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Nagore D, Candela A, Bürge M, Tamayo E, Murie-Fernández M, Vives M, Monedero P, Álvarez J, Mendez E, Pasqualetto A, Mon T, Pita R, Varela MA, Esteva C, Pereira MA, Sanchez J, Rodriguez MA, Garcia A, Carmona P, López M, Pajares A, Vicente R, Aparicio R, Gragera I, Calderón E, Marcos JM, Gómez L, Rodríguez JM, Matilla A, Medina A, Hernández A, Morales L, Santana L, Garcia E, Montesinos S, Muñoz P, Bravo B, Alvarez J, Blanco V. Uric Acid and acute kidney injury in high-risk patients for developing Acute Kidney Injury undergoing cardiac surgery: a prospective multicenter study. Rev Esp Anestesiol Reanim (Engl Ed) 2024:S2341-1929(24)00094-5. [PMID: 38704092 DOI: 10.1016/j.redare.2024.04.019] [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] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/06/2023] [Accepted: 09/20/2023] [Indexed: 05/06/2024]
Abstract
PURPOSE It is unclear whether preoperative serum uric acid (SUA) elevation may play a role in the development of acute kidney injury (AKI) associated with cardiac surgery (CSA-AKI). We conducted a cohort study to evaluate the influence of preoperative hyperuricemia on AKI in patients at high risk for developing SC-AKI. DESIGN Multicenter prospective international cohort study. SETTING Fourteen university hospitals in Spain and the United Kingdom. PARTICIPANTS We studied 261 consecutive patients at high risk of developing CSA-AKI, according to a Cleveland score ≥4 points, from July to December 2017. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS AKIN criteria were used for the definition of AKI. Multivariable logistic regression models and propensity score-matched pairwise analysis were used to determine the adjusted association between preoperative hyperuricemia (≥7 mg/dL) and AKI. Elevated preoperative AUS (≥7 mg/dL) was present in 190 patients (72.8%), whereas CSA-AKI occurred in 145 patients (55.5%). In multivariable logistic regression models, hyperuricemia was not associated with a significantly increased risk of AKI (adjusted Odds Ratio [OR]: 1.58; 95% confidence interval [CI]: 0.81-3; p = 0.17). In propensity score-matched analysis of 140 patients, the hyperuricemia group experienced similar adjusted odds of AKI (OR 1.05, 95%CI 0.93-1.19, p = 0.37). CONCLUSIONS Hyperuricemia was not associated with an increased risk of AKI in this cohort of patients undergoing cardiac surgery at high risk of developing CSA-AKI.
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Affiliation(s)
- D Nagore
- Departamento de Anestesia y Medicina Perioperatoria, Grupo Quirón - Policlínica Guipúzcoa, San Sebastián, Spain; Departamento de Anestesiología y Medicina Perioperatoria, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - A Candela
- Departamento de Anestesia y Medicina Perioperatoria, Grupo Quirón - Policlínica Guipúzcoa, San Sebastián, Spain; Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - M Bürge
- Departamento de Anestesia y Medicina Perioperatoria, Barts Heart Centre, St Bartholomew's Hospital, Londres, UK
| | - E Tamayo
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - M Vives
- Departamento de Anestesiología & Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, Spain; Departamento de Anestesiología y Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, Spain.
| | - P Monedero
- Departamento de Anestesiología & Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, Spain
| | - J Álvarez
- Departamento de Anestesiología y Medicina Perioperatoria, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - E Mendez
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Pasqualetto
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - T Mon
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - R Pita
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Alvaro Cunqueiro Vigo, Vigo, Spain
| | - M A Varela
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Alvaro Cunqueiro Vigo, Vigo, Spain
| | - C Esteva
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Alvaro Cunqueiro Vigo, Vigo, Spain
| | - M A Pereira
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Alvaro Cunqueiro Vigo, Vigo, Spain
| | - J Sanchez
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - M A Rodriguez
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - A Garcia
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - P Carmona
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - M López
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - A Pajares
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - R Vicente
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - R Aparicio
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - I Gragera
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Infanta Cristina, Badajoz, Spain
| | - E Calderón
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario Puerta de Mar, Cádiz, Spain
| | - J M Marcos
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario de León, León, Spain
| | - L Gómez
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - J M Rodríguez
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario de Salamanca, Salamanca, Spain
| | - A Matilla
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario de Salamanca, Salamanca, Spain
| | - A Medina
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario de Málaga, Málaga, Spain
| | - A Hernández
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Policlínica Ibiza, Ibiza, Spain
| | - L Morales
- Servicio de Anestesiología y Medicina Perioperatoria, Hospital Universitario Dr, Negrín, Las Palmas de Gran Canaria, Spain
| | - L Santana
- Servicio de Anestesiología y Medicina Perioperatoria, Hospital Universitario Dr, Negrín, Las Palmas de Gran Canaria, Spain
| | - E Garcia
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - S Montesinos
- Departamento de Anestesiología y Medicina Perioperatoria, Centro Médico Teknon Barcelona, Barcelona, Spain
| | - P Muñoz
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital 12 de octubre, Madrid, Spain
| | - B Bravo
- Servicio de Anestesiología y Medicina Perioperatoria, Hospital de Cruces de Bizkaia, Bilbao, Spain
| | - Julian Alvarez
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | - V Blanco
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario Virgen de la Macarena, Sevilla, Spain
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Salmanton-García J, Bruns C, Rutz J, Albertsmeier M, Ankert J, Bernard L, Bataille C, Couvé-Deacon E, Fernández-Ferrer M, Fortún J, Galar A, Grill E, Guimard T, Classen AY, Vehreschild JJ, Stemler J, Naendrup JH, Hampl J, Tallon B, Sprute R, Horcajada JP, Mollar-Maseres J, Muñoz P, Pletz MW, Serracino-Inglott F, Soriano A, Vilz TO, Seifert H, Cornely OA, Mellinghoff SC, Liss BJ, Wingen-Heimann SM. Costs and resource utilization patterns in surgical site infections: a pre-COVID-19 perspective from France, Germany, Spain, and the UK. J Hosp Infect 2024; 147:123-132. [PMID: 38467251 DOI: 10.1016/j.jhin.2024.02.019] [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: 12/15/2023] [Revised: 01/30/2024] [Accepted: 02/06/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Surgical site infections (SSIs), mainly caused by Staphylococcus aureus, pose a significant economic burden in Europe, leading to increased hospitalization duration, mortality, and treatment costs, particularly with drug-resistant strains such as meticillin-resistant S. aureus. AIM To conduct a case-control study on the economic impact of S. aureus SSI in adult surgical patients across high-volume centres in France, Germany, Spain, and the UK, aiming to assess the overall and procedure-specific burden across Europe. METHODS The SALT study is a multinational, retrospective cohort study with a nested case-control analysis focused on S. aureus SSI in Europe. The study included participants from France, Germany, Italy, Spain, and the UK who underwent invasive surgery in 2016 and employed a micro-costing approach to evaluate health economic factors, matching S. aureus SSI cases with controls. FINDINGS In 2016, among 178,904 surgical patients in five European countries, 764 developed S. aureus SSI. Matching 744 cases to controls, the study revealed that S. aureus SSI cases incurred higher immediate hospitalization costs (€8,810), compared to controls (€6,032). Additionally, S. aureus SSI cases exhibited increased costs for readmissions within the first year post surgery (€7,961.6 versus €5,298.6), with significant differences observed. Factors associated with increased surgery-related costs included the cost of hospitalization immediately after surgery, first intensive care unit (ICU) admission within 12 months, and hospital readmission within 12 months, as identified through multivariable analysis. CONCLUSION The higher rates of hospitalization, ICU admissions, and readmissions among S. aureus SSI cases highlight the severity of these infections and their impact on healthcare costs, emphasizing the potential benefits of evidence-based infection control measures and improved patient care to mitigate the economic burden.
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Affiliation(s)
- J Salmanton-García
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - C Bruns
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - J Rutz
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany
| | - M Albertsmeier
- Department of General, Visceral and Transplantation Surgery, LMU University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - J Ankert
- Institute of Infectious Diseases and Infection Control, University Hospital Jena, Jena, Germany
| | - L Bernard
- Service de Médecine Interne et Maladies Infectieuses, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - C Bataille
- INSERM, CHU Limoges, UMR 1092, Université Limoges, Limoges, France
| | - E Couvé-Deacon
- INSERM, CHU Limoges, UMR 1092, Université Limoges, Limoges, France
| | - M Fernández-Ferrer
- Hospital del Mar-IMIM, Universitat Pompeu Fabra, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, CIBERINFEC, Madrid, Spain
| | - J Fortún
- Ramón y Cajal University Hospital, CIBERINFEC, IRYCIS, Madrid, Spain
| | - A Galar
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - E Grill
- Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München (LMU), Munich, Germany
| | - T Guimard
- Service de Médecine Post-Urgence, CH Départemental de Vendée, La Roche Sur Yon, France
| | - A Y Classen
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - J J Vehreschild
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - J Stemler
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - J-H Naendrup
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - J Hampl
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - B Tallon
- Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - R Sprute
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - J P Horcajada
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, CIBERINFEC, Madrid, Spain; Hospital del Mar-IMIM, Universitat Pompeu Fabra, Barcelona, Spain
| | - J Mollar-Maseres
- Preventive Medicine Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - P Muñoz
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - M W Pletz
- Institute of Infectious Diseases and Infection Control, University Hospital Jena, Jena, Germany
| | | | - A Soriano
- Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, CIBERINFEC, Barcelona, Spain
| | - T O Vilz
- Klinik und Poliklinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Bonn, Venusberg Campus 1, Bonn, Germany
| | - H Seifert
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - O A Cornely
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - S C Mellinghoff
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
| | - B J Liss
- Department I of Internal Medicine, Helios University Hospital Wuppertal, Wuppertal, Germany; School of Medi-Cine, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - S M Wingen-Heimann
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; FOM University of Applied Sciences, Essen, Germany
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Belmonte A, Muñoz P, Romero D. Lead and cadmium in blood and tissues of Atlantic bluefin tuna (Thunnus thynnus L., 1758). Mar Pollut Bull 2024; 199:115993. [PMID: 38217913 DOI: 10.1016/j.marpolbul.2023.115993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/15/2024]
Abstract
Cadmium (Cd) and lead (Pb) levels in blood and tissues of Atlantic bluefin tuna were analysed to gather information regarding their distribution, accumulation and inter-relationships, as well as to examine how sex affects them. In the whole population, the concentration range was from below the detection limit (bone) to 8.512 μg g-1 (liver) for Cd, and from below detection limit (bone and gills) to 0.063 μg g-1 (kidney) for Pb. The median concentration in the muscles (0.008 and 0.029 μg g-1 for Cd and Pb, respectively) was 10 times less than the maximum permitted for consumption. Sex was shown to be an important variable affecting concentrations of Cd in both liver and kidneys, so taking into account sex when interpreting results is highly recommended. The importance of Cd and Pb bioaccumulation in fishery by-products, increasingly important in commercial circuits, is also highlighted.
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Affiliation(s)
- Antonio Belmonte
- TAXON Estudios Ambientales S.L., C/Uruguay s/n, 30820 Alcantarilla, Spain
| | - Pilar Muñoz
- Department of Animal Health, Regional Campus of International Excellence "Campus Mare Nostrum", Universidad de Murcia, 30100 Murcia, Spain.
| | - Diego Romero
- Toxicology Department, Regional Campus of International Excellence "Campus Mare Nostrum", Universidad de Murcia, 30100 Murcia, Spain
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Soriano-Martín A, Muñoz P, García-Rodríguez J, Cantón R, Vena A, Bassetti M, Bouza E. Unresolved issues in the diagnosis of catheter related candidemia: A position paper. Rev Esp Quimioter 2024; 37:1-16. [PMID: 37953593 PMCID: PMC10874659 DOI: 10.37201/req/112.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/04/2023] [Indexed: 11/14/2023]
Abstract
The incidence and recent trends of candidemia and the contribution of the COVID-19 pandemic to its evolution are not well documented. The catheter is a major focus of Candida spp. infections, but the methods used to confirm the origin of candidemia are still based on the data generated for bacterial infection. The presence of Candida spp. on the tip of a removed catheter is the gold standard for confirmation but it is not always possible to remove it. Conservative methods, without catheter removal, have not been specifically studied for microorganisms whose times of growth are different from those of bacteria and therefore these results are not applicable to candidemia. The different Candida species do not have a particular tropism for catheter colonization and fungal biomarkers have not yet been able to contribute to the determination of the origin of candidemia. Techniques such Candida T2 Magnetic Resonance (T2MR) has not yet been applied for this purpose. Finally, there is not yet a consensus of how to proceed when Candida spp. is isolated from an extracted catheter and blood cultures obtained from simultaneous peripheral veins are negative. In this lack of firm data, a group of experts has formulated a series of questions trying to answer them based on the literature, indicating the current deficiencies and offering their own opinion. All authors agree with the conclusions of the manuscript and offer it as a position and discussion paper.
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Affiliation(s)
- A Soriano-Martín
- Ana Soriano Martín, Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón. Calle Doctor Esquerdo 46, 28007 Madrid, Spain.
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Díaz-García J, Gómez A, Machado M, Alcalá L, Reigadas E, Sánchez-Carrillo C, Pérez-Ayala A, Gómez-García de la Pedrosa E, González-Romo F, Cuétara MS, García-Esteban C, Quiles-Melero I, Zurita ND, Muñoz-Algarra M, Durán-Valle MT, Sánchez-García A, Muñoz P, Escribano P, Guinea J. Non-Candida isolates from blood cultures and intra-abdominal samples: data derived from a multicentre prospective study conducted in Madrid. Rev Esp Quimioter 2023; 36:541-544. [PMID: 37355994 PMCID: PMC10586730 DOI: 10.37201/req/025.2023] [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] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/19/2023] [Accepted: 05/23/2023] [Indexed: 06/27/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - J Guinea
- Jesús Guinea, Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, C/ Dr. Esquerdo, 46, 28007 Madrid, Spain.
