1
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Vidal-Correoso D, Mateo SV, Muñoz-Morales AM, Lucas-Ruiz F, Jover-Aguilar M, Alconchel F, Martínez-Alarcón L, Sánchez-Redondo S, Santos V, López-López V, Ríos-Zambudio A, Cascales P, Pons JA, Ramírez P, Pelegrín P, Peinado H, Baroja-Mazo A. Cell-specific Extracellular Vesicles and Their miRNA Cargo Released Into the Organ Preservation Solution During Cold Ischemia Storage as Biomarkers for Liver Transplant Outcomes. Transplantation 2024:00007890-990000000-00721. [PMID: 38578699 DOI: 10.1097/tp.0000000000005008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
BACKGROUND Liver transplantation (LT) is crucial for end-stage liver disease patients, but organ shortages persist. Donation after circulatory death (DCD) aims to broaden the donor pool but presents challenges. Complications like acute rejection, hepatic artery thrombosis, and biliary issues still impact posttransplant prognosis. Biomarkers, including extracellular vesicles (EVs) and microRNAs (miRNAs), show promise in understanding and monitoring posttransplant events. This study explores the role of EVs and their miRNA cargo in LT, including their potential as diagnostic tools. METHODS EVs from intrahepatic end-ischemic organ preservation solution (eiOPS) in 79 donated livers were detected using different techniques (nanosight tracking analysis, transmission electron microscopy, and flow cytometry). EV-derived miRNAs were identified by quantitative real time-polymerase chain reaction. Bioinformatics analysis was performed using the R platform. RESULTS Different-sized and origin-specific EVs were found in eiOPS, with significantly higher concentrations in DCD compared with donation after brain death organs. Additionally, several EV-associated miRNAs, including let-7d-5p, miR-28-5p, miR-200a-3p, miR-200b-3p, miR-200c-3p, and miR-429, were overexpressed in DCD-derived eiOPS. These miRNAs also exhibited differential expression patterns in liver tissue biopsies. Pathway analysis revealed enrichment in signaling pathways involved in extracellular matrix organization and various cellular processes. Moreover, specific EVs and miRNAs correlated with clinical outcomes, including survival and early allograft dysfunction. A predictive model combining biomarkers and clinical variables showed promise in acute rejection detection after LT. CONCLUSIONS These findings provide new insights into the use of EVs and miRNAs as biomarkers and their possible influence on posttransplantation outcomes, potentially contributing to improved diagnostic approaches and personalized treatment strategies in LT.
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Affiliation(s)
- Daniel Vidal-Correoso
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain
| | - Sandra V Mateo
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain
| | - Ana M Muñoz-Morales
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain
| | - Fernando Lucas-Ruiz
- Experimental Ophthalmology Group, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla) & Ophthalmology Department, Universidad de Murcia, Murcia, Spain
- Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marta Jover-Aguilar
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain
| | - Felipe Alconchel
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain
- General Surgery and Abdominal Solid Organ Transplantation Unit, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Laura Martínez-Alarcón
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain
| | - Sara Sánchez-Redondo
- Microenvironment & Metastasis Group, Molecular Oncology Program, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Vanesa Santos
- Microenvironment & Metastasis Group, Molecular Oncology Program, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Víctor López-López
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain
- General Surgery and Abdominal Solid Organ Transplantation Unit, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Antonio Ríos-Zambudio
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain
- General Surgery and Abdominal Solid Organ Transplantation Unit, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Pedro Cascales
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain
- General Surgery and Abdominal Solid Organ Transplantation Unit, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain
| | - José Antonio Pons
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain
- Hepatology and Liver Transplant Unit, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Pablo Ramírez
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain
- General Surgery and Abdominal Solid Organ Transplantation Unit, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Pablo Pelegrín
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain
- Department of Biochemistry and Molecular Biology B and Immunology, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - Héctor Peinado
- Microenvironment & Metastasis Group, Molecular Oncology Program, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Alberto Baroja-Mazo
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain
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2
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Lopez-Lopez V, Morise Z, Albaladejo-González M, Gavara CG, Goh BKP, Koh YX, Paul SJ, Hilal MA, Mishima K, Krürger JAP, Herman P, Cerezuela A, Brusadin R, Kaizu T, Lujan J, Rotellar F, Monden K, Dalmau M, Gotohda N, Kudo M, Kanazawa A, Kato Y, Nitta H, Amano S, Valle RD, Giuffrida M, Ueno M, Otsuka Y, Asano D, Tanabe M, Itano O, Minagawa T, Eshmuminov D, Herrero I, Ramírez P, Ruipérez-Valiente JA, Robles-Campos R, Wakabayashi G. Correction: Explainable artificial intelligence prediction-based model in laparoscopic liver surgery for segments 7 and 8: an international multicenter study. Surg Endosc 2024:10.1007/s00464-024-10787-x. [PMID: 38503907 DOI: 10.1007/s00464-024-10787-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Affiliation(s)
- Victor Lopez-Lopez
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain
| | - Zeniche Morise
- Department of Surgery, Fujita Health University School of Medicine Okazaki Medical Center, Okazaki, Aichi, Japan
| | | | - Concepción Gomez Gavara
- Department of HPB Surgery and Transplants, Vall d'Hebron University Hospital, Barcelona Autonomic University, Barcelona, Spain
| | - Brian K P Goh
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
- Surgery Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Ye Xin Koh
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
- Surgery Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Sijberden Jasper Paul
- Department of Surgery, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Mohammed Abu Hilal
- Department of Surgery, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Kohei Mishima
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
| | - Jaime Arthur Pirola Krürger
- Serviço de Cirurgia do Fígado, Divisão de Cirurgia do Aparelho Digestivo, Departamento de Gastroenterologia, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo Herman
- Serviço de Cirurgia do Fígado, Divisão de Cirurgia do Aparelho Digestivo, Departamento de Gastroenterologia, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Alvaro Cerezuela
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain
| | - Roberto Brusadin
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain
| | - Takashi Kaizu
- Department of General, Pediatric and Hepatobiliary-Pancreatic Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Juan Lujan
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain
- Department of General Surgery, School of Medicine, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Fernando Rotellar
- Department of General Surgery, School of Medicine, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Kazuteru Monden
- Department of Surgery, Fukuyama City Hospital, Hiroshima, Japan
| | - Mar Dalmau
- Department of HPB Surgery and Transplants, Vall d'Hebron University Hospital, Barcelona Autonomic University, Barcelona, Spain
| | - Naoto Gotohda
- Department of Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Masashi Kudo
- Department of Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Akishige Kanazawa
- Department of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Yutaro Kato
- Department of Surgery, Fujita Health University, Toyoake, Japan
| | - Hiroyuki Nitta
- Department of Surgery, Iwate Medical University, Iwate, Japan
| | - Satoshi Amano
- Department of Surgery, Iwate Medical University, Iwate, Japan
| | | | - Mario Giuffrida
- General Surgery Unit, Parma University Hospital, Parma, Italy
| | - Masaki Ueno
- Second Department of Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, Japan
| | | | - Daisuke Asano
- Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Minoru Tanabe
- Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Osamu Itano
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Takuya Minagawa
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Dilmurodjon Eshmuminov
- Department of Surgery and Transplantation, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Irene Herrero
- Department of Surgery, Getafe University Hospital, Madrid, Spain
| | - Pablo Ramírez
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain
| | | | - Ricardo Robles-Campos
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain
| | - Go Wakabayashi
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
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Lopez-Lopez V, Morise Z, Albaladejo-González M, Gavara CG, Goh BKP, Koh YX, Paul SJ, Hilal MA, Mishima K, Krürger JAP, Herman P, Cerezuela A, Brusadin R, Kaizu T, Lujan J, Rotellar F, Monden K, Dalmau M, Gotohda N, Kudo M, Kanazawa A, Kato Y, Nitta H, Amano S, Valle RD, Giuffrida M, Ueno M, Otsuka Y, Asano D, Tanabe M, Itano O, Minagawa T, Eshmuminov D, Herrero I, Ramírez P, Ruipérez-Valiente JA, Robles-Campos R, Wakabayashi G. Explainable artificial intelligence prediction-based model in laparoscopic liver surgery for segments 7 and 8: an international multicenter study. Surg Endosc 2024:10.1007/s00464-024-10681-6. [PMID: 38315197 DOI: 10.1007/s00464-024-10681-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/02/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Artificial intelligence (AI) is becoming more useful as a decision-making and outcomes predictor tool. We have developed AI models to predict surgical complexity and the postoperative course in laparoscopic liver surgery for segments 7 and 8. METHODS We included patients with lesions located in segments 7 and 8 operated by minimally invasive liver surgery from an international multi-institutional database. We have employed AI models to predict surgical complexity and postoperative outcomes. Furthermore, we have applied SHapley Additive exPlanations (SHAP) to make the AI models interpretable. Finally, we analyzed the surgeries not converted to open versus those converted to open. RESULTS Overall, 585 patients and 22 variables were included. Multi-layer Perceptron (MLP) showed the highest performance for predicting surgery complexity and Random Forest (RF) for predicting postoperative outcomes. SHAP detected that MLP and RF gave the highest relevance to the variables "resection type" and "largest tumor size" for predicting surgery complexity and postoperative outcomes. In addition, we explored between surgeries converted to open and non-converted, finding statistically significant differences in the variables "tumor location," "blood loss," "complications," and "operation time." CONCLUSION We have observed how the application of SHAP allows us to understand the predictions of AI models in surgical complexity and the postoperative outcomes of laparoscopic liver surgery in segments 7 and 8.
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Affiliation(s)
- Victor Lopez-Lopez
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain
| | - Zeniche Morise
- Department of Surgery, Fujita Health University School of Medicine Okazaki Medical Center, Okazaki, Aichi, Japan
| | | | - Concepción Gomez Gavara
- Department of HPB Surgery and Transplants, Vall d'Hebron University Hospital, Barcelona Autonomic University, Barcelona, Spain
| | - Brian K P Goh
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
- Surgery Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Ye Xin Koh
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
- Surgery Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Sijberden Jasper Paul
- Department of Surgery, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Mohammed Abu Hilal
- Department of Surgery, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Kohei Mishima
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
| | - Jaime Arthur Pirola Krürger
- Serviço de Cirurgia do Fígado, Divisão de Cirurgia do Aparelho Digestivo, Departamento de Gastroenterologia, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo Herman
- Serviço de Cirurgia do Fígado, Divisão de Cirurgia do Aparelho Digestivo, Departamento de Gastroenterologia, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Alvaro Cerezuela
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain
| | - Roberto Brusadin
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain
| | - Takashi Kaizu
- Department of General, Pediatric and Hepatobiliary-Pancreatic Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Juan Lujan
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain
- Department of General Surgery, School of Medicine, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Fernando Rotellar
- Department of General Surgery, School of Medicine, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Kazuteru Monden
- Department of Surgery, Fukuyama City Hospital, Hiroshima, Japan
| | - Mar Dalmau
- Department of HPB Surgery and Transplants, Vall d'Hebron University Hospital, Barcelona Autonomic University, Barcelona, Spain
| | - Naoto Gotohda
- Department of Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Masashi Kudo
- Department of Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Akishige Kanazawa
- Department of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Yutaro Kato
- Department of Surgery, Fujita Health University, Toyoake, Japan
| | - Hiroyuki Nitta
- Department of Surgery, Iwate Medical University, Iwate, Japan
| | - Satoshi Amano
- Department of Surgery, Iwate Medical University, Iwate, Japan
| | | | - Mario Giuffrida
- General Surgery Unit, Parma University Hospital, Parma, Italy
| | - Masaki Ueno
- Second Department of Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, Japan
| | | | - Daisuke Asano
- Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Minoru Tanabe
- Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Osamu Itano
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Takuya Minagawa
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Dilmurodjon Eshmuminov
- Department of Surgery and Transplantation, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Irene Herrero
- Department of Surgery, Getafe University Hospital, Madrid, Spain
| | - Pablo Ramírez
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain
| | | | - Ricardo Robles-Campos
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain
| | - Go Wakabayashi
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
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Ramírez P, Muñoz A. Liver xenotransplantation: Time to make the leap to the clinic. Cir Esp 2024:S2173-5077(24)00015-2. [PMID: 38224766 DOI: 10.1016/j.cireng.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 11/08/2023] [Indexed: 01/17/2024]
Affiliation(s)
- Pablo Ramírez
- Catedrático de Cirugía y Jefe de Servicio, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria Pascual Parrilla (IMIB), Murcia, Spain.
| | - Antonio Muñoz
- Catedrático de Producción Animal y Genética Porcina, Universidad de Murcia, Murcia, Spain
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5
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Ríos A, Carrillo J, López-Navas AI, Ayala-García MA, Alconchel F, Ramírez P. Unknowledgment of the brain death concept among African immigrants resident in Spain. Multivariant analysis of related factors. Nefrologia 2024; 44:100-102. [PMID: 38383172 DOI: 10.1016/j.nefroe.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Affiliation(s)
- Antonio Ríos
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Departamento de Cirugía, Pediatría, Obstetriciay Ginecología, Universidad de Murcia, Spain; Unidad de Trasplantes, Servicio de Cirugía, IMIB - Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.
| | - Joaquín Carrillo
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Departamento de Cirugía, Pediatría, Obstetriciay Ginecología, Universidad de Murcia, Spain
| | - Ana Isabel López-Navas
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Departamento de Psicología, Universidad Católica San Antonio, UCAM, Murcia, Spain
| | - Marco Antonio Ayala-García
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Hospital Regional General Número 58 del IMSS (Instituto Mexicano del Seguro Social), Delegación de Guanajuato, Guanajuato, Mexico
| | - Felipe Alconchel
- Unidad de Trasplantes, Servicio de Cirugía, IMIB - Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Pablo Ramírez
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Departamento de Cirugía, Pediatría, Obstetriciay Ginecología, Universidad de Murcia, Spain; Unidad de Trasplantes, Servicio de Cirugía, IMIB - Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
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Ríos A, Balaguer-Román A, Carrillo J, López-Navas AI, Ayala-García MA, Ramírez P. Living Kidney Donation Between African Immigrants. Prog Transplant 2023; 33:360-362. [PMID: 37964550 DOI: 10.1177/15269248231212909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Affiliation(s)
- Antonio Ríos
- International Collaborative Donor Project (Proyecto Colaborativo Internacional Donante), Pabellón Docente del Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
- Department of Surgery, Paediatrics, Obstetrics y Gynaecology, Pabellón Docente del Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
- Transplant Unit Surgery Service, IMIB Pabellón Docente del Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Andrés Balaguer-Román
- International Collaborative Donor Project (Proyecto Colaborativo Internacional Donante), Pabellón Docente del Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
- Department of Surgery, Paediatrics, Obstetrics y Gynaecology, Pabellón Docente del Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
- Transplant Unit Surgery Service, IMIB Pabellón Docente del Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Joaquín Carrillo
- International Collaborative Donor Project (Proyecto Colaborativo Internacional Donante), Pabellón Docente del Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
- Department of Surgery, Paediatrics, Obstetrics y Gynaecology, Pabellón Docente del Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Ana Isabel López-Navas
- International Collaborative Donor Project (Proyecto Colaborativo Internacional Donante), Pabellón Docente del Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
- Department of Psychology, Universidad Católica San Antonio, Murcia, Spain
| | - Marco Antonio Ayala-García
- International Collaborative Donor Project (Proyecto Colaborativo Internacional Donante), Pabellón Docente del Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
- Surgery Department, Hospital Regional de Alta Especialidad del Bajío, León, Guanajuato, Mexico
- Surgery Department, Hospital Regional General Número 58 del IMSS (Instituto Mexicano del Seguro Social), León, Guanajuato, Mexico
| | - Pablo Ramírez
- International Collaborative Donor Project (Proyecto Colaborativo Internacional Donante), Pabellón Docente del Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
- Department of Surgery, Paediatrics, Obstetrics y Gynaecology, Pabellón Docente del Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
- Transplant Unit Surgery Service, IMIB Pabellón Docente del Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
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Febrero B, Almela-Baeza J, Ros-Madrid I, Iniesta M, Martínez-Alarcón L, Ramírez P. Attitude of the Older Population Toward Controlled Asystole Donation. Transplant Proc 2023; 55:2250-2252. [PMID: 37775403 DOI: 10.1016/j.transproceed.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/29/2023] [Indexed: 10/01/2023]
Abstract
INTRODUCTION Studies about the knowledge of and attitude toward new lines of organ donation in a group of older people are important due to the increase in older organ donors. OBJECTIVES To analyze the attitude of citizens over 65 years of age in southeastern Spain toward controlled asystole donation (CAD) and to determine the psycho-social profile that influences this attitude. METHODS The study population consisted of citizens over 65 years of age. A representative sample was obtained in southeastern Spain (N = 420). A questionnaire about attitudes toward CAD was used, detailing in the questionnaire that this is a type of donation from people who have died of circulatory and respiratory criteria after the limitation of life support treatment. Several psychosocial variables were also taken into account. Statistical analysis included the χ2 test and multivariate analysis. RESULTS The completion rate was 84% (n = 351). Favorable attitude toward organ donation and transplantation (ODT) was 98% (n = 344) overall, and CAD was viewed favorably by 45% (n = 158). The psychosocial variables that influenced attitude toward CAD were mainly having received a talk about ODT (odds ratio [OR] 5.6), knowing the opinion of one's partner (OR 7.95), acceptance of cremation (OR 1.09), and acceptance of autopsy (OR 3.002). CONCLUSIONS The attitude of older people toward CAD is unfavorable despite a willingness to support ODT in general. This attitude is influenced by variables of social and family dialogue about ODT, attitude to body manipulation, and having received information about ODT.
