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Garcia-Puente LM, García-Montero C, Fraile-Martinez O, Bujan J, De León-Luis JA, Bravo C, Rodríguez-Benitez P, López-González L, Díaz-Pedrero R, Álvarez-Mon M, García-Honduvilla N, Saez MA, Ortega MA. Exploring the Importance of Differential Expression of Autophagy Markers in Term Placentas from Late-Onset Preeclamptic Pregnancies. Int J Mol Sci 2024; 25:2029. [PMID: 38396708 PMCID: PMC10888358 DOI: 10.3390/ijms25042029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/16/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
Preeclampsia (PE) is a serious hypertensive disorder affecting 4-5% of pregnancies globally, leading to maternal and perinatal morbidity and mortality and reducing life expectancy in surviving women post-gestation. Late-onset PE (LO-PE) is a clinical type of PE diagnosed after 34 weeks of gestation, being less severe than the early-onset PE (EO-PE) variant, although both entities have a notable impact on the placenta. Despite the fact that most studies have focused on EO-PE, LO-PE does not deserve less attention since its prevalence is much higher and little is known about the role of the placenta in this pathology. Via RT-qPCR and immunohistochemistry methods, we measured the gene and protein expressions of several macroautophagy markers in the chorionic villi of placentas from women who underwent LO-PE (n = 68) and compared them to normal pregnancies (n = 43). We observed a markedly distinct expression pattern, noticing a significant drop in NUP62 expression and a considerable rise in the gene and protein expressions of ULK1, ATG9A, LC3, ATG5, STX-17, and LAMP-1 in the placentas of women with LO-PE. A major induction of autophagic processes was found in the placental tissue of patients with LO-PE. Abnormal signaling expression of these molecular patterns in this condition aids in the understanding of the complexity of pathophysiology and proposes biomarkers for the clinical management of these patients.
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Affiliation(s)
- Luis M. Garcia-Puente
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (L.M.G.-P.); (C.G.-M.); (O.F.-M.); (J.B.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (L.L.-G.); (R.D.-P.)
| | - Cielo García-Montero
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (L.M.G.-P.); (C.G.-M.); (O.F.-M.); (J.B.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (L.L.-G.); (R.D.-P.)
| | - Oscar Fraile-Martinez
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (L.M.G.-P.); (C.G.-M.); (O.F.-M.); (J.B.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (L.L.-G.); (R.D.-P.)
| | - Julia Bujan
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (L.M.G.-P.); (C.G.-M.); (O.F.-M.); (J.B.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (L.L.-G.); (R.D.-P.)
| | - Juan A. De León-Luis
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (J.A.D.L.-L.); (C.B.); (P.R.-B.)
- Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, 28009 Madrid, Spain
- Health Research Institute Gregorio Marañón, 28009 Madrid, Spain
| | - Coral Bravo
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (J.A.D.L.-L.); (C.B.); (P.R.-B.)
- Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, 28009 Madrid, Spain
- Health Research Institute Gregorio Marañón, 28009 Madrid, Spain
| | - Patrocinio Rodríguez-Benitez
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (J.A.D.L.-L.); (C.B.); (P.R.-B.)
- Health Research Institute Gregorio Marañón, 28009 Madrid, Spain
- Department of Nephrology, University Hospital Gregorio Marañón, 28009 Madrid, Spain
| | - Laura López-González
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (L.L.-G.); (R.D.-P.)
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain
| | - Raul Díaz-Pedrero
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (L.L.-G.); (R.D.-P.)
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain
| | - Melchor Álvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (L.M.G.-P.); (C.G.-M.); (O.F.-M.); (J.B.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (L.L.-G.); (R.D.-P.)
- Immune System Diseases-Rheumatology and Internal Medicine Service, University Hospital Prince of Asturias, Networking Research Center on for Liver and Digestive Diseases (CIBEREHD), 28806 Alcalá de Henares, Spain
| | - Natalio García-Honduvilla
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (L.M.G.-P.); (C.G.-M.); (O.F.-M.); (J.B.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (L.L.-G.); (R.D.-P.)
| | - Miguel A. Saez
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (L.M.G.-P.); (C.G.-M.); (O.F.-M.); (J.B.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (L.L.-G.); (R.D.-P.)
- Pathological Anatomy Service, University Hospital Gómez-Ulla, 28806 Alcalá de Henares, Spain
| | - Miguel A. Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (L.M.G.-P.); (C.G.-M.); (O.F.-M.); (J.B.); (M.Á.-M.); (N.G.-H.); (M.A.S.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; (L.L.-G.); (R.D.-P.)
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Ortega MA, Jiménez-Álvarez L, Fraile-Martinez O, Garcia-Montero C, De León-Oliva D, Toledo-Lobo MDV, Palacios E, Granado P, Esteban A, Guijarro LG, Pekarek L, Asúnsolo Á, López-González L, Bujan J, García-Honduvilla N, Álvarez-Mon M, Saez MA, Díaz-Pedrero R. Elevated tissue expression of RANKL and RANK is associated with poorer survival rates in pancreatic cancer patients. Histol Histopathol 2023:18700. [PMID: 38230588 DOI: 10.14670/hh-18-700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Pancreatic cancer is a highly lethal malignancy with a growing incidence reported worldwide. Pancreatic ductal adenocarcinoma (PDAC) is the most common type of pancreatic cancer, which is often diagnosed at advanced stages, making its prognosis and medical management difficult. The identification of histopathological biomarkers has allowed a more precise stratification of pancreatic cancer patients, providing additional information about their prognosis and offering possible therapeutic targets to be explored. The prognostic value of the receptor activator of nuclear factor-kappa B (RANK) and its ligand (RANKL) has been evaluated in breast and prostate tumors, however, their usefulness has not been assessed in pancreatic cancer. In the present work, we analyzed the relationship between the protein expression of RANK and RANKL with the survival of 41 patients with pancreatic cancer followed for 60 months, by performing immunohistochemistry and Kaplan-Meier curves. Our results demonstrate a direct association of high expression levels of RANK and RANKL with poorer survival of pancreatic cancer patients in comparison to those with low/medium and null expression levels of both markers. Further studies should be conducted to explore the carcinogenic role of both components in this type of tumor, as well as additional promising translational uses.
