcoptic mange in ibex, no common patterns of action are yet available to manage this disease under field conditions. The lack of national and international protocols aimed at controlling sarcoptic mange has favoured the spontaneous emergence of various disease management initiatives in Spain. However, very little information is available concerning this trend and what there is tends to be available only as ‘grey literature’ or is consigned to the memory of local observers. Traditional strategies designed to combat this disease include the administration of medicated feed and the non–selective culling of mangy ibex. Here, we propose a management approach that takes into account aspects relating to the ecology and conservation of ibex populations, as well as public–health–related factors. Our recommendations are based on knowledge of the disease and host–parasite interaction, and aim to promote long–term advances in its control. Moreover, we discuss the efficacy of the measures traditionally used in mange management. The overall aim is to encourage debate between wildlife managers and motivate the development of alternative management strategies.
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Affiliation(s)
- J. Espinosa
- Instituto de Ganadería de Montaña (IGM), CSIC–ULe, Universidad de león, Spain
| | - J. M. Pérez
- Departamento de Biología Animal, Biología Vegetal y Ecología,Universidad de Jaén, Spain
| | - A. Baéz–Bravo
- Facultat de Veterinària, Universitat Autònoma de Barcelona (UAB), Spain
| | - P. Fandos
- Agencia de Medio Ambiente y Agua, Sevilla, Spain
| | - F. J. Cano–Manuel
- Consejería de Agricultura, Pesca, Ganadería y Desarrollo Sostenible, Granada, Spain
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Castellarnau S, Sierra P, Espinosa J, Sabaté S, Hernando D. Enhanced recovery after surgery program in radical cystectomy surgery: Impact on perioperative outcomes. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2019.03.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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13
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Stoffel S, Benito L, Milà N, Travier N, Binefa G, Vidal C, Espinosa J, Moreno V, Garcia M. Testing behavioral interventions to optimize participation in a population-based colorectal cancer screening program in Catalonia, Spain. Prev Med 2019; 119:58-62. [PMID: 30594532 DOI: 10.1016/j.ypmed.2018.12.013] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 12/08/2018] [Accepted: 12/24/2018] [Indexed: 10/27/2022]
Abstract
The aim of the study was to measure the effect of three cost-neutral behavioral interventions on participation compared to the standard invitation letter in a population-based colorectal cancer screening program in 2014. For that purpose, a four-arm randomized field trial was conducted among 5077 individuals aged 50 to 69 years. Over an 8-week period, each week was randomly allocated to the intervention or the control conditions. Individuals assigned to the intervention conditions additionally received a prompt to write down the date to pick up the screening test in a pharmacy. Two of the three intervention groups also included an additional paragraph in the invitation letter on either: 1) the high proportion of individuals participating regularly (social norms condition) or 2) the importance of regular participation (benefit condition). We measured screening participation before and after receiving a reminder letter six weeks after the screening invitation. An overall 8.0 percentage point increase in CRC screening was achieved as a direct result of receiving a reminder letter; however none of the intervention strategies influenced participation. The only significant difference was found for newly invited individuals. There, participation rates decreased from 34.9% to 24.2% when the invitation mailing mentioned the importance of regular participation (OR: 0.60; 95% CI: 0.38-0.95). While none of the intervention strategies improved participation rates we found that praising the benefit of regular screening may discourage individuals who have never been invited before as the continuous behavior may be perceived as a large request. Nevertheless, the reminder letter boosted participation rates independently of the intervention assigned.
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Affiliation(s)
- S Stoffel
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - L Benito
- Department of Fundamental Care and Medical-Surgical Nursing, University of Barcelona, L'Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - N Milà
- Cancer Prevention and Control Program, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBEResp), 28029 Madrid, Spain
| | - N Travier
- Cancer Prevention and Control Program, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - G Binefa
- Cancer Prevention and Control Program, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - C Vidal
- Cancer Prevention and Control Program, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - J Espinosa
- Cancer Prevention and Control Program, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - V Moreno
- Cancer Prevention and Control Program, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - M Garcia
- Cancer Prevention and Control Program, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
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Carmona-Bayonas A, Jimenez-Fonseca P, de Castro EM, Mata E, Biosca M, Custodio A, Espinosa J, Vázquez EG, Henao F, Ayala de la Peña F. SEOM clinical practice guideline: management and prevention of febrile neutropenia in adults with solid tumors (2018). Clin Transl Oncol 2018; 21:75-86. [PMID: 30470991 PMCID: PMC6339667 DOI: 10.1007/s12094-018-1983-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 11/08/2018] [Indexed: 01/15/2023]
Abstract
Febrile neutropenia (FN) is a common dose-limiting toxicity of chemotherapy, with a profound impact on the evolution of patients with cancer, due to the potential development of serious complications, mortality, delays, and decrease in treatment intensity. This article seeks to present an updated clinical guideline, with recommendations regarding the diagnosis, prevention, and treatment of febrile neutropenia in adults with solid tumors. The aspects covered include how to properly approach the risk of microbial resistances, epidemiological aspects, considerations about the initial empirical approach adapted to the risk, special situations, and prevention of complications. A decision-making algorithm is included for use in the emergency department based on a new, validated tool, the Clinical Index of Stable Febrile Neutropenia, which can be used in patients with solid tumors who appear stable in the initial phase of neutropenic infections, and can help detect those at high risk for complications in whom early discharge must be avoided.
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Affiliation(s)
- A Carmona-Bayonas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, IMIB, Avenida Marqués de los Vélez, 30008, Murcia, Spain
| | - P Jimenez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - E M de Castro
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - E Mata
- Medical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - M Biosca
- Medical Oncology Department, Hospital Vall D'Hebron, Barcelona, Spain
| | - A Custodio
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain.,CIBERONC (CB16/12/00398), Madrid, Spain
| | - J Espinosa
- Medical Oncology Department, Hospital General de Ciudad Real, Ciudad Real, Spain
| | - E G Vázquez
- Infectious Disease Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.,Departamento de Medicina, Facultad de Medicina, Universidad de Murcia, Murcia, Spain
| | - F Henao
- Medical Oncology Department, Complejo Hospitalario Regional Virgen Macarena, Seville, Spain
| | - F Ayala de la Peña
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, IMIB, Avenida Marqués de los Vélez, 30008, Murcia, Spain.