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Affiliation(s)
- Beatriz Febrero
- General Surgery Service, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigaciones Biosanitaria IMIB-Arrixaca, Murcia, Spain; Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia, Murcia, Spain
| | - Javier Almela-Baeza
- Faculty of Communication and Documentation, University of Murcia, Murcia, Spain.
| | | | - María Iniesta
- General Surgery Service, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigaciones Biosanitaria IMIB-Arrixaca, Murcia, Spain; Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia, Murcia, Spain
| | - Laura Martínez-Alarcón
- General Surgery Service, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigaciones Biosanitaria IMIB-Arrixaca, Murcia, Spain; Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia, Murcia, Spain
| | - Pablo Ramírez
- General Surgery Service, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigaciones Biosanitaria IMIB-Arrixaca, Murcia, Spain; Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia, Murcia, Spain
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8
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Gazek N, Feller AL, Vaiani E, Di Palma I, Savransky A, Ramírez P, Marino R, Pérez Garrido N, Lazzati JM, Herzovich V, Dujovne N. Treatment with TRIAC in pediatric patients with MCT8. ARCH ARGENT PEDIATR 2023; 121:e202202968. [PMID: 36883873 DOI: 10.5546/aap.2022-02968.eng] [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] [Indexed: 03/08/2023]
Abstract
Monocarboxylate transporters (MCTs) allow the cellular entry of thyroid hormones, especially into the central nervous system (CNS), where they are crucial for neurodevelopment. MCT8 deficiency results in the combination of hypothyroidism in the CNS and peripheral hyperthyroidism, characterized by elevated T3 levels. The only treatment currently available is 3,3',5-triiodothyroacetic acid (TRIAC), a thyroid hormone analogue aimed at improving peripheral thyrotoxicosis and preventing the progression of neurological impairment. Here we assess the clinical, imaging, biochemical, and genetic characteristics of 4 patients with MCT8 deficiency who have received TRIAC to date, the doses used, and the response to treatment.
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Affiliation(s)
- Natalia Gazek
- Department of Endocrinology; Hospital de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, City of Buenos Aires, Argentina
| | - Ana L Feller
- Department of Endocrinology; Hospital de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, City of Buenos Aires, Argentina
| | - Elisa Vaiani
- Department of Endocrinology; Hospital de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, City of Buenos Aires, Argentina
| | - Isabel Di Palma
- Department of Endocrinology; Hospital de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, City of Buenos Aires, Argentina
| | - Andrea Savransky
- Department of Neurology; Hospital de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, City of Buenos Aires, Argentina
| | - Pablo Ramírez
- Department of Molecular Biology; Hospital de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, City of Buenos Aires, Argentina
| | - Roxana Marino
- Department of Molecular Biology; Hospital de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, City of Buenos Aires, Argentina
| | - Natalia Pérez Garrido
- Department of Molecular Biology; Hospital de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, City of Buenos Aires, Argentina
| | - Juan M Lazzati
- Division of the Laboratory of Endocrinology; Hospital de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, City of Buenos Aires, Argentina
| | - Viviana Herzovich
- Department of Endocrinology; Hospital de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, City of Buenos Aires, Argentina
| | - Noelia Dujovne
- Department of Endocrinology; Hospital de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, City of Buenos Aires, Argentina
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9
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Villalba-López F, García-Bernal D, Mateo SV, Vidal-Correoso D, Jover-Aguilar M, Alconchel F, Martínez-Alarcón L, López-López V, Ríos-Zambudio A, Cascales P, Pons JA, Ramírez P, Pelegrín P, Baroja-Mazo A. Endothelial cell activation mediated by cold ischemia-released mitochondria is partially inhibited by defibrotide and impacts on early allograft function following liver transplantation. Biomed Pharmacother 2023; 167:115529. [PMID: 37729732 DOI: 10.1016/j.biopha.2023.115529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/29/2023] [Accepted: 09/15/2023] [Indexed: 09/22/2023] Open
Abstract
DAMPs (danger-associated molecular patterns) are self-molecules of the organism that appear after damage. The endothelium plays several roles in organ rejection, such as presenting alloantigens to T cells and contributing to the development of inflammation and thrombosis. This study aimed to assess whether DAMPs present in the organ preservation solution (OPS) after cold ischemic storage (CIS) contribute to exacerbating the endothelial response to an inflammatory challenge and whether defibrotide treatment could counteract this effect. The activation of cultured human umbilical vein endothelial cells (HUVECs) was analyzed after challenging with end-ischemic OPS (eiOPS) obtained after CIS. Additionally, transwell assays were performed to study the ability of eiOPS to attract lymphocytes across the endothelium. The study revealed that eiOPS upregulated the expression of MCP-1 and IL-6 in HUVECs. Moreover, eiOPS increased the membrane expression of ICAM-1and HLA-DR, which facilitated leukocyte migration toward a chemokine gradient. Furthermore, eiOPS demonstrated its chemoattractant ability. This activation was mediated by free mitochondria. Defibrotide was found to partially inhibit the eiOPS-mediated activation. Moreover, the eiOPS-mediated activation of endothelial cells (ECs) correlated with early allograft dysfunction in liver transplant patients. Our finding provide support for the hypothesis that mitochondria released during cold ischemia could trigger EC activation, leading to complications in graft outcomes. Therefore, the analysis and quantification of free mitochondria in the eiOPS samples obtained after CIS could provide a predictive value for monitoring the progression of transplantation. Moreover, defibrotide emerges as a promising therapeutic agent to mitigate the damage induced by ischemia in donated organs.
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Affiliation(s)
- Francisco Villalba-López
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120 Murcia, Spain
| | - David García-Bernal
- Department of Biochemistry and Molecular Biology B and Immunology, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain; Hematopoietic Transplant and Cell Therapy Group, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120 Murcia, Spain.
| | - Sandra V Mateo
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120 Murcia, Spain
| | - Daniel Vidal-Correoso
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120 Murcia, Spain
| | - Marta Jover-Aguilar
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120 Murcia, Spain
| | - Felipe Alconchel
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120 Murcia, Spain; General Surgery and Abdominal Solid Organ Transplantation Unit, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Laura Martínez-Alarcón
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120 Murcia, Spain
| | - Víctor López-López
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120 Murcia, Spain; General Surgery and Abdominal Solid Organ Transplantation Unit, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Antonio Ríos-Zambudio
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120 Murcia, Spain; General Surgery and Abdominal Solid Organ Transplantation Unit, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Pedro Cascales
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120 Murcia, Spain; General Surgery and Abdominal Solid Organ Transplantation Unit, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain
| | - José A Pons
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120 Murcia, Spain; Hepatology and Liver Transplant Unit, University Clinical Hospital Virgen de la Arrixaca, 30120 Murcia, Spain
| | - Pablo Ramírez
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120 Murcia, Spain; General Surgery and Abdominal Solid Organ Transplantation Unit, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Pablo Pelegrín
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120 Murcia, Spain; Department of Biochemistry and Molecular Biology B and Immunology, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain
| | - Alberto Baroja-Mazo
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120 Murcia, Spain.
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10
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Martínez-Alarcón L, Flores-Medina J, Ramis G, Gómez-Laguna J, Moll X, Falceto V, San Román-Ascaso F, San Román-Llorens F, Quereda JJ, Herrero JM, Mendonça L, Martin-Barrasa JL, Fernández OM, Muñoz A, Ramírez P, Gutiérrez P, López-Chicheri I, López-Navas A, Ríos A. Organ xenotransplantation acceptance in veterinary students: A multicentric opinion study in Spain. Xenotransplantation 2023; 30:e12823. [PMID: 37695105 DOI: 10.1111/xen.12823] [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: 06/01/2023] [Revised: 07/27/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND The shortage of available transplant organs has made it necessary to search for alternatives, one of which is xenotransplantation. However, the use of animal organs could face rejection from society and the personnel involved in its implementation. OBJECTIVES (a) to analyze the attitudes of Veterinary Degree students in six Spanish Universities towards xenotransplantation; and (b) to determine the factors that affect its acceptance. METHODS Of the 2815 students surveyed in the degree program, 2683 valid surveys were obtained. Attitudes towards organ xenotransplantation were evaluated using a validated questionnaire of organ donation. RESULTS If xenotransplantation was confirmed as a clinical reality, 93% (n = 2493) of those surveyed would accept a xenotransplanted organ, whilst 7% would not. If the results of xenotransplantation were worse than those obtained with human donors and it entailed more risk, 12% (n = 318) would be in favor. 56% (n = 1497) of the students would accept a xenotransplantation provisionally pending the arrival of a human organ. Attitudes towards xenotransplantation were affected by the academic year in which a student was studying, with more favorable attitudes among students in the last year (88% in first year vs. 95% in fifth year; p < .001). More favorable attitudes are also observed depending on the attitude they have towards organ transplantation, with those students being more in favor of donating their organs when they die (94% vs. 88%; p < .001). CONCLUSION Veterinary students would have a very favorable attitude toward xenotransplantation if these animal organs functioned as well as human organs. Therefore, these students could play an important role in the future promotion of this technique.
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Affiliation(s)
- Laura Martínez-Alarcón
- International Collaborative Donor Project, Murcia, Spain
- Surgery Service, Transplant Unit, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - Juan Flores-Medina
- Department of Psychology, Faculty of Medicine, Catholic University of Murcia (UCAM), Murcia, Spain
| | - Guillermo Ramis
- International Collaborative Donor Project, Murcia, Spain
- Surgery Service, Transplant Unit, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
- Department of Surgery, Paediatrics, Obstetrics and Gynaecology, University of Murcia, Murcia, Spain
- Department of Animal Production, Faculty of Veterinary Medicine, University of Murcia, Murcia, Spain
| | - Jaime Gómez-Laguna
- Department of Anatomy and Comparative Pathology and Toxicology, University of Córdoba, Córdoba, Spain
| | - Xavier Moll
- Faculty of Veterinary Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Victoria Falceto
- Department of Animal Pathology, Faculty of Veterinary Medicine, University of Zaragoza, Zaragoza, Spain
| | - Fidel San Román-Ascaso
- Department of Animal Medicine and Surgery, Faculty of Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Fidel San Román-Llorens
- Department of Animal Pathology, Faculty of Veterinary, University of Zaragoza, Zaragoza, Spain
| | - Juan José Quereda
- Department of Animal Production and Health, Veterinary Public Health and Food Science and Technology, Faculty of Veterinary, University Cardenal Herrera-CEU, Valencia, Spain
| | - Juan Manuel Herrero
- Department of Animal Production, Faculty of Veterinary Medicine, University of Murcia, Murcia, Spain
| | - Livia Mendonça
- Faculty of Veterinary, Universidade Federal de Goiás, Goiania, Brazil
| | - José Luis Martin-Barrasa
- Experimental Animal Facility, Research Unit, Hospital Universitario de Gran Canaria, Dr. Negrín, Las Palmas de Gran Canaria, Arucas, Spain
- Animal Infectious Diseases and Ictiopatology, University Institute of Animal Health (IUSA), University of Las Palmas de Gran Canaria, Arucas, Spain
| | - Olga María Fernández
- Animalario libre de Patógenos Arrixaca-Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - Antonio Muñoz
- Department of Animal Production, Faculty of Veterinary Medicine, University of Murcia, Murcia, Spain
| | - Pablo Ramírez
- International Collaborative Donor Project, Murcia, Spain
- Surgery Service, Transplant Unit, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
- Department of Surgery, Paediatrics, Obstetrics and Gynaecology, University of Murcia, Murcia, Spain
- Department of Animal Production, Faculty of Veterinary Medicine, University of Murcia, Murcia, Spain
| | - Pedro Gutiérrez
- Urology Service, Complejo Hospitalario Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
- Departmen of Surgery, University of La Laguna, San Cristóbal de la Laguna, Tenerife, Spain
| | - Isabel López-Chicheri
- Department of Psychology, Faculty of Medicine, Catholic University of Murcia (UCAM), Murcia, Spain
| | - Ana López-Navas
- International Collaborative Donor Project, Murcia, Spain
- Department of Psychology, Faculty of Medicine, Catholic University of Murcia (UCAM), Murcia, Spain
| | - Antonio Ríos
- International Collaborative Donor Project, Murcia, Spain
- Surgery Service, Transplant Unit, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
- Department of Surgery, Paediatrics, Obstetrics and Gynaecology, University of Murcia, Murcia, Spain
- Department of Animal Production, Faculty of Veterinary Medicine, University of Murcia, Murcia, Spain
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11
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Almela-Baeza J, Febrero B, Ramírez P. Teenagers, Audio-Visual Prosumers and Audience Generators in the Field of Organ Donation. Health Commun 2023:1-8. [PMID: 37528761 DOI: 10.1080/10410236.2023.2243661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
The creation of audio-visual content and the increase in the use of social networks by society have provided new opportunities for promoting health and the benefits of organ donation. This study analyzes the influence of audiovisual content produced by adolescents in the context of an educational program related to the promotion of organ donation with diffusion through social media. The program was implemented in the fourth year (mainly 15 and 16 year olds) in ten high schools in Spain. In the first phase, students learn about donation and create audio-visual messages about its benefits for society; in the second phase, they share this content on social networks. The influence of the content was measured using YouTube Analytics. In addition, a questionnaire was administered after the program to measure the way in which they shared the content on social networks. A total of 391 students participated in program, submitting 63 short films that obtained 104,912 views. The short films focused on appealing to society about the need for organs and the benefits of the organ donation and transplantation process. The social network that was used most frequently to share the content was WhatsApp (81.8%). Educating teenagers and turning them into prescribers of the health benefits of the organ donation and transplantation process through the use of social networks could be a good tool that can be exported to other fields of health.