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Affiliation(s)
- Miguel A Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Madrid, Spain.
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Cancer Registry and Pathology Department, Principe de Asturias University Hospital, Alcala de Henares, Madrid, Spain
| | - Laura Jiménez-Álvarez
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Madrid, Spain
- Department of General and Digestive Surgery, General and Digestive Surgery, Príncipe de Asturias Teaching Hospital, Alcala de Henares, Madrid, Spain
| | - Oscar Fraile-Martinez
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Madrid, Spain.
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Cielo Garcia-Montero
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Diego De León-Oliva
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - María Del Val Toledo-Lobo
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Unit of Cell Biology, Department of Biomedicine and Biotechnology, University of Alcala, Alcala de Henares, Madrid, 6Inari Biotech S.L., Madrid, Spain
| | | | | | | | - Luis G Guijarro
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Unit of Biochemistry and Molecular Biology, Department of System Biology (CIBEREHD), University of Alcalá, Alcala de Henares, Spain
| | - Leonel Pekarek
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Oncology Service, Guadalajara University Hospital, Guadalajara, Spain
| | - Ángel Asúnsolo
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Madrid, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, University of New York, New York, NY, United States
| | - Laura López-González
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Department of General and Digestive Surgery, General and Digestive Surgery, Príncipe de Asturias Teaching Hospital, Alcala de Henares, Madrid, Spain
| | - Julia Bujan
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Natalio García-Honduvilla
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Melchor Álvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Immune System Diseases-Rheumatology, Oncology Service and Internal Medicine (CIBEREHD), University Hospital Príncipe de Asturias, Alcala de Henares, Madrid, Spain
| | - Miguel A Saez
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Pathological Anatomy Service, Central University Hospital of Defence-UAH Madrid, Alcala de Henares, Madrid, Spain
| | - Raúl Díaz-Pedrero
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Department of General and Digestive Surgery, General and Digestive Surgery, Príncipe de Asturias Teaching Hospital, Alcala de Henares, Madrid, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, University of New York, New York, NY, United States
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Continente X, Henderson E, López-González L, Fernández E, Tigova O, Semple S, O'Donnell R, Navas-Acién A, Cortés-Francisco N, Ramírez N, Dobson R, López MJ. Exposure to secondhand and thirdhand smoke in private vehicles: Measurements in air and dust samples. Environ Res 2023; 235:116681. [PMID: 37474087 DOI: 10.1016/j.envres.2023.116681] [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: 06/16/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND This study aimed to estimate airborne nicotine concentrations and nicotine, cotinine, and tobacco-specific nitrosamines (TSNAs) in settled dust from private cars in Spain and the UK. METHODS We measured vapor-phase nicotine concentrations in a convenience sample of 45 private cars from Spain (N = 30) and the UK (N = 15) in 2017-2018. We recruited non-smoking drivers (n = 20), smoking drivers who do not smoke inside the car (n = 15), and smoking drivers who smoke inside (n = 10). Nicotine, cotinine, and three TSNAs (NNK, NNN, NNA) were also measured in settled dust in a random subsample (n = 20). We computed medians and interquartile ranges (IQR) of secondhand smoke (SHS) and thirdhand smoke (THS) compounds according to the drivers' profile. RESULTS 24-h samples yielded median airborne nicotine concentrations below the limit of quantification (LOQ) (IQR: CONCLUSIONS All cars of smokers had measurable SHS and THS pollution, the exposure levels markedly higher in vehicles of drivers where smoking took place. Our results evidence the need for policies to prohibit smoking in vehicles, but also urge for more comprehensive strategies aiming towards the elimination of tobacco consumption.
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Affiliation(s)
- Xavier Continente
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain.
| | - Elisabet Henderson
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain.
| | | | - Esteve Fernández
- Unitat de Control de Tabac, Institut Català d'Oncologia, Av. Granvia de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat, Spain; Institut D'Investigació Biomèdica de Bellvitge, Av. Granvia de l'Hospitalet 199, 08908, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, Campus de Bellvitge, School of Medicine and Health Sciences, University of Barcelona, Feixa Llarga, S/n, 08907, L'Hospitalet de Llobregat, Spain; Centre for Biomedical Research in Respiratory Diseases (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain.
| | - Olena Tigova
- Unitat de Control de Tabac, Institut Català d'Oncologia, Av. Granvia de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat, Spain; Institut D'Investigació Biomèdica de Bellvitge, Av. Granvia de l'Hospitalet 199, 08908, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, Campus de Bellvitge, School of Medicine and Health Sciences, University of Barcelona, Feixa Llarga, S/n, 08907, L'Hospitalet de Llobregat, Spain; Centre for Biomedical Research in Respiratory Diseases (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain.
| | - Sean Semple
- Institute for Social Marketing, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
| | - Rachel O'Donnell
- Institute for Social Marketing, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
| | - Ana Navas-Acién
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, United States.
| | - Núria Cortés-Francisco
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain.
| | - Noelia Ramírez
- Institut d'Investigació Sanitària Pere Virgili, Dr. Mallafré Guasch, 4, 43007, Tarragona, Spain; Universitat Rovira i Virgili, Department of Electronic Engineering, Escorxador, s/n, 43003, Tarragona, Spain; Centre for Biomedical Research in Diabetes and Associated Metabolic Diseases (CIBERDEM), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain.
| | - Ruaraidh Dobson
- Institute for Social Marketing, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
| | - Maria José López
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain; Departament de Ciències Experimentals i de la Salut (DCEXS), Universitat Pompeu Fabra, Doctor Aiguader, 88, 08003, Barcelona, Spain.