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Aguilera-Correa JJ, Salinas B, González-Arjona M, de Pablo D, Muñoz P, Bouza E, Fernández Aceñero MJ, Esteban J, Desco M, Cussó L. Positron Emission Tomography-Computed Tomography and Magnetic Resonance Imaging Assessments in a Mouse Model of Implant-Related Bone and Joint Staphylococcus aureus Infection. Microbiol Spectr 2023; 11:e0454022. [PMID: 37010409 PMCID: PMC10269916 DOI: 10.1128/spectrum.04540-22] [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: 11/07/2022] [Accepted: 03/04/2023] [Indexed: 04/04/2023] Open
Abstract
Osteomyelitis is an infection of the bone, associated with an inflammatory process. Imaging plays an important role in establishing the diagnosis and the most appropriate patient management. However, data are lacking regarding the use of preclinical molecular imaging techniques to assess osteomyelitis progression in experimental models. This study aimed to compare structural and molecular imaging to assess disease progression in a mouse model of implant-related bone and joint infections caused by Staphylococcus aureus. In SWISS mice, the right femur was implanted with a resorbable filament impregnated with S. aureus (infected group, n = 10) or sterile culture medium (uninfected group, n = 6). Eight animals (5 infected, 3 uninfected) were analyzed with magnetic resonance imaging (MRI) at 1, 2, and 3 weeks postintervention, and 8 mice were analyzed with [18F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)-computed tomography (CT) at 48 h and at 1, 2, and 3 weeks postintervention. In infected animals, CT showed bone lesion progression, mainly in the distal epiphysis, although some uninfected animals presented evident bone sequestra at 3 weeks. MRI showed a lesion in the articular area that persisted for 3 weeks in infected animals. This lesion was smaller and less evident in the uninfected group. At 48 h postintervention, FDG-PET showed higher joint uptake in the infected group than in the uninfected group (P = 0.025). Over time, the difference between groups increased. These results indicate that FDG-PET imaging was much more sensitive than MRI and CT for differentiating between infection and inflammation at early stages. FDG-PET clearly distinguished between infection and postsurgical bone healing (in uninfected animals) from 48 h to 3 weeks after implantation. IMPORTANCE Our results encourage future investigations on the utility of the model for testing different therapeutic procedures for osteomyelitis.
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Affiliation(s)
- J. J. Aguilera-Correa
- Departamento de Química en Ciencias Farmacéuticas. Universidad Complutense de Madrid, Madrid, Spain
- CIBERINFEC-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - B. Salinas
- Unidad de Medicina y Cirugía Experimenta, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Departamento de Bioingeniería, Universidad Carlos III de Madrid, Madrid, Spain
- Unidad de Imagen Avanzada, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III. Madrid, Spain
| | - M. González-Arjona
- Unidad de Medicina y Cirugía Experimenta, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Unidad de Imagen Avanzada, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
| | - D. de Pablo
- Servicio de Anatomía Patológica Hospital Clínico San Carlos, Fundación para la Investigación Biomédica HCSC, Madrid, Spain
| | - P. Muñoz
- Servicio de Microbiología y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Enfermedades Respiratorias, CIBERES, Madrid, Spain
| | - E. Bouza
- Servicio de Microbiología y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Enfermedades Respiratorias, CIBERES, Madrid, Spain
| | - M. J. Fernández Aceñero
- Servicio de Anatomía Patológica Hospital Clínico San Carlos, Fundación para la Investigación Biomédica HCSC, Madrid, Spain
| | - J. Esteban
- CIBERINFEC-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
- Clinical Microbiology Department, IIS-Fundacion Jimenez Diaz, UAM, Madrid, Spain
| | - M. Desco
- Unidad de Medicina y Cirugía Experimenta, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Departamento de Bioingeniería, Universidad Carlos III de Madrid, Madrid, Spain
- Unidad de Imagen Avanzada, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III. Madrid, Spain
| | - L. Cussó
- Unidad de Medicina y Cirugía Experimenta, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Unidad de Imagen Avanzada, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III. Madrid, Spain
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7
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Ruiz de Ybáñez MR, Del Río L, Flores-Flores C, Muñoz P, Berriatua E, Rubio S, Martínez-Carrasco C. Monitoring for Anguillicoloides crassus, Anguillid herpesvirus 1, aquabirnavirus EVE and rhabdovirus EVEX in the European eel population of southern Spain. J Fish Dis 2023; 46:417-431. [PMID: 36651585 DOI: 10.1111/jfd.13754] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 12/23/2022] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
European eel is critically endangered in Europe. Among other stressors, pathogens are well-known to harm eels' fitness. One hundred and eighty-two eels were captured in three Eel Management Units in Andalucía (SE Spain) and analysed for Anguillicoloides crassus, Anguillid herpesvirus 1 (AngHV1), the rhabdovirus Eel Virus European X (EVEX) and the aquabirnavirus Eel Virus European (EVE). A. crassus adults and preadults were isolated and morphometrically identified, and the eel swimbladders were artificially digested to count A. crassus larvae. Also, eel tissues were examined by PCRs for the presence of viruses. EVEX and EVE were not detected in any of the eels. The estimated prevalence (95% confidence limits) was 71 (64-78)% for A. crassus and 35 (28-42)% for AngHV-1, varying these prevalences significantly between and within EMUs. Moreover, A. crassus prevalence was highest in smaller eels, in sites closest to the sea and eels sampled in the autumn. By contrast, AngHV-1 prevalence was highest in biggest eels, in sites far from the sea and sampled in the summer or winter. However, in mixed effects logistic models including site as a random variable, the risk of infection was associated with distance to the sea in both A. crassus and AngHV-1 infections and also to winter sampling in the case of AngHV-1 and not to other variables. These results are evidence that both pathogens are highly endemic in eels from Andalusian habitats. Further studies are needed to better understand the risk factors associated with these pathogens on eel populations.
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Affiliation(s)
- M Rocío Ruiz de Ybáñez
- Departamento de Sanidad Animal, Facultad de Veterinaria, Campus de Excelencia Internacional Regional "Campus Mare Nostrum", Universidad de Murcia, Murcia, Spain
| | - Laura Del Río
- Departamento de Sanidad Animal, Facultad de Veterinaria, Campus de Excelencia Internacional Regional "Campus Mare Nostrum", Universidad de Murcia, Murcia, Spain
| | - César Flores-Flores
- Sección de Biología Molecular, Área Científica y Técnica de Investigación, Universidad de Murcia, Murcia, Spain
| | - Pilar Muñoz
- Departamento de Sanidad Animal, Facultad de Veterinaria, Campus de Excelencia Internacional Regional "Campus Mare Nostrum", Universidad de Murcia, Murcia, Spain
| | - Eduardo Berriatua
- Departamento de Sanidad Animal, Facultad de Veterinaria, Campus de Excelencia Internacional Regional "Campus Mare Nostrum", Universidad de Murcia, Murcia, Spain
| | - Silvia Rubio
- Planificación Cinegética y Piscícola, Agencia de Medio Ambiente y Agua, Junta de Andalucía, Granada, Spain
| | - Carlos Martínez-Carrasco
- Departamento de Sanidad Animal, Facultad de Veterinaria, Campus de Excelencia Internacional Regional "Campus Mare Nostrum", Universidad de Murcia, Murcia, Spain
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8
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Cobos A, Valerio M, Palomo M, Adán I, Catalán P, Veintimilla C, López-Andújar F, Rincón C, Galar A, Alonso R, Machado M, Gijón P, Aldámiz-Echevarría Lois T, Pérez Latorre L, Diez C, Fanciulli C, Bouza Santiago E, Muñoz P. Demographic, clinical and microbiological characteristics of the first 30 human monkeypox confirmed cases attended in a tertiary hospital in Madrid (Spain), during the May-June 2022 international outbreak. Rev Esp Quimioter 2023; 36:194-200. [PMID: 36651283 PMCID: PMC10066919 DOI: 10.37201/req/112.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The present outbreak of Human Monkeypox (HMPX) that has begun in May 2022 and has spread across all continents in less than two months has qualitative and quantitative characteristics that make it different from the pattern of human disease previously caused by this virus. It has spread with enormous ease, affects almost exclusively adults, behaves as a sexually transmitted disease and focuses on very specific groups and transmission conditions. The high incidence in the city of Madrid in males that have sex with males (MSM) has allowed us to observe and report the experience with the first 30 cases diagnosed in our institution. Patients presented with febrile symptoms, genital and paragenital skin lesions reminiscent of smallpox, but less extensive and severe. The disease may also cause proctitis, pharyngitis and perioral lesions. The PCR test for diagnostic confirmation has been shown to be very sensitive and effective, not only in skin lesions but also in blood and other fluids such as pharyngeal, rectal exudates and blood. A very high proportion of patients with HMPX also have other sexually transmitted diseases that must be actively detected in this context. The spontaneous evolution of our patients has been good and hospitalization has been practically unnecessary. Transmission to non-sexual cohabitants and health personnel has been nonexistent and the lesions have disappeared in less than 30 days without leaving sequelae and no need for specific antiviral treatment.
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Affiliation(s)
| | - M Valerio
- Maricela Valerio. Professor of School of Medicine, Universidad Complutense de Madrid, Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo 46, 28007 Madrid, Spain.
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9
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Bouza E, García Navarro JA, Alonso S, Duran Alonso JC, Escobar C, Fontecha Gómez BJ, Galvá Borrás MI, García Rojas AJ, Gómez Pavón FJ, Gracia D, Gutiérrez Rodríguez J, Kestler M, Martínez Cuervo F, Martín Sánchez FJ, Melero C, Escobar C, Menéndez Villanueva R, Muñoz P, Palomo E, Pérez-Castejón Garrote JM, Serra Rexach JA, Santaeugenia SJ, Tarazona Santabalbina FJ, Vidán Astiz MT. Infection control in long term care institutions for the elderly: A reflection document on the situation in Spain. Rev Esp Quimioter 2023. [PMID: 36987393 DOI: 10.37201/req/002.2023] [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] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
A progressively increasing percentage of the elderly live during the last years of their lives in nursing homes. Although these institutions are intended to mimic life at home as much as possible, they have characteristics that make them quite similar to a “nosocomiun”, i.e. an establishment for the treatment of the sick. The very coexistence among the elderly, the fact of sharing caregivers and the very significant exposure to third parties, together with the frequent predisposing diseases to infection in this population, make infection frequent among residents and also easily transmissible. This leads us to ask what can be done to prevent infection in this environment and more specifically what is the state of the art of the matter in a Western European nation such as ours. The Board of Trustees of the Health Sciences Foundation has asked itself a series of questions on the subject of infection prevention in Nursing Homes, the structure of procedures, the legislation available, compliance with the measures indicated, the best indicators of the processes and therefore, the need to promote in Spain a document of recommendations to avoid infections in this poplation whose morbidity and mortality need not be highlighted. To this end, a multidisciplinary group of experts in different aspects of this problem has been convened and asked the proposed questions. The questions were discussed by the group as a whole and led to a series of conclusions agreed upon by the participants. The results of the meeting are reported below.
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Affiliation(s)
- E Bouza
- Emilio Bouza, Instituto de Investigación Sanitaria Gregorio Marañón. C/ Dr. Esquerdo, 46 - 28007 Madrid, Spain.
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10
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Muñoz P, Castillejo C, Gómez JA, Miranda L, Lesemann S, Olbricht K, Petit A, Chartier P, Haugeneder A, Trinkl J, Mazzoni L, Masny A, Zurawicz E, Ziegler FMR, Usadel B, Schwab W, Denoyes B, Mezzetti B, Osorio S, Sánchez-Sevilla JF, Amaya I. QTL analysis for ascorbic acid content in strawberry fruit reveals a complex genetic architecture and association with GDP-L-galactose phosphorylase. Hortic Res 2023; 10:uhad006. [PMID: 36938573 PMCID: PMC10022485 DOI: 10.1093/hr/uhad006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/10/2023] [Indexed: 06/18/2023]
Abstract
Strawberry (Fragaria × ananassa) fruits are an excellent source of L-ascorbic acid (AsA), a powerful antioxidant for plants and humans. Identifying the genetic components underlying AsA accumulation is crucial for enhancing strawberry nutritional quality. Here, we unravel the genetic architecture of AsA accumulation using an F1 population derived from parental lines 'Candonga' and 'Senga Sengana', adapted to distinct Southern and Northern European areas. To account for environmental effects, the F1 and parental lines were grown and phenotyped in five locations across Europe (France, Germany, Italy, Poland and Spain). Fruit AsA content displayed normal distribution typical of quantitative traits and ranged five-fold, with significant differences among genotypes and environments. AsA content in each country and the average in all of them was used in combination with 6,974 markers for quantitative trait locus (QTL) analysis. Environmentally stable QTLs for AsA content were detected in linkage group (LG) 3A, LG 5A, LG 5B, LG 6B and LG 7C. Candidate genes were identified within stable QTL intervals and expression analysis in lines with contrasting AsA content suggested that GDP-L-Galactose Phosphorylase FaGGP(3A), and the chloroplast-located AsA transporter gene FaPHT4;4(7C) might be the underlying genetic factors for QTLs on LG 3A and 7C, respectively. We show that recessive alleles of FaGGP(3A) inherited from both parental lines increase fruit AsA content. Furthermore, expression of FaGGP(3A) was two-fold higher in lines with high AsA. Markers here identified represent a useful resource for efficient selection of new strawberry cultivars with increased AsA content.
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Affiliation(s)
- Pilar Muñoz
- Centro IFAPA de Málaga, Instituto Andaluz de Investigación y Formación Agraria y Pesquera (IFAPA), 29140, Málaga, Spain
- PhD program in Advanced Biotechnology, Universidad de Málaga, 29071, Málaga, Spain
| | - Cristina Castillejo
- Centro IFAPA de Málaga, Instituto Andaluz de Investigación y Formación Agraria y Pesquera (IFAPA), 29140, Málaga, Spain
| | | | - Luis Miranda
- Finca el Cebollar, Centro IFAPA las Torres, 04745, Huelva, Spain
| | | | | | | | | | - Annika Haugeneder
- Biotechnology of Natural Products, Technische Universität München, 85354, Freising, Germany
| | - Johanna Trinkl
- Biotechnology of Natural Products, Technische Universität München, 85354, Freising, Germany
| | - Luca Mazzoni
- Dipartimento di Scienze Agrarie, Alimentari e Ambientali, Università Politecnica delle Marche, 60131, Ancona, Italy
| | - Agnieszka Masny
- Department of Horticultural Crop Breeding, the National Institute of Horticultural Research, Konstytucji 3 Maja 1/3, 96-100, Skierniewice, Poland
| | | | | | - Björn Usadel
- Institute of Bio- and Geosciences, Bioinformatics (IBG-4), Forschungszentrum Jülich GmbH, 52428, Jülich, Germany
| | - Wilfried Schwab
- Biotechnology of Natural Products, Technische Universität München, 85354, Freising, Germany
| | - Béatrice Denoyes
- Univ. Bordeaux, INRAE, Biologie du Fruit et Pathologie, UMR 1332, F-33140, France
| | - Bruno Mezzetti
- Dipartimento di Scienze Agrarie, Alimentari e Ambientali, Università Politecnica delle Marche, 60131, Ancona, Italy
| | - Sonia Osorio
- Departamento de Biología Molecular y Bioquímica, Instituto de Hortofruticultura Subtropical y Mediterránea "La Mayora", Universidad de Málaga-Consejo Superior de Investigaciones Científicas, Campus de Teatinos, 29071 Málaga, Spain
- Unidad Asociada de I+D+i IFAPA-CSIC Biotecnología y Mejora en Fresa, 29010, Málaga, Spain
| | - José F Sánchez-Sevilla
- Centro IFAPA de Málaga, Instituto Andaluz de Investigación y Formación Agraria y Pesquera (IFAPA), 29140, Málaga, Spain
- Unidad Asociada de I+D+i IFAPA-CSIC Biotecnología y Mejora en Fresa, 29010, Málaga, Spain
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11
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Tristán-Manzano M, Maldonado-Pérez N, Justicia-Lirio P, Cortijo-Gutierréz M, Tristán-Ramos P, Blanco-Benítez C, Pavlovic K, Aguilar-González A, Muñoz P, Molina-Estevez FJ, Griesche V, Marchal JA, Heras SR, Benabdellah K, Martin F. Lentiviral vectors for the generation of inducible, transactivator-free Advanced Therapy Medicinal Products: application to CAR-T cells. Molecular Therapy - Nucleic Acids 2023; 32:322-339. [PMID: 37125150 PMCID: PMC10141506 DOI: 10.1016/j.omtn.2023.03.018] [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] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/23/2023] [Indexed: 03/30/2023]
Abstract
Controlling transgene expression through an externally administered inductor is envisioned as a potent strategy to improve safety and efficacy of gene therapy approaches. Generally, inducible ON systems require a chimeric transcription factor (transactivator) that becomes activated by an inductor, which is not optimal for clinical translation due to their toxicity. We generated previously the first all-in-one, transactivator-free, doxycycline (Dox)-responsive (Lent-On-Plus or LOP) lentiviral vectors (LVs) able to control transgene expression in human stem cells. Here, we have generated new versions of the LOP LVs and have analyzed their applicability for the generation of inducible advanced therapy medicinal products (ATMPs) with special focus on primary human T cells. We have shown that, contrary to all other cell types analyzed, an Is2 insulator must be inserted into the 3' long terminal repeat of the LOP LVs in order to control transgene expression in human primary T cells. Importantly, inducible primary T cells generated by the LOPIs2 LVs are responsive to ultralow doses of Dox and have no changes in phenotype or function compared with untransduced T cells. We validated the LOPIs2 system by generating inducible CAR-T cells that selectively kill CD19+ cells in the presence of Dox. In summary, we describe here the first transactivator-free, all-one-one system capable of generating Dox-inducible ATMPs.