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Affiliation(s)
| | - Beatriz Febrero
- General Surgery Service, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biosanitaria IMIB-Arrixaca
- Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia
| | - Pablo Ramírez
- General Surgery Service, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biosanitaria IMIB-Arrixaca
- Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia
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12
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Ríos A, Iniesta-Sepúlveda M, Ramírez P, López-Navas AI. Meta-regression analysis to determine the effect of knowledge of the concept of brain death on the attitude towards organ donation among medical students. Nefrologia 2023; 43:504-506. [PMID: 37748961 DOI: 10.1016/j.nefroe.2021.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 04/25/2021] [Indexed: 09/27/2023] Open
Affiliation(s)
- Antonio Ríos
- Proyecto Colaborativo Internacional Donante, Murcia, Spain.
| | | | - Pablo Ramírez
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Departamento de Cirugía, Pediatría, Ginecología y Obstetricia, Universidad de Murcia, Murcia, Spain; Unidad de Trasplantes, Hospital Clínico Universitario Virgen de la Arrixaca - IMIB, Murcia, Spain
| | - Ana Isabel López-Navas
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Departamento de Psicología, Universidad Católica de Murcia, UCAM, Murcia, Spain
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13
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Villarreal E, Ramírez P, Gordon M, Vicent C, Gómez MD, de Hevia L, Vacacela K, Alonso R, Vila J. Anti-endotoxin antibodies consumption in cardiovascular collapse: Pathophysiological concerns. Med Intensiva 2023; 47:338-344. [PMID: 36344341 DOI: 10.1016/j.medine.2022.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 04/26/2022] [Indexed: 05/29/2023]
Abstract
OBJECTIVE Abnormal endotoxin activity in critically ill patients has been described in the absence of Gram-negative bacterial (GNB) infection. As disease severity seems to be crucial in the detection of this phenomenon, we decided to assess and compare endotoxin exposure in those patients representing the critical situation: septic shock and cardiogenic shock. DESIGN Prospective, observational non intervention study. SETTING Critical Care Department of a University tertiary hospital. PATIENTS Cardiogenic shock (CS) and septic shock (SS) patients. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Follow-up was performed for the first three days. Inflammatory biomarkers (C-reactive protein, procalcitonin and interleuquin-6) and IgM antiendotoxin-core antibodies titter (IgM EndoCAb) were daily analyzed. Sixty-two patients were included; twenty-five patients with SS and thirty-seven with CS. Microbial etiology was established in 23 SS patients (92%) and GNB were present in 13 cases (52%). Although infection was suspected and even treated in 30 CS patients (81%), any episode could be finally confirmed. EndoCAb consumption was more intense in SS patients, although twenty-two CS patients (59.5%) had IgM anti-endotoxin value below 10th percentile range for healthy people. No statistically significant difference in endotoxin exposure was detected between Gram-positive and Gram-negative infections in the SS group. Endotoxin exposure ability to distinguish between SS and CS was moderate (AUC 0.7892, 95% IC: 0.6564-0.9218). CONCLUSIONS In the severely ill patient some mechanisms take place allowing endotoxin incursion and therefore blurring the limits of diseases pathophysiology. Our work representatively shows how exposure to endotoxin was not fully capable of distinguishing between CS and SS.
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Affiliation(s)
- E Villarreal
- Critical Care Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - P Ramírez
- Critical Care Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain.
| | - M Gordon
- Critical Care Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - C Vicent
- Critical Care Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - M D Gómez
- Microbiology Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - L de Hevia
- Critical Care Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - K Vacacela
- Critical Care Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - R Alonso
- Laboratory Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - J Vila
- Department of Microbiology, Hospital Clinic, IDIBAPS, School of Medicine, University of Barcelona, Barcelona, Spain
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14
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Ríos A, López-Gómez S, Belmonte J, Balaguer A, Gutiérrez PR, Ruiz-Merino G, Ayala-García MA, Ramírez P, López-Navas AI. The Roma population's fear of donating their own organs for transplantation. Cir Esp 2023; 101:350-358. [PMID: 35777627 DOI: 10.1016/j.cireng.2022.06.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 05/09/2022] [Indexed: 05/16/2023]
Abstract
BACKGROUND The refusal rate for donating organs among the Roma people is much higher than that of any other social group. OBJECTIVE To analyze the attitude towards the donation of one's own organs among the Roma population living in Spain. METHOD . TYPE OF STUDY Spanish national observational sociological study stratified by gender and age. STUDY POPULATION Roma population aged ≥15 years living in Spain. SAMPLE SIZE 1,253 respondents. Assessment instrument: Validated questionnaire on attitude towards organ donation for transplantation "PCID - DTO Ríos". Field work: Random selection based on stratification. Anonymous and self-administered completion. The collaboration of people of Roma ethnicity was required. STATISTICS Student's t test, χ2, Fisher's exact test and a logistic regression analysis. RESULTS The degree of completion was 18.2% (n = 228). Of those who completed the questionnaire, 42.1% (n = 96) were in favor of donation, 30.3% (n = 69) were undecided and the remaining 27.6% (n = 63) were against it. Of the 1,025 (81.8%) who declined to complete the questionnaire, 1,004 (98%) indicated that it was for fear of speaking about and filling in a questionnaire that raises the issue of death and organ donation after death. If those who did not complete the questionnaire due to fear of death and donating organs after death are considered not in favor, the results would be as follows: 7.8% (n = 96) in favor of donating their organs compared to 92.2% (n = 1166) not in favor (against or undecided). CONCLUSIONS A majority of the Roma population prefer not speak of death nor organ donation after death. These findings show that current campaigns to promote organ donation are not effective in this population group.
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Affiliation(s)
- Antonio Ríos
- Proyecto Colaborativo Internacional Donante, Murcia, Spain.
| | | | - Javier Belmonte
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Unidad de Trasplante. Servicio de Cirugía, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Andrés Balaguer
- Unidad de Trasplante. Servicio de Cirugía, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Pedro R Gutiérrez
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Servicio de Urología, Complejo Hospitalario Universitario de Canarias (CHUC), Departamento de Cirugía, Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - Guadalupe Ruiz-Merino
- Fundación para la Formación e Investigación Sanitarias de la Región de Murcia (FFIS), Murcia, Spain
| | - Marco Antonio Ayala-García
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Hospital Regional General Número 58 del Instituto Mexicano del Seguro Social (IMSS), Delegación de Guanajuato, Guanajuato. México
| | - Pablo Ramírez
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Departamento de Cirugía, Pediatría, Obstetricia y Ginecología, Universidad de Murcia, Murcia, Spain; Unidad de Trasplante. Servicio de Cirugía, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Ana Isabel López-Navas
- Proyecto Colaborativo Internacional Donante, Murcia, Spain; Departamento de Psicología, Universidad Católica San Antonio de Murcia (UCAM), Murcia, Spain
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15
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Lopez-Lopez V, Miura K, Kuemmerli C, Capel A, Eshmuminov D, Ferreras D, Baroja-Mazo A, Cascales-Campos P, Jiménez-Mascuñán MI, Pons JA, Castellon MI, Sánchez-Bueno F, Robles-Campos R, Ramírez P. Selecting the Appropriate Downstaging and Bridging Therapies for Hepatocellular Carcinoma: What Is the Role of Transarterial Radioembolization? A Pooled Analysis. Cancers (Basel) 2023; 15:cancers15072122. [PMID: 37046783 PMCID: PMC10093460 DOI: 10.3390/cancers15072122] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/25/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
Background: Transarterial radioembolization in HCC for LT as downstaging/bridging has been increasing in recent years but some indication criteria are still unclear. Methods: We conducted a systematic literature search of primary research publications conducted in PubMed, Scopus and ScienceDirect databases until November 2022. Relevant data about patient selection, HCC features and oncological outcomes after TARE for downstaging or bridging in LT were analyzed. Results: A total of 14 studies were included (7 downstaging, 3 bridging and 4 mixed downstaging and bridging). The proportion of whole liver TARE was between 0 and 1.6%. Multiple TARE interventions were necessary for 16.7% up to 28% of the patients. A total of 55 of 204 patients across all included studies undergoing TARE for downstaging were finally transplanted. The only RCT included presents a higher tumor response with the downstaging rate for LT of TARE than TACE (9/32 vs. 4/34, respectively). Grade 3 or 4 adverse effects rate were detected between 15 and 30% of patients. Conclusions: TARE is a safe therapeutic option with potential advantages in its capacity to necrotize and reduce the size of the HCC for downstaging or bridging in LT.
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Affiliation(s)
- Victor Lopez-Lopez
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, 30120 Murcia, Spain
- Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
- Department of General, Visceral and Transplantation Surgery, University Hospital Virgen de la Arrixaca. Ctra., Madrid-Cartagena, s/n, El Palmar, 30120 Murcia, Spain
| | - Kohei Miura
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 950-2181, Japan
| | - Christoph Kuemmerli
- Department of Surgery, Clarunis—University Center for Gastrointestinal and Liver Diseases, 4052 Basel, Switzerland
| | - Antonio Capel
- Department of Vascular Intervenional Radiololy, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, 30120 Murcia, Spain
| | - Dilmurodjon Eshmuminov
- Department of Surgery and Transplantation, Swiss Hepato-Pancreato-Biliary (HPB) Center, University Hospital Zurich, 8091 Zurich, Switzerland
| | - David Ferreras
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, 30120 Murcia, Spain
- Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Alberto Baroja-Mazo
- Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Pedro Cascales-Campos
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, 30120 Murcia, Spain
- Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - María Isabel Jiménez-Mascuñán
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, 30120 Murcia, Spain
- Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - José Antonio Pons
- Department of Hepatology, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, 30120 Murcia, Spain
| | - Maria Isabel Castellon
- Department of Nuclear Medicines, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, 30120 Murcia, Spain
| | - Francisco Sánchez-Bueno
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, 30120 Murcia, Spain
- Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Ricardo Robles-Campos
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, 30120 Murcia, Spain
- Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Pablo Ramírez
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, 30120 Murcia, Spain
- Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
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16
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Lopez-Lopez V, Hiciano-Guillermo A, Martinez-Alarcon L, Delegido A, Alconchel F, Pons JA, Fernández JÁ, Ríos A, Rodríguez JM, Miura K, Sánchez-Bueno F, Robles-Campos R, Ramírez P. Postoperative negative-pressure incision therapy after liver transplant (PONILITRANS study): A randomized controlled trial. Surgery 2023; 173:1072-1078. [PMID: 36549975 DOI: 10.1016/j.surg.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/08/2022] [Accepted: 11/13/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Postoperative complications of surgical incisions are frequent in liver transplantation. However, evidence justifying the use of incisional negative pressure wound therapy to improve surgical wound outcomes remains limited. METHODS Participating patients were randomly assigned to receive incisional negative pressure wound therapy or standard surgical dressing on the closed surgical incision of the liver transplantation. The primary endpoint was surgical site infection incidence 30 days postoperatively. The secondary endpoints included surgical site events (ie, surgical site infection, dehiscence, hematoma, and seroma) and wound quality of life. RESULTS Between December 2018 and September 2021, 108 patients (54 in the incisional negative pressure wound therapy group and 54 in the control group) were enrolled in this study. The incidence of surgical site infection at 30 days postoperatively was 7.4% in the treatment group and 13% in the control group (P = .34). The rate of surgical site events was similar in the treatment in the and control group (27.8% vs 29.6%, P = .83). In relation to wound quality of life, the mean score was 75.20 ± 7.27 in the incisional negative pressure wound therapy group and 72.82 ± 10.57 in the control group (P = .23). CONCLUSION The prophylactic use of negative pressure wound therapy on primarily closed incisions did not significantly reduce incisional surgical site infection and surgical site event rates after liver transplantation compared with standard surgical dressings.
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Affiliation(s)
- Victor Lopez-Lopez
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain.
| | - Alberto Hiciano-Guillermo
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
| | - Laura Martinez-Alarcon
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
| | - Ana Delegido
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
| | - Felipe Alconchel
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
| | - Jose Antonio Pons
- Department of Hepatology, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain
| | - Juan Ángel Fernández
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
| | - Antonio Ríos
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
| | - José Manuel Rodríguez
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
| | - Kohei Miura
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Francisco Sánchez-Bueno
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
| | - Ricardo Robles-Campos
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain
| | - Pablo Ramírez
- Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain; Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia, Spain. https://twitter.com/ramirez_cirugia
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17
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Re OL, López-López V, Balaguer-Román A, Martínez-Sánchez MA, Eshmuminov D, Llamoza-Torres CJ, Miura K, Baroja-Mazo A, Ramírez P, Robles-Campos R, Ramos-Molina B. New challenges in cholangiocarcinoma candidates for elective surgery: harnessing the microbiome dysbiosis. Langenbecks Arch Surg 2023; 408:134. [PMID: 37000331 DOI: 10.1007/s00423-023-02867-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 03/21/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND The gut microbiota, composed by several species of microorganisms, works to preserve the liver-gut homeostasis and plays an important role during digestion and absorption of nutrients, and in the immune response of the host. In this review, we analyzed the influence of microbiota in patients with cholangiocarcinoma (CCA) who were candidates for elective surgery. METHODS A literature review was conducted to identify papers that provided empiric evidence to support that the altered microbiota composition (dysbiosis) is related also to CCA development. RESULTS Bacteria such as Helicobacter pylori, Helicobacter hepaticus, and Opisthorchis viverrini increase the risk of CCA. The most abundant genera were Enterococcus, Streptococcus, Bacteroides, Klebsiella, and Pyramidobacter in CCA's biliary microbiota. Additionally, levels of Bacteroides, Geobacillus, Meiothermus, and Anoxybacillus genera were significantly higher. An enrichment of Bifidobacteriaceae, Enterobacteriaceae, and Enterococcaceae families has also been observed in CCA tumor tissue. Microbiota is related to postoperative outcomes in abdominal surgery. The combination of caloric restriction diets in liver cancer or CCA increases the effect of the chemotherapy treatment. CONCLUSION The correct use of nutrition for microbiota modulation according to each patient's needs could be a therapeutic tool in combination with elective surgery and chemotherapy to diminish side effects and improve prognosis. Further investigations are needed to fully understand the mechanisms by which they are related.
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Affiliation(s)
- Oriana Lo Re
- International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
- Department of Translational Stem Cell Biology, Research Institute of the Medical University of Varna, Varna, Bulgaria
| | - Victor López-López
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, 30120, Murcia, Spain.
- Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia (IMIB), Murcia, Spain.
| | - Andrés Balaguer-Román
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, 30120, Murcia, Spain
- Obesity and Metabolism Laboratory, Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
| | | | - Dilmurodjon Eshmuminov
- Department of Surgery and Transplantation, Swiss Hepato-Pancreato-Biliary (HPB) Center, University Hospital Zurich, Zurich, Switzerland
| | | | - Kohei Miura
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Alberto Baroja-Mazo
- Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
| | - Pablo Ramírez
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, 30120, Murcia, Spain
- Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
| | - Ricardo Robles-Campos
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, 30120, Murcia, Spain
- Digestive and Endocrine Surgery and Transplantation of Abdominal Organs Research Group, Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
| | - Bruno Ramos-Molina
- Obesity and Metabolism Laboratory, Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
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18
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Lucas-Ruiz F, Mateo SV, Jover-Aguilar M, Alconchel F, Martínez-Alarcón L, de Torre-Minguela C, Vidal-Correoso D, Villalba-López F, López-López V, Ríos-Zambudio A, Pons JA, Ramírez P, Pelegrín P, Baroja-Mazo A. Danger signals released during cold ischemia storage activate NLRP3 inflammasome in myeloid cells and influence early allograft function in liver transplantation. EBioMedicine 2022; 87:104419. [PMID: 36543018 PMCID: PMC9794897 DOI: 10.1016/j.ebiom.2022.104419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/04/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Innate immunity plays a fundamental role in solid organ transplantation. Myeloid cells can sense danger signals or DAMPs released after tissue or cell damage, such as during ischemia processes. This study aimed to identify DAMPs released during cold ischemia storage of human liver and analyze their ability to activate the inflammasome in myeloid cells and the possible implications in terms of short-term outcomes of liver transplantation. METHODS 79 samples of organ preservation solution (OPS) from 79 deceased donors were collected after cold static storage. We used different analytical methods to measure DAMPs in these end-ischemic OPS (eiOPS) samples. We also used eiOPS in the human macrophage THP-1 cell line and primary monocyte cultures to study inflammasome activation. FINDINGS Different DAMPs were identified in eiOPS, several of which induced both priming and activation of the NLRP3 inflammasome in human myeloid cells. Cold ischemia time and donation after circulatory death negatively influenced the DAMP signature. Moreover, the presence of oligomeric inflammasomes and interleukin-18 in eiOPS correlated with early allograft dysfunction in liver transplant patients. INTERPRETATION DAMPs released during cold ischemia storage prime and activate the NLRP3 inflammasome in liver macrophages after transplantation, inducing a pro-inflammatory environment that will complicate the outcome of the graft. The use of pharmacological blockers targeting DAMPs or the NLRP3 inflammasome in liver ischemia during static cold storage or through extracorporeal organ support could be a suitable strategy to increase the success of liver transplantation. FUNDING Fundación Mutua Madrileña and Instituto de Salud Carlos III, Madrid, Spain.
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Affiliation(s)
- Fernando Lucas-Ruiz
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120, Murcia, Spain
| | - Sandra V. Mateo
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120, Murcia, Spain
| | - Marta Jover-Aguilar
- Transplant Unit, Surgery Service, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain,Biomedical Research Institute of Murcia IMIB-Pascual Parrilla, Murcia, Spain
| | - Felipe Alconchel
- Transplant Unit, Surgery Service, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain,Biomedical Research Institute of Murcia IMIB-Pascual Parrilla, Murcia, Spain
| | - Laura Martínez-Alarcón
- Transplant Unit, Surgery Service, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain,Biomedical Research Institute of Murcia IMIB-Pascual Parrilla, Murcia, Spain
| | - Carlos de Torre-Minguela
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120, Murcia, Spain
| | - Daniel Vidal-Correoso
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120, Murcia, Spain
| | - Francisco Villalba-López
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120, Murcia, Spain
| | - Víctor López-López
- Transplant Unit, Surgery Service, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain,Biomedical Research Institute of Murcia IMIB-Pascual Parrilla, Murcia, Spain
| | - Antonio Ríos-Zambudio
- Transplant Unit, Surgery Service, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain,Biomedical Research Institute of Murcia IMIB-Pascual Parrilla, Murcia, Spain
| | - José A. Pons
- Liver Transplantation Unit, Gastroenterology and Hepatology Service, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120, Murcia, Spain
| | - Pablo Ramírez
- Transplant Unit, Surgery Service, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain,Biomedical Research Institute of Murcia IMIB-Pascual Parrilla, Murcia, Spain
| | - Pablo Pelegrín
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120, Murcia, Spain,Department of Biochemistry and Molecular Biology B and Immunology, Faculty of Medicine, University of Murcia, 30120, Murcia, Spain,Corresponding author. Campus de Ciencias de la Salud, Edificio LAIB, Office 4.15, Ctra. Buenavista s/n, 30120, Murcia, Spain.
| | - Alberto Baroja-Mazo
- Molecular Inflammation Group, University Clinical Hospital Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), 30120, Murcia, Spain,Corresponding author. Campus de Ciencias de la Salud, Edificio LAIB, Office 4.21, Ctra. Buenavista s/n, 30120, Murcia, Spain.
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19
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Orenes-Piñero E, Moreno-Docón A, Candela-González J, Navas-Carrillo D, Ortega-García JA, Ramírez P. Confirmation of radiant catalytic ionization efficacy for airborne SARS-CoV-2 elimination indoors using "COVID19 traps". J Infect Public Health 2022; 15:1551-1554. [PMID: 36442385 PMCID: PMC9678206 DOI: 10.1016/j.jiph.2022.11.014] [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: 10/05/2022] [Revised: 11/07/2022] [Accepted: 11/13/2022] [Indexed: 11/23/2022] Open
Abstract
Radiant catalytic ionization (RCI) is a novel technology that uses the appropriate wavelength (240-260 nm) and the phenomenon of photo-oxidation leading to permanent removal of viruses, bacteria, and fungi. Here, two analyses were performed. The first of them was a complete analysis of environmental biosecurity in a hospital environment. The second one was a longitudinal study with 40 patients with confirmed COVID19 and high viral load to assess the efficacy of RCI technology eliminating airborne SARS-CoV-2 indoors. A significant decrease in the number of bacteria and fungi colony-forming units (CFUs) was found in rooms with RCI when compared with rooms without it (p=0.03 for both of them). In the second part of the study, 16 samples out of 40 (40%) were positives when RCI technology was absent; whereas, these samples were negative when the equipment was on. Incidence rates (IR) with their Poisson 95% Confidence Intervals (CI) were calculated as the number of positive tests with the purifier or without it, showing an IR difference of 48.5% [CI(15.9-81), p=0.004]. Furthermore, the IR ratio was calculated obtaining a value of 3.3, confirming that RCI diminished more than 3-fold the presence of the SARS-CoV-2 in the air of the patients' rooms, thus laying the first stone in the fight for prevention of SARS-CoV-2 dissemination indoors.
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Affiliation(s)
- Esteban Orenes-Piñero
- Proteomic Unit, Instituto Murciano de Investigaciones Biosanitarias (IMIB_Pascual Parrilla), Murcia, Spain,Correspondence to: Campus Ciencias de la Salud, Carretera Buenavista s/n, CP 30120 El Palmar, Murcia, Spain
| | - Antonio Moreno-Docón
- Department of Virology, Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), Murcia, Spain
| | | | | | - Juan A. Ortega-García
- Environment and Human Health (EH2) Lab IMIB-Pascual Parrilla, Pediatric Environmental Health, HCUVA, Murcia, Spain
| | - Pablo Ramírez
- Department of Surgery, HCUVA, University of Murcia, Murcia, Spain
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20
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Lucas-Ruiz F, Peñín-Franch A, Pons JA, Ramírez P, Pelegrín P, Cuevas S, Baroja-Mazo A. Emerging Role of NLRP3 Inflammasome and Pyroptosis in Liver Transplantation. Int J Mol Sci 2022; 23:ijms232214396. [PMID: 36430874 PMCID: PMC9698208 DOI: 10.3390/ijms232214396] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/11/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
The nucleotide-binding domain leucine-rich repeat-receptor, pyrin domain-containing-3 (NLRP3) inflammasome contributes to the inflammatory response by activating caspase-1, which in turn participates in the maturation of interleukin (IL)-1β and IL-18, which are mainly secreted via pyroptosis. Pyroptosis is a lytic type of cell death that is controlled by caspase-1 processing gasdermin D. The amino-terminal fragment of gasdermin D inserts into the plasma membrane, creating stable pores and enabling the release of several proinflammatory factors. The activation of NLRP3 inflammasome and pyroptosis has been involved in the progression of liver fibrosis and its end-stage cirrhosis, which is among the main etiologies for liver transplantation (LT). Moreover, the NLRP3 inflammasome is involved in ischemia-reperfusion injury and early inflammation and rejection after LT. In this review, we summarize the recent literature addressing the role of the NLRP3 inflammasome and pyroptosis in all stages involved in LT and argue the potential targeting of this pathway as a future therapeutic strategy to improve LT outcomes. Likewise, we also discuss the impact of graft quality influenced by donation after circulatory death and the expected role of machine perfusion technology to modify the injury response related to inflammasome activation.
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Affiliation(s)
- Fernando Lucas-Ruiz
- Molecular Inflammation Group, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), University Clinical Hospital Virgen de la Arrixaca, 30120 Murcia, Spain
| | - Alejandro Peñín-Franch
- Molecular Inflammation Group, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), University Clinical Hospital Virgen de la Arrixaca, 30120 Murcia, Spain
| | - José Antonio Pons
- Hepatology and Liver Transplant Unit, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), University Clinical Hospital Virgen de la Arrixaca, 30120 Murcia, Spain
| | - Pablo Ramírez
- General Surgery and Abdominal Solid Organ Transplantation Unit, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), University Clinical Hospital Virgen de la Arrixaca, 30120 Murcia, Spain
| | - Pablo Pelegrín
- Molecular Inflammation Group, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), University Clinical Hospital Virgen de la Arrixaca, 30120 Murcia, Spain
- Department of Biochemistry and Molecular Biology B and Immunology, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain
- Correspondence: (P.P.); (A.B.-M.); Tel.: +34-86-8885-031 (P.P.); Tel.: +34-86-8885-039 (A.B.-M.)
| | - Santiago Cuevas
- Molecular Inflammation Group, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), University Clinical Hospital Virgen de la Arrixaca, 30120 Murcia, Spain
| | - Alberto Baroja-Mazo
- Molecular Inflammation Group, Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), University Clinical Hospital Virgen de la Arrixaca, 30120 Murcia, Spain
- Correspondence: (P.P.); (A.B.-M.); Tel.: +34-86-8885-031 (P.P.); Tel.: +34-86-8885-039 (A.B.-M.)
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21
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Sánchez-Rojas T, Espinoza-Culupú A, Ramírez P, Iwai LK, Montoni F, Macedo-Prada D, Sulca-López M, Durán Y, Farfán-López M, Herencia J. Proteomic Study of Response to Copper, Cadmium, and Chrome Ion Stress in Yarrowia lipolytica Strains Isolated from Andean Mine Tailings in Peru. Microorganisms 2022; 10:microorganisms10102002. [PMID: 36296278 PMCID: PMC9611812 DOI: 10.3390/microorganisms10102002] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/22/2022] [Accepted: 10/02/2022] [Indexed: 11/16/2022] Open
Abstract
Mine tailings are produced by mining activities and contain diverse heavy metal ions, which cause environmental problems and have negative impacts on ecosystems. Different microorganisms, including yeasts, play important roles in the absorption and/or adsorption of these heavy metal ions. This work aimed to analyze proteins synthesized by the yeast Yarrowia lipolytica AMJ6 (Yl-AMJ6), isolated from Andean mine tailings in Peru and subjected to stress conditions with common heavy metal ions. Yeast strains were isolated from high Andean water samples impacted by mine tailings from Yanamate (Pasco, Peru). Among all the isolated yeasts, the Yl-AMJ6 strain presented LC50 values of 1.06 mM, 1.42 mM, and 0.49 mM for the Cr+6, Cu+2, and Cd+2 ions, respectively. Proteomic analysis of theYl-AMJ6 strain under heavy metal stress showed that several proteins were up- or downregulated. Biological and functional analysis of these proteins showed that they were involved in the metabolism of proteins, nucleic acids, and carbohydrates; response to oxidative stress and protein folding; ATP synthesis and ion transport; membrane and cell wall; and cell division. The most prominent proteins that presented the greatest changes were related to the oxidative stress response and carbohydrate metabolism, suggesting the existence of a defense mechanism in these yeasts to resist the impact of environmental contamination by heavy metal ions.
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Affiliation(s)
- Tito Sánchez-Rojas
- Laboratory of Environmental Microbiology and Biotechnology, Faculty of Biological Sciences, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru
- Correspondence: (T.S.-R.); (A.E.-C.)
| | - Abraham Espinoza-Culupú
- Laboratory Research on Health Science, Universidad Señor de Sipán, Chiclayo 14001, Peru
- Correspondence: (T.S.-R.); (A.E.-C.)
| | - Pablo Ramírez
- Molecular Microbiology and Biotechnology Laboratory, Faculty of Biological Sciences, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru
| | - Leo Kei Iwai
- Laboratory for Applied Toxinology Center of Toxins, Immune-Response and Cell Signaling (LETA/CeTICS), Butantan Institute, São Paulo 05503-900, Brazil
| | - Fabio Montoni
- Laboratory for Applied Toxinology Center of Toxins, Immune-Response and Cell Signaling (LETA/CeTICS), Butantan Institute, São Paulo 05503-900, Brazil
| | - Diego Macedo-Prada
- Laboratory of Environmental Microbiology and Biotechnology, Faculty of Biological Sciences, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru
| | - Marcos Sulca-López
- Molecular Microbiology and Biotechnology Laboratory, Faculty of Biological Sciences, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru
| | - Yerson Durán
- Laboratory of Environmental Microbiology and Biotechnology, Faculty of Biological Sciences, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru
| | - Mariella Farfán-López
- Molecular Microbiology and Biotechnology Laboratory, Faculty of Biological Sciences, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru
| | - Jennifer Herencia
- Molecular Microbiology and Biotechnology Laboratory, Faculty of Biological Sciences, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru
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Iannacone G, Ramírez P. Accumulation of population polymorphisms in the mitonuclear genome with probable adaptive effect to extreme environments as altitude for forensic purposes. Forensic Science International: Genetics Supplement Series 2022. [DOI: 10.1016/j.fsigss.2022.09.027] [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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Martínez-Alarcón L, Balaguer A, Santainés-Borredá E, Agras-Suarez MC, Cañadas-De la Fuente GA, Hurtado-Pardos B, Bárcena-Calvo C, Perelló-Campaner C, Arribas-Marin JM, García-Mayor S, Soto-Ruíz MN, Navalón JC, Bertran-Noguer C, Peña-Amaro MP, Jiménez-Herrera MF, Blanco-Sánchez R, Calvo-Sánchez MD, Prado-Laguna MC, González-García A, Martínez-Rodríguez A, Bas-Sarmiento P, Faus-Gabandé F, Muiños-Alvarez A, Peyró-Gregori L, Hernández-Martínez H, Saez A, Sánchez Á, López-Navas A, Ramírez P, Ríos A. Nursing students faced with organ donation: Multicenter stratified national study. Nurse Educ Pract 2022; 63:103394. [DOI: 10.1016/j.nepr.2022.103394] [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] [Received: 02/21/2022] [Revised: 05/23/2022] [Accepted: 06/25/2022] [Indexed: 10/17/2022]
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Ríos A, López-Navas A, Ayala-García MA, Ramírez P. The acceptance of xenotransplantation among African immigrants living in Spain. Cir Esp 2022:S2173-5077(22)00229-0. [PMID: 35777626 DOI: 10.1016/j.cireng.2022.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/26/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Antonio Ríos
- Proyecto Colaborativo Internacional Donante (International Collaborative Donor Project), Murcia, Spain.
| | - Ana López-Navas
- Proyecto Colaborativo Internacional Donante (International Collaborative Donor Project), Murcia, Spain; Departamento de Psicología, Universidad Católica San Antonio de Murcia, Murcia, Spain
| | - Marco Antonio Ayala-García
- Proyecto Colaborativo Internacional Donante (International Collaborative Donor Project), Murcia, Spain; Hospital Regional General Número 58 del IMSS, Guanajuato, México
| | - Pablo Ramírez
- Proyecto Colaborativo Internacional Donante (International Collaborative Donor Project), Murcia, Spain; Unidad de Trasplantes, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain; Departamento de Cirugía, Pediatría, Obstetricia y Ginecología, Universidad de Murcia, Murcia, Spain
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Iniesta-Sepúlveda M, López-Navas AI, Gutiérrez PR, Ramírez P, Ríos A. The Willingness to Donate Organs in Medical Students From an International Perspective: A Meta-Analysis. Transpl Int 2022; 35:10446. [PMID: 35837470 PMCID: PMC9273723 DOI: 10.3389/ti.2022.10446] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/17/2022] [Indexed: 11/30/2022]
Abstract
Attitude toward organ donation mobilizes donation behavior and makes transplant surgery possible. As future health professionals, medical students will be a relevant generating opinion group and will have an important role in the organ requesting process. The goals of this meta-analysis were to obtain polled rates of medical students who are in favor, against, or indecisive toward cadaveric organ donation in the studies conducted around the world, and to explore sociocultural variables influencing the willingness to donate. Electronic search and revision of references from previous literature allowed us to locate 57 studies fulfilling the inclusion criteria. Data extraction and risk of bias assessment were performed by two independent investigators. Pooled estimations were computed assuming a random-effects model. Despite the fact that willingness to donate was elevated in medical students, estimated rates in studies from different geographical areas and sociocultural backgrounds exhibited significant differences. The age and the grade of the students also influenced the rate of students in favor. Donation campaigns should take into account cultural factors, especially in countries where certain beliefs and values could hamper organ donation. Also, knowledge and skills related to organ donation and transplant should be acquired early in the medical curriculum when a negative attitude is less resistant to change.