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15
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Gomez-Iturriaga A, Casquero F, Buchser D, Minguez P, Espinosa J, Perez F, Cacicedo J, San Miguel I, Suarez F, Pijoan J, Bilbao P. OC-0286: Clinical outcomes of HDR-prostate brachytherapy 19Gy single fraction: prospective phase II trial. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30596-6] [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]
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16
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Espinosa J, Madrigal J, De La Cruz AC, Guijarro M, Jimenez E, Hernando C. Short-term effects of prescribed burning on litterfall biomass in mixed stands of Pinus nigra and Pinus pinaster and pure stands of Pinus nigra in the Cuenca Mountains (Central-Eastern Spain). Sci Total Environ 2018; 618:941-951. [PMID: 29146076 DOI: 10.1016/j.scitotenv.2017.08.291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/01/2017] [Accepted: 08/29/2017] [Indexed: 06/07/2023]
Abstract
Fire severity, defined as the magnitude of fire effects in an ecosystem, is a key factor to consider in planning management strategies for protecting forests against fire. Although prescribed burning has been used as a fuel reduction tool in forest ecosystems, it is quite limited in the Mediterranean region. Furthermore, little is known about how tree crowns are affected by prescribed underburning aimed at reducing fire severity in conifer stands. As part of an ongoing study to assess the effects of prescribed burning on the tree canopy, litterfall is currently being monitored in a network of experimental plots located in mixed (Pinus nigra and Pinus pinaster) and pure (P. nigra) conifer stands in the Cuenca Mountains (Castilla La Mancha, Spain). A total of 12 study plots (30m×30m) were established in a completely randomized experimental design to determine the effect of burning, with 2 treatments: no burning (control) and burning (i.e. with three replicate plots for each treatment and site). Burning was conducted in May 2016. In each plot, 8 litterfall collectors were installed at regular intervals, according to international protocols (ICP Forests), and all biomass falling into the collectors is being monitored monthly. The specific objective of this study is to assess how prescribed burning affects the rate of generation of foliar and non-foliar litterfall biomass due to the fire. In addition, the Leaf Area Index was estimated before burning and one year later to verify possible changes in the structure of the stands. This information could be used to help minimize the negative impacts of prescribed underburning on litterfall. To our knowledge, this study represents the first attempt to evaluate the effect of prescribed burning on litterfall biomass in Europe.
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Affiliation(s)
- J Espinosa
- INIA, Forest Research Centre, Department of Silviculture and Forest Management, Forest Fire Laboratory, Ctra. Coruña Km 7.5, 28040 Madrid, Spain.
| | - J Madrigal
- INIA, Forest Research Centre, Department of Silviculture and Forest Management, Forest Fire Laboratory, Ctra. Coruña Km 7.5, 28040 Madrid, Spain; iuFOR, University Institute for Sustainable Forest Management, uVA-INIA, Spain
| | - A C De La Cruz
- INIA, Forest Research Centre, Department of Silviculture and Forest Management, Forest Fire Laboratory, Ctra. Coruña Km 7.5, 28040 Madrid, Spain
| | - M Guijarro
- INIA, Forest Research Centre, Department of Silviculture and Forest Management, Forest Fire Laboratory, Ctra. Coruña Km 7.5, 28040 Madrid, Spain; iuFOR, University Institute for Sustainable Forest Management, uVA-INIA, Spain
| | - E Jimenez
- Forest Research Center of Lourizán. Xunta de Galicia, 36080 Pontevedra, Spain
| | - C Hernando
- INIA, Forest Research Centre, Department of Silviculture and Forest Management, Forest Fire Laboratory, Ctra. Coruña Km 7.5, 28040 Madrid, Spain; iuFOR, University Institute for Sustainable Forest Management, uVA-INIA, Spain
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Väkeväinen K, Valderrama A, Espinosa J, Centurión D, Rizo J, Reyes-Duarte D, Díaz-Ruiz G, von Wright A, Elizaquível P, Esquivel K, Simontaival AI, Aznar R, Wacher C, Plumed-Ferrer C. Characterization of lactic acid bacteria recovered from atole agrio, a traditional Mexican fermented beverage. Lebensm Wiss Technol 2018. [DOI: 10.1016/j.lwt.2017.10.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Pérez-Cataluña A, Elizaquível P, Carrasco P, Espinosa J, Reyes D, Wacher C, Aznar R. Diversity and dynamics of lactic acid bacteria in Atole agrio, a traditional maize-based fermented beverage from South-Eastern Mexico, analysed by high throughput sequencing and culturing. Antonie van Leeuwenhoek 2017; 111:385-399. [DOI: 10.1007/s10482-017-0960-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/10/2017] [Indexed: 12/13/2022]
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19
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Gomez-Iturriaga A, Casquero F, Minguez P, Espinosa J, Bueso A, Cacicedo J, Fernandez L, Pedraza S, Garcia Escovedo J, Bilbao P. OC-0270: QoL and toxicity of HDR prostate brachytherapy as monotherapy 19Gy single fraction:phase II trial. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30713-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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20
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Villa Guzmán JC, Espinosa J, Cervera R, Delgado M, Patón R, Cordero García JM. Gastric and colon metastasis from breast cancer: case report, review of the literature, and possible underlying mechanisms. Breast Cancer (Dove Med Press) 2016; 9:1-7. [PMID: 28096693 PMCID: PMC5207330 DOI: 10.2147/bctt.s79506] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 12/18/2022]
Abstract
Gastrointestinal metastases from breast cancer are not common. We present a 58-year-old female diagnosed with lobular breast cancer some years before whose relapses were gastric and colonic mucosal. Simultaneous metastases are extremely rare. To our knowledge, no cases of initial dual affectation have been reported. The patient also showed gastritis by Helicobacter pylori. Invasive lobular breast carcinoma is the most frequent special type of breast cancer and carries some specific molecular alterations such as loss of expression of E-cadherin. Although underlying mechanisms of metastasization are not entirely known, chemokines as well as inflammatory events seem to be implicated in this process. Interaction between chemokines and their receptors frequently induces cell migration. We hypothesize that H. pylori, inflammatory cells, and chemokines may create a favorable environment attracting tumor cells.
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Affiliation(s)
| | | | | | | | - R Patón
- Department of Gastroenterology
| | - J M Cordero García
- Department of Nuclear Medicine, University Ciudad Real General Hospital, Ciudad Real, Spain
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21
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Muñoz M, Santaballa A, Seguí MA, Beato C, de la Cruz S, Espinosa J, Fonseca PJ, Perez J, Quintanar T, Blasco A. SEOM Clinical Guideline of fertility preservation and reproduction in cancer patients (2016). Clin Transl Oncol 2016; 18:1229-1236. [PMID: 27896641 PMCID: PMC5138251 DOI: 10.1007/s12094-016-1587-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 11/30/2022]
Abstract
Chemotherapy and radiotherapy often result in reduced fertility in cancer patients. With increasing survival rates, fertility is an important quality-of-life concern for many young cancer patients. Around 70–75% of young cancer survivors are interested in parenthood but the numbers of patients who access fertility preservation techniques prior to treatment are significantly lower. Moreover, despite existing guidelines, healthcare professionals do not address fertility preservation issues adequately. There is a critical need for improvements in clinical care to ensure patients are well informed about infertility risks and fertility preservation options and to support them in their reproductive decision-making prior to cancer treatment.