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Affiliation(s)
- María Tristán-Manzano
- LentiStem Biotech, Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
| | - Noelia Maldonado-Pérez
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Av. de la Ilustración 114, 18016 Granada, Spain
- Departamento de Bioquimica y Biología Molecular III e Inmunologia, Facultad de Medicina, Universidad de Granada, PTS Granada – Avenida de la Investigación, 11, 18006 Granada, Spain
| | - Pedro Justicia-Lirio
- LentiStem Biotech, Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Av. de la Ilustración 114, 18016 Granada, Spain
| | - Marina Cortijo-Gutierréz
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Av. de la Ilustración 114, 18016 Granada, Spain
| | - Pablo Tristán-Ramos
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Av. de la Ilustración 114, 18016 Granada, Spain
- Department de Bioquimica y Biología Molecular II, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja, 18071 Granada, Spain
| | - Carlos Blanco-Benítez
- LentiStem Biotech, Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Av. de la Ilustración 114, 18016 Granada, Spain
| | - Kristina Pavlovic
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Av. de la Ilustración 114, 18016 Granada, Spain
- Maimonides Institute of Biomedical Research in Cordoba (IMIBIC), Cellular Therapy Unit, Reina Sofía University Hospital, University of Cordoba, Cordoba, Spain
| | - Araceli Aguilar-González
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Av. de la Ilustración 114, 18016 Granada, Spain
- Department of Medicinal & Organic Chemistry and Excellence Research Unit of “Chemistry Applied to Biomedicine and the Environment”, Faculty of Pharmacy, University of Granada, Campus de Cartuja s/n, 18071 Granada, Spain
| | - Pilar Muñoz
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Av. de la Ilustración 114, 18016 Granada, Spain
- Department de Biología Celular, Facultad de Ciencias, Universidad de Granada, Campus Fuentenueva, 18071 Granada, Spain
| | - Francisco J. Molina-Estevez
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Av. de la Ilustración 114, 18016 Granada, Spain
| | - Valerie Griesche
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Av. de la Ilustración 114, 18016 Granada, Spain
- DKFZ. German Cancer Research Center, Heidelberg, Baden-Wurtemberg, Germany
| | - Juan Antonio Marchal
- Instituto de Investigación Biosanitaria ibs.GRANADA, University Hospitals of Granada – University of Granada, 18016 Granada, Spain
- Excellence Research Unit “Modeling Nature” (MNat), University of Granada, 18016 Granada, Spain
- Biopathology and Regenerative Medicine Institute (IBIMER), Center for Biomedicinal Research (CIBM), University of Granada, 18016 Granada, Spain
- Department of Human Anatomy and Embryology, Faculty of Medicine, University of Granada, Biosanitary Research Institute of Granada (ibs.GRANADA), Granada, Spain
| | - Sara R. Heras
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Av. de la Ilustración 114, 18016 Granada, Spain
- Department de Bioquimica y Biología Molecular II, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja, 18071 Granada, Spain
| | - Karim Benabdellah
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Av. de la Ilustración 114, 18016 Granada, Spain
| | - Francisco Martin
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Av. de la Ilustración 114, 18016 Granada, Spain
- Departamento de Bioquimica y Biología Molecular III e Inmunologia, Facultad de Medicina, Universidad de Granada, PTS Granada – Avenida de la Investigación, 11, 18006 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, University Hospitals of Granada – University of Granada, 18016 Granada, Spain
- Excellence Research Unit “Modeling Nature” (MNat), University of Granada, 18016 Granada, Spain
- Corresponding author: Francisco Martin, Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Av. de la Ilustración 114, 18016 Granada, Spain.
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12
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Hernanz F, Martínez P, Jimeno J, Paz L, Muñoz P. Long-term outcomes of bilateral breast reduction in women with obesity and symptomatic macromastia. A cohort study. J Plast Reconstr Aesthet Surg 2023; 76:133-135. [PMID: 36516503 DOI: 10.1016/j.bjps.2022.11.050] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022]
Affiliation(s)
- F Hernanz
- Breast Unit. Hospital Valdecilla, University of Cantabria, Avd. Valdecilla sn, Santander 39008, Spain.
| | - P Martínez
- Breast Unit. Hospital Valdecilla, University of Cantabria, Avd. Valdecilla sn, Santander 39008, Spain
| | - J Jimeno
- Breast Unit. Hospital Valdecilla, University of Cantabria, Avd. Valdecilla sn, Santander 39008, Spain
| | - L Paz
- Breast Unit. Hospital Valdecilla, University of Cantabria, Avd. Valdecilla sn, Santander 39008, Spain
| | - P Muñoz
- Servicio Cántabro de Salud (SCS), Cantabria, Spain
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13
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Hidalgo-Tenorio C, Sadyrbaeva S, Enríquez-Gómez A, Muñoz P, Plata Ciezar A, Miró Meda J, Alarcón A, Martínez Marcos F, Loheches B, Eschiruela-Vidal F, Vinuesa D, Herrero C, Badia Martí C, Arenas M, García Vázquez E, Fariñas M, Pasquau J. COHORTE EN-DALBACEN 2.0: DALBAVANCINA COMO TRATAMIENTO ANTIBIÓTICO DE CONSOLIDACIÓN DE EI POR COCOS GRAM POSITIVOS. Cirugía Cardiovascular 2023. [DOI: 10.1016/j.circv.2022.12.020] [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: 02/15/2023] Open
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14
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Tripodoro VA, Llanos V, Daud ML, Muñoz P, Del Mar E, Tranier R, Sandjian S, De Lellis S, Días JM, Saurí Á, De Simone GG, Gómez-Batiste X. New embracing approach for better advanced cancer patient comprehensive care. Medicina (B Aires) 2023; 83:241-255. [PMID: 37094193] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
INTRODUCTION Cancer patients have multiple and complex needs. Argentina has a medium-high cancer incidence. Only 14% of patients with palliative care needs have access to specialized services. This study aimed to develop and implement an integrated cancer care model in three hospitals and at home based care level. METHODS The NECPAL2 was a prospective longitudinal observational study. We report a two-year healthcare intervention and its implementation process. The NECPAL tool was used as a screening instrument. Adult cancer patients were recruited and assessed. NECPAL+ patients are those with a positive surprise question - Would you be surprised if this patient dies in the next year? (no)- and, at least one indicator of advanced disease. Patients were reassessed periodically with validated scales. Feedback was given for clinical case management. The project was developed in three consecutive stages and six phases. Data were collected for statistical analysis with a prognosis and palliative approach. RESULTS 2104 cancer patients screened. 681 were NECPAL+. 21% of them presented more than six parameters of severity or progression. The mean general survival was 8 months. 61.9% died within the follow-up period. Survival predictors were identified. Over 65% of patients were referred to palliative care; 10% received home-care. Areas for improvement were recognized. An implementation document was created. DISCUSSION This study showed that a predictive model is feasible, improving chances for timely referral and needs approach. It provided the basis for further implementation research and should encourage policymakers for embracing palliative model development for better cancer patient care.
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Affiliation(s)
- Vilma A Tripodoro
- Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina. E-mail:
- Instituto Pallium Latinoamérica, Buenos Aires, Argentina
| | - Victoria Llanos
- Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina
- Instituto Pallium Latinoamérica, Buenos Aires, Argentina
| | | | - Pilar Muñoz
- Instituto Pallium Latinoamérica, Buenos Aires, Argentina
| | - Eden Del Mar
- Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina
| | - Romina Tranier
- Instituto de Oncología Ángel H. Roffo, Universidad de Buenos Aires, Argentina
| | - Sol Sandjian
- Instituto Pallium Latinoamérica, Buenos Aires, Argentina
| | | | | | - Álvaro Saurí
- Instituto de Oncología Ángel H. Roffo, Universidad de Buenos Aires, Argentina
| | - Gustavo G De Simone
- Instituto Pallium Latinoamérica, Buenos Aires, Argentina
- Hospital de Gastroenterología Carlos B. Udaondo, Buenos Aires, Argentina
| | - Xavier Gómez-Batiste
- Cátedra de Cuidados Paliativos, Facultad de Medicina, Universidad de Vic - Universidad Central de Cataluña, Vic, Barcelona, España
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15
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Pérez-Vegas A, Pérez-López M, Barcala E, Romero D, Muñoz P. Organochlorine residues in muscle of European eels (Anguilla anguilla) from four Spanish Mediterranean wetlands and coastal lagoons. Mar Pollut Bull 2023; 186:114408. [PMID: 36521362 DOI: 10.1016/j.marpolbul.2022.114408] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/14/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
European eels (Anguilla anguilla) are an endangered species throughout their range, and chlorine organic compounds are some of the most important pollutants for marine species. Data on contaminants in eel stocks remain incomplete, so organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) in muscle of European eels from four Spanish Mediterranean ecosystems were analyzed. COPs are presents in eels from all areas, but some compounds are not detected: HCH α, β and γ (lindane), endosulfan sulfate, heptachlor, and PCBs 28, 52 and 180. The high percentage of DDT 2,4' in eels from S'Albufera des Grau Natural Park, an ecosystem with good ecological status according to the Water Framework Directive, and the presence of PCBs in S'Albufereta Natural Reserve indicate the need to carry out further studies in the future. The results obtained can improve the management of this species in the studied areas.
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Affiliation(s)
- Alonso Pérez-Vegas
- Department of Animal Health, Regional Campus of International Excellence "Campus Mare Nostrum", Universidad de Murcia, 30100 Murcia, Spain
| | - Marcos Pérez-López
- Toxicology Unit, Veterinary School, Avda. de la Universidad s/n, 10003 Cáceres, Spain
| | - Elena Barcala
- Centro Nacional Instituto Español de Oceanografía, Centro Oceanográfico de Murcia, CSIC, C/Varadero, s/n, 30740 San Pedro del Pinatar, Spain
| | - Diego Romero
- Toxicology Department, Regional Campus of International Excellence "Campus Mare Nostrum", Universidad de Murcia, 30100 Murcia, Spain.
| | - Pilar Muñoz
- Department of Animal Health, Regional Campus of International Excellence "Campus Mare Nostrum", Universidad de Murcia, 30100 Murcia, Spain
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Martín-Delgado MC, Martín Sánchez FJ, Martínez-Sellés M, Molero García JM, Moreno Guillén S, Rodríguez-Artalejo FJ, Ruiz-Galiana J, Cantón R, De Lucas Ramos P, García-Botella A, García-Lledó A, Hernández-Sampelayo T, Gómez-Pavón J, González Del Castillo J, Muñoz P, Valerio M, Catalán P, Burillo A, Cobo A, Alcamí A, Bouza E. Monkeypox in humans: a new outbreak. Rev Esp Quimioter 2022; 35:509-518. [PMID: 35785957 PMCID: PMC9728594 DOI: 10.37201/req/059.2022] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/01/2022] [Indexed: 12/24/2022]
Abstract
Infection caused by Monkeypox Virus (MPVX) has small rodents as its natural reservoir and both monkeys and humans are occasional hosts. The causative agent is an Orthopoxvirus (MPVX) that was isolated in monkeys in 1958 and proved capable of passing to humans in 1970. It remained contained in Africa, causing isolated episodes of infection, until 2003 when an outbreak occurred in the United States following importation of animals from that continent. Since then, anecdotal cases have continued to be reported outside Africa, usually very clearly linked to travelers to those countries, but in May 2022, a broad outbreak of this disease has begun, now affecting several continents, with the emergence of human cases of MPVX (H-MPVX) infection mainly among Men that have Sex with Men (MSM). The disease has an incubation time ranging from 5 to 15 days and is characterized by the presence of pustules, fever, malaise and headache. The presence of significant regional lymphadenopathy is a differential feature with episodes of classical smallpox. Proctitis and pharyngitis, with minimal skin lesions, may be another form of presentation. Diagnosis can be confirmed by PCR testing of lesions or by demonstration of MPVX in other body fluids or tissues, although in the appropriate epidemiologic setting the clinical picture is highly suggestive of the disease. Effective drug treatment has been developed as part of programs to protect against potential bioterrorist agents and smallpox vaccinees are known to have high protection against monkeypox. New vaccines are available, but neither the drugs nor the vaccines are yet freely available on the market. The prognosis of the disease appears, at least in adults in developed countries, to be good, with very low mortality figures and much less aggressive behavior than that described in classical smallpox. Isolation measures, essential for the control of the outbreak, have been published by the health authorities.
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Affiliation(s)
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- Servicio de Microbiología Clínica y Enfermedades Infecciosas del Hospital General Universitario Gregorio Marañón, Universidad Complutense. CIBERES. Ciber de Enfermedades Respiratorias. Madrid, Spain.