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Affiliation(s)
| | - Ana I. López-Navas
- Department of Psychology, Catholic University of Murcia, UCAM, Murcia, Spain
| | - Pedro R. Gutiérrez
- Department of Surgery, University of La Laguna (ULL), San Cristóbal de La Laguna, Spain
| | - Pablo Ramírez
- Department of Surgery, Pediatrics, Obstetrics y Gynecology, University of Murcia, Murcia, Spain
- Transplant Unit, Surgery Service, IMIB – University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Antonio Ríos
- Department of Surgery, Pediatrics, Obstetrics y Gynecology, University of Murcia, Murcia, Spain
- Transplant Unit, Surgery Service, IMIB – University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain
- *Correspondence: Antonio Ríos,
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Gil PJ, Ruiz-Manzanera JJ, Ruiz de Angulo D, Munitiz V, Ferreras D, López V, Conesa A, Ortiz Á, Martínez de Haro LF, Ramírez P. Learning Curve for Laparoscopic Sleeve Gastrectomy: a Cumulative Summation (CUSUM) Analysis. Obes Surg 2022; 32:2598-2604. [PMID: 35687255 DOI: 10.1007/s11695-022-06145-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/03/2022] [Accepted: 06/03/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Bariatric surgery is currently considered the most effective and durable treatment option for morbid obesity. Laparoscopic sleeve gastrectomy (LSG) has become a popular technique and may currently be the most frequently practiced surgical operation to treat obesity. However, no objective analyses of its learning curve have been reported. OBJECTIVE to analyze the learning curve for LSG. MATERIALS AND METHODS We included all LSGs performed in our hospital (University Hospital, Spain; Public Practice) from April 2013 to February 2016. The learning curve for LSG was evaluated using cumulative sum (CUSUM) analysis. All variables among the learning curve phases were compared. RESULTS According to the CUSUM analysis, the learning curve was divided into three unique phases: early learning (the initial 26 patients), acquisition of skills (the middle 30 patients), and mastery of technique (the final 56 patients). The operative time and gastric stenosis significantly decreased with progression of the learning curve without differences in the 30-day postoperative complication rate, postoperative stay, or weight loss. CONCLUSION According to this study, the learning curve for LSG can be divided into 3 distinct phases, and about 25 patients are needed to demonstrate an improvement in surgical skill.
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Affiliation(s)
- Pedro J Gil
- General Surgery Service, "Virgen de La Arrixaca" Clinical University Hospital, 30120, El Palmar, Murcia, Spain
| | - Juan José Ruiz-Manzanera
- General Surgery Service, "Virgen de La Arrixaca" Clinical University Hospital, 30120, El Palmar, Murcia, Spain.
| | - David Ruiz de Angulo
- Bariatric Surgery Unit and Upper Gastrointestinal Surgical, General Surgery Service, "Virgen de La Arrixaca" Clinical University Hospital, 30120, El Palmar, Murcia, Spain
| | - Vicente Munitiz
- General Surgery Service, Upper Gastrointestinal Surgical Unit, "Virgen de La Arrixaca" Clinical University Hospital, 30120, El Palmar, Murcia, Spain
| | - David Ferreras
- General Surgery Service, "Virgen de La Arrixaca" Clinical University Hospital, 30120, El Palmar, Murcia, Spain
| | - Víctor López
- General Surgery Service, "Virgen de La Arrixaca" Clinical University Hospital, 30120, El Palmar, Murcia, Spain
| | - Ana Conesa
- General Surgery Service, Upper Gastrointestinal Surgical Unit, "Virgen de La Arrixaca" Clinical University Hospital, 30120, El Palmar, Murcia, Spain
| | - Ángeles Ortiz
- General Surgery Service, Upper Gastrointestinal Surgical Unit, "Virgen de La Arrixaca" Clinical University Hospital, 30120, El Palmar, Murcia, Spain
| | - Luisa F Martínez de Haro
- General Surgery Service, Upper Gastrointestinal Surgical Unit, "Virgen de La Arrixaca" Clinical University Hospital, 30120, El Palmar, Murcia, Spain
| | - Pablo Ramírez
- General Surgery Service, "Virgen de La Arrixaca" Clinical University Hospital, 30120, El Palmar, Murcia, Spain.,Instituto Murciano De Investigación Biosanitaria (IMIB), 30120, El Palmar, Murcia, Spain
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Ríos A, López-Navas A, Ayala-García MA, Ramírez P. Aceptación del xenotrasplante de órganos entre los inmigrantes africanos residentes en España. Cir Esp 2022. [DOI: 10.1016/j.ciresp.2022.05.012] [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: 11/26/2022]
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Ríos A, López-Gómez S, Belmonte J, Balaguer A, Gutiérrez PR, Ruiz-Merino G, Ayala-García MA, Ramírez P, López-Navas AI. La población gitana tiene miedos sobre la donación de órganos propios para trasplante. Cir Esp 2022. [DOI: 10.1016/j.ciresp.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
The appearance and spread of new mechanisms of bacterial resistance to antibiotics is a serious health problem. One of the most difficult resistance mechanisms to treat is the production of carbapenemases. Carbapenemase KPC is one of those mechanisms with few therapeutic options. Meropenem-vaborbactam has shown great efficacy against this type of microorganism, both from a clinical and microbiological point of view. Its good pharmacokinetics, including in the lung, and its safety profile make meropenem-vaborbactam an excellent therapeutic option. Finally, the absence of resistance genesis during treatment seems to indicate that its efficacy will be long-lasting.
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Affiliation(s)
| | | | - P Ramírez
- Paula Ramírez, Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain.
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30
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Ríos A, Sánchez-Martínez A, Ayala-García MA, Gutiérrez PR, Palacios G, Iniesta-Sepúlveda M, Ramírez P, López-Navas AI. International Population Study in Spain, Cuba, and the United States of Attitudes Toward Organ Donation Among the Cuban Population. Liver Transpl 2022; 28:581-592. [PMID: 34664347 DOI: 10.1002/lt.26338] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 12/07/2022]
Abstract
Cuban immigrants constitute an important group in both the United States and Spain, with different behaviors toward organ donation having been described among the different Latin American nationalities. We analyzed the attitude toward organ donation among the Cuban populations in Cuba, Spain, and Florida. The study population was Cuban immigrants over 15 years of age residing in Cuba, Spain, and Florida, with samples randomly stratified by age and sex. A validated questionnaire on psychosocial aspects of organ donation (PCID-DTO Rios) was used. Census was used as the sampling base in all 3 countries; however, additionally, in Spain and the United States (Florida), we sought the support of immigration support associations to determine the Cuban population without legal documentation. The questionnaire was completed anonymously and self-administered. The completion rate of the study was 74% (4123/5574) among 424 surveyed in Spain, 1224 in Florida, and 2475 in Cuba. The attitude in favor of donating their own organs upon death was 60.6% of those surveyed in Spain, 37.6% in Florida, and 68.9% in Cuba, or 58% of the global sample. Multivariate analysis showed that country of residence was an independent factor associated with attitude toward organ donation (odds ratio, 1.929). Other factors associated with attitude were sex, educational level, performance of prosocial activities, knowledge of the brain death concept, religion, the couple's opinion toward donation, fear of mutilation after donation, and attitude toward manipulation of the body after death. The attitude toward organ donation among Cubans in their country of origin and immigrants in Spain was similar, being significantly different from those who emigrate to Florida, where the attitude is much less favorable.
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Affiliation(s)
- Antonio Ríos
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain
- Department of Surgery, Paediatrics, Obstetrics and Gynaecology, University of Murcia, Murcia, Spain
- Transplant Unit, Surgery Service, IMIB - Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Alvaro Sánchez-Martínez
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain
- Transplant Unit, Surgery Service, IMIB - Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Marco Antonio Ayala-García
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain
- Hospital Regional General Número 58 del IMSS (Instituto Mexicano del Seguro Social), Delegación de Guanajuato, Mexico
| | - Pedro R Gutiérrez
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain
- Servicio de Urología, Complejo Hospitalario Universitario de Canarias (CHUC), Tenerife, Spain
- Departamento de Cirugía, Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Tenerife, Spain
| | - Gerardo Palacios
- Transplant Coordination Center, UMAE Hospital de Especialidades Nº 25 IMSS, Monterrey, Mexico
| | | | - Pablo Ramírez
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain
- Department of Surgery, Paediatrics, Obstetrics and Gynaecology, University of Murcia, Murcia, Spain
- Transplant Unit, Surgery Service, IMIB - Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Ana Isabel López-Navas
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain
- Department of Psychology, Universidad Católica de Murcia (UCAM), Murcia, Spain
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31
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Hessheimer AJ, de la Rosa G, Gastaca M, Ruíz P, Otero A, Gómez M, Alconchel F, Ramírez P, Bosca A, López-Andújar R, Atutxa L, Royo-Villanova M, Sánchez B, Santoyo J, Marín LM, Gómez-Bravo MÁ, Mosteiro F, Villegas Herrera MT, Villar Del Moral J, González-Abos C, Vidal B, López-Domínguez J, Lladó L, Roldán J, Justo I, Jiménez C, López-Monclús J, Sánchez-Turrión V, Rodríguez-Laíz G, Velasco Sánchez E, López-Baena JÁ, Caralt M, Charco R, Tomé S, Varo E, Martí-Cruchaga P, Rotellar F, Varona MA, Barrera M, Rodríguez-Sanjuan JC, Briceño J, López D, Blanco G, Nuño J, Pacheco D, Coll E, Domínguez-Gil B, Fondevila C. Abdominal normothermic regional perfusion in controlled donation after circulatory determination of death liver transplantation: Outcomes and risk factors for graft loss. Am J Transplant 2022; 22:1169-1181. [PMID: 34856070 DOI: 10.1111/ajt.16899] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/11/2021] [Accepted: 11/11/2021] [Indexed: 01/25/2023]
Abstract
Postmortem normothermic regional perfusion (NRP) is a rising preservation strategy in controlled donation after circulatory determination of death (cDCD). Herein, we present results for cDCD liver transplants performed in Spain 2012-2019, with outcomes evaluated through December 31, 2020. Results were analyzed retrospectively and according to recovery technique (abdominal NRP [A-NRP] or standard rapid recovery [SRR]). During the study period, 545 cDCD liver transplants were performed with A-NRP and 258 with SRR. Median donor age was 59 years (interquartile range 49-67 years). Adjusted risk estimates were improved with A-NRP for overall biliary complications (OR 0.300, 95% CI 0.197-0.459, p < .001), ischemic type biliary lesions (OR 0.112, 95% CI 0.042-0.299, p < .001), graft loss (HR 0.371, 95% CI 0.267-0.516, p < .001), and patient death (HR 0.540, 95% CI 0.373-0.781, p = .001). Cold ischemia time (HR 1.004, 95% CI 1.001-1.007, p = .021) and re-transplantation indication (HR 9.552, 95% CI 3.519-25.930, p < .001) were significant independent predictors for graft loss among cDCD livers with A-NRP. While use of A-NRP helps overcome traditional limitations in cDCD liver transplantation, opportunity for improvement remains for cases with prolonged cold ischemia and/or technically complex recipients, indicating a potential role for complimentary ex situ perfusion preservation techniques.
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Affiliation(s)
- Amelia J Hessheimer
- General & Digestive Surgery, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.,General & Digestive Surgery Service, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Barcelona, Spain.,IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain
| | | | | | | | - Alejandra Otero
- Complejo Hospitalario Universitario La Coruña, A Coruna, Spain
| | - Manuel Gómez
- Complejo Hospitalario Universitario La Coruña, A Coruna, Spain
| | - Felipe Alconchel
- Hospital Clínico Universitario Virgen de la Arrixaca, IMIB, El Palmar, Spain
| | - Pablo Ramírez
- Hospital Clínico Universitario Virgen de la Arrixaca, IMIB, El Palmar, Spain
| | - Andrea Bosca
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Rafael López-Andújar
- Hospital Universitario y Politécnico La Fe, Valencia, Spain.,CIBERehd, Instituto de Salud Carlos III, Madrid, Spain
| | - Lánder Atutxa
- Hospital Universitario Donostia, San Sebastián, Spain
| | | | | | | | - Luís M Marín
- Hospital Universitario Virgen del Rocío, Seville, Spain
| | | | | | | | | | - Carolina González-Abos
- General & Digestive Surgery Service, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Barcelona, Spain
| | - Bárbara Vidal
- Hospital General Universitario de Castellón, Castellón, Spain
| | | | - Laura Lladó
- Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Spain
| | - José Roldán
- Hospital Universitario de Navarra, Pamplona, Spain
| | - Iago Justo
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | | | - Gonzalo Rodríguez-Laíz
- Department of General & Digestive Surgery, ISABIAL, Hospital General Universitario de Alicante, Alicante, Spain
| | | | | | - Mireia Caralt
- Hospital Universitario Vall d'Hebrón, Barcelona, Spain
| | - Ramón Charco
- Hospital Universitario Vall d'Hebrón, Barcelona, Spain
| | - Santiago Tomé
- Complejo Hospitalario Universitario Santiago, Santiago de Compostela, Spain
| | - Evaristo Varo
- Complejo Hospitalario Universitario Santiago, Santiago de Compostela, Spain
| | - Pablo Martí-Cruchaga
- HPB and Liver Transplant Unit, General & Digestive Surgery, Clínica Universitaria de Navarra, Pamplona, Spain
| | - Fernando Rotellar
- HPB and Liver Transplant Unit, General & Digestive Surgery, Clínica Universitaria de Navarra, Pamplona, Spain
| | - María A Varona
- Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Manuel Barrera
- Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | | | | | - Diego López
- Hospital Universitario Infanta Cristina, Badajoz, Spain
| | | | - Javier Nuño
- Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - David Pacheco
- Hospital Universitario Río Hortega, Valladolid, Spain
| | | | | | - Constantino Fondevila
- General & Digestive Surgery, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.,General & Digestive Surgery Service, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Barcelona, Spain.,IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain
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Ríos A, Carrillo J, López-Navas AI, Ayala-García MA, Alconchel F, Iniesta-Sepúlveda M, Ramírez P. African Immigrants Living in Spain: Awareness Toward Organ Donation and the Need for Specific Awareness Campaigns. EXP CLIN TRANSPLANT 2022; 20:199-208. [PMID: 35282812 DOI: 10.6002/ect.2021.0480] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The African population is an important, growing population group in Spain. Our objective was to determine attitudes toward organ donation among the African population living in Spain and to determine factors influencing attitudes. MATERIALS AND METHODS A population sample was taken of Africans residing in Spain, stratified by age and sex (n = 4145). Attitude was assessed using a validated questionnaire, which was self-administered and completed anonymously. Descriptive statistics, the chi-squared test, ttest, and logistic regression analysis were used for data analyses. RESULTS The questionnaire completion rate was 87% (n = 3618). Attitudes toward donation of one's own organs was favorable in 31% of respondents (n = 1112). Among the remaining respondents, attitude was unfavorable in 40% (n = 1458) and undecided in 29% (n = 1037). Multivariate analysis showed the following variables as being associated with attitude: (1) age (P < .001), (2) having descendents (P < .001), (3) education level (P < .001), (4) belief of respondent that he or she may need a transplant in the future (P = .001), (5) knowledge ofthe concept of brain death (P < .001), (6) attitude toward donation of a family member's organ (P < .001), (7) having spoken with one's family about donation and transplant (P < .001), (8) opinion of one's partner toward organ donation (P < .001), (9) respondent's religion (P < .001), (10) knowledge of the view of one's religion toward organ donation and transplant (P < .001), and (10) fear of possible mutilation of the body after donation (P < .001). CONCLUSIONS Attitudes toward donation of an individual's organs after death were negative among Africans living in Spain and may be related to psychosocial factors. This group should have priority for receiving organ donation awareness campaigns in Spain.