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Affiliation(s)
- M Muñoz
- Servicio de Oncología Médica, Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Hospital Clínic de Barcelona, Villarroel, 170-08036, Barcelona, Spain.
| | - A Santaballa
- Hospital Universitari I Politècnic la Fe, Valencia, Spain
| | - M A Seguí
- Corporació Sanitària Parc Taulì, Sabadell, Spain
| | - C Beato
- Hospital Universitario Virgen Macarena, Seville, Spain
| | - S de la Cruz
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | - J Espinosa
- Hospital General de Ciudad Real, Ciudad Real, Spain
| | - P J Fonseca
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J Perez
- Hospital General Universitario de Elche y Vega Baja, Elche, Spain
| | - T Quintanar
- Hospital General Universitario de Elche y Vega Baja, Elche, Spain
| | - A Blasco
- Hospital General Universitario de Valencia, Valencia, Spain
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22
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Rios R, Ospina J, Lafond C, Acosta O, Espinosa J, de Crevoisier R. Characterization of Bladder Motion and Deformation in Prostate Cancer Radiotherapy. Ing Rech Biomed 2016. [DOI: 10.1016/j.irbm.2016.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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23
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Torres-Zárate C, Molina D, Vences A, Espinosa J, Palacios M, Hernández D, Cárdenas R, Shalkow J. Intratumoral expression of cytochrome P450 in pediatric soft tissue sarcomas. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.07.615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Muñoz-Yáñez C, Pérez-Morales R, Moreno-Macías H, Calleros-Rincón E, Ballesteros G, González RA, Espinosa J. Polymorphisms FTO rs9939609, PPARG rs1801282 and ADIPOQ rs4632532 and rs182052 but not lifestyle are associated with obesity related-traits in Mexican children. Genet Mol Biol 2016; 39:547-553. [PMID: 27560839 PMCID: PMC5127146 DOI: 10.1590/1678-4685-gmb-2015-0267] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 02/29/2016] [Indexed: 11/26/2022] Open
Abstract
Concerning the genetic factors of obesity, no consistent association between populations has been reported, which may be due to the frequency of polymorphisms, the lifestyle of studied populations and its interaction with other factors. We studied a possible association of polymorphisms FTO rs9939609, PPARG rs1801282, and ADIPOQ rs4632532 and rs182052 with obesity phenotypes in 215 Mexican children. Glucose, triglycerides, cholesterol, HDL and LDL were measured. In addition, weight, height, waist circumference and triceps skin thickness were recorded. High-energy diets and sedentary behavior were evaluated with a validated questionnaire. In contrast with other reports, only FTO rs9939609 was associated with obesity related-traits, including BMI (p = 0.03), waist circumference (p = 0.02), triceps skinfold (p = 0.03) and waist/height ratio (p = 0.01), and also with cholesterol levels (p = 0.02) and LDL (p = 0.009). Lower levels of triglycerides (p=0.04) were related with presence of PPARG rs1801282, while ADIPOQ rs4632532 showed an effect on HDL (p = 0.03) levels. On the other hand, diet, physical activity and screen time were not related with obesity. In summary, only FTO rs9939609 was associated with obesity related-traits, while PPARG2 rs1801282 and ADIPOQ rs4632532 were involved in lipid metabolism.
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Affiliation(s)
- C Muñoz-Yáñez
- Departamento de Investigación, Facultad de Medicina, Universidad Juárez del Estado de Durango, Durango, México
| | - R Pérez-Morales
- Departamento de Biología Molecular, Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango, Durango, México
| | - H Moreno-Macías
- Departamento de Economía, División CSH de la Universidad Autónoma Metropolitana, Unidad Iztapalapa, D.F. México, México
| | - E Calleros-Rincón
- Departamento de Biología Molecular, Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango, Durango, México
| | - G Ballesteros
- Facultad de Ciencias, Universidad Autónoma del Estado de Morelos, Cuernavaca, Morelos, México
| | - R A González
- Facultad de Ciencias, Universidad Autónoma del Estado de Morelos, Cuernavaca, Morelos, México
| | - J Espinosa
- Departamento de Investigación, Facultad de Medicina, Universidad Juárez del Estado de Durango, Durango, México
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25
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Carmona-Bayonas A, Jiménez-Fonseca P, Virizuela J, Antonio M, Font C, Biosca M, Ramchandani A, Martinez-Garcia J, Hernando J, Espinosa J, de Castro EM, Ghanem I, Beato C, Blasco A, Garrido M, Mondéjar R, Arcusa MÁ, Aragón I, Manzano A, Sevillano E, Castañón E, Ayala F. Performance of the clinical index of stable febrile neutropenia (CISNE) in different types of infections and tumors. Clin Transl Oncol 2016; 19:386-395. [PMID: 27525978 DOI: 10.1007/s12094-016-1540-y] [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: 06/07/2016] [Accepted: 08/02/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE The clinical index of stable febrile neutropenia (CISNE) can contribute to patient safety without increasing the complexity of decision-making. However, febrile neutropenia (FN) is a diverse syndrome. The aim of this analysis is to assess the performance of CISNE according to the type of tumor and infection and to characterize these patients. METHODS We prospectively recruited 1383 FN episodes in situations of apparent clinical stability. Bonferroni-adjusted z tests of proportions were used to assess the association between the infections suspected at the time of onset and the type of tumor with the risk of serious complications and mortality. The performance of CISNE was appraised in each category using the Breslow-Day test for homogeneity of odds ratios and Forest Plots. RESULTS 171 patients had a serious complication (12.3 %, 95 % confidence interval 10.7-14.2 %). The most common initial assumptive diagnoses were: fever without focus (34.5 %), upper respiratory infection (14.9 %), enteritis (12.7 %), stomatitis (11.8 %), and acute bronchitis (10.7 %). Lung and breast were the most common tumors, accounting for approximately 56 % of the series. The distribution of complications, mortality, and bacteremia varies for each of these categories. However, Breslow-Day tests indicate homogeneity of the odds ratio of the dichotomized CISNE score to predict complications in all infection and tumor subtypes. CONCLUSION Despite FN's clinical and microbiological heterogeneity, the CISNE score was seen to be consistent and robust in spite of these variations. Hence, it appears to be a safe tool in seemingly stable FN.