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De Leon-Oliva D, Barrena-Blázquez S, Jiménez-Álvarez L, Fraile-Martinez O, García-Montero C, López-González L, Torres-Carranza D, García-Puente LM, Carranza ST, Álvarez-Mon MÁ, Álvarez-Mon M, Diaz R, Ortega MA. The RANK-RANKL-OPG System: A Multifaceted Regulator of Homeostasis, Immunity, and Cancer. Medicina (Kaunas) 2023; 59:1752. [PMID: 37893470 PMCID: PMC10608105 DOI: 10.3390/medicina59101752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/21/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
The RANK-RANKL-OPG system is a complex signaling pathway that plays a critical role in bone metabolism, mammary epithelial cell development, immune function, and cancer. RANKL is a ligand that binds to RANK, a receptor expressed on osteoclasts, dendritic cells, T cells, and other cells. RANKL signaling promotes osteoclast differentiation and activation, which leads to bone resorption. OPG is a decoy receptor that binds to RANKL and inhibits its signaling. In cancer cells, RANKL expression is often increased, which can lead to increased bone resorption and the development of bone metastases. RANKL-neutralizing antibodies, such as denosumab, have been shown to be effective in the treatment of skeletal-related events, including osteoporosis or bone metastases, and cancer. This review will provide a comprehensive overview of the functions of the RANK-RANKL-OPG system in bone metabolism, mammary epithelial cells, immune function, and cancer, together with the potential therapeutic implications of the RANK-RANKL pathway for cancer management.
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Affiliation(s)
- Diego De Leon-Oliva
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (D.D.L.-O.); (S.B.-B.); (L.J.-Á.); (O.F.-M.); (C.G.-M.); (D.T.-C.); (L.M.G.-P.); (S.T.C.); (M.Á.Á.-M.); (M.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Silvestra Barrena-Blázquez
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (D.D.L.-O.); (S.B.-B.); (L.J.-Á.); (O.F.-M.); (C.G.-M.); (D.T.-C.); (L.M.G.-P.); (S.T.C.); (M.Á.Á.-M.); (M.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Department of Nursing and Physiotherapy, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain
| | - Laura Jiménez-Álvarez
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (D.D.L.-O.); (S.B.-B.); (L.J.-Á.); (O.F.-M.); (C.G.-M.); (D.T.-C.); (L.M.G.-P.); (S.T.C.); (M.Á.Á.-M.); (M.Á.-M.)
- Surgery Service, University Hospital Principe de Asturias, 28801 Alcala de Henares, Spain
| | - Oscar Fraile-Martinez
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (D.D.L.-O.); (S.B.-B.); (L.J.-Á.); (O.F.-M.); (C.G.-M.); (D.T.-C.); (L.M.G.-P.); (S.T.C.); (M.Á.Á.-M.); (M.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Cielo García-Montero
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (D.D.L.-O.); (S.B.-B.); (L.J.-Á.); (O.F.-M.); (C.G.-M.); (D.T.-C.); (L.M.G.-P.); (S.T.C.); (M.Á.Á.-M.); (M.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Laura López-González
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain;
| | - Diego Torres-Carranza
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (D.D.L.-O.); (S.B.-B.); (L.J.-Á.); (O.F.-M.); (C.G.-M.); (D.T.-C.); (L.M.G.-P.); (S.T.C.); (M.Á.Á.-M.); (M.Á.-M.)
| | - Luis M. García-Puente
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (D.D.L.-O.); (S.B.-B.); (L.J.-Á.); (O.F.-M.); (C.G.-M.); (D.T.-C.); (L.M.G.-P.); (S.T.C.); (M.Á.Á.-M.); (M.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Sara T. Carranza
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (D.D.L.-O.); (S.B.-B.); (L.J.-Á.); (O.F.-M.); (C.G.-M.); (D.T.-C.); (L.M.G.-P.); (S.T.C.); (M.Á.Á.-M.); (M.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Miguel Ángel Álvarez-Mon
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (D.D.L.-O.); (S.B.-B.); (L.J.-Á.); (O.F.-M.); (C.G.-M.); (D.T.-C.); (L.M.G.-P.); (S.T.C.); (M.Á.Á.-M.); (M.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Melchor Álvarez-Mon
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (D.D.L.-O.); (S.B.-B.); (L.J.-Á.); (O.F.-M.); (C.G.-M.); (D.T.-C.); (L.M.G.-P.); (S.T.C.); (M.Á.Á.-M.); (M.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain;
- Immune System Diseases-Rheumatology Service, University Hospital Principe de Asturias, 28801 Alcala de Henares, Spain
| | - Raul Diaz
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Surgery Service, University Hospital Principe de Asturias, 28801 Alcala de Henares, Spain
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain;
| | - Miguel A. Ortega
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain; (D.D.L.-O.); (S.B.-B.); (L.J.-Á.); (O.F.-M.); (C.G.-M.); (D.T.-C.); (L.M.G.-P.); (S.T.C.); (M.Á.Á.-M.); (M.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
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Gracia-Ahufinger I, López-González L, Vasallo FJ, Galar A, Siller M, Pitart C, Bloise I, Torrecillas M, Gijón-Cordero D, Viñado B, Castillo-García J, Campo R, Mulet X, Madueño-Alonso A, Chamizo-López FJ, Arrastia-Erviti M, Galán-Sánchez F, Fernández-Quejo M, Rodríguez-Díaz JC, Gutiérrez-Zufiaurre MN, Rodríguez-Maresca MA, Ortega-Lafont MDP, Yagüe-Guirao G, Chaves-Blanco L, Colomina-Rodríguez J, Vidal-Acuña MR, Portillo ME, Franco-Álvarez de Luna F, Centelles-Serrano MJ, Azcona-Gutiérrez JM, Delgado-Iribarren García Campero A, Rey-Cao S, Muñoz P, Calvo-Montes J, Zboromyrska Y, Grandioso D, Càmara J, Cantón R, Larrosa-Escartín N, Díaz-Regañón J, Martínez-Martínez L. The CARBA-MAP study: national mapping of carbapenemases in Spain (2014-2018). Front Microbiol 2023; 14:1247804. [PMID: 37744921 PMCID: PMC10516297 DOI: 10.3389/fmicb.2023.1247804] [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: 06/26/2023] [Accepted: 08/15/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Infections caused by carbapenem-resistant Enterobacterales (CRE) and carbapenem-resistant Pseudomonas aeruginosa, including isolates producing acquired carbapenemases, constitute a prevalent health problem worldwide. The primary objective of this study was to determine the distribution of the different carbapenemases among carbapenemase-producing Enterobacterales (CPE, specifically Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, and Klebsiella aerogenes) and carbapenemase-producing P. aeruginosa (CPPA) in Spain from January 2014 to December 2018. Methods A national, retrospective, cross-sectional multicenter study was performed. The study included the first isolate per patient and year obtained from clinical samples and obtained for diagnosis of infection in hospitalized patients. A structured questionnaire was completed by the participating centers using the REDCap platform, and results were analyzed using IBM SPSS Statistics 29.0.0. Results A total of 2,704 carbapenemase-producing microorganisms were included, for which the type of carbapenemase was determined in 2692 cases: 2280 CPE (84.7%) and 412 CPPA (15.3%), most often using molecular methods and immunochromatographic assays. Globally, the most frequent types of carbapenemase in Enterobacterales and P. aeruginosa were OXA-48-like, alone or in combination with other enzymes (1,523 cases, 66.8%) and VIM (365 cases, 88.6%), respectively. Among Enterobacterales, carbapenemase-producing K. pneumoniae was reported in 1821 cases (79.9%), followed by E. cloacae complex in 334 cases (14.6%). In Enterobacterales, KPC is mainly present in the South and South-East regions of Spain and OXA-48-like in the rest of the country. Regarding P. aeruginosa, VIM is widely distributed all over the country. Globally, an increasing percentage of OXA-48-like enzymes was observed from 2014 to 2017. KPC enzymes were more frequent in 2017-2018 compared to 2014-2016. Discussion Data from this study help to understand the situation and evolution of the main species of CPE and CPPA in Spain, with practical implications for control and optimal treatment of infections caused by these multi-drug resistant organisms.
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Affiliation(s)
- Irene Gracia-Ahufinger
- Unit of Microbiology, Reina Sofia University Hospital, Cordoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
- Center for Biomedical Research in Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Laura López-González
- Clinical Microbiology Service, IML, San Carlos Clinical University Hospital, Madrid, Spain
- Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Francisco José Vasallo
- Microbiology Service, Vigo University Hospital Complex (CHUVI), Vigo, Spain
- Health Research Institute Galicia Sur (IISGS), Vigo, Spain
| | - Alicia Galar
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Health Research Institute Hospital Gregorio Marañón, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERes), Instituto de Salud Carlos III, Madrid, Spain
| | - María Siller
- Microbiology Service, Marqués de Valdecilla University Hospital, Santander, Spain
- Marqués de Valdecilla Health Research Institute (IDIVAL), Santander, Spain
| | - Cristina Pitart
- Microbiology Service, Hospital Clinic, Barcelona, Spain
- Department of Basic Clinical Practice, University of Barcelona, Barcelona, Spain
- Institute of Global Health of Barcelona, Barcelona, Spain
| | - Iván Bloise
- Clinical Microbiology Department, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPaz), Madrid, Spain
| | - Miriam Torrecillas
- Clinical Microbiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
| | - Desirée Gijón-Cordero
- Microbiology Service, Ramón y Cajal University Hospital, Madrid, Spain
- Ramón y Cajal Institute for Health Research (IRYCIS), Madrid, Spain
| | - Belén Viñado
- Microbiology Service, Vall d'Hebron University Hospital, Barcelona, Spain
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Javier Castillo-García
- Microbiology Service, Lozano Blesa Clinical University Hospital, Zaragoza, Spain
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- School of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Rainer Campo
- Microbiology Service, Asturias Central University Hospital, Oviedo, Spain
| | - Xavier Mulet
- Center for Biomedical Research in Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain
- Microbiology Service, Son Espases University Hospital, Palma de Mallorca, Spain
- Institute for Health Research Illes Balears (IdISBa), Palma, Spain
| | - Ana Madueño-Alonso
- Microbiology Service, University Hospital of the Canary Islands, Tenerife, Spain
| | | | | | | | | | - Juan Carlos Rodríguez-Díaz
- Microbiology Service, General University Hospital Dr. Balmis, Alicante, Spain
- Health and Biomedical Research Institute of Alicante (ISABIAL), Alicante, Spain
| | | | | | | | - Genoveva Yagüe-Guirao
- Virgen de la Arrixaca University Hospital, Murcia, Spain
- Department of Genetics and Microbiology, University of Murcia, Murcia, Spain
- Murcian Institute for Biomedical Research (IMIB), Murcia, Spain
| | - Lucía Chaves-Blanco
- Microbiology Service, San Cecilio Clinical University Hospital, Granada, Spain
| | | | | | - María Eugenia Portillo
- Clinical Microbiology Service, University Hospital of Navarra, Pamplona, Spain
- Health Research Institute of Navarra (IdiSNA), Pamplona, Spain
| | | | - María José Centelles-Serrano
- Microbiology Area, Clinical Laboratory, Hospital of Tortosa Virgen de la Cinta, Tortosa, Spain
- Institute for Health Research Pere Virgili, Tortosa, Spain
| | | | | | - Sonia Rey-Cao
- Microbiology Service, Vigo University Hospital Complex (CHUVI), Vigo, Spain
- Health Research Institute Galicia Sur (IISGS), Vigo, Spain
| | - Patricia Muñoz
- Center for Biomedical Research in Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Health Research Institute Hospital Gregorio Marañón, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERes), Instituto de Salud Carlos III, Madrid, Spain
| | - Jorge Calvo-Montes
- Center for Biomedical Research in Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain
- Microbiology Service, Marqués de Valdecilla University Hospital, Santander, Spain
- Marqués de Valdecilla Health Research Institute (IDIVAL), Santander, Spain
| | - Yuliya Zboromyrska
- Microbiology Service, Hospital Clinic, Barcelona, Spain
- Department of Basic Clinical Practice, University of Barcelona, Barcelona, Spain
| | - David Grandioso
- Clinical Microbiology Department, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPaz), Madrid, Spain
| | - Jordi Càmara
- CIBER de Enfermedades Respiratorias (CIBERes), Instituto de Salud Carlos III, Madrid, Spain
- Department of Basic Clinical Practice, University of Barcelona, Barcelona, Spain