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Affiliation(s)
- Antonio Ríos
- From the Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain.,From the Department of Surgery, Paediatrics, Obstetrics, and Gynaecology, University of Murcia, Murcia, Spain.,From the Transplant Unit, Surgery Service, IMIB - Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
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Orenes-Piñero E, Navas-Carrillo D, Moreno-Docón A, Ortega-García JA, Torres-Cantero AM, García-Vázquez E, Ramírez P. Confirmation of SARS-CoV-2 airborne dissemination indoors using "COVID-19 traps". J Infect 2021; 84:343-350. [PMID: 34953900 PMCID: PMC8694655 DOI: 10.1016/j.jinf.2021.12.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/21/2021] [Accepted: 12/15/2021] [Indexed: 01/02/2023]
Affiliation(s)
- Esteban Orenes-Piñero
- Proteomic Unit, Instituto Murciano de Investigaciones Biosanitarias (IMIB-Arrixaca), Murcia, Spain.
| | - Diana Navas-Carrillo
- Department of Surgery, Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), Murcia, Spain
| | | | - Juan A Ortega-García
- Environment and Human Health (EH2) Lab IMIB-Arrixaca, Pediatric Environmental Health, HCUVA, Murcia, Spain
| | | | | | - Pablo Ramírez
- Department of Surgery, Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), Murcia, Spain
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Almela-Baeza J, Febrero B, Alconchel F, Pérez-Manzano A, Ramírez P. Film Creation for Education on Concepts Related to Religion, Immigration, and Legislation in the Field of Organ Donation and Transplantation. Transplant Proc 2021; 54:11-14. [PMID: 34876269 DOI: 10.1016/j.transproceed.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 09/29/2021] [Accepted: 10/08/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND In education, we can use cinema to create methodologies that develop the critical thinking to acquire knowledge in a collaborative way. Favorable attitudes toward organ donation and transplantation (ODT) is low in adolescents. Working on topics related to ODT, such as religion, immigration, and the law, can help to improve students' knowledge and endear them toward ODT with innovative educational methodologies. OBJECTIVES This study aims to analyze the change in knowledge about religion, immigration, and legislation on ODT after an educational proposal based on film creation. METHODS In this study, 16-year-old students participated in an educational proposal based on ODT education through filmmaking. A total of 543 students participated in the experimental group, and 320 participated in the control group. A validated ODT knowledge form was administered to both groups. Statistical analysis was carried out with SPSS version 21.0 package (SPSS, Inc, Chicago, IL, USA). A descriptive analysis and χ2 test were performed to analyze the differences between the experimental group and control group. P < .05 was considered statistically significant. RESULTS The study had a 72% participation rate in the experimental group. After receiving the educational proposal, the students presented a greater knowledge with respect to the control group in all aspects: the position of the different religions in relation to organ donation, knowledge of the rights and obligations of immigrants in relation to the ODT, and knowledge of the law of presumed consent in ODT CONCLUSIONS: Working in the classroom on psychosocial aspects such as religion, immigration, and legislation through filmmaking can favorably influence the adolescent's awareness of organ donation.
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Affiliation(s)
- Javier Almela-Baeza
- Faculty of Communication and Documentation, University of Murcia, Murcia, Spain
| | - Beatriz Febrero
- Transplant Unit, General Surgery Service, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biosanitaria (IMIB) Arrixaca, Murcia, Spain; Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia, Murcia, Spain.
| | - Felipe Alconchel
- Transplant Unit, General Surgery Service, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biosanitaria (IMIB) Arrixaca, Murcia, Spain; Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia, Murcia, Spain
| | - Antonio Pérez-Manzano
- Department of Evolutionary Psychology and Education, University of Murcia, Murcia, Spain
| | - Pablo Ramírez
- Transplant Unit, General Surgery Service, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biosanitaria (IMIB) Arrixaca, Murcia, Spain; Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia, Murcia, Spain
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Almela-Baeza J, Febrero B, Alconchel F, Bonache-Ibáñez A, Ramírez P. The Audiovisual Creation in Educational Proposals on Organ Donation: Attitude Towards Organ Donation and Transplantation of Secondary School Teachers. Transplant Proc 2021; 54:7-10. [PMID: 34844739 DOI: 10.1016/j.transproceed.2021.09.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 09/29/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Audiovisual creation allows teachers and students to become consumers and producers of information, creating collaborative environments. In the field of organ donation and transplantation (ODT), most of the educational proposals analyzed to date consist of presentations. The teacher does not usually have a decisive role in this type of methodologies, in addition to not having the appropriate training to be able to participate actively. OBJECTIVES To analyze the change in teachers' attitudes towards ODT after participating in an educational proposal based on the creation of short films. METHODS Teachers of secondary education in ten schools in southeastern Spain. The proposal consisted in the creation of short films based on topics related to ODT by the students. A validated ODT attitude form was administered to teachers at the beginning of the proposal and at the end of the proposal. A descriptive analysis was carried out together with McNemar test was used to compare the pre and post test results of the teacher. P < .05 was considered statiscally significant. RESULTS The favorable attitude towards organ donation at death increased after the proposal (64% vs 88%; P = .008). Favorable attitude towards organ donation from a relative also improved (52% vs 76%; P = .008), as did favorable attitude towards living kidney donation (52% vs 88%; P < .001), living liver donation (36% vs 85%; P = .008) and xenotransplantation (45% vs 82%; P < .001). CONCLUSIONS The teachers improves after an educational proposal based on the creation of short films related to ODT.
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Affiliation(s)
- Javier Almela-Baeza
- Faculty of Communication and Documentation, University of Murcia, Murcia, Spain
| | - Beatriz Febrero
- Transplant Unit, General Surgery Service, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biosanitaria IMIB-Arrixaca, Murcia, Spain; Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia, Murcia, Spain.
| | - Felipe Alconchel
- Transplant Unit, General Surgery Service, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biosanitaria IMIB-Arrixaca, Murcia, Spain; Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia, Murcia, Spain
| | | | - Pablo Ramírez
- Transplant Unit, General Surgery Service, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biosanitaria IMIB-Arrixaca, Murcia, Spain; Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia, Murcia, Spain
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Estella Á, Vidal-Cortés P, Rodríguez A, Andaluz Ojeda D, Martín-Loeches I, Díaz E, Suberviola B, Gracia Arnillas MP, Catalán González M, Álvarez-Lerma F, Ramírez P, Nuvials X, Borges M, Zaragoza R. [Management of infectious complications associated with coronavirus infection in severe patients admitted to ICU]. Med Intensiva 2021; 45:485-500. [PMID: 33994616 PMCID: PMC8086823 DOI: 10.1016/j.medin.2021.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 02/22/2021] [Revised: 04/13/2021] [Accepted: 04/17/2021] [Indexed: 12/29/2022]
Abstract
Infections have become one of the main complications of patients with severe SARS-CoV-2 pneumonia admitted in ICU. Poor immune status, frequent development of organic failure requiring invasive supportive treatments, and prolonged ICU length of stay in saturated structural areas of patients are risk factors for infection development. The Working Group on Infectious Diseases and Sepsis GTEIS of the Spanish Society of Intensive Medicine and Coronary Units SEMICYUC emphasizes the importance of infection prevention measures related to health care, the detection and early treatment of major infections in the patient with SARS-CoV-2 infections. Bacterial co-infection, respiratory infections related to mechanical ventilation, catheter-related bacteremia, device-associated urinary tract infection and opportunistic infections are review in the document.
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Affiliation(s)
- Á Estella
- Servicio de Medicina Intensiva, Hospital Universitario de Jerez, Departamento de Medicina, Facultad de Medicina de Cádiz, Jerez de la Frontera, Cádiz, España
| | - P Vidal-Cortés
- Servicio de Medicina Intensiva, Complexo Hospitalario Universitario de Ourense, Ourense, España
| | - A Rodríguez
- Servicio de Medicina Intensiva, Hospital Universitario Joan XXIII de Tarragona, Tarragona, España
| | - D Andaluz Ojeda
- Servicio de Medicina Intensiva, Hospital Universitario de Sanchinarro de Madrid, Madrid, España
| | - I Martín-Loeches
- PhD JFICMI Consultant in Intensive Care Medicine, CLOD Dublin Midlands group, St James's University Hospital, Trinity Centre for Health Sciences, HRB-Welcome Trust St James's Hospital, Dublín, EIRE, Universidad de Barcelona, Barcelona, España
| | - E Díaz
- Servicio de Medicina Intensiva, Hospital Parc Tauli, Sabadell, España
| | - B Suberviola
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla. Santander, España
| | - M P Gracia Arnillas
- Servicio de Medicina Intensiva, Hospital Universitario del Mar, Barcelona, España
| | - M Catalán González
- Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España
| | - F Álvarez-Lerma
- Servicio de Medicina Intensiva, Parc de Salut Mar, Hospital del Mar, Barcelona, España
| | - P Ramírez
- Servicio de Medicina Intensiva, Hospital La Fe de Valencia, Valencia, España
| | - X Nuvials
- Servicio de Medicina Intensiva, Hospital Vall d'Hebrón, Barcelona, España
| | - M Borges
- Unidad Multidisciplinar de Sepsis, Servicio de Medicina Intensiva, Hospital Universitario Son Llatzer, IDISBA, Enfermedades Infecciosas UIB, Palma de Mallorca, Área de Sepsis e Infecciosas, Federación Ibérica y Panamericana de Medicina Intensiva (FEPIMCTI), Palma de Mallorca, España
| | - R Zaragoza
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, España
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Lopez-Lopez V, Martínez-Caceres C, Ferreras D, Peña-Moral JDL, Cruz JDL, Royo-Villanova M, Rodríguez JM, Fernández-Hernández JA, Zambudio AR, Pons JA, Martínez-Barba E, Sánchez-Bueno F, Campos RR, Ramírez P. Biomarkers of Early Liver Graft Damage in Circulatory Death and Brain Death Donors: A Propensity Score Matching Analysis. Transplant Proc 2021; 53:2659-2662. [PMID: 34602295 DOI: 10.1016/j.transproceed.2021.07.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/16/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Donation after circulatory death (DCD) is related to a warm ischemia time and more complications compared with traditional donors (donation after brain death [DBD]). METHODS This study included biopsy samples retrospectively collected from November 2014 to December 2018 to compare histologic and biological markers of DCD and DBD liver grafts. The analysis includes marker of early apoptosis (p21), senescence (telomerase reverse transcriptase [TERT]), cell damage (caspase-3 active), endothelial damage (vascular endothelial growth factor), stem cell (CD90), hypoxia (HIF1A), inflammatory activation (COX-2), and cross-organ allograft rejection (CD44). A propensity score matching (PSM) was used to match patients receiving DCD livers to those receiving DBD livers. We analyzed the immunohistochemical initial liver damage-related warm ischemia time. RESULTS Positive staining expression of liver damage biomarkers (COX-2, CD44, TERT, HIF1A, and CD90) was found, but no significant differences were found between DCD and DBD and with ischemic cholangiopathy. After PSM, there was a significant relationship between CD90 and male donors (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.07-0.91), TERT with donor sodium (OR, 1.11; 95% CI, 1.02-1.2), HIF1A with steatosis (OR, 0.33; 95% CI, 0.13-0.83), and CD44 with donor vasoactive drugs (OR, 0.36; 95% CI, 0.13-1) and glutamic oxaloacetic transaminase 1 week increase (OR, 1.01; 95% CI, 1-1.03). CONCLUSIONS DCD immunohistochemical initial liver damage was found to behave similarly to DBD. The increase in complications and cholangiopathy associated with warm ischemia could be related to a different later phenomenon.
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Affiliation(s)
- Víctor Lopez-Lopez
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain.
| | | | - David Ferreras
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | | | - Juan De La Cruz
- Group of Applied Mathematics in Science and Engineering, Faculty of Computer Science, University of Murcia, Murcia, Spain
| | - Mario Royo-Villanova
- Intensive Care Unit, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Jose Manuel Rodríguez
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Juan Angel Fernández-Hernández
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Antonio Ríos Zambudio
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Jose Antonio Pons
- Department of Hepatology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | - Francisco Sánchez-Bueno
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Ricardo Robles Campos
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Pablo Ramírez
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
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Castellanos-Ortega A, Broch M, Barrios M, Fuentes-Dura M, Sancerni-Beitia M, Vicent C, Gimeno R, Ramírez P, Pérez F, García-Ros R. Análisis de la aceptación y validez de los métodos utilizados para la implementación de un programa de formación basado en competencias en un servicio de Medicina Intensiva de un hospital universitario de referencia. Med Intensiva 2021. [DOI: 10.1016/j.medin.2019.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fernández JÁ, Alconchel F, Gómez B, Martínez J, Ramírez P. Unresectable GIST liver metastases and liver transplantation: A review and theoretical basis for a new indication. Int J Surg 2021; 94:106126. [PMID: 34592432 DOI: 10.1016/j.ijsu.2021.106126] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Liver metastases from gastrointestinal stromal tumors (GIST) can be found synchronously to a primary tumor and in the medium/long term after resection of a high-risk GIST. In these cases, treatment with tyrosine kinase inhibitors like imatinib has provided good results, but drug resistance is common after two years of treatment. Liver resection of potentially resectable metastases can improve the results of medical treatment. In cases of unresectability, the role of liver transplantation (LT) has not been well-studied. MATERIALS AND METHODS A review of the literature was undertaken from January 1995 to December 2020 following the PRISMA and AMSTAR guidelines. RESULTS Fifteen cases were identified. In eight cases, the LT was carried out before 2002. Mutational status was only studied in seven cases. LT was performed in 12 cases with a deceased donor and in three cases with a living donor. After a mean follow-up of 52.4 months, overall survival was 86.6% with disease-free survival of 53.3% CONCLUSION: LT in the management of unresectable GIST metastases has rarely been performed. Although its application has a solid theoretical basis, its use understood as a radical extension of a standard resection can only be recommended within prospective studies by groups with considerable experience in both GIST and transplantation care.