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Affiliation(s)
- A Carmona-Bayonas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, Calle Marqués de los Vélez s/n, 30008, Murcia, Spain.
| | | | - J Virizuela
- Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - M Antonio
- ICO Duran i Reynals, Barcelona, Spain
| | - C Font
- Hospital Universitario Clínic, Barcelona, Spain
| | - M Biosca
- Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - A Ramchandani
- Hospital Universitario Insular de Gran Canaria, Las Palmas, Spain
| | | | - J Hernando
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - J Espinosa
- Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - E M de Castro
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - I Ghanem
- Hospital Universitario La Paz, Madrid, Spain
| | - C Beato
- Hospital Nisa Sevilla Aljarafe, Hospital Universitario Clínico San Carlos, Sevilla, Spain
| | - A Blasco
- Hospital General Universitario de Valencia, Valencia, Spain
| | - M Garrido
- Universidad Católica Pontificia de Chile, Santiago de Chile, Chile
| | - R Mondéjar
- Hospital Universitario de la Princesa, Madrid, Spain
| | - M Á Arcusa
- Consorci Sanitari de Terrassa, Barcelona, Spain
| | - I Aragón
- Hospital Juan Ramón Jiménez, Huelva, Spain
| | - A Manzano
- Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - E Sevillano
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - E Castañón
- Clínica Universidad de Navarra, Pamplona, Spain
| | - F Ayala
- Hospital Universitario Morales Messeguer, Murcia, Spain
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Cocho D, Monell J, Planells G, Ricciardi A, Pons J, Boltes A, Espinosa J, Ayats M, Garcia N, Otermin P. Rapid diagnosis and treatment of TIA results in low rates of stroke, myocardial infarction and vascular death. Neurología (English Edition) 2016. [DOI: 10.1016/j.nrleng.2014.05.002] [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] Open
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28
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Espinosa J, González-Larriba JL, Maroto P, Méndez-Vidal MJ, Díaz-Cerezo S. Cost-Utility Analysis of Pazopanib Verse Sunitinib as First-Line Treatment of Metastatic Renal Cell Carcinoma (MRCC) iN Spain. Value Health 2014; 17:A632-A633. [PMID: 27202249 DOI: 10.1016/j.jval.2014.08.2265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- J Espinosa
- Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | | | - P Maroto
- Hospital Sant Pau, Barcelona, Spain
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Dilla T, Lizán L, Paz S, Garrido P, Avendaño C, Cruz JJ, Espinosa J, Sacristan JA. Do new cancer drugs offer good value for money? the perspective of oncologists, payers, patients, and general population. Value Health 2014; 17:A327. [PMID: 27200550 DOI: 10.1016/j.jval.2014.08.592] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - L Lizán
- Outcomes 10, Castellon, Spain
| | - S Paz
- Outcomes 10, Castellon, Spain
| | - P Garrido
- Hospital Ramon y Cajal, Madrid, Spain
| | - C Avendaño
- Hospital Puerta de Hierro, Madrid, Spain
| | - J J Cruz
- Hospital Clinico Universitario, Salamanca, Spain
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30
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Cocho D, Monell J, Planells G, Ricciardi AC, Pons J, Boltes A, Espinosa J, Ayats M, Garcia N, Otermin P. Rapid diagnosis and treatment of TIA results in low rates of stroke, myocardial infarction and vascular death. Neurologia 2014; 31:18-23. [PMID: 25261166 DOI: 10.1016/j.nrl.2014.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 03/11/2014] [Revised: 05/25/2014] [Accepted: 05/29/2014] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The 90-day risk of cerebral infarction in patients with transient ischaemic attack (TIA) is estimated at between 8% and 20%. There is little consensus as to which diagnostic strategy is most effective. This study evaluates the benefits of early transthoracic echocardiography (TTE) with carotid and transcranial Doppler ultrasound in patients with TIA. METHODS Prospective study of patients with TIA in an emergency department setting. Demographic data, vascular risk factors, and ABCD(2) score were analysed. TIA aetiology was classified according to TOAST criteria. All patients underwent early vascular studies (<72hours), including TTE, carotid ultrasound, and transcranial Doppler. Primary endpoints were recurrence of stroke or TIA, myocardial infarction (MI), or vascular death during the first year. RESULTS We evaluated 92 patients enrolled over 24 months. Mean age was 68.3±13 years and 61% were male. The mean ABCD(2) score was 3 points (≥5 in 30%). The distribution of TIA subtypes was as follows: 12% large-artery atherosclerosis; 30% cardioembolism; 10% small-vessel occlusion; 40% undetermined cause; and 8% rare causes. Findings from the early TTE led to a change in treatment strategy in 6 patients (6.5%) who displayed normal physical examination and ECG findings. At one year of follow-up, 3 patients had experienced stroke (3.2%) and 1 patient experienced MI (1%); no vascular deaths were identified. CONCLUSIONS In our TIA patients, early vascular study and detecting patients with silent cardiomyopathy may have contributed to the low rate of vascular disease recurrence.
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Affiliation(s)
- D Cocho
- Servicio de Neurología, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, España.
| | - J Monell
- Servicio de Cardiología, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, España
| | - G Planells
- Servicio de Urgencias Médicas, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, España
| | - A C Ricciardi
- Servicio de Neurología, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, España
| | - J Pons
- Servicio de Neurología, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, España
| | - A Boltes
- Servicio de Neurología, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, España
| | - J Espinosa
- Servicio de Neurología, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, España
| | - M Ayats
- Servicio de Cardiología, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, España
| | - N Garcia
- Servicio de Urgencias Médicas, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, España
| | - P Otermin
- Servicio de Neurología, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, España
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Fonseca P, Carmona-Bayonas A, Font C, Antonio Rebollo M, Ramchandani A, Hernando Cubero J, Espinosa J, De Castro E, Ghanem I, Martínez J, Beato C, Virizuela J, Blasco A, Bonilla Y, Manzano A, Castañon E, Sevillano E, Vicente Conesa M, De La Peña F. Prognostic Evaluation of Clinically Stable Febrile Neutropenia: Prospective Data from 921 Patients from the Finite Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu356.7] [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: 11/13/2022] Open
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Gomez-iturriaga A, Casquero F, Crook J, Espinosa J, Minguez P, Ezquerro A, Canteli B, Urresola A, Llarena R, Lopez J, Pijoan J, Irasarri A, Bilbao J. International phase II trial of dose escalation to dominant intraprostatic lesion (DIL) with real-time high dose rate (HDR) brachytherapy. Rep Pract Oncol Radiother 2013. [DOI: 10.1016/j.rpor.2013.03.860] [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] Open