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Anchuelo J, Rivero A, Galdós P, Alonso L, Astudillo R, Navarrete P, Arrojo E, Jimeno J, Albendea J, Pinto F, Fabregat R, De Juan A, Hinojo C, Hernanz F, Merino P, Díaz de Tuesta M, Borniquel F, Mazaira J, Muñoz P, Prada P. Accelerated partial breast irradiation (APBI) in a single 18 Gy fraction with high-dose-rate brachytherapy (HDR). Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01483-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Marí Hualde A, Ardila Mantilla J, Orcajo Rincón J, Rotger Regí A, Kestler M, Muñoz P, Delgado-Montero A, Cuerpo-Caballero G, Pinilla B, Alonso Farto J. Relevancia de la PET/TC con [18F]FDG en la detección de enfermedad localizada en el colon en pacientes estudiados por bacteriemia o endocarditis infecciosa causadas por microorganismos enteropatógenos. Rev Esp Med Nucl Imagen Mol 2022. [DOI: 10.1016/j.remn.2022.09.006] [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: 11/22/2022]
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Maldonado-Pérez N, Tristán-Manzano M, Justicia-Lirio P, Martínez-Planes E, Muñoz P, Pavlovic K, Cortijo-Gutiérrez M, Blanco-Benítez C, Castella M, Juan M, Wenes M, Romero P, Molina-Estévez FJ, Marañón C, Herrera C, Benabdellah K, Martin F. Efficacy and safety of universal (TCRKO) ARI-0001 CAR-T cells for the treatment of B-cell lymphoma. Front Immunol 2022; 13:1011858. [PMID: 36275777 PMCID: PMC9585383 DOI: 10.3389/fimmu.2022.1011858] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/22/2022] [Indexed: 12/04/2022] Open
Abstract
Autologous T cells expressing the Chimeric Antigen Receptor (CAR) have been approved as advanced therapy medicinal products (ATMPs) against several hematological malignancies. However, the generation of patient-specific CAR-T products delays treatment and precludes standardization. Allogeneic off-the-shelf CAR-T cells are an alternative to simplify this complex and time-consuming process. Here we investigated safety and efficacy of knocking out the TCR molecule in ARI-0001 CAR-T cells, a second generation αCD19 CAR approved by the Spanish Agency of Medicines and Medical Devices (AEMPS) under the Hospital Exemption for treatment of patients older than 25 years with Relapsed/Refractory acute B cell lymphoblastic leukemia (B-ALL). We first analyzed the efficacy and safety issues that arise during disruption of the TCR gene using CRISPR/Cas9. We have shown that edition of TRAC locus in T cells using CRISPR as ribonuleorproteins allows a highly efficient TCR disruption (over 80%) without significant alterations on T cells phenotype and with an increased percentage of energetic mitochondria. However, we also found that efficient TCRKO can lead to on-target large and medium size deletions, indicating a potential safety risk of this procedure that needs monitoring. Importantly, TCR edition of ARI-0001 efficiently prevented allogeneic responses and did not detectably alter their phenotype, while maintaining a similar anti-tumor activity ex vivo and in vivo compared to unedited ARI-0001 CAR-T cells. In summary, we showed here that, although there are still some risks of genotoxicity due to genome editing, disruption of the TCR is a feasible strategy for the generation of functional allogeneic ARI-0001 CAR-T cells. We propose to further validate this protocol for the treatment of patients that do not fit the requirements for standard autologous CAR-T cells administration.
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Affiliation(s)
- Noelia Maldonado-Pérez
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Granada, Spain
| | - María Tristán-Manzano
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Granada, Spain
- LentiStem Biotech, Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research (GENYO), PTS, Granada, Spain
| | - Pedro Justicia-Lirio
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Granada, Spain
- LentiStem Biotech, Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research (GENYO), PTS, Granada, Spain
| | - Elena Martínez-Planes
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Granada, Spain
| | - Pilar Muñoz
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Granada, Spain
- Department of Celular Biology, Faculty of Sciences, University of Granada, Granada, Spain
| | - Kristina Pavlovic
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Granada, Spain
- Cellular Therapy Unit, Maimonides Institute of Biomedical Research in Córdoba (IMIBIC), Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain
| | - Marina Cortijo-Gutiérrez
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Granada, Spain
| | - Carlos Blanco-Benítez
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Granada, Spain
- LentiStem Biotech, Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research (GENYO), PTS, Granada, Spain
| | - María Castella
- Department of Hematology, ICMHO, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Manel Juan
- Department of Hematology, ICMHO, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Mathias Wenes
- Department of Oncology, University of Lausanne, Épalinges, Switzerland
| | - Pedro Romero
- Department of Oncology, University of Lausanne, Épalinges, Switzerland
| | - Francisco J. Molina-Estévez
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Granada, Spain
| | - Concepción Marañón
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Granada, Spain
| | - Concha Herrera
- Cellular Therapy Unit, Maimonides Institute of Biomedical Research in Córdoba (IMIBIC), Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain
| | - Karim Benabdellah
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Granada, Spain
| | - Francisco Martin
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Granada, Spain
- Department of Biochemistry and Molecular Biology III and Immunology, Faculty of Medicine, University of Granada, Granada, Spain
- *Correspondence: Francisco Martin,
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Tristán-Manzano M, Maldonado-Pérez N, Justicia-Lirio P, Muñoz P, Cortijo-Gutiérrez M, Pavlovic K, Jiménez-Moreno R, Nogueras S, Carmona MD, Sánchez-Hernández S, Aguilar-González A, Castella M, Juan M, Marañón C, Marchal JA, Benabdellah K, Herrera C, Martin F. Physiological lentiviral vectors for the generation of improved CAR-T cells. Mol Ther Oncolytics 2022; 26:245. [PMID: 35919458 PMCID: PMC9310073 DOI: 10.1016/j.omto.2022.07.005] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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21
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Amado CA, García-Unzueta M, Agüero J, Martín-Audera P, Fueyo P, Lavín BA, Guerra AR, Muñoz P, Tello S, Berja A, Casanova C. Associations of serum sclerostin levels with body composition, pulmonary function, and exacerbations in COPD patients. Pulmonology 2022:S2531-0437(22)00131-3. [PMID: 35963832 DOI: 10.1016/j.pulmoe.2022.06.003] [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: 01/10/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND In COPD, the bronchial epithelium shows a pathologically activated Wnt pathway. Sclerostin (SOST) is a secreted glycoprotein that is associated with bone metabolism and blocks the Wnt pathway. We hypothesized that low sclerostin levels might be associated with lung function and COPD exacerbations in patients. METHODS We studied 139 outpatients with stable COPD and normal kidney function. We assessed the serum levels of SOST and bone metabolism parameters, body composition, clinical characteristics and lung function at baseline. We followed the patients prospectively for 12 months after enrolment. Moderate exacerbations and hospital admissions were recorded during follow-up. RESULTS The serum SOST levels were 23.98±7.6 pmol/l (men: 25.5±7.7 pmol/l, women: 20.3±5.9 pmol/l (p < 0.001)). SOST showed correlations with age (r = 0.36), FFMI (r = 0.38), FEV1 (r = 0.27), DLCO (r = 0.39), 6MWD (r = 0.19) and CAT (r = -0.24). In multivariate linear regression analysis, only age (beta=0.264) and FFMI (beta=1.241) remained significant. SOST showed a significant negative correlation with serum phosphorus (r = -0.29). Cox proportional risk analysis indicated that patients in the lower tertile of SOST levels were at higher risk of moderate COPD exacerbation (HR 2.015, CI95% 1.136-3.577, p = 0.017) and hospital admission due to COPD (HR 5.142, CI95% 1.380-19.158, p = 0.015) than the rest of the patients. CONCLUSIONS SOST levels are associated with body composition and lung function in patients with COPD. Furthermore, lower SOST levels predict a higher risk of exacerbations and hospitalization.
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Affiliation(s)
- C A Amado
- Department of Pulmonology, Hospital Universitario Marqués de Valdecilla. Santander, Spain; University of Cantabria. Santander, Spain; IDIVAL (Instituto de Investigación Biomédica de Cantabria). Santander, Spain.
| | - M García-Unzueta
- University of Cantabria. Santander, Spain; Department of Biochemistry, Hospital Universitario Marqués de Valdecilla. Santander, Spain
| | - J Agüero
- Department of Pulmonology, Hospital Universitario Marqués de Valdecilla. Santander, Spain
| | - P Martín-Audera
- Department of Biochemistry, Hospital Universitario Marqués de Valdecilla. Santander, Spain
| | - P Fueyo
- University of Cantabria. Santander, Spain
| | - B A Lavín
- Department of Biochemistry, Hospital Universitario Marqués de Valdecilla. Santander, Spain
| | - A R Guerra
- Department of Biochemistry, Hospital Universitario Marqués de Valdecilla. Santander, Spain
| | - P Muñoz
- Servicio Cántabro de Salud. Santander, Spain
| | - S Tello
- Department of Pulmonology, Hospital Universitario Marqués de Valdecilla. Santander, Spain
| | - A Berja
- Department of Biochemistry, Hospital Universitario Marqués de Valdecilla. Santander, Spain
| | - C Casanova
- Servicio de Neumología-Unidad de Investigación, Hospital Universitario La Candelaria, Universidad de La Laguna, Tenerife, Spain
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22
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Garcia-Montero M, Ortiz-Bautista C, Valerio M, Olmedo M, Muñoz P, Zatarain Nicolás E, Fernandez-Cordon C, Fernández-Avilés F. Herpes zoster complicated with aseptic meningitis after cardiac transplantation: Report of two cases and review of the literature. Rev Esp Quimioter 2022; 35:415-417. [PMID: 35818634 PMCID: PMC9333122 DOI: 10.37201/req/033.2022] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- M Garcia-Montero
- Marta García Montero, Cardiology Department, Hospital General Universitario Gregorio Marañón. Calle Doctor Esquerdo 46, 28007, Madrid, Spain.
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Bouza E, Vargas F, Alcázar B, Álvarez T, Asensio A, Cruceta G, Gracia D, Guinea J, Gil MA, Linares C, Muñoz P, Pastor P, Pedro-Botet ML, Querol X, Tovar J, Urrutia I, Villar F, Palomo E. Air pollution and health prevention: A document of reflection. Rev Esp Quimioter 2022; 35:307-332. [PMID: 35277084 PMCID: PMC9333116 DOI: 10.37201/req/171.2021] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Ambient air quality, pollution and its implication on health is a topic of enormous importance that is normally dealt with by major specialists in their particular areas of interest. In general, it is not discussed from multidisciplinary approaches or with a language that can reach everyone. For this reason, the Health Sciences Foundation, from its prevention area, has formulated a series of questions to people with very varied competences in the area of ambient air quality in order to obtain a global panorama of the problem and its elements of measurement and control. The answers have been produced by specialists in each subject and have been subjected to a general discussion that has allowed conclusions to be reached on each point. The subject was divided into three main blocks: external ambient air, internal ambient air, mainly in the work-place, and hospital ambient air and the consequences of its poor control. Along with the definitions of each area and the indicators of good and bad quality, some necessary solutions have been pointed out. We have tried to know the current legislation on this problem and the competences of the different administrations on it. Despite its enormous importance, ambient air quality and health is not usually a topic of frequent presence in the general media and we have asked about the causes of this. Finally, the paper addresses a series of reflections from the perspective of ethics and very particularly in the light of the events that the present pandemic raises. This work aims to provide objective data and opinions that will enable non-specialists in the field to gain a better understanding of this worrying reality.
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Affiliation(s)
- E Bouza
- Servicio de Microbiología Clínica y Enfermedades Infecciosas del Hospital General Universitario Gregorio Marañón, Universidad Complutense. CIBERES. Ciber de Enfermedades Respiratorias. Madrid, Spain.