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Affiliation(s)
- Juan Ángel Fernández
- Department of Surgery and Organ Transplantation. Virgen de la Arrixaca University Hospital. Ctra. Madrid-Cartagena s/n, 30120 Murcia Spain Department of Clinical Oncology. Virgen de la Arrixaca University Hospital. Ctra. Madrid-Cartagena s/n, 30120 Murcia Spain Biomedical Research Institute of Murcia (IMIB-Arrixaca). Campus de Ciencias de la Salud. Ctra. Buenavista s/n, 30120 Murcia Spain
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Castellanos-Ortega A, Broch MJ, Barrios M, Fuentes-Dura MC, Sancerni-Beitia MD, Vicent C, Gimeno R, Ramírez P, Pérez F, García-Ros R. Acceptance and validity of the methods used to implement a competency based medical education programme in an Intensive Care Department of a teaching referral center. Med Intensiva 2021; 45:411-420. [PMID: 34563341 DOI: 10.1016/j.medine.2019.12.011] [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: 09/19/2019] [Accepted: 12/02/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES 1. To determine the satisfaction of tutors and residents with a specific methodology used to implement CoBaTrICE. 2. To determine the reliability and validity of the global rating scales designed ad hoc to assess the performance of the residents for training purposes. DESIGN Prospective cohort study. PARTICIPANTS All the residents and tutors of the ICU Department of the Hospital Universitario y Politécnico la Fe de Valencia. INTERVENTION CoBaTrICE implementation started in March 2016, it was based on: (1) Training the tutors in feedback techniques; (2) Performing multiple objective and structured work based assessments to achieve the competences of the program; and (3) The use of an electronic portfolio to promote learning reflection and to collect the evidence that learning was taking place. METHODS The acceptance of CoBaTrICE was explored through a satisfaction survey conducted after 9 months of implementation of the training program. The 15 residents and 5 tutors of the ICU Department were asked about the methodology of the formative assessments, the quality of the feedback, self-learning regulation and the electronic portfolio usefulness. The validity of the global rating scales was assessed through the tests alfa de Cronbach, reliability and generalizability indexes, and intraclass correlation coefficient. RESULTS The implementation of CoBaTrICE was satisfactory in all the dimensions studied. The global rating scales used for formative purposes showed reliability and validity. CONCLUSIONS The methodology used to implement CoBaTrICE was highly valued by tutors and residents. The global rating scales used for formative purposes showed reliability and validity.
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Affiliation(s)
- A Castellanos-Ortega
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - M J Broch
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - M Barrios
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - M C Fuentes-Dura
- Departamento de Metodología de Ciencias del Comportamiento, Universidad de Valencia, Valencia, Spain
| | - M D Sancerni-Beitia
- Departamento de Metodología de Ciencias del Comportamiento, Universidad de Valencia, Valencia, Spain
| | - C Vicent
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - R Gimeno
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - P Ramírez
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - F Pérez
- Servicio de Medicina Intensiva, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - R García-Ros
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Valencia, Valencia, Spain.
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Almela-Baeza J, Febrero B, Pérez-Manzano A, Bonache-Ibáñez A, Ramírez P. Audiovisual Content to Promote Women Scientists on the YouTube Channels of Spanish Biosanitary Research Institutes. Int J Environ Res Public Health 2021; 18:ijerph18189698. [PMID: 34574632 PMCID: PMC8467258 DOI: 10.3390/ijerph18189698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/04/2021] [Accepted: 09/12/2021] [Indexed: 11/20/2022]
Abstract
YouTube is an appropriate social network for disseminating scientific audiovisual content, and this content can help to make the position of women in science, and gender equality, more visible. The aim of this study is to analyse the visibility of women scientists on the YouTube channels of Spanish biosanitary research institutes accredited by the Instituto de Salud Carlos III. A mixed study of the channels and communication departments of the institutions has been carried out, analysing metrics of audience impact, the type of audiovisual production and the use of YouTube in the institution. Of the 1914 videos analysed, 4% (n = 76) of the content is related to the visibility of women scientists and has little impact. The audiovisual production is basic and informative, without a dramatic narrative structure and focused on transmitting the personal experiences of women scientists. It is necessary to invest resources in institutions to improve the production and dissemination of content that makes women in the scientific field more visible, especially among students.
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Affiliation(s)
- Javier Almela-Baeza
- Faculty of Communication and Documentation, University of Murcia, 30100 Murcia, Spain;
| | - Beatriz Febrero
- Department of Surgery, Pediatrics, Gynecology and Obstetrics, Instituto Murciano de Investigaciones Biosanitaria IMIB-Arrixaca, School of Medicine, University of Murcia, 30100 Murcia, Spain;
- Correspondence: ; Tel.: +34-659-174-716
| | - Antonio Pérez-Manzano
- Department of Evolutionary Psychology and Education, University of Murcia, 30100 Murcia, Spain; (A.P.-M.); (A.B.-I.)
| | - Adrián Bonache-Ibáñez
- Department of Evolutionary Psychology and Education, University of Murcia, 30100 Murcia, Spain; (A.P.-M.); (A.B.-I.)
| | - Pablo Ramírez
- Department of Surgery, Pediatrics, Gynecology and Obstetrics, Instituto Murciano de Investigaciones Biosanitaria IMIB-Arrixaca, School of Medicine, University of Murcia, 30100 Murcia, Spain;
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Ríos A, López Navas AI, Rigabert M, Martínez-Alarcón L, Ayala-García MA, Ruiz-Merino G, de Moya M, Ramírez P. Usefulness of an organ donation opinion survey as a tool to promote organ donation among the adolescent population. Transpl Int 2021; 34:2138-2145. [PMID: 34486763 DOI: 10.1111/tri.14034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 08/13/2021] [Accepted: 08/31/2021] [Indexed: 01/29/2023]
Abstract
Opinion surveys on health issues are considered health promotion tools. However, no studies have confirmed this in deceased organ donation for transplantation. This study aimed to analyse the impact of completing an opinion questionnaire about deceased organ donation on the attitude towards organ donation among the adolescent population. This longitudinal study with repeated measurements of attitude towards deceased organ donation was conducted with an adolescent population. The measurement instrument was a validated questionnaire of the attitude towards organ donation (PCID-DTO-Ríos). The study process involved the application of the questionnaire at an initial time, 1 month later, and 6 months later. A total of 1374 adolescents participated in this study. The favourable attitude towards donation was 43.1%, which fell to 41.4% at 1 month (P = 0.145), and to 39.7% at 6 months (P = 0.019). Changes in the attitude were observed in all groups, both 1 and 6 months after the questionnaire was completed. There was no objective relationship between the adolescent's socio-family environment and the effect of completing the questionnaire on their attitude towards deceased organ donation. In conclusion, the opinion questionnaire was not useful for promoting organ donation and did not have a positive effect on adolescents' attitudes towards organ donation in the medium or long term.
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Affiliation(s)
- Antonio Ríos
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain.,Department of Surgery, Paediatrics, Obstetrics y Gynaecology, University of Murcia, Murcia, Spain.,Transplant Unit, Surgery Service, IMIB - Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
| | - Ana Isabel López Navas
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain.,Department of Psychology, UCAM, Catholic University of San Antonio, Murcia, Spain
| | - Mariano Rigabert
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain.,Transplant Unit, Surgery Service, IMIB - Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
| | - Laura Martínez-Alarcón
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain.,Transplant Unit, Surgery Service, IMIB - Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
| | - Marco Antonio Ayala-García
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain.,General Regional Hospital Number 58 of the IMSS (Mexican Institute of Social Security), Guanajuato Delegation, Mexico
| | - Guadalupe Ruiz-Merino
- Statistics Unit, Foundation for Health Training and Research of the Murcia Region (FFIS), Murcia, Spain
| | - María de Moya
- Department of Psychology, UCAM, Catholic University of San Antonio, Murcia, Spain
| | - Pablo Ramírez
- Proyecto Colaborativo Internacional Donante ("International Collaborative Donor Project"), Murcia, Spain.,Department of Surgery, Paediatrics, Obstetrics y Gynaecology, University of Murcia, Murcia, Spain.,Transplant Unit, Surgery Service, IMIB - Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
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Estella Á, Vidal-Cortés P, Rodríguez A, Andaluz Ojeda D, Martín-Loeches I, Díaz E, Suberviola B, Gracia Arnillas MP, Catalán González M, Álvarez-Lerma F, Ramírez P, Nuvials X, Borges M, Zaragoza R. Management of infectious complications associated with coronavirus infection in severe patients admitted to ICU. Med Intensiva 2021; 45:485-500. [PMID: 34475008 PMCID: PMC8382590 DOI: 10.1016/j.medine.2021.08.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/17/2021] [Indexed: 12/29/2022]
Abstract
Infections have become one of the main complications of patients with severe SARS-CoV-2 pneumonia admitted in ICU. Poor immune status, frequent development of organic failure requiring invasive supportive treatments, and prolonged ICU length of stay in saturated structural areas of patients are risk factors for infection development. The Working Group on Infectious Diseases and Sepsis GTEIS of the Spanish Society of Intensive Medicine and Coronary Units SEMICYUC emphasizes the importance of infection prevention measures related to health care, the detection and early treatment of major infections in the patient with SARS-CoV-2 infections. Bacterial co-infection, respiratory infections related to mechanical ventilation, catheter-related bacteremia, device-associated urinary tract infection and opportunistic infections are review in the document.
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Affiliation(s)
- Á Estella
- Servicio de Medicina Intensiva, Hospital Universitario de Jerez, Departamento de Medicina, Facultad de Medicina de Cádiz, Jerez de la Frontera, Cádiz, Spain.
| | - P Vidal-Cortés
- Servicio de Medicina Intensiva, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | - A Rodríguez
- Servicio de Medicina Intensiva, Hospital Universitario Joan XXIII de Tarragona, Tarragona, Spain
| | - D Andaluz Ojeda
- Servicio de Medicina Intensiva, Hospital Universitario de Sanchinarro de Madrid, Madrid, Spain
| | - I Martín-Loeches
- PhD JFICMI Consultant in Intensive Care Medicine, CLOD Dublin Midlands Group, St James's University Hospital, Trinity Centre for Health Sciences, HRB-Welcome Trust St James's Hospital, Dublin, EIRE, Universidad de Barcelona, Barcelona, Spain
| | - E Díaz
- Servicio de Medicina Intensiva, Hospital Parc Tauli, Sabadell, Spain
| | - B Suberviola
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - M P Gracia Arnillas
- Servicio de Medicina Intensiva, Hospital Universitario del Mar, Barcelona, Spain
| | - M Catalán González
- Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - F Álvarez-Lerma
- Servicio de Medicina Intensiva, Parc de Salut Mar, Hospital del Mar, Barcelona, Spain
| | - P Ramírez
- Servicio de Medicina Intensiva, Hospital La Fe de Valencia, Valencia, Spain
| | - X Nuvials
- Servicio de Medicina Intensiva, Hospital Vall d'Hebrón, Barcelona, Spain
| | - M Borges
- Unidad Multidisciplinar de Sepsis, Servicio de Medicina Intensiva, Hospital Universitario Son Llatzer, IDISBA, Enfermedades Infecciosas UIB, Palma de Mallorca, Área de Sepsis e Infecciosas, Federación Ibérica y Panamericana de Medicina Intensiva (FEPIMCTI), Palma de Mallorca, Spain
| | - R Zaragoza
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, Spain
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Febrero B, Almela-Baeza J, Ros I, Pérez-Sánchez MB, Pérez-Manzano A, Cascales P, Martínez-Alarcón L, Ramírez P. The impact of information and communications technology and broadcasting on YouTube for improving attitude toward organ donation in secondary education with the creation of short films. Patient Educ Couns 2021; 104:2317-2326. [PMID: 33658142 DOI: 10.1016/j.pec.2021.02.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 01/15/2021] [Accepted: 02/17/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE There is a lack of awareness about organ donation among teenagers, a fact that could decrease future donation rates. The objective is to analyze the impact of an educational proposal based on the creation of short films. METHODS Fifteen schools were randomly selected: ten for the experimental group (EG), and five for the control group (CG). In both groups all students from the selected classes participated (EG: n = 543, CG: n = 320). An intervention was undertaken in the EG, providing a website to make a short film about organ donation and transplantation (ODT) to be broadcast on YouTube. The students completed a questionnaire before and after the proposal. STATISTICS Mann-Whitney test was conducted to compare the pre-test data, McNemar test compare the pre and post test results of each group, and Chi-square test to compare the change in responses between the two groups. RESULTS The change to a more favorable response was greater in the EG in all variables. The YouTube channel received 104,912 viewings. CONCLUSIONS An innovative educational intervention has a positive influence on teenage attitude and knowledge about ODT; it also has important social repercussions. PRACTICE IMPLICATIONS Implementing this educational proposal about ODT could help improve future donation rates.
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Affiliation(s)
- Beatriz Febrero
- General Surgery Service, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biosanitarias (IMIB), Murcia, Spain; Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia, Spain
| | | | - Inmaculada Ros
- Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia, Spain
| | - Mª Belén Pérez-Sánchez
- Department of Statistics, Mathematics and Informatics, University of Miguel Hernández, Elche, Spain
| | | | - Pedro Cascales
- General Surgery Service, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biosanitarias (IMIB), Murcia, Spain; Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia, Spain
| | - Laura Martínez-Alarcón
- General Surgery Service, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biosanitarias (IMIB), Murcia, Spain
| | - Pablo Ramírez
- General Surgery Service, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biosanitarias (IMIB), Murcia, Spain; Department of Surgery, Pediatrics, Gynecology and Obstetrics, School of Medicine, University of Murcia, Spain
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45
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Ríos A, Iniesta-Sepúlveda M, Ramírez P, López-Navas AI. Análisis de metarregresión para determinar el efecto del conocimiento del concepto de muerte encefálica en la actitud hacia la donación de órganos entre los estudiantes de Medicina. Nefrologia 2021. [DOI: 10.1016/j.nefro.2021.04.018] [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: 11/16/2022] Open
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46
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López-López V, Pérez-Sánz F, de Torre-Minguela C, Marco-Abenza J, Robles-Campos R, Sánchez-Bueno F, Pons JA, Ramírez P, Baroja-Mazo A. Proteomics in Liver Transplantation: A Systematic Review. Front Immunol 2021; 12:672829. [PMID: 34381445 PMCID: PMC8350337 DOI: 10.3389/fimmu.2021.672829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/12/2021] [Indexed: 01/10/2023] Open
Abstract
Background Although proteomics has been employed in the study of several models of liver injury, proteomic methods have only recently been applied not only to biomarker discovery and validation but also to improve understanding of the molecular mechanisms involved in transplantation. Methods The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology and the guidelines for performing systematic literature reviews in bioinformatics (BiSLR). The PubMed, ScienceDirect, and Scopus databases were searched for publications through April 2020. Proteomics studies designed to understand liver transplant outcomes, including ischemia-reperfusion injury (IRI), rejection, or operational tolerance in human or rat samples that applied methodologies for differential expression analysis were considered. Results The analysis included 22 studies after application of the inclusion and exclusion criteria. Among the 497 proteins annotated, 68 were shared between species and 10 were shared between sample sources. Among the types of studies analyzed, IRI and rejection shared a higher number of proteins. The most enriched pathway for liver biopsy samples, IRI, and rejection was metabolism, compared to cytokine-cytokine receptor interactions for tolerance. Conclusions Proteomics is a promising technique to detect large numbers of proteins. However, our study shows that several technical issues such as the identification of proteoforms or the dynamic range of protein concentration in clinical samples hinder the successful identification of biomarkers in liver transplantation. In addition, there is a need to minimize the experimental variability between studies, increase the sample size and remove high-abundance plasma proteins.