- Clinical Microbiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Institut Investigacio Biomedica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
| | - Rafael Cantón
- Center for Biomedical Research in Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain
- Microbiology Service, Ramón y Cajal University Hospital, Madrid, Spain
- Ramón y Cajal Institute for Health Research (IRYCIS), Madrid, Spain
| | - Nieves Larrosa-Escartín
- Center for Biomedical Research in Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain
- Microbiology Service, Vall d'Hebron University Hospital, Barcelona, Spain
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | | | - Luis Martínez-Martínez
- Unit of Microbiology, Reina Sofia University Hospital, Cordoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
- Center for Biomedical Research in Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain
- Department of Agricultural Chemistry, Soil Science and Microbiology, University of Cordoba, Cordoba, Spain
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Abstract
Background: Client-centred practice aims to involve the person in making decisions during the therapeutic intervention process, giving him or her a central and active role.Objectives: To analyze the effects of client-centred practice in occupational therapy on issues related to occupational performance and participation among people with stroke and traumatic brain injury.Material and methods: A systematic review of randomized clinical trials examining the effects of a client-centred practice carried out by occupational therapists in patients with stroke or traumatic brain injury aged over 18 years was conducted. PubMed, Web of Science, Scopus, OT Seeker, PsycINFO and EBSCO were used to retrieve potentially eligible publications.Results: Eight studies, from 294 identified, were included. The extracted data showed that the application of client-centred practice in occupational therapy improved satisfaction with occupational performance compared to conventional interventions. However, client-centred practice and conventional intervention had similar effects on functionality (Activities of Daily Living), life satisfaction and burden on caregivers.Conclusions and significance: Client-centred practice has the effect of achieving greater satisfaction with occupational performance. This suggests that client-centred practice in occupational therapy helps patients to accept the new limitations on their occupational performance. Further studies are needed to determine the effects of client-centred practice on other aspects.
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Affiliation(s)
| | | | - Jose Antonio Merchán-Baeza
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, University of Vic - Central University of Catalonia (UVIC-UCC), Vic, Spain
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Candel FJ, Rico CM, Díaz de la Torre I, Laguna B, Martínez-Jordán J, Medrano S, Escobar-Porcel MC, López-Delgado A, López-González L, Viñuela-Prieto JM, Matesanz M, González Del Castillo J, Arribi A. Update in Infectious Diseases 2019. Rev Esp Quimioter 2019; 32 Suppl 2:1-9. [PMID: 31475801 PMCID: PMC6755363] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The IX Course of Antimicrobials and Infectious Diseases update included a review of the main issues in clinical microbiology, epidemiology and clinical aspects for a current approach of infectious pathology. The present introduction summarizes about the most important meetings related to infectious diseases during 2018 (ECCMID, IAS, ASM and ID Week). In addition, the course provides a practical information to focus on nosocomial infection models, with immunosuppressed patients or complex multidrug-resistant pathogens. The closing lecture of this year reviewed the infection during donation process.
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Affiliation(s)
- F J Candel
- Francisco Javier Candel, Clinical Microbiology and Infectious Diseases Department. Hospital Clínico San Carlos. IML Health Institute. Avda Profesor Martín Lagos s/n - 28040. Madrid, Spain.
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8
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López-González L, Viñuela-Prieto JM, Rodriguez-Avial I, Manzano R, Candel FJ. Description of carbapenemase-producing Enterobacteriaceae isolates in a Spanish tertiary hospital. Epidemiological analysis and clinical impact. Rev Esp Quimioter 2019; 32:254-262. [PMID: 30968674 PMCID: PMC6609934] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to carry out an epidemiological analysis of patients with carbapenemase-producing Enterobacteriaceae (CPE) isolations in our hospital as well as to perform a description of the genotypic temporal evolution of CPE isolated. METHODS An observational prospective cohort study was performed involving all patients with CPE isolates from clinical samples during November 2014 to November 2016 in a Spanish teaching hospital. Patients were clinically evaluated and classified either as infected or colonized. Information on the consumption of carbapenems in the hospital during the study period was also analyzed. PCR was used for identification of the carbapenemase genes blaKPC, blaVIM, and blaOXA-48. RESULTS A total of 301 CPE isolates were obtained (107 in 2014, 89 in 2015 and 105 in 2016). Klebsiella pneumoniae (73.4%) was the most prevalent microorganism. Hundred and seventy (56.7%) of carbapenemases detected were blaOXA-48, 73 (24.3%) were blaKPC and 57 (19%) were blaVIM. In year 2014 KPC was predominant while in 2016 OXA-48 predominated. In 2014 we observed a significant association between the medical wards and the ICU with a higher prevalence of OXA-48 (OR 4.15; P<0.001) and VIM (OR 7.40; P<0.001) in the univariate analysis, in the following years there was no association. Regarding the clinical significance of microbiological results after assessing our patients, 60% of isolates represented infection and 40% behaved as colonizers. One third of hospitalized patients with CPE isolation died within 30 days, regardless of whether they were colonized or infected. CONCLUSIONS We have observed an epidemiological change in the genotypes of our isolates along the study period. A thorough knowledge of the CPE's epidemiological distribution in each hospital is fundamental for optimizing antimicrobial chemotherapy.