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Gomez-iturriaga A, Casquero F, Carvajal C, Urresola A, Canteli B, Ezquerro A, Llarena R, Hortelano E, San Miguel I, Cacicedo J, Espinosa J, Minguez P, Martinez-indart L, Bilbao P. Impact of magnetic resonance imaging in the local staging, risk group classification and treatment of prostate cancer patients with combination of high dose rate brachytherapy and external beam radiotherapy. Rep Pract Oncol Radiother 2013. [DOI: 10.1016/j.rpor.2013.03.492] [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] Open
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Sosa MA, Chovau S, Van der Bruggen B, Espinosa J. Ethanol Production from Corn Contaminated with Fumonisins: A Preliminary Economic Analysis Including Novel Processing Alternatives. Ind Eng Chem Res 2013. [DOI: 10.1021/ie303040p] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. A. Sosa
- INGAR-CONICET & UNL, Avellaneda 3657, S3002 GJC Santa Fe, Argentina
| | - S. Chovau
- Department of Chemical Engineering,
Laboratory of Applied Physical Chemistry and Environmental Technology, KU Leuven, W. de Croylaan 46, B-3001 Leuven, Belgium
| | - B. Van der Bruggen
- Department of Chemical Engineering,
Laboratory of Applied Physical Chemistry and Environmental Technology, KU Leuven, W. de Croylaan 46, B-3001 Leuven, Belgium
| | - J. Espinosa
- INGAR-CONICET & UNL, Avellaneda 3657, S3002 GJC Santa Fe, Argentina
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Núñez A, Ocampo-Martinez C, De Schutter B, Valencia F, López J, Espinosa J. A multiobjective-based switching topology for hierarchical model predictive control applied to a hydro-power valley. ACTA ACUST UNITED AC 2013. [DOI: 10.3182/20130902-3-cn-3020.00042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Alvarez-Lerma F, Soriano MC, Rodríguez M, Catalán M, Llorente AM, Vidart N, Garitacelaya M, Maraví E, Fernández E, Alvarado F, López M, Alvarez-Sánchez B, Espinosa J, Quintana E. Impact of liposomal amphotericin B on renal function in critically ill patients with renal function impairment. Rev Esp Quimioter 2012; 25:206-215. [PMID: 22987267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To assess the tolerability of liposomal amphotericin B (L-AmB) in critically ill patients with elevated serum creatinine concentrations (Cr) (> 1.5 mg/dL) at starting L-AmB therapy. METHODS Retrospective, multicenter, comparative study of two cohorts of critically ill patients treated with L-AmB during 3 or more days, the difference between them was the level of Cr at the beginning of treatment. A cutoff value of Cr of 1.5 mg/dL was established. Patients undergoing extrarenal depuration procedures before or 48 hours after starting L-AmB were excluded. The primary endpoint was the difference between Cr values at the end of treatment as compared with Cr at starting L-AmB. Secondary endpoints were treatment-related withdrawals, need of extrarenal depuration techniques, and treatment-related severe adverse events. Demographic data, underlying illness, indication of L-AmB therapy, concomitant risk factors of nephrotoxicity, and vital status at ICU and hospital discharge were recorded. RESULTS A total of 122 patients admitted to 26 ICUs (16 with Cr > 1.5 g/dL; 106 with normal Cr levels) were recruited. Main reasons for the use of L-AmB in both groups were the broad spectrum of the drug and the presence of hemodynamic instability. L-AmB was administered as first-line treatment in 68.8% of patients with elevated Cr and in 52.8% with normal Cr. The APACHE II score on ICU admission was 25 in patients with elevated Cr and 17 in those with normal Cr values (p < 0.001). Duration of treatment with L-AmB was 16 and 12 days in patients with elevate and normal Cr values, respectively, with a mean dose of 3.5 vs 3.9 mg/kg/day. The use of concomitant nephrotoxic drugs, mortality rate, and ICU and hospital length of stay were similar in both cohorts. In patients with renal function impairment at the initiation of L-AmB treatment, an absolute decrease of Cf-Ci of 1.08 mg/dL was observed (P < 0.001). A decrease of Cr levels to normal limits was observed in 50% of the patients; in 37.5% of patients there was a decrease but normal levels were not achieved, whereas a Cr increased occurred in only one (6.25%) patient. None of the patients required withdrawal of L-AmB or use of extrarenal depuration procedures. Treatment-related severe adverse events were not reported. CONCLUSIONS In critically ill patients with impaired renal function, the impact of L-AmB on renal function was minimal. L-AmB can be used for the treatment of fungal infections in critically ill patients independently of renal function at the initiation of treatment.
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Affiliation(s)
- F Alvarez-Lerma
- Servicio de Medicina Intensiva, Parc de Salut Mar, Barcelona, Spain.
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del MMSM, García-Vicente A, Ortega-Ruipérez C, Palomar-Muñoz A, Molina-Garrido MJ, Olaverri-Hernández A, Santiago-Crespo JA, Martín-Ordóñez F, Val-Pérez E, Cordero-García JM, Chacón JI, Fernández-Aramburu A, Espinosa J, Viana A, Soriano-Castrejón A. P2-09-10: Giant or Windmill? 18F-FDG-PET/CT Semi-Quantitative Parameters and Biological Prognostic Parameters in Women with Breast Cancer Treated with Neoadjuvant Chemotherapy: A Multicentric Study in La Mancha. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p2-09-10] [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
Background: To analyze the possible predictive-prognostic value of 18F-FDG-PET/CT to evaluate response to primary preoperative neoadjuvant (NA) chemotherapy (CT) in women with breast cancer (BC) a multicenter study is being conducted in most Hospitals in Castilla - La Mancha (central Spain). As per protocol a PET/CT study has to be conducted prior to 1st cycle, after 2nd cycle and at the end of induction CT. We report here the initial results with the correlation between the PET/CT results and pathological-radiological-clinical findings prior to NA CT.
Aim: To analyze the correlation between 18F-FDG uptake assessed by PET/CT and histopathological and inmunohistochemical prognostic factors in BC prior to NA CT.
Material and methods: 68 women diagnosed of BC (36 with locally advanced BC) were prospectively evaluated. PET/CT was requested in the initial staging previous to NA CT. Clinical and metabolic stages were assessed according to TNM classification. All biological prognostic parameters, such as ER, PR, p53 and c-erbB-2 expression, proliferation rate (Ki-67), and grading (SBR) were determined from tissue of the primary tumour prior to NA CT. All patients underwent an 18F-FDG PET/CT with a dual-time-point acquisition performed in the early phase 1 h after FDG administration (PET-1) and in the delayed phase 3 h after FDG administration (PET-2). Both examinations were evaluated qualitatively and semiquantitatively with calculation of SUVmax values in PET-1 (SUV-1) and in PET-2 (SUV-2) and the percentage variation of the standard uptake values (retention index) between PET-1 and PET-2. Metabolic, clinical and biological parameters were correlated. Student, ANOVA and Bonferroni tests were used to compare the means, chi-score to compare proportions and Pearson correlation to compare two quantitative variables.