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Affiliation(s)
- Victor López-López
- Department of Surgery, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.,Digestive and Endocrine Surgery and Transplantation of Abdominal Organs, Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - Fernando Pérez-Sánz
- Biomedical Informatic and Bioinformatic Platform, Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - Carlos de Torre-Minguela
- Digestive and Endocrine Surgery and Transplantation of Abdominal Organs, Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain
| | | | - Ricardo Robles-Campos
- Department of Surgery, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.,Digestive and Endocrine Surgery and Transplantation of Abdominal Organs, Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - Francisco Sánchez-Bueno
- Department of Surgery, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.,Digestive and Endocrine Surgery and Transplantation of Abdominal Organs, Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - José A Pons
- Digestive and Endocrine Surgery and Transplantation of Abdominal Organs, Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Gastroenterology, Unit of Hepatology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Pablo Ramírez
- Department of Surgery, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.,Digestive and Endocrine Surgery and Transplantation of Abdominal Organs, Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - Alberto Baroja-Mazo
- Digestive and Endocrine Surgery and Transplantation of Abdominal Organs, Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain
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Vishnopolska SA, Mercogliano MF, Camilletti MA, Mortensen AH, Braslavsky D, Keselman A, Bergadá I, Olivieri F, Miranda L, Marino R, Ramírez P, Pérez Garrido N, Patiño Mejia H, Ciaccio M, Di Palma MI, Belgorosky A, Martí MA, Kitzman JO, Camper SA, Pérez-Millán MI. Comprehensive Identification of Pathogenic Gene Variants in Patients With Neuroendocrine Disorders. J Clin Endocrinol Metab 2021; 106:1956-1976. [PMID: 33729509 PMCID: PMC8208670 DOI: 10.1210/clinem/dgab177] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 02/12/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE Congenital hypopituitarism (CH) can present in isolation or with other birth defects. Mutations in multiple genes can cause CH, and the use of a genetic screening panel could establish the prevalence of mutations in known and candidate genes for this disorder. It could also increase the proportion of patients that receive a genetic diagnosis. METHODS We conducted target panel genetic screening using single-molecule molecular inversion probes sequencing to assess the frequency of mutations in known hypopituitarism genes and new candidates in Argentina. We captured genomic deoxyribonucleic acid from 170 pediatric patients with CH, either alone or with other abnormalities. We performed promoter activation assays to test the functional effects of patient variants in LHX3 and LHX4. RESULTS We found variants classified as pathogenic, likely pathogenic, or with uncertain significance in 15.3% of cases. These variants were identified in known CH causative genes (LHX3, LHX4, GLI2, OTX2, HESX1), in less frequently reported genes (FOXA2, BMP4, FGFR1, PROKR2, PNPLA6) and in new candidate genes (BMP2, HMGA2, HNF1A, NKX2-1). CONCLUSION In this work, we report the prevalence of mutations in known CH genes in Argentina and provide evidence for new candidate genes. We show that CH is a genetically heterogeneous disease with high phenotypic variation and incomplete penetrance, and our results support the need for further gene discovery for CH. Identifying population-specific pathogenic variants will improve the capacity of genetic data to predict eventual clinical outcomes.
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Affiliation(s)
- Sebastian Alexis Vishnopolska
- Instituto de Biociencias, Biotecnología y Biología Traslacional (IB3), Departamento de Fisiología, Biología Molecular y Celular, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad de Buenos Aires,Argentina
- Instituto de Química Biología en Exactas y Naturales (IQUIBICEN-CONICET), Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad de Buenos Aires,Argentina
| | - Maria Florencia Mercogliano
- Instituto de Química Biología en Exactas y Naturales (IQUIBICEN-CONICET), Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad de Buenos Aires,Argentina
| | - Maria Andrea Camilletti
- Instituto de Biociencias, Biotecnología y Biología Traslacional (IB3), Departamento de Fisiología, Biología Molecular y Celular, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad de Buenos Aires,Argentina
- Instituto de Química Biología en Exactas y Naturales (IQUIBICEN-CONICET), Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad de Buenos Aires,Argentina
| | - Amanda Helen Mortensen
- Deptartment of Human Genetics, University of Michigan Medical School, Ann Arbor, MI 48198-5618, USA
| | - Debora Braslavsky
- Centro de Investigaciones Endocrinológicas “Dr. César Bergadá,” (CEDIE), FEI – CONICET – División de Endocrinología, Hospital de Niños Ricardo Gutiérrez, Ciudad de Buenos Aires, C1425EFD, Argentina
| | - Ana Keselman
- Centro de Investigaciones Endocrinológicas “Dr. César Bergadá,” (CEDIE), FEI – CONICET – División de Endocrinología, Hospital de Niños Ricardo Gutiérrez, Ciudad de Buenos Aires, C1425EFD, Argentina
| | - Ignacio Bergadá
- Centro de Investigaciones Endocrinológicas “Dr. César Bergadá,” (CEDIE), FEI – CONICET – División de Endocrinología, Hospital de Niños Ricardo Gutiérrez, Ciudad de Buenos Aires, C1425EFD, Argentina
| | - Federico Olivieri
- Instituto de Química Biología en Exactas y Naturales (IQUIBICEN-CONICET), Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad de Buenos Aires,Argentina
| | - Lucas Miranda
- Instituto de Química Biología en Exactas y Naturales (IQUIBICEN-CONICET), Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad de Buenos Aires,Argentina
| | - Roxana Marino
- Servicio de Endocrinología, Hospital Garrahan, Ciudad de Buenos Aires, C1245, Argentina
| | - Pablo Ramírez
- Servicio de Endocrinología, Hospital Garrahan, Ciudad de Buenos Aires, C1245, Argentina
| | - Natalia Pérez Garrido
- Servicio de Endocrinología, Hospital Garrahan, Ciudad de Buenos Aires, C1245, Argentina
| | - Helen Patiño Mejia
- Servicio de Endocrinología, Hospital Garrahan, Ciudad de Buenos Aires, C1245, Argentina
| | - Marta Ciaccio
- Servicio de Endocrinología, Hospital Garrahan, Ciudad de Buenos Aires, C1245, Argentina
| | - Maria Isabel Di Palma
- Servicio de Endocrinología, Hospital Garrahan, Ciudad de Buenos Aires, C1245, Argentina
| | - Alicia Belgorosky
- Hospital de Pediatría Garrahan-CONICET, Ciudad de Buenos Aires, Argentina
| | - Marcelo Adrian Martí
- Instituto de Química Biología en Exactas y Naturales (IQUIBICEN-CONICET), Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad de Buenos Aires,Argentina
| | - Jacob Otto Kitzman
- Deptartment of Human Genetics, University of Michigan Medical School, Ann Arbor, MI 48198-5618, USA
| | - Sally Ann Camper
- Deptartment of Human Genetics, University of Michigan Medical School, Ann Arbor, MI 48198-5618, USA
- Correspondence: Sally A. Camper, PhD, University of Michigan Medical School, Ann Arbor, MI 48198-5618, United States. E-mail: ; or Maria Ines Perez-Millan, PhD, University of Buenos Aires, Buenos Aires, C1428EHA, Argentina. E-mail:
| | - Maria Ines Pérez-Millán
- Instituto de Biociencias, Biotecnología y Biología Traslacional (IB3), Departamento de Fisiología, Biología Molecular y Celular, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad de Buenos Aires,Argentina
- Correspondence: Sally A. Camper, PhD, University of Michigan Medical School, Ann Arbor, MI 48198-5618, United States. E-mail: ; or Maria Ines Perez-Millan, PhD, University of Buenos Aires, Buenos Aires, C1428EHA, Argentina. E-mail:
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48
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Armijo G, Puentes Á, Ceballos A, Quezada M, Tamayo C, Donoso H, Ramírez P, Backhouse C, Nombela-Franco L. [Percutaneous implantation of an aortic prosthetic valve on a degenerated mitral bioprosthesis. Report of one case]. Rev Med Chil 2021; 149:137-141. [PMID: 34106146 DOI: 10.4067/s0034-98872021000100137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/16/2020] [Indexed: 11/17/2022]
Abstract
Reintervention of a mitral degenerated bioprosthesis has a high surgical risk, especially in elderly patients with multiple comorbidities. We report a 74 years old female with two previous cardiac surgical procedures and a new structural mitral bioprosthesis deterioration with severe mitral regurgitation. Considering her high-surgical risk, a fully percutaneous treatment was performed with a balloon-expandable aortic valve in mitral position (valve-in-valve) through a transseptal approach with a favorable outcome. This technique is an attractive and effective option with a relatively low rate of complications that could solve this challenging and complex disease.
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Affiliation(s)
- Germán Armijo
- Centro de Enfermedades Cardiovasculares, Hospital San Juan de Dios, Santiago, Chile
| | - Ángel Puentes
- Centro de Enfermedades Cardiovasculares, Hospital San Juan de Dios, Santiago, Chile
| | - Alejandro Ceballos
- Centro de Enfermedades Cardiovasculares, Hospital San Juan de Dios, Santiago, Chile
| | - Mauricio Quezada
- Centro de Enfermedades Cardiovasculares, Hospital San Juan de Dios, Santiago, Chile
| | - Carlos Tamayo
- Centro de Enfermedades Cardiovasculares, Hospital San Juan de Dios, Santiago, Chile
| | - Hernán Donoso
- Centro de Enfermedades Cardiovasculares, Hospital San Juan de Dios, Santiago, Chile
| | - Pablo Ramírez
- Centro de Enfermedades Cardiovasculares, Hospital San Juan de Dios, Santiago, Chile
| | - Christian Backhouse
- Centro de Enfermedades Cardiovasculares, Hospital San Juan de Dios, Santiago, Chile
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Sarmiento M, Rojas P, Triantafilo N, Campbell J, García MJ, Ocqueteau M, Sandoval V, Rojas A, Gazmuri JT, Guerrero G, Vergara M, Bertin P, Ramírez P, Jara V, Gutiérrez C, Soto K, Arellano S, Pizarro I, Lorca C. [Age does not affect the outcome of allogeneic hematopoietic precursor transplantation for acute myeloid leukemia]. Rev Med Chil 2021; 149:22-29. [PMID: 34106132 DOI: 10.4067/s0034-98872021000100022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 11/23/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND In our country, transplantation centers differ in the age limit for allogeneic hematopoietic transplantation (ALOHT). In our program, transplants with age- adjusted conditioning are performed in patients until 70 years old. Currently more than 60% of ALOHT reported to the Center for International Bone Marrow Transplantation Research (CIBMTR) are performed in patients older than 40 years. AIM To report our experience with ALOHT in acute myelogenous leukemia (AML), analyzing patient age at transplantation in different periods and transplant results in different age groups. MATERIAL AND METHODS A retrospective analysis of the database of adult hematopoietic transplants in AML patients was performed. Demographic data, disease characteristics, transplant data, survival and relapse times, and mortality were collected. RESULTS In our program, 1030 transplants were performed in adults and 119 ALOHT were performed in AML patients, between 1990 and 2020. The median age of patients in all periods was 41 years, (range 16-69). The median age was 33 and 45 years, in the periods 1990-2000 and 2000-2020 respectively (p < 0.01). Seventy-eight patients received myeloablative conditioning (median age 44 years) and 41 reduced intensity conditioning (median age 53 years). Five-year overall survival was 44.6% (confidence intervals (CI) 41-48). Non relapse mortality of all periods was 19% (CI 17 - 40%) and relapse rate was 17 % (CI 16-22). No difference in five years overall survival among patients younger than 40, 41 to 50 and over 51 years was observed. CONCLUSIONS Overall Survival, non-relapse mortality and relapse rate were similar in younger and older patients in our program and similar to those previously reported in other centers.
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Affiliation(s)
- Mauricio Sarmiento
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Patricio Rojas
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicolás Triantafilo
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - James Campbell
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - María José García
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Ocqueteau
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Vicente Sandoval
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrés Rojas
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - José Tomás Gazmuri
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gonzalo Guerrero
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maximiliano Vergara
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Bertin
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Ramírez
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Verónica Jara
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Catherine Gutiérrez
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Katherine Soto
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Silvana Arellano
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Isabel Pizarro
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carla Lorca
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Llinares R, Ramírez P, Carmona JA, Trujillo-Cayado LA, Muñoz J. Assessment of Fennel Oil Microfluidized Nanoemulsions Stabilization by Advanced Performance Xanthan Gum. Foods 2021; 10:foods10040693. [PMID: 33805109 PMCID: PMC8064095 DOI: 10.3390/foods10040693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/18/2021] [Accepted: 03/20/2021] [Indexed: 12/03/2022] Open
Abstract
In this work, nanoemulsion-based delivery system was developed by encapsulation of fennel essential oil. A response surface methodology was used to study the influence of the processing conditions in order to obtain monomodal nanoemulsions of fennel essential oil using the microchannel homogenization technique. Results showed that it was possible to obtain nanoemulsions with very narrow monomodal distributions that were homogeneous over the whole observation period (three months) when the appropriate mechanical energy was supplied by microfluidization at 14 MPa and 12 passes. Once the optimal processing condition was established, nanoemulsions were formulated with advanced performance xanthan gum, which was used as both viscosity modifier and emulsion stabilizer. As a result, more desirable results with enhanced physical stability and rheological properties were obtained. From the study of mechanical spectra as a function of aging time, the stability of the nanoemulsions weak gels was confirmed. The mechanical spectra as a function of hydrocolloid concentration revealed that the rheological properties are marked by the biopolymer network and could be modulated depending on the amount of added gum. Therefore, this research supports the role of advanced performance xanthan gum as a stabilizer of microfluidized fennel oil-in-water nanoemulsions. In addition, the results of this research could be useful to design and formulate functional oil-in-water nanoemulsions with potential application in the food industry for the delivery of nutraceuticals and antimicrobials.
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Affiliation(s)
- Rubén Llinares
- Departamento de Ingeniería Química, Facultad de Química, Universidad de Sevilla c/P, García González, 1, E41012 Sevilla, Spain; (R.L.); (P.R.); (J.A.C.); (J.M.)
| | - Pablo Ramírez
- Departamento de Ingeniería Química, Facultad de Química, Universidad de Sevilla c/P, García González, 1, E41012 Sevilla, Spain; (R.L.); (P.R.); (J.A.C.); (J.M.)
| | - José Antonio Carmona
- Departamento de Ingeniería Química, Facultad de Química, Universidad de Sevilla c/P, García González, 1, E41012 Sevilla, Spain; (R.L.); (P.R.); (J.A.C.); (J.M.)
| | - Luis Alfonso Trujillo-Cayado
- Departamento de Ingeniería Química, Escuela Politécnica Superior, Universidad de Sevilla c/Virgen de África, 7, E41011 Sevilla, Spain
- Correspondence: ; Tel.: +34-95-455-28-45
| | - José Muñoz
- Departamento de Ingeniería Química, Facultad de Química, Universidad de Sevilla c/P, García González, 1, E41012 Sevilla, Spain; (R.L.); (P.R.); (J.A.C.); (J.M.)
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