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de la Villa S, Rojas A, Estévez A, Álvarez-Uria A, Valerio M, Machado M, Kestler M, Ramallo VG, Abella HR, Bouza E, Muñoz P. Endocarditis Infecciosa Causada Por Microorganismos Multirresistentes. Cirugía Cardiovascular 2022. [DOI: 10.1016/j.circv.2022.03.003] [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: 11/17/2022] Open
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de la Villa S, Rojas A, Álvarez-Uria A, Valerio M, Machado M, Kestler M, Bouza E, Muñoz P. VALIDACIÓN DE DOS SCORES PREDICTORES DE ENDOCARDITIS EN BACTERIEMIA POR S. AUREUS. Cirugía Cardiovascular 2022. [DOI: 10.1016/j.circv.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Estévez A, Machado M, Valerio M, Sánchez C, Marín M, Adán I, Bouza E, Hualde AM, Pinilla B, Muñoz P. Endocarditis polimicrobiana, ¿una entidad real? Análisis de nuestra cohorte de endocarditis HGUGM 2008-2020. Cirugía Cardiovascular 2022. [DOI: 10.1016/j.circv.2022.03.015] [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: 10/17/2022] Open
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De la Rubia Navarro M, Ivorra Cortés J, Grau García E, Gonzalez Puig L, Negueroles Albuixech R, Martínez Cordellat I, Ortiz-Sanjuán F, Oller Rodríguez JE, Leal Rodriguez S, Pávez Perales C, Fragío Gil JJ, Vicens Bernabeu E, Riesco Barcena C, Huaylla Quispe AV, Mas Sanchez L, Muñoz P, Nájera Herranz C, Cánovas Olmos I, Román Ivorra JA. AB0435 LUPUS NEPHRITIS RESPONSE IN TERMS OF KIDNEY FUNCTION, URINE SEDIMENT AND SEROLOGICAL ACTIVITY AFTER SUBCUTANEOUS BELIMUMAB TREATMENT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundSystemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease. Kidney affection appears in 40-50% of SLE patients and may condition the prognosis. Belimumab is a monoclonal antibody approved for SLE since 2011, but it had no lupus nephritis (NL) indication. Recently, promising results from a controlled Belimumab trial in LN were published.ObjectivesTo analyze effectiveness of Belimumab in LN patients under follow-up by the rheumatology department of a tertiary hospital.MethodsObservational, retrospective and cross-sectional study including SLE patients (SLICC/ACR 2012 criteria) treated with subcutaneous and/or intravenous Belimumab. Demographic and serological data, concomitant treatment, kidney function and urine sediment were collected.ResultsSixteen patients with a median age of 47.56 (11.66) years and with 5.40 (0.55) years since Belimumab onset were included. Five patients had LN demonstrated by kidney biopsy and they were included on analysis data. In this group, median age was 39 (6.96) years, patients had 17.80 (10.38) years since SLE diagnosis and 6.6 (0,89) years since Belimumab onset. The most prevalent nephritis type was III and IV, only one patient presented V type.Regarding the treatment, every patient received antimalarial drugs (cloroquine 40%, hydroxicloroquine 60%) and mycophenolic acid. Concerning the corticosteroid therapy, all patients receive prednisone, with an average dose of 4 mg per day.The results obtained were included in the Table 1.Table 1.OnsetCurrentlyPatientNL typeProteinuria (g/24h)Creatinine (mg/dL)Glomerular filtration (ml/min)Anti-DNAC3, C4Proteinuria (g/24h)Creatinine (mg/dL)Glomerular filtration (ml/min)Anti-DNAC3, C41III10.81905080, 80.40.73892480, 202V0.750.4013024normal00.4913043normal3III0.750.73101164normal00.8082.978normal4IV0.961.265521normal0.701.29712.2normal5IV0.951.297115101, 100.170.88848589, 23ConclusionBelimumab can improve LN, in terms of serological activity, kidney function and urine sediment. It could be a promising option associated to standard therapy for SLE patients with kidney affection.Disclosure of InterestsNone declared
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De la Rubia Navarro M, Ivorra Cortés J, Grau García E, Gonzalez Puig L, Negueroles Albuixech R, Martínez Cordellat I, Ortiz-Sanjuán F, Fragío Gil JJ, Oller Rodríguez JE, Vicens Bernabeu E, Pávez Perales C, Leal Rodriguez S, Mas Sanchez L, Muñoz P, Riesco Barcena C, Huaylla Quispe AV, Cánovas Olmos I, Nájera Herranz C, Román Ivorra JA. AB1168 CLINICAL AND SEROLOGICAL EVOLUTION OF RHEUMATIC PATIENTS INFECTED BY SARS-COV-2. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundSARS-CoV-2 infection is a public health problem due to its high contagiousness and mortality. Spectrum of symptoms ranges from no symptoms to interstitial pneumonia. Patients with rheumatic disease present an increased infectious risk, especially those treated with immunosuppressants or biologic therapy. Since the beginning of the pandemic, risk of contagion and development of complications in these patients has been questioned.ObjectivesTo describe hospitalization prevalence, seroconversion, and symptoms in patients under follow-up by the rheumatology department of a tertiary hospital.MethodsObservational, cross-sectional study conducted by phone interview including patients with different diagnosis of rhematic diseases.Data about symptoms, hospital admission, serology by ELISA (when >15 days of evolution), diagnosis and baseline treatment, from March 2020 to February 2021 were collected.ResultsEighty-six patients with different rheumatic diseases and positive COVID-19 PCR were included (82.35% women) in Table 1. Mean age was 49.30 years (16.16). The 48.71% received biological therapy, JAK inhibitors or apremilast, with a median of 3.11 years (Q1 1,08; Q3 3,17). Secukinumab was the biological therapy most often used (24,32%), followed by Tocilizumab (13,51%). The 34,18% received DMARDs or immunosuppressors, with a median of 5.09 years (Q1 12,25; Q3 11.09). The most frequent symptoms were asthenia (72.15%), headache (66.23%) and cough (59.49%). Nine patients (11.25%) were admitted to hospital, eight of them (10%) for pneumonia. Three of them were admitted to intensive care and one died.Seroconversion occurred in 53.25%. low IgG titers were present in 2.94% and IgM persisted positive in 56.25% of this group. In 6.45% the result was indeterminate.Table 1.DiagnosisNumber (%)Rheumatoid arthritis24%Psoriasic arthritis16%Ankylosing espondilitis16%Systemic erythematosus lupus8%Juvenile idiopathic arthritis8%Systemic sclerosis7%Behçet disease5%Sjögren syndrome3%Mediterranean fever3%Sarcoidosis1%Granulomatosis with polyangitis1%Mixed connective tissue disease1%Leucocitoclastic vasculitis1%Rhupus1%Rheumatic polymyalgia1%Dermatomyositis1%Cutaneous panarteritis1%ConclusionHospitalization and mortality rate obtained was low and the most frequent symptoms were mild. Seroconversion occurred in more than 50% of patients and the result of 6.45% was indeterminate.It’s important to highlight that since March 2020 to May 2020 IgG positive prevalence was 25%, while since September 2021 to February 2021, this prevalence increased until 57,45%. This difference is due to a modification of autoantibody detection technique since summer 2020.Disclosure of InterestsNone declared
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Olmedo M, Kestler M, Valerio M, Padilla B, Rodríguez González C, Chamarro E, Machado M, Álvarez-Uría A, Alcalá L, Muñoz P, Bouza E. Bezlotoxumab in the treatment of Clostridioides difficile infections: a real-life experience. Rev Esp Quimioter 2022; 35:279-283. [PMID: 35279984 PMCID: PMC9134882 DOI: 10.37201/req/120.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/15/2021] [Accepted: 01/15/2022] [Indexed: 12/02/2022]
Abstract
OBJECTIVE Following the approval of bezlotoxumab in 2017, studies evaluating its effectiveness in prevention of Clostridioides difficile infection under "real-life" conditions are scarce. METHODS We conducted a retrospective study developed in a large tertiary care hospital describing the use and outcomes of patients with Clostridioides difficile infection (CDI) treated with bezlotoxumab. RESULTS A total of 16 patients were include, all of whom had an episode of CDI with high probability of recurrence and 14 of them had some kind of immunosuppression. Bezlotoxumab was effective in the prevention of CDI recurrence in 11 of the 14 cases in which follow up was possible, without significant side effects. CONCLUSIONS Bezlotoxumab was well tolerated and the incidence of recurrent CDI in a high-risk population for recurrence was only 21.4%.
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Affiliation(s)
- M Olmedo
- María Olmedo, Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
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Escribano P, Pérez-Granda MJ, Alonso R, Catalán P, Alcalá L, Serra-Rexarch JA, Osuna L, Fernández A, Conti AP, Castellanos A, Guinea J, Muñoz P, Bouza E. High incidence of COVID-19 at nursing homes in Madrid, Spain, despite preventive measures. Rev Esp Quimioter 2022; 35:288-292. [PMID: 35397483 PMCID: PMC9134887 DOI: 10.37201/req/008.2022] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To assess the impact of COVID-19 at nine nursing homes in Madrid, Spain, during the first wave of COVID-19 infection and lockdown period when preventive measures were taken to avoid transmission among residents. METHODS Nine hundred forty-two residents and 846 staff members from nine nursing homes participated in the study (April 18 to June 20, 2020). All participants were tested for SARS-CoV-2 in the nasopharynx by PCR and for IgG antibodies detection. Microbiological status at sampling was defined as active infection (positive PCR ± presence of antibodies), past infection (negative PCR + presence of antibodies), or naïve participants (negative PCR + absence of antibodies). RESULTS Laboratory results helped classify the residents as having active infection (n=224; 23.8%), past infection (n=462; 49.1%), or being naïve (n=256; 27.1%); staff members were actively infected (n=127; 15.1%), had had a past infection (n=290; 34.2%), or were naïve (n=429; 50.7%). Overall, the percentage of participants with COVID-19 was significantly higher in residents than in staff members (72.8% vs 49.2%; P=0.001). The clinical situation of residents vs staff at sampling was as follows: acute manifestations compatible with COVID-19 (7.3% vs 3.9%; P<0.01) and no manifestations of infection (92.7% vs 96.0%; P<0.01). A large proportion of both asymptomatic and symptomatic residents (69.4% vs 86.6%; P=0.015) had positive PCR results (mostly alongside positive IgG determinations). CONCLUSIONS COVID-19 affects 75% of the residents in nursing homes in Madrid. The high impact in these settings, despite the strict restrictions adopted during the lockdown, demonstrates the ability of SARS-CoV-2 to cause outbreaks.
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Affiliation(s)
- P Escribano
- Pilar Escribano, Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, C/ Dr. Esquerdo, 46, 28007 Madrid, Spain.
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Batule S, Ramos A, Pérez-Montes de Oca A, Fuentes N, Martínez S, Raga J, Pena X, Tural C, Muñoz P, Soldevila B, Alonso N, Umpierrez G, Puig-Domingo M. Comparison of Glycemic Variability and Hypoglycemic Events in Hospitalized Older Adults Treated with Basal Insulin plus Vildagliptin and Basal-Bolus Insulin Regimen: A Prospective Randomized Study. J Clin Med 2022; 11:jcm11102813. [PMID: 35628938 PMCID: PMC9143484 DOI: 10.3390/jcm11102813] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 12/10/2022] Open
Abstract
Background: The basal−bolus insulin regimen is recommended in hospitalized patients with diabetes mellitus (DM), but has an increased risk of hypoglycemia. We aimed to compare dipeptidyl peptidase 4 inhibitors (DPP4-i) and basal−bolus insulin glycemic outcomes in hospitalized type 2 DM patients. Methods and patients: Our prospective randomized study included 102 elderly T2DM patients (82 ± 9 years, HbA1c 6.6% ± 1.9). Glycemic control: A variability coefficient assessed by continuous glucose monitoring (Free Style® sensor), mean insulin dose and hypoglycemia rates obtained with the two treatments were analyzed. Results: No differences were found between groups in glycemic control (mean daily glycemia during the first 10 days: 152.6 ± 38.5 vs. 154.2 ± 26.3 mg/dL; p = 0.8). The total doses Kg/day were 0.40 vs. 0.20, respectively (p < 0.001). A lower number of hypoglycemic events (9% vs. 15%; p < 0.04) and lower glycemic coefficient of variation (22% vs. 28%; p < 0.0002) were observed in the basal−DPP4-i compared to the basal−bolus regimen group. Conclusions: Treatment of inpatient hyperglycemia with basal insulin plus DPP4-i is an effective and safe regimen in old subjects with T2DM, with a similar mean daily glucose concentration, but lower glycemic variability and fewer hypoglycemic episodes compared to the basal bolus insulin regimen.
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Affiliation(s)
- Sol Batule
- Servicio de Endocrinología y Nutrición, Hospital Germans Trias i Pujol, 08916 Badalona, Spain; (S.B.); (A.R.); (A.P.-M.d.O.); (N.F.); (S.M.); (B.S.); (N.A.)
| | - Analía Ramos
- Servicio de Endocrinología y Nutrición, Hospital Germans Trias i Pujol, 08916 Badalona, Spain; (S.B.); (A.R.); (A.P.-M.d.O.); (N.F.); (S.M.); (B.S.); (N.A.)
| | - Alejandra Pérez-Montes de Oca
- Servicio de Endocrinología y Nutrición, Hospital Germans Trias i Pujol, 08916 Badalona, Spain; (S.B.); (A.R.); (A.P.-M.d.O.); (N.F.); (S.M.); (B.S.); (N.A.)
| | - Natalia Fuentes
- Servicio de Endocrinología y Nutrición, Hospital Germans Trias i Pujol, 08916 Badalona, Spain; (S.B.); (A.R.); (A.P.-M.d.O.); (N.F.); (S.M.); (B.S.); (N.A.)
| | - Santiago Martínez
- Servicio de Endocrinología y Nutrición, Hospital Germans Trias i Pujol, 08916 Badalona, Spain; (S.B.); (A.R.); (A.P.-M.d.O.); (N.F.); (S.M.); (B.S.); (N.A.)
| | - Joan Raga
- Servicio de Medicina Interna, Hospital Germans Trias i Pujol, 08916 Badalona, Spain; (J.R.); (X.P.); (C.T.); (P.M.)
| | - Xoel Pena
- Servicio de Medicina Interna, Hospital Germans Trias i Pujol, 08916 Badalona, Spain; (J.R.); (X.P.); (C.T.); (P.M.)
| | - Cristina Tural
- Servicio de Medicina Interna, Hospital Germans Trias i Pujol, 08916 Badalona, Spain; (J.R.); (X.P.); (C.T.); (P.M.)
| | - Pilar Muñoz
- Servicio de Medicina Interna, Hospital Germans Trias i Pujol, 08916 Badalona, Spain; (J.R.); (X.P.); (C.T.); (P.M.)
| | - Berta Soldevila
- Servicio de Endocrinología y Nutrición, Hospital Germans Trias i Pujol, 08916 Badalona, Spain; (S.B.); (A.R.); (A.P.-M.d.O.); (N.F.); (S.M.); (B.S.); (N.A.)
| | - Nuria Alonso
- Servicio de Endocrinología y Nutrición, Hospital Germans Trias i Pujol, 08916 Badalona, Spain; (S.B.); (A.R.); (A.P.-M.d.O.); (N.F.); (S.M.); (B.S.); (N.A.)
| | | | - Manel Puig-Domingo
- Servicio de Endocrinología y Nutrición, Hospital Germans Trias i Pujol, 08916 Badalona, Spain; (S.B.); (A.R.); (A.P.-M.d.O.); (N.F.); (S.M.); (B.S.); (N.A.)
- Correspondence: ; Tel.: +34-93-497-88-60
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Tristán-Manzano M, Maldonado-Pérez N, Justicia-Lirio P, Muñoz P, Cortijo-Gutiérrez M, Pavlovic K, Jiménez-Moreno R, Nogueras S, Carmona MD, Sánchez-Hernández S, Aguilar-González A, Castella M, Juan M, Marañón C, Marchal JA, Benabdellah K, Herrera C, Martin F. Physiological lentiviral vectors for the generation of improved CAR-T cells. Molecular Therapy - Oncolytics 2022; 25:335-349. [PMID: 35694446 PMCID: PMC9163403 DOI: 10.1016/j.omto.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 05/07/2022] [Indexed: 10/29/2022]
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Fresco-Taboada A, Garcia-Duran M, Aira C, López L, Sastre P, Van der Hoek L, Van Gils M, Brouwer P, Sanders R, Holzer B, Zimpernik I, López-Collazo E, Muñoz P, Rueda P, Vela C. Surveillance of Immunological Status after Vaccination by two Serological Assays based on SARS-CoV-2 Spike Protein. Int J Infect Dis 2022. [PMCID: PMC8884736 DOI: 10.1016/j.ijid.2021.12.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Purpose Two serological assays, an Enzyme-Linked Immunosorbent Assay (ELISA) and a Lateral Flow Assay (LFA), have been developed based on the SARS-CoV-2 recombinant Receptor Binding Domain (RBD-ELISA) and the combination of Trimeric Spike (S) and Nucleoprotein (N), S-LFA and N-LFA, respectively, as candidate tools for both indirect measurement of virus circulation and assessment of infection and vaccine-induced immunity. Methods & Materials A total of 1272 human serum samples collected from volunteers (SARS-CoV-2 infected, non-infected or vaccinated) were evaluated by the two assays. For the RBD-ELISA, plates were coated with RBD, sera were added at 1/5 dilution and bound antibodies were detected with RBD labelled with Horseradish Peroxidase. For the LFA, two parallel strips were used: one for detection of N-specific antibodies (Hoste A. el al, 2020); and another one for detection of S-specific antibodies, using S both as capture and detector reagent. Twenty microliters of blood or ten microliters of serum were applied to each cassette and results were interpreted after ten minutes. A seroneutralization assay was used as reference for the detection of neutralizing antibodies with RBD-ELISA and Reference sera (World Health Organization), for determination of the Limit of detection (LoD). MedCalc® 10 software was used for statistical analysis. Results The potential diagnostic application with sera from naturally infected and non-infected volunteers showed sensitivity, specificity and agreement (kappa) values of 95.1%, 99.0% and 0.94 respectively for RBD-ELISA; while 97.2%, 99.3% and 0.967 respectively for N-LFA; or 93.2% 98.3 %, 0.923, respectively for S-LFA. Serum samples from vaccinated individuals were analyzed for the specific detection of antibodies to the S protein: for vaccinated but non-infected individuals, sensitivity reached 97.3% after 15 days post-second vaccination dose whereas for previously infected people reached 100% after only 15 days post-first dose. The performance of RBD-ELISA showed good agreement with seroneutralization and excellent agreement with S-LFA (kappa 0.979). Conclusion The dual N/S LFA represents a valuable tool to detect SARS-CoV-2 infection due to its complementary information on N and S-specific antibody response. Furthermore, the S-LFA and RBD-ELISA are both proven to be able to determine the extent of antibody response after vaccination.