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Affiliation(s)
- Laura López-González
- Department of Clinical Microbiology and Infectious Diseases, Hospital Clínico San Carlos. IdISSC Health Research Institute. Madrid. Spain
| | - José Manuel Viñuela-Prieto
- Department of Clinical Microbiology and Infectious Diseases, Hospital Clínico San Carlos. IdISSC Health Research Institute. Madrid. Spain
| | - Icíar Rodriguez-Avial
- Department of Clinical Microbiology and Infectious Diseases, Hospital Clínico San Carlos. IdISSC Health Research Institute. Madrid. Spain
| | - Rocío Manzano
- Department of Pharmacy, Hospital Clínico San Carlos. IdISSC Health Research Institute. Madrid. Spain
| | - Francisco Javier Candel
- Department of Clinical Microbiology and Infectious Diseases, Hospital Clínico San Carlos. IdISSC Health Research Institute. Madrid. Spain,Universidad Complutense. Madrid. Spain,Correspondence: Francisco Javier Candel González, Department of Clinical Microbiology and Infectious Diseases. Hospital Clínico San Carlos. IdISSC Health Research Institute. Universidad Complutense. Madrid. Spain Phone: +34 91 330 3486 E-mail:
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9
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Candel FJ, Emilov T, Diaz de la Torre I, Ruedas A, Viñuela Prieto JM, Visiedo C, Martínez-Jordán J, López-González L, Matesanz M, Arribi A. Update in Infectious Diseases 2018. Rev Esp Quimioter 2018; 31 Suppl 1:1-8. [PMID: 30209913 PMCID: PMC6459573] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
VIII Updating Course of Antimicrobials and Infectious Diseases has reviewed useful microbiological, epidemiological and clinical aspects for a current approach of infectious pathology. Present manuscript summarizes a chronicle about the main infection related meetings during 2017 (ECCMID, IAS, ASM and ID Week). In addition, the course proposed a practical approach for understanding different type of pathogens and our selected topics this year were the epidemiology of bacterial nosocomial infection, a practical approach to Clostridium difficile infection patients, a two year selection of the top ten papers about fungal infection and an update in fungal biofilms. Finally, proffesors made a practical approach by main clinical syndromes like sepsis, infections in oncohematological patients, CNS infections in immunosuppressed patients and reviewed the top ten papers in transplant infectious diseases and infection control during the last two years.
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Affiliation(s)
- F J Candel
- Francisco Javier Candel González, Department of Clínical Microbiology. Health Research Institute (IdISSC). Hospital Clínico Universitario San Carlos. UCM. Avda Profesor Martín Lagos S/N. 28040. Madrid. Spain.
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10
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Mar Muñoz Sánchez MD, Carmen Soriano Rodríguez MD, Molina Garrido MJ, López-González A, García-Palomo A, López-González L, Plata Fernández MY, Caro NL, Rovira PS. Experience with eribulin in HR+/HER2- metastatic breast cancer, including a male patient: case studies. Future Oncol 2018; 14:5-12. [DOI: 10.2217/fon-2017-0355] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Numerous patient- and disease-related factors must be considered when deciding a treatment approach for hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer. Hormone therapy (HT) is generally the first option in the absence of compelling reasons for chemotherapy (e.g., rapidly progressive visceral disease). After failure of first-choice HT, alternative HT options are usually attempted until hormone resistance occurs and chemotherapy becomes the treatment of choice. The first two patients presented herein experienced prolonged disease control with third-line eribulin after two lines of HT. The third report involves a case of male breast cancer which typically presents as the HR+/HER2- phenotype. Eribulin in the second line provided prolonged clinical improvement and was well tolerated.
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Affiliation(s)
| | | | | | - Ana López-González
- Medical Oncology Department, Complejo Asistencial Universitario de León, León, Spain
| | - Andrés García-Palomo
- Medical Oncology Department, Complejo Asistencial Universitario de León, León, Spain
| | - Laura López-González
- Medical Oncology Department, Complejo Asistencial Universitario de León, León, Spain
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11
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González-Del Castillo J, Teja-Marina J, Candel FJ, Barberán J, Moreno-Cuervo A, Chiarella F, López-González L, Ramos-Cordero P, Martín-Sánchez FJ. BAHNG score: predictive model for detection of subjects with the oropharynx colonized by uncommon microorganisms. Rev Esp Quimioter 2017; 30:422-428. [PMID: 29115367] [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: 06/07/2023]
Abstract
OBJECTIVE Pneumonia is most frequently produced by the microaspiration of flora that colonizes the oropharynx. Etiological diagnosis of pneumonia is infrequent in clinical practise and empirical treatment should be prescribed. The aims of the present study were to determine the factors associated with oropharynx colonization by uncommon microorganisms (UM) and to develop a predictive model. METHODS A cross-sectional study that included all pa-tients living in one long-term care facilities was developed. Demographic, comorbidities, basal functional status and clinical data were collected. To determinate the oropharyngeal colonization, a single sample of pharynx was obtained for each subject using a cotton swab. RESULTS A total of 221 subjects were included, mean age 86.27 (SD 8.05) years and 157 (71%) were female. In 32 (14.5%) subjects UM flora was isolated, Gram-negative bacilli in 16 (7.2%) residents, and Staphylococcus aureus in 16 (7.2%). The predictive model included the presence of hypertension, neuromuscular disease, Barthel <90 and use of PEG. The BAHNG score (BArthel, Hypertension, Neuromuscular, Gastrostomy), showed an area under the curve of 0.731 (CI 95% 0.643-0.820; p<0.001). We have classified patients according to this score in low (0-2 points), intermediate (3-5 points) and high risk (≥ 6). The probability of UM colonization in the oropharyngeal based on this classification is 4.1%, 15.8% and 57.1% for low, intermediate and high risk, respectively. CONCLUSIONS The BAHNG score could help in the identifications of elderly patients with high risk of colonization by UM. In case of pneumonia the evaluation of the subject through this score could help in the initial decisions concerning antibiotic treatment.