Results: A positive relationship was found between the SUVmax, tumour size, clinical and metabolic stages. SUV-1 and SUV-2 values showed significant statistical correlation (p<0.05) with PET stage and tumour size assessed by PET. On the contrary, the retention index showed relation with clinical stage (p<0.05). About the biological parameters, retention index showed the best results with positive and significant relation (p<0.05) with histological grade, ER status, Ki-67 and c-erbB-2 expression. Isolated SUV values only showed significant relation to Ki-67 expression.
Conclusion: The retention index showed the best correlation with biological and clinical parameters compared to isolated SUVmax values. It may be useful as a predictive marker of tumor biological behavior. Nevertheless these are only the results of PET/CT prior to NA CT, with longer follow up we hopefully will be able to look at the correlation between PET/CT and radiological, clinical and pathological response after NA CT.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-09-10.
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Affiliation(s)
- Mar Muñoz-Sánchez M del
- 1Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Complejo Hospitalario de Toledo, Toledo, Spain; Complejo Hospitalario Universitario de Alabacete, Albacete, Spain; Hospital General Ntra ***Sadel Prado, Talavera, Toledo, Spain
| | - A García-Vicente
- 1Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Complejo Hospitalario de Toledo, Toledo, Spain; Complejo Hospitalario Universitario de Alabacete, Albacete, Spain; Hospital General Ntra ***Sadel Prado, Talavera, Toledo, Spain
| | - C Ortega-Ruipérez
- 1Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Complejo Hospitalario de Toledo, Toledo, Spain; Complejo Hospitalario Universitario de Alabacete, Albacete, Spain; Hospital General Ntra ***Sadel Prado, Talavera, Toledo, Spain
| | - A Palomar-Muñoz
- 1Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Complejo Hospitalario de Toledo, Toledo, Spain; Complejo Hospitalario Universitario de Alabacete, Albacete, Spain; Hospital General Ntra ***Sadel Prado, Talavera, Toledo, Spain
| | - MJ Molina-Garrido
- 1Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Complejo Hospitalario de Toledo, Toledo, Spain; Complejo Hospitalario Universitario de Alabacete, Albacete, Spain; Hospital General Ntra ***Sadel Prado, Talavera, Toledo, Spain
| | - A Olaverri-Hernández
- 1Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Complejo Hospitalario de Toledo, Toledo, Spain; Complejo Hospitalario Universitario de Alabacete, Albacete, Spain; Hospital General Ntra ***Sadel Prado, Talavera, Toledo, Spain
| | - JA Santiago-Crespo
- 1Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Complejo Hospitalario de Toledo, Toledo, Spain; Complejo Hospitalario Universitario de Alabacete, Albacete, Spain; Hospital General Ntra ***Sadel Prado, Talavera, Toledo, Spain
| | - F Martín-Ordóñez
- 1Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Complejo Hospitalario de Toledo, Toledo, Spain; Complejo Hospitalario Universitario de Alabacete, Albacete, Spain; Hospital General Ntra ***Sadel Prado, Talavera, Toledo, Spain
| | - E Val-Pérez
- 1Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Complejo Hospitalario de Toledo, Toledo, Spain; Complejo Hospitalario Universitario de Alabacete, Albacete, Spain; Hospital General Ntra ***Sadel Prado, Talavera, Toledo, Spain
| | - JM Cordero-García
- 1Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Complejo Hospitalario de Toledo, Toledo, Spain; Complejo Hospitalario Universitario de Alabacete, Albacete, Spain; Hospital General Ntra ***Sadel Prado, Talavera, Toledo, Spain
| | - JI Chacón
- 1Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Complejo Hospitalario de Toledo, Toledo, Spain; Complejo Hospitalario Universitario de Alabacete, Albacete, Spain; Hospital General Ntra ***Sadel Prado, Talavera, Toledo, Spain
| | - A Fernández-Aramburu
- 1Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Complejo Hospitalario de Toledo, Toledo, Spain; Complejo Hospitalario Universitario de Alabacete, Albacete, Spain; Hospital General Ntra ***Sadel Prado, Talavera, Toledo, Spain
| | - J Espinosa
- 1Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Complejo Hospitalario de Toledo, Toledo, Spain; Complejo Hospitalario Universitario de Alabacete, Albacete, Spain; Hospital General Ntra ***Sadel Prado, Talavera, Toledo, Spain
| | - A Viana
- 1Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Complejo Hospitalario de Toledo, Toledo, Spain; Complejo Hospitalario Universitario de Alabacete, Albacete, Spain; Hospital General Ntra ***Sadel Prado, Talavera, Toledo, Spain
| | - A Soriano-Castrejón
- 1Hospital General Virgen de la Luz, Cuenca, Spain; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Complejo Hospitalario de Toledo, Toledo, Spain; Complejo Hospitalario Universitario de Alabacete, Albacete, Spain; Hospital General Ntra ***Sadel Prado, Talavera, Toledo, Spain
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Roig JV, Cantos M, Balciscueta Z, Uribe N, Espinosa J, Roselló V, García-Calvo R, Hernandis J, Landete F. Hartmann's operation: how often is it reversed and at what cost? A multicentre study. Colorectal Dis 2011; 13:e396-402. [PMID: 21801298 DOI: 10.1111/j.1463-1318.2011.02738.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIM The study evaluated the rate of reversal of Hartmann's operation after the initial surgery and its morbidity. METHOD A multicentre retrospective study was carried out in seven hospitals in the Valencia area of patients who underwent Hartmann's operation from 2004 to 2008. The incidence of reversal was determined. RESULTS Four hundred and fifty-two patients of mean age 67.5 ± 15.4 years were included, of whom 78.8% had an emergency operation. The most common diagnosis was cancer (58.6%), although diverticulitis predominated in the emergency setting. At a median follow up of 44 months, 159 (35.2%) patients had undergone reversal, including 16.6% after elective surgery and 40.4% after an emergency Hartmann's procedure (P < 0.001). The most frequent reason why reversal was not done was death (74 [25%] patients). Patients undergoing reversal were younger and had a low ASA risk. Trauma was associated with a higher rate of reversal, followed by diverticular disease. Surgery was performed at a median of 10 months. An open approach with stapled anastomosis was used in most cases. The mortality was 3.5%. Complications occurred in 45.2%, with a 6.2% rate of anastomotic leakage. Complications were associated with age, diabetes mellitus, arteriosclerosis, obesity, smoking, chemotherapy and COPD. CONCLUSION Hartmann's reversal was performed in a small percentage of patients, mostly including those with benign disease. It had a significant morbidity.
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Affiliation(s)
- J V Roig
- Department of General and Digestive Surgery, Consorcio Hospital General Universitario, Valencia, Spain.