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Tripodoro VA, Llanos V, Daud ML, Muñoz P, Del Mar E, Tranier R, Sandjian S, Lellis SD, Días JM, Saurí A, De Simone GG, Gómez-Batiste X. Palliative and prognostic approach in cancer patients identified in the multicentre NECesidades PALiativas 2 study in Argentina. Ecancermedicalscience 2022; 15:1316. [PMID: 35047067 PMCID: PMC8723739 DOI: 10.3332/ecancer.2021.1316] [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: 07/05/2021] [Indexed: 11/25/2022] Open
Abstract
Background Early identification of palliative needs has proven benefits in quality of life, survival and decision-making. The NECesidades PALiativas (NECPAL) Centro Coordinador Organización Mundial de la Salud - Instituto Catalán de Oncología (CCOMS-ICO©) tool combines the physician’s insight with objective disease progression parameters and advanced chronic conditions. Some parameters have been independently associated with mortality risk in different populations. According to the concept of the ‘prognostic approach’ as a companion of the ‘palliative approach’, predictive models that identify individuals at high mortality risk are needed. Objective We aimed to identify prognostic factors of mortality in cancer in our cultural context. Method We assessed cancer patients with palliative needs until death using this validated predictive tool at three hospitals in Buenos Aires City. This multifactorial, quantitative and qualitative non-dichotomous assessment process combines subjective perception (the surprise question: Would you be surprised if this patient dies in the next year?) with other parameters, including the request (and need) for palliative care (PC), the assessment of disease severity, geriatric syndromes, psychosocial factors and comorbidities, as well as the use of healthcare resources. Results 2,104 cancer patients were identified, 681 were NECPAL+ (32.3%). During a 2-year follow-up period, 422 NECPAL+ patients died (61.9%). The mean overall survival was 8 months. A multivariate model was constructed with significant indicators in univariate analysis. The best predictors of mortality were: nutritional decline (p < 0.000), functional decline (p < 0.000), palliative performance scale (PPS) ≤ 50 (p < 0.000), persistent symptoms (p < 0.002), functional dependence (p < 0.000), poor treatment response (p < 0.000), primary cancer diagnosis (p = 0.024) and condition (in/outpatients) (p < 0.000). Only three variables remained as survival predictors: low response to treatment (p < 0.001), PPS ≤ 50 (p < 0.000) and condition (in/outpatients) (p < 0.000). Conclusion This prospective model aimed to improve cancer survival prediction and timely PC referral in Argentinian hospitals.
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Affiliation(s)
- Vilma Adriana Tripodoro
- Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Av Combatientes de Malvinas 3150, C1427 ARN, Buenos Aires, Argentina.,Instituto Pallium Latinoamérica, Bonpland 2257 (1425), Ciudad de Buenos Aires, Argentina.,https://orcid.org/0000-0003-2328-6032
| | - Victoria Llanos
- Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Av Combatientes de Malvinas 3150, C1427 ARN, Buenos Aires, Argentina.,Instituto Pallium Latinoamérica, Bonpland 2257 (1425), Ciudad de Buenos Aires, Argentina
| | - María Laura Daud
- Instituto Pallium Latinoamérica, Bonpland 2257 (1425), Ciudad de Buenos Aires, Argentina
| | - Pilar Muñoz
- Instituto Pallium Latinoamérica, Bonpland 2257 (1425), Ciudad de Buenos Aires, Argentina
| | - Eden Del Mar
- Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Av Combatientes de Malvinas 3150, C1427 ARN, Buenos Aires, Argentina
| | - Romina Tranier
- Instituto de Oncología Ángel Roffo, Universidad de Buenos Aires, Av San Martín 5481 (1417), Ciudad de Buenos Aires, Argentina
| | - Sol Sandjian
- Instituto Pallium Latinoamérica, Bonpland 2257 (1425), Ciudad de Buenos Aires, Argentina
| | - Silvina De Lellis
- Instituto Pallium Latinoamérica, Bonpland 2257 (1425), Ciudad de Buenos Aires, Argentina
| | - Juan Manuel Días
- Instituto Pallium Latinoamérica, Bonpland 2257 (1425), Ciudad de Buenos Aires, Argentina
| | - Alvaro Saurí
- Instituto de Oncología Ángel Roffo, Universidad de Buenos Aires, Av San Martín 5481 (1417), Ciudad de Buenos Aires, Argentina
| | - Gustavo Gabriel De Simone
- Instituto Pallium Latinoamérica, Bonpland 2257 (1425), Ciudad de Buenos Aires, Argentina.,Hospital de Gastroenterología Dr. Carlos Bonorino Udaondo, Av Caseros 2061 (1264), Ciudad de Buenos Aires, Argentina
| | - Xavier Gómez-Batiste
- Cátedra de Cuidados Paliativos, Universitat de Vic-Universitat Central de Catalunya, C Miquel Martí i Pol 1, 08500 Vic, Catalonia, Spain
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Muñoz P, Doñaque E, Larrañaga A, Martínez Torres J. Tourism-Related Placeness Feature Extraction from Social Media Data Using Machine Learning Models. IJIMAI 2022. [DOI: 10.9781/ijimai.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Muñoz P, De la Villa S, Martínez-Sellés M, Goenaga MA, Reviejo-Jaka K, Revillas FADL, García-Cuello L, Hidalgo-Tenorio C, Rodríguez-Esteban MA, Antorrena I, Castelo-Corral L, García-Vázquez E, De la Torre J, Bouza E. Linezolid for infective endocarditis: A structured approach based on a national database experience. Medicine (Baltimore) 2021; 100:e27597. [PMID: 34941026 PMCID: PMC8701757 DOI: 10.1097/md.0000000000027597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 10/06/2021] [Indexed: 01/05/2023] Open
Abstract
Current data on the frequency and efficacy of linezolid (LNZ) in infective endocarditis (IE) are based on small retrospective series. We used a national database to evaluate the effectiveness of LNZ in IE.This is a retrospective study of IE patients in the Spanish GAMES database who received LNZ. We defined 3 levels of therapeutic impact: LNZ < 7 days, LNZ high-impact (≥ 7 days, > 50% of the total treatment, and > 50% of the LNZ doses prescribed in the first weeks of treatment), and LNZ ≥ 7 days not fulfilling the high-impact criteria (LNZ-NHI). Effectiveness of LNZ was assessed using propensity score matching and multivariate analysis of high-impact cases in comparison to patients not treated with LNZ from the GAMES database matched for age-adjusted comorbidity Charlson index, heart failure, renal failure, prosthetic and intracardiac IE device, left-sided IE, and Staphylococcus aureus. Primary outcomes were in-hospital mortality and one-year mortality. Secondary outcomes included IE complications and relapses.From 3467 patients included in the GAMES database, 295 (8.5%) received LNZ. After excluding 3 patients, 292 were grouped as follows for the analyses: 99 (33.9%) patients in LNZ < 7 days, 11 (3.7%) in LNZ high-impact, and 178 (61%) in LNZ-NHI. In-hospital mortality was 51.5%, 54.4%, and 19.1% respectively. In the propensity analysis, LNZ high-impact group presented with respect to matched controls not treated with LNZ higher in-hospital mortality (54.5% vs 18.2%, P = .04). The multivariate analysis showed an independent relationship of LNZ use with in-hospital mortality (odds ratio 9.06, 95% confidence interval 1.15--71.08, P = .03).Treatment with LNZ is relatively frequent, but most cases do not fulfill our high-impact criteria. Our data suggest that the use of LNZ as definitive treatment in IE may be associated with higher in-hospital mortality.
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Affiliation(s)
- P Muñoz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - S De la Villa
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - M Martínez-Sellés
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, CIBERCV, Universidad Complutense, Universidad Europea, Madrid, Spain
| | - M A Goenaga
- Servicio de Enfermedades Infecciosas. Hospital Universitario Donosti, San Sebastián
| | - K Reviejo-Jaka
- Servicio de Medicina Intensiva. Policlínica-Grupo Quirón Gipuzkoa, San Sebastián, Spain
| | - F Arnáiz de Las Revillas
- Servicio de Enfermedades Infecciosas. Hospital Universitario Marqués de Valdecilla. Universidad de Cantabria, Santander, Spain
| | - L García-Cuello
- Servicio de Enfermedades Infecciosas. Hospital Universitario Marqués de Valdecilla. Universidad de Cantabria, Santander, Spain
| | - C Hidalgo-Tenorio
- Unidad de Gestión Clínica de Enfermedades Infecciosas. Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - M A Rodríguez-Esteban
- Unidad de Cuidados Intensivos Cardiológicos. Hospital Universitario Central de Asturias, Oviedo, Spain
| | - I Antorrena
- Servicio de Cardiología. Hospital Universitario La Paz, Madrid, Spain
| | - L Castelo-Corral
- Servicio de Enfermedades Infecciosas, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - E García-Vázquez
- Servicio de Medicina Interna-Infecciosas. IMIB. Hospital Clínico Universitario Virgen de la Arrixaca. Facultad de Medicina, Universidad de Murcia, Murcia, Spain
| | - J De la Torre
- Grupo de Enfermedades Infecciosas de la Unidad de Medicina Interna. Hospital Costa del Sol, Málaga, Spain
| | - E Bouza
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
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Belmonte A, Muñoz P, Santos-Echeandía J, Romero D. Tissue Distribution of Mercury and Its Relationship with Selenium in Atlantic Bluefin Tuna ( Thunnus thynnus L.). Int J Environ Res Public Health 2021; 18:ijerph182413376. [PMID: 34948982 PMCID: PMC8708749 DOI: 10.3390/ijerph182413376] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 11/29/2022]
Abstract
Mercury (Hg) is an important heavy metal to consider in marine predators, while selenium (Se) has a natural antagonistic effect on this metal in fish. The Atlantic bluefin tuna (ABFT, Thunnus thynnus) is a pelagic top-level predator of the trophic web and their Hg muscular content is an object of concern in food safety. Nevertheless, little is known about levels of this metal in remaining tissues, which may be important as by-product source, and its relationship with Se. Thus, concentration of both elements in liver, kidney, brain, gill and bone, in addition to muscle, of ABFT were determined. The kidney was the tissue with the highest concentration of Hg (Total-Hg, THg) and Se, and the Se/THg concentration ratio was similar in all tissues, except bone and muscle. The Selenium Health Benefit Value (HBVSe) was positive in each specimen and tissue, indicating that the Se plays an important role against Hg not only in the muscle.
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Affiliation(s)
- Antonio Belmonte
- TAXON Estudios Ambientales S.L. C/Uruguay s/n, 30820 Alcantarilla, Spain;
| | - Pilar Muñoz
- Departamento de Sanidad Animal, Facultad de Veterinaria, Campus de Espinardo, Universidad de Murcia, 30100 Murcia, Spain;
| | | | - Diego Romero
- Área de Toxicología, Facultad de Veterinaria, Campus de Espinardo, Universidad de Murcia, 30100 Murcia, Spain
- Correspondence: ; Tel.: +34-868-884-318
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Heimroth RD, Casadei E, Benedicenti O, Amemiya CT, Muñoz P, Salinas I. The lungfish cocoon is a living tissue with antimicrobial functions. Sci Adv 2021; 7:eabj0829. [PMID: 34788085 PMCID: PMC8597997 DOI: 10.1126/sciadv.abj0829] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
Terrestrialization is an extreme physiological adaptation by which African lungfish survive dry seasons. For months and up to several years, lungfish live inside a dry mucus cocoon that protects them from desiccation. Light and electron microscopy reveal that the lungfish cocoon is a living tissue that traps bacteria. Transcriptomic analyses identify a global state of inflammation in the terrestrialized lungfish skin characterized by granulocyte recruitment. Recruited granulocytes transmigrate into the cocoon where they release extracellular traps. In vivo DNase I surface spraying during terrestrialization results in dysbiosis, septicemia, skin wounds, and hemorrhages. Thus, lungfish have evolved unique immunological adaptations to protect their bodies from infection for extended periods of time while living on land. Trapping bacteria outside their bodies may benefit estivating vertebrates that undergo metabolic torpor.
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Affiliation(s)
- Ryan Darby Heimroth
- Center for Evolutionary and Theoretical Immunology, Biology Department, University of New Mexico, Albuquerque, NM, USA
| | - Elisa Casadei
- Center for Evolutionary and Theoretical Immunology, Biology Department, University of New Mexico, Albuquerque, NM, USA
| | - Ottavia Benedicenti
- Center for Evolutionary and Theoretical Immunology, Biology Department, University of New Mexico, Albuquerque, NM, USA
| | - Chris Tsuyoshi Amemiya
- Department of Molecular and Cell Biology, University of California, Merced, Merced, CA, USA
| | - Pilar Muñoz
- Department of Animal Health, Campus de Espinardo, University of Murcia, 30100 Murcia, Spain
| | - Irene Salinas
- Center for Evolutionary and Theoretical Immunology, Biology Department, University of New Mexico, Albuquerque, NM, USA
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Pérez-Vegas A, Pérez-López M, Barcala E, Trofimova E, Romero D, Muñoz P. Organochlorine pesticides and PCBs in European eel (Anguilla anguilla) from Spanish Balearic coastal lagoons. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00672-x] [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: 10/20/2022]
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Núñez J, García-Angarita FJ, Puerta A, Muñoz P, Sanjuanbenito A. Sleeve gastrectomy for idiopathic acute gastric dilatation with transmural necrosis. Ann R Coll Surg Engl 2021; 103:e275-e277. [PMID: 34431688 DOI: 10.1308/rcsann.2020.7121] [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] [Indexed: 11/22/2022] Open
Abstract
Acute gastric dilatation (AGD) is usually related to eating disorders, postoperative status and mechanical obstruction of the duodenum. When intragastric pressure is augmented, it can lead to alteration of blood flow and result in transmural necrosis. However, there are very few reports on idiopathic AGD and so here we describe the case of a 26-year-old woman diagnosed with AGD without any apparent cause. Conservative treatment was initially conducted, but because of the persistence of dilatation, presence of gastric ulcer and gastric pneumatosis, a surgical approach was necessary. During surgery, gastric necrosis was observed in the greater curvature. A sleeve gastrectomy was conducted from the angle of His to the antrum. No complications were present during the postoperative course. Oeso-gastro-duodenal barium study showed no signs of gastric emptying and psychiatric evaluation ruled out any eating disorder.