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Affiliation(s)
- J González-Del Castillo
- Juan González del Castillo, Emergency Department. Hospital Clínico San Carlos. Calle Profesor Martín-Lagos s/n, 28040 Madrid, Spain.
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12
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López-González L, Candel FJ, Viñuela-Prieto JM, González-Del Castillo J, García AB, Pena I, Rodríguez-Avial I. Useful independent factors for distinguish infection and colonization in patients with urinary carbapenemase-producing Enterobacteriaceae isolation. Rev Esp Quimioter 2017; 30:450-457. [PMID: 29115369] [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: 06/07/2023]
Abstract
OBJECTIVE The aim of this study is to know epidemiologic and clinical differences among those patients colonized or infected by carbapenemase-producing Enterobacteriaceae (CPE) and develop a predictive model to facilitate the clinical approach concerning to start antimicrobial therapy. METHODS Observational retrospective cohort study was performed involving all patients with Urine carbapenemase-producing Enterobacteriaceae isolation (UCPEI) between November 2013 and July 2015. Patients were classifieds as colonized or infected considering Center for Disease Control and Prevention (CDC) definition for urinary tract infection (UTI). RESULTS A total of 72 patients were included, mean age 76.4 (IQR 23-99) years and 40 (55.6%) were women. Thirty-four (47.2%) were colonized and 38 (52.8%) met the criteria of UTI and were considered infected. The independent variables associated to infection were female sex, peripheral vascular disease, admission in medical ward, permanent urinary catheter carrier, previous antimicrobial therapy, and length of stay. Isolation of OXA-48 carbapenemase-producing Enterobacteriaceae behaved as a non UTI (colonization) factor in comparison with KPC or VIM CPE. The developed predictive model showed an area under the curve (AUC) of 0.901 (95% CI: 0.832-0.970; p < 0.001). CONCLUSIONS The predictive model that includes all this factors has demonstrated a good accuracy for infection diagnosis in these patients, an important issue considering that establishing the diagnosis of infection is not always easy in the profile of patients in which a CPE is isolated.
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Affiliation(s)
| | - F J Candel
- Dr Francisco Javier Candel González, Department of Clinical Microbiology and Infectious Diseases. Hospital Clínico San Carlos. IDISSC. Universidad Complutense. Avda Profesor Martín Lagos s/n, 28040. Madrid, Spain.
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López-González A, Sillero ID, Flores ML, López-González L, Palomo AG. Fulvestrant in breast cancer: also a good option in triple-positive breast cancer. Breast Cancer Management 2017. [DOI: 10.2217/bmt-2017-0012] [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: 11/21/2022] Open
Abstract
Fulvestrant is indicated in the treatment of locally advanced or metastatic breast cancer in postmenopausal women with hormone receptor-positive breast cancer as second line at the present time, after first line hormone therapy. We present here a case report of a 47-year-old woman diagnosed with infiltrating ductal carcinoma left breast cancer in 1998, stage II, luminal B HER2-positive and a liver and ganglionar relapse 3 years later. After radical treatment, fulvestrant was indicated. She has been 10 years with this treatment, with an excellent tolerance and without showing progression until now.
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Affiliation(s)
- Ana López-González
- Complejo Asistencial Universitario de León – Medical Oncology, C/Altos de Nava Leon, Leon 24007, Spain
| | - Irene Delgado Sillero
- Complejo Asistencial Universitario de León – Medical Oncology, C/Altos de Nava Leon, Leon 24007, Spain
| | - Mariana Lopez Flores
- Complejo Asistencial Universitario de León – Medical Oncology, C/Altos de Nava Leon, Leon 24007, Spain
| | - Laura López-González
- Complejo Asistencial Universitario de León – Medical Oncology, C/Altos de Nava Leon, Leon 24007, Spain
| | - Andres Garcia Palomo
- Complejo Asistencial Universitario de León – Medical Oncology, C/Altos de Nava Leon, Leon 24007, Spain
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14
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García AB, Viñuela-Prieto JM, López-González L, Candel FJ. Correlation between resistance mechanisms in Staphylococcus aureus and cell wall and septum thickening. Infect Drug Resist 2017; 10:353-356. [PMID: 29089777 PMCID: PMC5655128 DOI: 10.2147/idr.s146748] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of the present study is to examine cell wall and septum thickening of methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), and methicillin- and linezolid-resistant S. aureus (MLRSA) isolates by transmission electron microscopy to correlate the association of resistance mechanisms with major changes in the morphology of membrane or septum. Materials and methods MSSA, MRSA, and MLRSA strains obtained from clinical samples of an outbreak that occurred in 2010 at the Intensive Care Unit of our Hospital were thawed and sown at 37°C in blood agar overnight. After that, they were washed, pelleted, and treated with a fixer solution. Pellets were dehydrated and finally embedded in resin. Transmission electron microscopy was used to characterize cell wall and septum thickening in all isolates. The comparison between the measurements obtained for each group was performed by a Kruskal–Wallis test and a post hoc Dunn–Bonferroni’s pairwise comparison method. Results Differences in cell wall and septum thickness were statistically significant (P<0.001 and P<0.001, respectively) between the three groups. Moreover, significant differences were detected in wall and septum thickness between the MSSA and MRSA strains (P<0.001 and P<0.001, respectively) and between the MSSA and MLRSA strains (P<0.001 and P<0.001, respectively) but not between the MRSA and MLRSA strains (P=0.386 and P=0.117). Conclusion In this analysis, we correlate the resistance mediated by alterations in the cell membrane of S. aureus (methicillin-resistant, for example) with a greater thickness of the wall or septum. The resistance added to linezolid did not determine significant changes in the characteristics of the wall or septum with respect to those strains resistant only to methicillin.