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Carballeira C, Espinosa J, Carballeira A. Linking δ 15N and histopathological effects in molluscs exposed in situ to effluents from land-based marine fish farms. Mar Pollut Bull 2011; 62:2633-2641. [PMID: 22024543 DOI: 10.1016/j.marpolbul.2011.09.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 09/20/2011] [Accepted: 09/28/2011] [Indexed: 05/31/2023]
Abstract
Histopathological alterations can indicate time-integrated impacts on organisms stemming from alterations at lower biological organisation levels. Long-term (native mussels) and short-term (transplanted clams) changes in the tissues of molluscs exposed to the effluents from two land-based marine fish farms (LBMFFs) were determined. Histological alterations were related to the δ(15)N isotopic signal measured in mussels and macroalgae. Effluents from LBMFFs were found to cause severe and moderate gill filament exfoliation in clams and mussels, respectively. Some transplanted clams showed severe degrees of hemocytic phagocytosis in gonads and connective tissue. In an attempt to semi-quantitatively summarize the observed histopathological alterations, a weighted index of damage (WID) was calculated for each type of alteration, species and sampling site. The WID was clearly related to the δ(15)N descriptor of exposure. Further studies aimed at standardizing this relationship may establish critical thresholds of the descriptor for its implementation within environmental monitoring plans for LBMFFs.
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Affiliation(s)
- C Carballeira
- Grupo de Ecotoxicología Marina, Dpt° Química Física, Facultad de Ciencias del Mar (UCA), Spain.
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Cano J, Cervera R, Berciano M, Villa J, Garcia P, Espinosa J. 3521 POSTER Serum Levels of Vitamin D of Patients in First Visit in a Clinical Oncology Department. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71177-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
REASONS FOR PERFORMING STUDY The assessment of a normal range for cross-sectional area (CSA) of tendons in the tarsal region is important in order to use them as reference values in the identification of pathological changes of dimensions. OBJECTIVES To provide normal reference values for the CSA of the tendons of the tarsus of Standardbred trotter horses (STH) by means of ultrasonography. METHODS Transverse echographic images of the tendons were obtained at different levels proximodistally; these images were digitised and CSA values (mean ± s.d.) were obtained for each structure. RESULTS The largest structure corresponded with the lateral digital flexor/caudal tibial tendon complex at Level 1 and the smallest was the medial digital flexor tendon at Level 4. Almost all tendons showed a slight decreasing in their CSA when crossing the tarsus. CONCLUSIONS The normal CSA values of tendinous structures in the tarsal region of the STH are reported. These data could be used as anatomical references. POTENTIAL RELEVANCE The establishment of reference values could serve as a tool to discriminate between normal and abnormal dimensions of tarsal tendons in STH. Other horse breeds should need their own reference values.
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Affiliation(s)
- J M Vilar
- Animal Pathology Department, Faculty of Veterinary Medicine, Las Palmas de Gran Canaria University, Arucas.
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Espinosa J, Brunner T, Fiedler N, Forchhammer K, Muro-Pastor AM, Maldener I. DevT (Alr4674), resembling a Ser/Thr protein phosphatase, is essential for heterocyst function in the cyanobacterium Anabaena sp. PCC 7120. Microbiology (Reading) 2010; 156:3544-3555. [DOI: 10.1099/mic.0.043398-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Robles NR, Velasco J, Espinosa J, Mena C, Angulo E. Persistent microalbuminuria after treatment with renin-angiotensin axis blockers: causes and results of treatment intensification. J Renin Angiotensin Aldosterone Syst 2010; 12:333-9. [PMID: 20647247 DOI: 10.1177/1470320310374215] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
AIMS The first phase of this study aimed to determine the causes of persistent microalbuminuria after treatment with renin-angiotensin axis (RAA) blocking drugs. In a second phase we tried to determine if strict control of blood pressure and intensive RAA blockade could induce remission or reduction of microalbuminuria in clinical (primary care) practice. PATIENTS AND METHODS The study included both diabetic patients and non-diabetic hypertensive patients treated with RAA drugs in the presence of microalbuminuria. 211 patients were recruited (mean age 66.6±11.3 years, 111 men, 117 were diabetic). In the first phase treatment was optimized at standard doses. In the second phase treatment was increased during a three months period to reach a blood pressure (BP) < 130/80 mmHg by adding other antihypertensive treatment and to obtain maximal RAA blockade using long-acting drugs, increased dosage, or adding further medication at night. RESULTS Initial mean BP was 141±16/81±11 mmHg. BP control was unsatisfactory (control of systolic blood pressure [SBP] 19.3%; diastolic blood pressure [DBP] 37.6%). Dosage of RAA blocking drugs was inadequate in 21% of patients. Only 27.4% of patients were taking antihypertensive drugs at night. 30.1% of patients took once daily short acting drugs. During the studymean SBP was reduced to 137±13 mmHg (p < .001) and DBP decreased to 79±10 mmHg (p < .001). Control of SBP improved to 24.5% and DBP control went to 44.4%. Mean microalbuminuria decreased from 64.4±47.0 mg/day to 50.1±53.0 mg/day (p < .001) and the prevalence of microalbuminuria was reduced to 59.1%. CONCLUSIONS Persistent microalbuminuria was associated with poor blood pressure control and inadequate drug dosage. Low frequency of administration of drugs at night and inappropriate once-daily pills intake were frequent. Strict control of blood pressure and intensive RAA blockade significantly reduced the prevalence of microalbuminuria.
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Affiliation(s)
- N R Robles
- Cátedra de Riesgo Cardiovascular, Facultad de Medicina, Universidad de Salamanca, Spain.
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Batista-Arteaga M, Santana M, Lozano O, Méndez J, Quesada O, Arbelo M, Espinosa J. Medical and surgical management of a dystocia because of foetopelvic disproportion in an African lioness (Panthera leo). Reprod Domest Anim 2010; 46:362-5. [PMID: 20456665 DOI: 10.1111/j.1439-0531.2010.01630.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Medical and surgical management of a foetopelvic dystocia in an African lioness (Panthera leo) and the post-operative complications are reported. A caesarean section was performed to extract an oversize foetus blocked at the cervical canal; the lioness died 36 h after surgery. At necropsy, an abdominal effusion with sero-haemorrhagic fluid was observed, along with a fibrinopurulent exudate adhered to the serosal surfaces of the pelvic and abdominal cavities. In addition, the pelvic symphysis was not cartilaginous, but formed a firm and rigid joint between the pubis and ischium of each hip. The macroscopic and microscopic findings confirmed the presence of metritis, vaginitis and peritonitis. Dystocia may be caused by the premature ossification of the pelvic symphysis, reducing the dimensions of the pelvic cavity.
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Affiliation(s)
- M Batista-Arteaga
- Unit of Reproduction and Obstetrics, University Veterinary Hospital, Las Palmas, Spain.