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Affiliation(s)
- J Núñez
- Ramon y Cajal University Hospital, Madrid, Spain
| | | | - A Puerta
- Ramon y Cajal University Hospital, Madrid, Spain
| | - P Muñoz
- Ramon y Cajal University Hospital, Madrid, Spain
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López C, Muñoz P, Zanga D, Girón-Calva PS, Eizaguirre M. Fitness Costs of Two Maize Lepidopteran Pests Fed on Bacillus thuringiensis (Bt) Diets Enriched with Vitamins A and C. Insects 2021; 12:insects12080718. [PMID: 34442284 PMCID: PMC8396949 DOI: 10.3390/insects12080718] [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] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/15/2021] [Accepted: 08/09/2021] [Indexed: 12/03/2022]
Abstract
Simple Summary Biotechnologists are designing new transgenic plants enriched with micronutrients and vitamins that are resistant to insects. These new plants could favor the development of some pest insects. This work aims to discover the effect of adding two vitamins, A and C, to insect diets prepared with Bt and no-Bt maize in two maize insect pests. M. unipuncta was less sensitive to the toxin, although ingestion of the Bt diet resulted in longer larval development and lower pupal weight, which were not mitigated by any of the vitamins. However, the two vitamins reduced the mortality of H. armigera larvae fed on the Bt diet. In addition, we found evidence of the antioxidant function of vitamin A. The results obtained here indicate that crops enriched with these vitamins will hardly favor the development of H. armigera and suggest that they do not affect M. unipuncta’s development at all. Abstract Serious malnutrition problems occur in developing countries where people’s diets are mainly based on staple crops. To alleviate this, high-production crops are being developed that are better adapted to climate change, enriched in micronutrients and vitamins, or resistant to pests. In some cases, new varieties have been developed with several of the characteristics mentioned above, such as biofortified and pest-resistant crops. The development of biofortified Bacillus thuringiensis (Bt) crops raises the question of whether vitamin enrichment of Bt crops can in any way favor those pests that are not very susceptible to the Bt toxin that feed on these crops, such as Helicoverpa armigera (Hübner) or Mythimna unipuncta (Haworth) (Lepidoptera: Noctuidae). In this study, the response to a Bt diet enriched with vitamins A (β-carotene) and C (ascorbic acid) was somewhat different between the two species. M. unipuncta was less sensitive to the toxin than H. armigera, although the ingestion of the Bt diet resulted in oxidative stress (longer larval development and lower pupal weight) which was not mitigated by the vitamins. However, the two vitamins reduced the mortality of H. armigera larvae fed on a Bt-enriched diet; in addition, ß-carotene reduced the activity of the antioxidant glutathione S-transferase (GST) of both species, suggesting it has an antioxidant role. The results obtained here indicate that biofortified Bt crops will not favor the development of H. armigera very much and will not affect M. unipuncta’s development at all, although the effect of the increase in vitamins may be very variable and should be studied for each specific phytophagous.
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Affiliation(s)
- Carmen López
- Department of Crop and Forest Sciences, University of Lleida-Agrotenio Center, Av. Al. Rovira Roure 191, 25198 Lleida, Spain; (C.L.); (P.M.); (P.S.G.-C.)
| | - Pilar Muñoz
- Department of Crop and Forest Sciences, University of Lleida-Agrotenio Center, Av. Al. Rovira Roure 191, 25198 Lleida, Spain; (C.L.); (P.M.); (P.S.G.-C.)
| | - Daniela Zanga
- Laboratori de Sanitat Vegetal, Departament d’Agricultura, Ramadera i Pesca, Generalitat de Catalunya, 25198 Lleida, Spain;
| | - Patricia Sarai Girón-Calva
- Department of Crop and Forest Sciences, University of Lleida-Agrotenio Center, Av. Al. Rovira Roure 191, 25198 Lleida, Spain; (C.L.); (P.M.); (P.S.G.-C.)
| | - Matilde Eizaguirre
- Department of Crop and Forest Sciences, University of Lleida-Agrotenio Center, Av. Al. Rovira Roure 191, 25198 Lleida, Spain; (C.L.); (P.M.); (P.S.G.-C.)
- Correspondence:
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Fortún J, Buitrago MJ, Gioia F, Gómez-Gª de la Pedrosa E, Alvarez ME, Martín-Dávila P, Pintado V, Cobeta P, Martinez-Castro N, Soriano C, Moreno I, Corral S, Muñoz P, Moreno-Jimenez G, Cuenca-Estrella M, Moreno-Guillen S. Roles of the multiplex real-time PCR assay and β-D-glucan in a high-risk population for intra-abdominal candidiasis (IAC). Med Mycol 2021; 58:789-796. [PMID: 31811285 DOI: 10.1093/mmy/myz123] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/14/2019] [Accepted: 11/23/2019] [Indexed: 01/05/2023] Open
Abstract
Multiplex quantitative real-time PCR (MRT-PCR) using blood can improve the diagnosis of intra-abdominal candidiasis (IAC). We prospectively studied 39 patients with suspected IAC in the absence of previous antifungal therapy. Blood cultures, MRT-PCR, and β-D-glucan (BDG) in serum were performed in all patients. IAC was defined according to the 2013 European Consensus criteria. For MRT-PCR, the probes targeted the ITS1 or ITS2 regions of ribosomal DNA. Candidaemia was confirmed only in four patients (10%), and IAC criteria were present in 17 patients (43.6%). The sensitivity of MRT-PCR was 25% but increased to 63.6% (P = .06) in plasma obtained prior to volume overload and transfusion; specificity was above 85% in all cases. BDG performance was improved using a cutoff > 260 pg/ml, and improvement was not observed in samples obtained before transfusion. In this cohort of high risk of IAC and low rate of bloodstream infection, the performance of non-culture-based methods (MRT-PCR or BDG) was moderate but may be a complementary tool given the limitations of diagnostic methods available in clinical practice. Volume overload requirements, in combination with other factors, decrease the accuracy of MRT-PCR in patients with IAC.
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Affiliation(s)
- J Fortún
- Infectious Diseases Department; Hospital Ramón y Cajal, Madrid
| | - M J Buitrago
- Reference Laboratory in Mycology; Centro Nacional Microbiología, Majadahonda
| | - F Gioia
- Infectious Diseases Department; Hospital Ramón y Cajal, Madrid
| | | | - M E Alvarez
- Infectious Diseases Department; Hospital Ramón y Cajal, Madrid
| | - P Martín-Dávila
- Infectious Diseases Department; Hospital Ramón y Cajal, Madrid
| | - V Pintado
- Infectious Diseases Department; Hospital Ramón y Cajal, Madrid
| | - P Cobeta
- Anaesthetic Department and Surgical Intensive Care Unit; Hospital Ramón y Cajal, Madrid
| | - N Martinez-Castro
- Anaesthetic Department and Surgical Intensive Care Unit; Hospital Ramón y Cajal, Madrid
| | - C Soriano
- Intensive Medicine Department and Medical Intensive Care Unit; Hospital Ramón y Cajal, Madrid
| | - I Moreno
- Surgey Department; Hospital Ramón y Cajal, Madrid
| | - S Corral
- Surgey Department; Hospital Ramón y Cajal, Madrid
| | - P Muñoz
- Clinical Microbiology and Infectious Diseases Department; Hospital Gregorio Marañon, Madrid
| | - G Moreno-Jimenez
- Hematology Department; Blood Bank Unit. Hospital Ramón y Cajal, Madrid
| | - M Cuenca-Estrella
- Reference Laboratory in Mycology; Centro Nacional Microbiología, Majadahonda
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Cantenys‐Molina S, Fernández‐Cruz E, Francos P, Lopez Bernaldo de Quirós JC, Muñoz P, Gil‐Herrera J. Lymphocyte subsets early predict mortality in a large series of hospitalized COVID-19 patients in Spain. Clin Exp Immunol 2021; 203:424-432. [PMID: 33187018 PMCID: PMC7753314 DOI: 10.1111/cei.13547] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 02/06/2023] Open
Abstract
The role of lymphocytes and their main subsets as prognostic factors of death in SARS-CoV-2-infected patients remains unclear, with no information obtained from patients outside China. We aimed to assess whether measuring lymphocyte subpopulations added clinical value to the total lymphocyte counting regarding mortality when they were simultaneously tested at hospital admission. Peripheral blood was analysed in 701 polymerase chain reaction (PCR)-confirmed consecutive patients by lysed-no washed flow cytometry. Demographic and clinical features were registered in electronic medical records. Statistical analysis was performed after a 3-month follow-up. The 112 patients who died were older and had significantly higher frequencies of known co-morbidities than survivor COVID-19 patients. A significant reduction in total lymphocytes, CD3+ , CD4+ , CD8+ and CD19+ counts and CD3+ percentage was found in the group of deceased patients (P < 0·001), while the percentage of CD56+ /CD16+ natural killer (NK) cells was significantly higher (P < 0·001). Multivariate logistic regression analysis showed a significantly increased risk of in-hospital death associated to age [odds ratio (OR) = 2·36, 95% confidence interval (CI) = 1·9-3·0 P < 0·001]; CD4+ T counts ≤ 500 cells/μl, (OR = 2·79, 95% CI = 1·1-6·7, P = 0·021); CD8+ T counts ≤ 100 cells/μl, (OR = 1·98, 95% CI = 1·2-3·3) P = 0·009) and CD56+ /CD16+ NK ≥ 30%, (OR = 1·97, 95% CI = 1·1-3·1, P = 0·002) at admission, independent of total lymphocyte numbers and co-morbidities, with area under the curve 0·85 (95% CI = 0·81-0·88). Reduced counts of CD4+ and CD8+ T cells with proportional expansion of NK lymphocytes at admission were prognostic factors of death in this Spanish series. In COVID-19 patients with normal levels of lymphocytes or mild lymphopenia, imbalanced lymphocyte subpopulations were early markers of in-hospital mortality.
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Affiliation(s)
- S. Cantenys‐Molina
- Division of ImmunologyHospital General Universitario ‘Gregorio Marañón’MadridSpain
| | - E. Fernández‐Cruz
- Division of ImmunologyHospital General Universitario ‘Gregorio Marañón’MadridSpain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM)MadridSpain
| | - P. Francos
- Division of ImmunologyHospital General Universitario ‘Gregorio Marañón’MadridSpain
| | - J. C. Lopez Bernaldo de Quirós
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM)MadridSpain
- Department of Clinical Microbiology and Infectious DiseasesHospital General Universitario ‘Gregorio Marañón’MadridSpain
| | - P. Muñoz
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM)MadridSpain
- Department of Clinical Microbiology and Infectious DiseasesHospital General Universitario ‘Gregorio Marañón’MadridSpain
- Medicine DepartmentSchool of MedicineUniversidad Complutense de Madrid (UCM)MadridSpain
- CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058)MadridSpain
| | - J. Gil‐Herrera
- Division of ImmunologyHospital General Universitario ‘Gregorio Marañón’MadridSpain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM)MadridSpain
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Muñoz P, Ocaña J, García F, Corral S, Rivas S. Estadificación axilar post-neoadyuvancia en pacientes con cáncer de mama con metástasis ganglionares al diagnóstico. Nuestra experiencia preliminar con biopsia selectiva de ganglio centinela y disección axilar dirigida guiada con semilla de iodo-125. Clínica e Investigación en Ginecología y Obstetricia 2021. [DOI: 10.1016/j.gine.2020.04.007] [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: 11/30/2022]
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Falagüerra T, Muñoz P, Correa G. Analysis of the cathode side of a PEMFC varying design parameters to optimize current distribution and power density. J Electroanal Chem (Lausanne) 2021. [DOI: 10.1016/j.jelechem.2020.114820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Castillejo C, Waurich V, Wagner H, Ramos R, Oiza N, Muñoz P, Triviño JC, Caruana J, Liu Z, Cobo N, Hardigan MA, Knapp SJ, Vallarino JG, Osorio S, Martín-Pizarro C, Posé D, Toivainen T, Hytönen T, Oh Y, Barbey CR, Whitaker VM, Lee S, Olbricht K, Sánchez-Sevilla JF, Amaya I. Allelic Variation of MYB10 Is the Major Force Controlling Natural Variation in Skin and Flesh Color in Strawberry ( Fragaria spp.) Fruit. Plant Cell 2020; 32:3723-3749. [PMID: 33004617 PMCID: PMC7721342 DOI: 10.1105/tpc.20.00474] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/13/2020] [Accepted: 09/25/2020] [Indexed: 05/02/2023]
Abstract
The fruits of diploid and octoploid strawberry (Fragaria spp) show substantial natural variation in color due to distinct anthocyanin accumulation and distribution patterns. Anthocyanin biosynthesis is controlled by a clade of R2R3 MYB transcription factors, among which MYB10 is the main activator in strawberry fruit. Here, we show that mutations in MYB10 cause most of the variation in anthocyanin accumulation and distribution observed in diploid woodland strawberry (F. vesca) and octoploid cultivated strawberry (F ×ananassa). Using a mapping-by-sequencing approach, we identified a gypsy-transposon in MYB10 that truncates the protein and knocks out anthocyanin biosynthesis in a white-fruited F. vesca ecotype. Two additional loss-of-function mutations in MYB10 were identified among geographically diverse white-fruited F. vesca ecotypes. Genetic and transcriptomic analyses of octoploid Fragaria spp revealed that FaMYB10-2, one of three MYB10 homoeologs identified, regulates anthocyanin biosynthesis in developing fruit. Furthermore, independent mutations in MYB10-2 are the underlying cause of natural variation in fruit skin and flesh color in octoploid strawberry. We identified a CACTA-like transposon (FaEnSpm-2) insertion in the MYB10-2 promoter of red-fleshed accessions that was associated with enhanced expression. Our findings suggest that cis-regulatory elements in FaEnSpm-2 are responsible for enhanced MYB10-2 expression and anthocyanin biosynthesis in strawberry fruit flesh.