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Affiliation(s)
- Ana Belén García
- Department of Clinical Microbiology, Hospital Clínico San Carlos, Complutense University, Madrid, Spain
| | | | - Laura López-González
- Department of Clinical Microbiology, Hospital Clínico San Carlos, Complutense University, Madrid, Spain
| | - Francisco Javier Candel
- Department of Clinical Microbiology, Hospital Clínico San Carlos, Complutense University, Madrid, Spain.,Health Research Institute, Hospital Universitario San Carlos, Madrid, Spain
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Peñuelas M, Candel FJ, Lejarraga C, López-González L, Viñuela-Prieto JM, López de Mendoza D. Activity of linezolid and tedizolid against clinical isolates of methicillin-resistant and methicillin and linezolid resistant Staphylococcus aureus: an in vitro comparison. Rev Esp Quimioter 2016; 29:255-258. [PMID: 27374726] [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: 06/06/2023]
Abstract
OBJECTIVE The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Spain is approximately 20-30%. However, resistance to linezolid is rare, and the main reports are from nosocomial outbreaks. The objective of the present study was to compare the in vitro susceptibility of linezolid with that of tedizolid against MRSA isolates and methicillin-and linezolid-resistant isolates (MLRSA) mediated by the cfr gene. METHODS The in vitro susceptibility of linezolid and tedizolid was determined using the E-test with 18 MRSA strains and 18 cfr-mediated MLRSA strains obtained from clinical isolates in the microbiology service of a tertiary university hospital. RESULTS All MRSA strains were susceptible to both antibiotics. Analysis of the MRSA isolates revealed that the MIC50 and MIC90 of linezolid were 1.5 and 2 mg/L, respectively; those of tedizolid were 0.25 and 0.4 mg/L. The MIC50 and MIC90 of tedizolid remained at 0.75 and 1 mg/L against the MLRSA strains (MIC90 ≥ 8 mg/L). CONCLUSIONS Both for MRSA and for MLRSA, the MICs obtained for tedizolid were at least 2 dilutions lower than those of linezolid, thus demonstrating between 2 and 4 times greater activity in vitro than linezolid.
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Affiliation(s)
| | - F J Candel
- Francisco Javier Candel, Servicio de Microbiología Clínica, Hospital Clínico San Carlos. Universidad Complutense Avda Dr Martín Lagos s/n 28040 Madrid, Spain.
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16
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Fernández-Alemán JL, López-González L, González-Sequeros O, Jayne C, López-Jiménez JJ, Toval A. The evaluation of i-SIDRA – a tool for intelligent feedback – in a course on the anatomy of the locomotor system. Int J Med Inform 2016; 94:172-81. [PMID: 27573325 DOI: 10.1016/j.ijmedinf.2016.07.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Revised: 07/05/2016] [Accepted: 07/10/2016] [Indexed: 11/24/2022]
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Candel FJ, García-García AB, Peñuelas M, García-Alvarez A, Chiarella F, López-González L, García-Salguero C, Lejárraga C, Rodríguez-Avial I. [Update in Infectious Diseases 2016]. Rev Esp Quimioter 2016; 29 Suppl 1:1-5. [PMID: 27608304] [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: 06/06/2023]
Abstract
Antimicrobial resistance increases it health, social and economic impact. in all areas (state, regional and local), initiatives to try to contain the problem of resistance arise. In the update of this year 2016, we study microbiological, epidemiological and clinical aspects of multi-resistant bacteria, as well as resources for therapeutic approach, from ancient to modern drugs from therapeutic combinations to optimization Stewardship programs. In the case of fungal infection, we analyze clinical scenarios with different species in yeast or new clinical settings in filamentous fungi. Taking paediatric population, homologies and differences with adults in invasive fungal infection were compared. Finally in the field of parasitology, treatment of severe malaria imported or that resistant to antimalarial drugs were reviewed.
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Affiliation(s)
- F J Candel
- Francisco Javier Candel González. Servicio de Microbiología Clínica. Hospital Clínico San Carlos. Universidad Complutense. Madrid. Avda Doctor Martín Lágos s/n28040 Madrid, Spain.
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18
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Vidal-Casariego A, López-González L, Jiménez-Pérez A, Ballesteros-Pomar M, Kyriakos G, Urioste-Fondo A, Álvarez-San Martín R, Cano-Rodríguez I, Jiménez-García de la Marina J. Accuracy of Ultrasound Elastography in the Diagnosis of Thyroid Cancer in a Low-risk Population. Exp Clin Endocrinol Diabetes 2012; 120:635-8. [DOI: 10.1055/s-0032-1323804] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- A. Vidal-Casariego
- Sección de Endocrinología y Nutrición, Complejo Asistencial Universitario de León (Spain)
| | - L. López-González
- Servicio de Radiología, Complejo Asistencial Universitario de León (Spain)
| | - A. Jiménez-Pérez
- Servicio de Radiología, Complejo Asistencial Universitario de León (Spain)
| | - M. Ballesteros-Pomar
- Sección de Endocrinología y Nutrición, Complejo Asistencial Universitario de León (Spain)
| | - G. Kyriakos
- Sección de Endocrinología y Nutrición, Complejo Asistencial Universitario de León (Spain)
| | - A. Urioste-Fondo
- Sección de Endocrinología y Nutrición, Complejo Asistencial Universitario de León (Spain)
| | - R. Álvarez-San Martín
- Sección de Endocrinología y Nutrición, Complejo Asistencial Universitario de León (Spain)
| | - I. Cano-Rodríguez
- Sección de Endocrinología y Nutrición, Complejo Asistencial Universitario de León (Spain)
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