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Cárdenas R, Chávez M, González JL, Aley P, Espinosa J, Jiménez-García LF. Oocyte structure and ultrastructure in the Mexican silverside fish Chirostoma humboldtianum (Atheriniforme: Atherinopsidae). REV BIOL TROP 2008; 56:1371-1380. [PMID: 19419050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
The structural and ultrastructural features of gonads from endemic Mexican fish have received scarce attention. This study describes the histological and ultrastructural characteristics of oocyte from Chirostoma humboldtianum. The ovary is asynchronic, and as such, most phases of oocyte development are found in the same ovary. The complete process of oogenesis was divided in five stages: oogonium and folliculogenesis, primary growth, cortical alveoli and lipid inclusions, vitellogenesis, and maturation. The presence of big filaments, which appear at the end of primary growth, induces some common follicular adaptation. During primary growth, abundant ribosomes, the rough endoplasmic reticulum, and mitochondria are grouped in the cytoplasm. At the end of this stage, the Z1 layer of the chorion is developed, while microvilli start to be evident. In the cortical alveoli and lipid droplets phase, intense PAS positive vesicles, some of them containing nucleoid material, are observed in the peripheral cytoplasm and the lipid droplets take a more central position. In vitellogenesis, the proteic yolk accumulates in a centripetal way while the chorion is completely formed. During maturation, the germinal vesicle migrates to the animal pole, meiosis is restored, and there is nuclear breakdown. The oocyte increases its size and holds some oil droplets and a big fluid mass of yolk. On the outside, filaments completely surround the oocyte.
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Affiliation(s)
- R Cárdenas
- Laboratorio de Endocrinología de Peces, Unidad de Morfología y Función, Facultad de Estudios Superiores Iztacala, U.N.A.M. Av. de los Barrios #1, Los Reyes Iztacala, Tlalnepantla, Edo de México, México, CP 54090, AP 314 Tlal.
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Abstract
Measurement of social stressors among Hispanic women is a growing and important area of study, particularly in terms of understanding explanatory mechanisms for health disparities. This study involved adaptation of the Hispanic Stress Inventory and the Latin American Stress Inventory to create a measure of social stressors specifically for both immigrant and nonimmigrant Hispanic women. The measurement development process included review of existing scales, focus groups with Hispanic women (U.S.- and Mexico-born) in New Mexico, and creation, pilot testing, and factor analysis of a 41-item scale. Results indicate that the Hispanic Women's Social Stressor Scale is a reliable and valid measure of the social stressors experienced by U.S.-born and Mexico-born Hispanic women in the Southwest. Factor analyses revealed six reliable and conceptually distinct sub-scales of social stressors: immigration, socioeconomic, racism-related, familial, parental, and employment. Convergent and criterion validity were supported.
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Perez J, Espinosa J, Illueca C, Vázquez C, Moreno I. Real time modulable multifocality through annular optical elements. Opt Express 2008; 16:5095-5106. [PMID: 18542609 DOI: 10.1364/oe.16.005095] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We present and analyze new multifocal optical elements based on an annular distribution of the transmittance. These elements provide selectable number of foci and can be designed to work between two fixed positions or even to provide extended focal depth. The energy of the foci can be modulated through a single parameter that controls the area of each ring. In our study we analyze the quality of the peaks and also the limit number of foci that can be obtained. The properties shown by these elements make them usable in instrumental optics or in ophthalmic optics, as new intraocular implants, where multifocal elements are required. The implementation has been done on a twisted nematic spatial light modulator, thus allowing real time reconfiguration of the element.
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Affiliation(s)
- J Perez
- Departamento de Optica, Universidad de Alicante. Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante, Spain.
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Illueca C, Alió JL, Mas D, Ortiz D, Pérez J, Espinosa J, Esperanza S. Pseudoaccommodation and Visual Acuity With Technovision PresbyLASIK and a Theoretical Simulated Array® Multifocal Intraocular Lens. J Refract Surg 2008; 24:344-9. [PMID: 18500082 DOI: 10.3928/1081597x-20080401-05] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Carlos Illueca
- Department of Optics, Universidad de Alicante, Alicante, Spain
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Mas D, Espinosa J, Perez J, Illueca C. Three dimensional analysis of chromatic aberration in diffractive elements with extended depth of focus. Opt Express 2007; 15:17842-17854. [PMID: 19551079 DOI: 10.1364/oe.15.017842] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The paper presents the polychromatic analysis of two diffractive optical elements with extended depth of focus: the linear axicon and the light sword optical element. Chromatic aberration produces axial displacement of the focal segment line. Thus, we explore the possibility of extending the focal depth of these elements to permit superposition of the chromatic foci. In the case of an axicon, we achieve an achromatic zone where focusing is produced. In the case of the light sword element, we show that the focusing segment is out of axis. Therefore a superposition of colors is produced, but not on axis overlapping. Instead, three colored and separated foci are simultaneously obtained in a single plane. Three dimensional structures of the propagated beams are analyzed in order to provide better understanding of the properties and applications of such elements.
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Affiliation(s)
- D Mas
- Dept. Optica, Univ. Alicante, Carretera San Vicente del Raspeig s/n - 03690 San Vicente del Raspeig, Alicante Spain.
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50
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Abstract
PURPOSE To evaluate the changes in the optical quality of corneas of hyperopic patients operated using central multifocal presbyLASIK treatment through the study of light patterns around the retinal plane. METHODS This study included eight hyperopic eyes that underwent central presbyLASIK surgery with Presby-one software using an H. Eye Tech Technovision excimer laser platform. Mean patient age was 57 years. Mean preoperative spherical equivalent refraction was 1.28 +/- 0.87 diopters (D). Mean distance decimal visual acuity with correction was 1.02 +/- 0.13 and without correction was 0.37 +/- 0.15. The optical quality was characterized by the Strehl ratio, the spot size on the retina, and objective decimal visual acuity calculated based on measured corneal topography using Fresnel propagation algorithm based on a realistic eye model. RESULTS The postoperative spherical equivalent refraction was -0.55 +/- 0.48 D. The distance decimal visual acuity with correction was 0.94 and without correction was 0.70. The pseudoaccommodation range was 1.60 +/- 0.40 D. A good Pearson correlation coefficient was obtained (r2 = 0.86) for the linear fit between the real and calculated decimal visual acuity for the eight eyes. The Strehl ratio value on the retinal plane increased after the surgery by a mean factor of 4.7. CONCLUSIONS With a complete characterization of the eye and a complete propagation algorithm (that takes into account all refractive surfaces in the eye at the same time), it is possible to evaluate the optical quality in eyes of patients who have undergone central presbyLASlK treatment.
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Affiliation(s)
- Dolores Ortiz
- Research and Investigation Department, Instituto Oftalmológico Alicante, Vissum Corporation, Avda Denia s/n Edificio Vissum, 03016 Alicante, Spain.
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