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Affiliation(s)
- Cristina Castillejo
- Laboratorio de Genómica y Biotecnología, Instituto Andaluz de Investigación y Formación Agraria y Pesquera (IFAPA) Centro de Málaga, 29140 Málaga, Spain
- Unidad Asociada de I + D + i IFAPA-Consejo Superior de Investigaciones Científicas-Universidad de Málaga (IFAPA-IHSM) Biotecnología y Mejora en Fresa, Málaga 29071, Spain
| | - Veronika Waurich
- Hansabred GmbH & Co. KG, 01108 Dresden, Germany
- Institut für Botanik, Technische Universität Dresden, 01062 Dresden, Germany
| | - Henning Wagner
- Hansabred GmbH & Co. KG, 01108 Dresden, Germany
- Institut für Botanik, Technische Universität Dresden, 01062 Dresden, Germany
| | - Rubén Ramos
- Laboratorio de Genómica y Biotecnología, Instituto Andaluz de Investigación y Formación Agraria y Pesquera (IFAPA) Centro de Málaga, 29140 Málaga, Spain
- Unidad Asociada de I + D + i IFAPA-Consejo Superior de Investigaciones Científicas-Universidad de Málaga (IFAPA-IHSM) Biotecnología y Mejora en Fresa, Málaga 29071, Spain
| | - Nicolás Oiza
- Laboratorio de Genómica y Biotecnología, Instituto Andaluz de Investigación y Formación Agraria y Pesquera (IFAPA) Centro de Málaga, 29140 Málaga, Spain
- Unidad Asociada de I + D + i IFAPA-Consejo Superior de Investigaciones Científicas-Universidad de Málaga (IFAPA-IHSM) Biotecnología y Mejora en Fresa, Málaga 29071, Spain
| | - Pilar Muñoz
- Laboratorio de Genómica y Biotecnología, Instituto Andaluz de Investigación y Formación Agraria y Pesquera (IFAPA) Centro de Málaga, 29140 Málaga, Spain
- Unidad Asociada de I + D + i IFAPA-Consejo Superior de Investigaciones Científicas-Universidad de Málaga (IFAPA-IHSM) Biotecnología y Mejora en Fresa, Málaga 29071, Spain
| | | | - Julie Caruana
- Department of Cell Biology and Molecular Genetics, University of Maryland, College Park, Maryland 20742
| | - Zhongchi Liu
- Department of Cell Biology and Molecular Genetics, University of Maryland, College Park, Maryland 20742
| | - Nicolás Cobo
- Department of Plant Sciences, University of California, Davis, California 95616
- Departamento de Producción Agropecuaria, Universidad de La Frontera, Temuco 01145, Chile
| | - Michael A Hardigan
- Department of Plant Sciences, University of California, Davis, California 95616
| | - Steven J Knapp
- Department of Plant Sciences, University of California, Davis, California 95616
| | - José G Vallarino
- Unidad Asociada de I + D + i IFAPA-Consejo Superior de Investigaciones Científicas-Universidad de Málaga (IFAPA-IHSM) Biotecnología y Mejora en Fresa, Málaga 29071, Spain
- Departmento de Biología Molecular y Bioquímica, Instituto de Hortofruticultura Subtropical y Mediterránea "La Mayora" (IHSM), Universidad de Málaga-Consejo Superior de Investigaciones Científicas, Campus de Teatinos 29071, Málaga, Spain
| | - Sonia Osorio
- Unidad Asociada de I + D + i IFAPA-Consejo Superior de Investigaciones Científicas-Universidad de Málaga (IFAPA-IHSM) Biotecnología y Mejora en Fresa, Málaga 29071, Spain
- Departmento de Biología Molecular y Bioquímica, Instituto de Hortofruticultura Subtropical y Mediterránea "La Mayora" (IHSM), Universidad de Málaga-Consejo Superior de Investigaciones Científicas, Campus de Teatinos 29071, Málaga, Spain
| | - Carmen Martín-Pizarro
- Unidad Asociada de I + D + i IFAPA-Consejo Superior de Investigaciones Científicas-Universidad de Málaga (IFAPA-IHSM) Biotecnología y Mejora en Fresa, Málaga 29071, Spain
- Departmento de Biología Molecular y Bioquímica, Instituto de Hortofruticultura Subtropical y Mediterránea "La Mayora" (IHSM), Universidad de Málaga-Consejo Superior de Investigaciones Científicas, Campus de Teatinos 29071, Málaga, Spain
| | - David Posé
- Unidad Asociada de I + D + i IFAPA-Consejo Superior de Investigaciones Científicas-Universidad de Málaga (IFAPA-IHSM) Biotecnología y Mejora en Fresa, Málaga 29071, Spain
- Departmento de Biología Molecular y Bioquímica, Instituto de Hortofruticultura Subtropical y Mediterránea "La Mayora" (IHSM), Universidad de Málaga-Consejo Superior de Investigaciones Científicas, Campus de Teatinos 29071, Málaga, Spain
| | - Tuomas Toivainen
- Department of Agricultural Sciences, Viikki Plant Science Centre, University of Helsinki, Helsinki 00790, Finland
| | - Timo Hytönen
- Department of Agricultural Sciences, Viikki Plant Science Centre, University of Helsinki, Helsinki 00790, Finland
- Organismal and Evolutionary Biology Research Programme, Faculty of Biological and Environmental Sciences, Viikki Plant Science Centre, University of Helsinki, Helsinki 00790, Finland
- National Institute of Agricultural Botany East Malling Research (NIAB EMR), Kent ME19 6BJ, United Kingdom
| | - Youngjae Oh
- Department of Horticultural Sciences, University of Florida, Institute of Food and Agricultural Sciences (IFAS) Gulf Coast Research and Education Center, Wimauma, Florida 33598
| | - Christopher R Barbey
- Department of Horticultural Sciences, University of Florida, Institute of Food and Agricultural Sciences (IFAS) Gulf Coast Research and Education Center, Wimauma, Florida 33598
| | - Vance M Whitaker
- Department of Horticultural Sciences, University of Florida, Institute of Food and Agricultural Sciences (IFAS) Gulf Coast Research and Education Center, Wimauma, Florida 33598
| | - Seonghee Lee
- Department of Horticultural Sciences, University of Florida, Institute of Food and Agricultural Sciences (IFAS) Gulf Coast Research and Education Center, Wimauma, Florida 33598
| | | | - José F Sánchez-Sevilla
- Laboratorio de Genómica y Biotecnología, Instituto Andaluz de Investigación y Formación Agraria y Pesquera (IFAPA) Centro de Málaga, 29140 Málaga, Spain
- Unidad Asociada de I + D + i IFAPA-Consejo Superior de Investigaciones Científicas-Universidad de Málaga (IFAPA-IHSM) Biotecnología y Mejora en Fresa, Málaga 29071, Spain
| | - Iraida Amaya
- Laboratorio de Genómica y Biotecnología, Instituto Andaluz de Investigación y Formación Agraria y Pesquera (IFAPA) Centro de Málaga, 29140 Málaga, Spain
- Unidad Asociada de I + D + i IFAPA-Consejo Superior de Investigaciones Científicas-Universidad de Málaga (IFAPA-IHSM) Biotecnología y Mejora en Fresa, Málaga 29071, Spain
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Viñuela MC, De León-Luis JA, Alonso R, Catalán P, Lizarraga S, Muñoz P, Bouza E. SARS-CoV-2 screening of asymptomatic women admitted for delivery must be performed with a combination of microbiological techniques: an observational study. Rev Esp Quimioter 2020; 33:415-421. [PMID: 32945157 PMCID: PMC7712338 DOI: 10.37201/req/088.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/02/2020] [Accepted: 09/07/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study is to assess the value of systematic screening in asymptomatic women admitted for spontaneous delivery with a combination of reverse transcription polymerase chain reaction (RT-PCR) and cycle threshold (Ct) and serum antibodies. METHODS Since May 6 all women admitted for spontaneous delivery underwent RT-PCR in nasopharyngeal swabs and specific antibodies IgG of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in serum that were performed as part of routine clinical care in our institution. Ct of the PCR was recorded. We analyzed the first 100 women consecutively admitted for spontaneous delivery at our institution. RESULTS Nine women were positive for SARS-CoV-2 in nasopharyngeal samples (9%) and 13 (13%) presented positive specific antibodies of the coronavirus. Overall, SARS-CoV-2 prior exposure was 15%. The Ct determination (RT-PCR test) of our 9 positive patients ranged from 36 to 41 cycles with a median of 40. Vaginal delivery occurred in 94% of the cases and only 6% underwent a cesarean section, always for obstetric reasons. No fetal transmission was observed and maternal and neonatal prognosis was excellent. CONCLUSIONS During epidemic episodes in asymptomatic women in labor, universal testing with RT-PCR (considering Ct determination), and the detection of antibodies, permits a better interpretation of the results and avoid unnecessary isolation procedures.
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Affiliation(s)
- M C Viñuela
- Maria Carmen Viñuela, Department of Obstetrics and Gynecology. University Hospital Gregorio Marañón, School of Medicine, Complutense University of Madrid. O'Donnell Street 48, 28009 Madrid, Spain.
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Candel FJ, Barreiro P, San Román J, Abanades JC, Barba R, Barberán J, Bibiano C, Canora J, Cantón R, Calvo C, Carretero M, Cava F, Delgado R, García-Rodríguez J, González Del Castillo J, González de Villaumbrosia C, Hernández M, Losa JE, Martínez-Peromingo FJ, Molero JM, Muñoz P, Onecha E, Onoda M, Rodríguez J, Sánchez-Celaya M, Serra JA, Zapatero A. Recommendations for use of antigenic tests in the diagnosis of acute SARS-CoV-2 infection in the second pandemic wave: attitude in different clinical settings. Rev Esp Quimioter 2020; 33:466-484. [PMID: 33070578 PMCID: PMC7712344 DOI: 10.37201/req/120.2020] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [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: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 01/10/2023]
Abstract
The high transmissibility of SARS-CoV-2 before and shortly after the onset of symptoms suggests that only diagnosing and isolating symptomatic patients may not be sufficient to interrupt the spread of infection; therefore, public health measures such as personal distancing are also necessary. Additionally, it will be important to detect the newly infected individuals who remain asymptomatic, which may account for 50% or more of the cases. Molecular techniques are the "gold standard" for the diagnosis of SARS-CoV-2 infection. However, the massive use of these techniques has generated some problems. On the one hand, the scarcity of resources (analyzers, fungibles and reagents), and on the other the delay in the notification of results. These two facts translate into a lag in the application of isolation measures among cases and contacts, which favors the spread of the infection. Antigen detection tests are also direct diagnostic methods, with the advantage of obtaining the result in a few minutes and at the very "pointof-care". Furthermore, the simplicity and low cost of these tests allow them to be repeated on successive days in certain clinical settings. The sensitivity of antigen tests is generally lower than that of nucleic acid tests, although their specificity is comparable. Antigenic tests have been shown to be more valid in the days around the onset of symptoms, when the viral load in the nasopharynx is higher. Having a rapid and real-time viral detection assay such as the antigen test has been shown to be more useful to control the spread of the infection than more sensitive tests, but with greater cost and response time, such as in case of molecular tests. The main health institutions such as the WHO, the CDC and the Ministry of Health of the Government of Spain propose the use of antigenic tests in a wide variety of strategies to respond to the pandemic. This document aims to support physicians involved in the care of patients with suspected SC2 infection, in the context of a growing incidence in Spain since September 2020, which already represents the second pandemic wave of COVID-19.
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Affiliation(s)
- F J Candel
- Dr. Francisco Javier Candel. Enfermedades Infecciosas y Microbiología Clínica. Hospital Clínico San Carlos. Institutos IdISSC e IML. Profesor Asociado. Facultad de Medicina. UCM. Madrid. Spain.
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Sancho-Muriel J, Ocaña J, Cholewa H, Nuñez J, Muñoz P, Flor B, García JC, García-Granero E, Die J, Frasson M. Biological mesh reconstruction versus primary closure for preventing perineal morbidity after extralevator abdominoperineal excision: a multicentre retrospective study. Colorectal Dis 2020; 22:1714-1723. [PMID: 32619064 DOI: 10.1111/codi.15225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/10/2020] [Indexed: 02/08/2023]
Abstract
AIM The aim of the study was to compare the incidence of perineal hernia and the perineal wound morbidity following extralevator abdominoperineal excision (ELAPE) between two groups - primary perineal closure and reconstruction with a biological mesh. METHOD One hundred and forty-seven consecutive patients who underwent ELAPE for primary rectal cancer between January 2007 and December 2018 in two tertiary referral centres were retrospectively identified from prospective databases. Perineal closure was carried out via primary closure or with a biological mesh (porcine dermal collagen mesh). Outcome measures were perineal hernia and perineal wound morbidity (infection, dehiscence, persistent sinus and chronic pain). RESULTS A total of 139 patients were included in the study. A prophylactic mesh was used in 80 (57.5%) and primary closure was practised in 59 (42.4%) patients. The median follow-up was 30 (interquartile range 46.88) months. Thirty patients (21.6%) developed perineal hernia. No significant differences were found between prophylactic mesh and primary closure (16.3% vs 23.3%, P = 0.07). The median period between surgery and hernia diagnosis was 8 months in the primary closure group and 24 months in the mesh group (P < 0.01). Perineal wound morbidity was significantly higher in the prophylactic mesh group (55% vs 33.9%, P < 0.01). CONCLUSION In our study, the use of a biological mesh did not reduce the rate of perineal hernia, although it did delay its appearance. Perineal closure using a biological mesh may increase perineal morbidity, both acute and chronic.
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Affiliation(s)
- J Sancho-Muriel
- Division of Coloproctology, Department of General and Digestive Surgery, La Fe University Hospital, Valencia, Spain
| | - J Ocaña
- Division of Coloproctology, Department of General and Digestive Surgery, Ramón y Cajal University Hospital, Madrid, Spain
| | - H Cholewa
- Division of Coloproctology, Department of General and Digestive Surgery, La Fe University Hospital, Valencia, Spain
| | - J Nuñez
- Division of Coloproctology, Department of General and Digestive Surgery, Ramón y Cajal University Hospital, Madrid, Spain
| | - P Muñoz
- Division of Coloproctology, Department of General and Digestive Surgery, Ramón y Cajal University Hospital, Madrid, Spain
| | - B Flor
- Division of Coloproctology, Department of General and Digestive Surgery, La Fe University Hospital, Valencia, Spain
| | - J C García
- Division of Coloproctology, Department of General and Digestive Surgery, Ramón y Cajal University Hospital, Madrid, Spain
| | - E García-Granero
- Division of Coloproctology, Department of General and Digestive Surgery, La Fe University Hospital, Valencia, Spain
| | - J Die
- Division of Coloproctology, Department of General and Digestive Surgery, Ramón y Cajal University Hospital, Madrid, Spain
| | - M Frasson
- Division of Coloproctology, Department of General and Digestive Surgery, La Fe University Hospital, Valencia, Spain
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Marcos-Zambrano L, Gómez A, Sánchez-Carrillo C, Bouza E, Muñoz P, Escribano P, Guinea J. Corrigendum to “Isavuconazole is highly active in vitro against Candida species isolates but shows trailing effect” [Clin Microbiol Infect 24 (12) (December 2018) 1343.e1-1343.e4]. Clin Microbiol Infect 2020. [DOI: 10.1016/j.cmi.2020.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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