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Ugarte A, Bachero I, Cucchiari D, Sala M, Pereta I, Castells E, Subirana N, Loscos A, García L, Cardozo C, Rico V, García-Poutón N, Torres M, Lopera C, Aldea A, Suárez A, Coloma E, Seijas N, Altés J, Nicolás D. Effectiveness and Safety of Postoperative Hospital at Home for Surgical Patients: A Cohort Study. Ann Surg 2024; 279:727-733. [PMID: 38116685 DOI: 10.1097/sla.0000000000006180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
OBJECTIVE To determine the feasibility and effectiveness of a Hospital at Home (HaH) enabled early transfer pathways for surgical patients. BACKGROUND HaH serves as a safe alternative to traditional hospitalization by providing acute care to patients in their homes through a comprehensive range of hospital-level interventions. To our knowledge, no studies have been published to date reporting a large cohort of early home-transferred patients after surgery through a HaH unit. METHODS Cohort study enrolling every patient admitted to the HaH unit of a tertiary hospital who underwent any of 6 surgeries with a predefined early transfer pathway and fitting both general and surgery inclusion criteria (clinical and hemodynamic stability, uncomplicated surgery, presence of a caregiver, among others) from November 2021 to May 2023. Protocols were developed for each pathway between surgical services and HaH to deliver the usual postoperative care in the home setting. Discharge was decided according to protocol. An urgent escalation pathway was also established. RESULTS During the study period, 325 patients were included: 141 were bariatric surgeries, 85 kidney transplants, 45 thoracic surgeries, 37 cystectomies, 10 appendicectomies, and 7 ventral hernia repairs. The overall escalation of care during HaH occurred in 7.3% of patients and 30-day readmissions in 7%. Most adverse events were managed at home and the overall mortality was zero. The total mean length of stay was 8 days (interquartile range 2-14), and patients with HaH were transferred home 3 days (interquartile range 1-6) earlier than the usual pathway; a total of 1551 bed-days were saved. CONCLUSIONS The implementation of early home transfer pathways for surgical patients through HaH is feasible and effective, with favorable safety outcomes.
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Affiliation(s)
- Ainoa Ugarte
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
- Internal Medicine Service, Hospital Clínic of Barcelona, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Irene Bachero
- General Surgery and Digestive System Service, Hospital Clínic of Barcelona, Barcelona, Spain
| | - David Cucchiari
- Nephrology and Urology Service, Kidney Transplant Unit, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Marta Sala
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Irene Pereta
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Eva Castells
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Nuria Subirana
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Andrea Loscos
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Laura García
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Celia Cardozo
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- Infectious Diseases Service, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Verónica Rico
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- Infectious Diseases Service, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Nicol García-Poutón
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- Infectious Diseases Service, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Manuel Torres
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
- Internal Medicine Service, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Carlos Lopera
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- Infectious Diseases Service, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Anna Aldea
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
- Internal Medicine Service, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Adolfo Suárez
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Emmanuel Coloma
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
- Internal Medicine Service, Hospital Clínic of Barcelona, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Nuria Seijas
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Jordi Altés
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
| | - David Nicolás
- Hospital at Home Unit, Medical and Nurse Direction, Hospital Clínic of Barcelona, Barcelona, Spain
- Internal Medicine Service, Hospital Clínic of Barcelona, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
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Ruiz-Saavedra S, Salazar N, Suárez A, Diaz Y, González Del Rey C, González S, de Los Reyes-Gavilán CG. Human fecal alpha-glucosidase activity and its relationship with gut microbiota profiles and early stages of intestinal mucosa damage. Anaerobe 2024; 87:102853. [PMID: 38614290 DOI: 10.1016/j.anaerobe.2024.102853] [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: 12/21/2023] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVES We investigated potential relationships among initial lesions of the intestinal mucosa, fecal enzymatic activities and microbiota profiles. METHODS Fecal samples from 54 volunteers were collected after recruitment among individuals participating in a colorectal cancer (CRC) screening program in our region (Northern Spain) or attending for consultation due to clinical symptoms; intestinal mucosa samples were resected during colonoscopy. Enzymatic activities were determined in fecal supernatants by a semi-quantitative method. The fecal microbiota composition was determined by 16S rRNA gene-based sequencing. The results were compared between samples from clinical diagnosis groups (controls and polyps), according with the type of polyp (hyperplastic polyps or conventional adenomas) and considering the grade of dysplasia for conventional adenomas (low and high grade dysplasia). RESULTS High levels of α-glucosidase activity were more frequent among samples from individuals diagnosed with intestinal polyps, reaching statistical significance for conventional adenomas and for low grade dysplasia adenomas when compared to controls. Regarding the microbiota profiles, higher abundance of Christensenellaceae_R-7 group and Oscillospiraceae_UCG-002 were found in fecal samples displaying low α-glucosidase activity as compared with those with higher activity as well as in controls with respect to conventional adenomas. A relationship was evidenced among intestinal mucosal lesions, gut glucosidase activities and intestinal microbiota profiles. CONCLUSIONS Our findings suggest a relationship among altered fecal α-glucosidase levels, the presence of intestinal mucosal lesions, which can be precursors of CRC, and shifts in defined microbial groups of the fecal microbiota.
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Affiliation(s)
- Sergio Ruiz-Saavedra
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), Villaviciosa, Spain; Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Nuria Salazar
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), Villaviciosa, Spain; Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Adolfo Suárez
- Digestive Service, Central University Hospital of Asturias (HUCA), Oviedo, Spain; Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Ylenia Diaz
- Digestive Service, Carmen and Severo Ochoa Hospital, Cangas del Narcea, Spain
| | - Carmen González Del Rey
- Department of Anatomical Pathology, Central University Hospital of Asturias (HUCA), Oviedo, Spain
| | - Sonia González
- Department of Functional Biology, University of Oviedo, Oviedo, Spain; Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Clara G de Los Reyes-Gavilán
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), Villaviciosa, Spain; Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.
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Medina‐Prado L, Sala‐Miquel N, Aicart‐Ramos M, López‐Cardona J, Ponce‐Romero M, Ortíz O, Pellisé M, Aguilera L, Díez‐Redondo P, Núñez‐Rodríguez H, Seoane A, Domper‐Arnal M, Borao‐Laguna C, González‐Bernardo Ó, Suárez A, Muñoz‐Tornero M, Bustamante‐Balén M, Soutullo‐Castiñeiras C, Balleste‐Peris B, Esteban P, Jiménez‐Gómez M, Albert M, Lucas J, Valdivieso‐Cortázar E, López‐Serrano A, Solano M, Tejedor‐Tejada J, Trelles M, Zapater P, Jover R. Effect of the SARS-CoV-2 pandemic on colorectal cancer diagnosis and prognosis. Cancer Med 2024; 13:e6923. [PMID: 38491824 PMCID: PMC10943366 DOI: 10.1002/cam4.6923] [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: 05/29/2023] [Revised: 10/23/2023] [Accepted: 12/21/2023] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND AND STUDY AIMS Our aim was to determine the impact of the SARS-CoV-2 pandemic on the diagnosis and prognosis of colorectal cancer (CRC). PATIENTS AND METHODS This prospective cohort study included individuals diagnosed with CRC between March 13, 2019 and June 20, 2021 across 21 Spanish hospitals. Two time periods were compared: prepandemic (from March 13, 2019 to March 13, 2020) and pandemic (from March 14, 2020 to June 20, 2021, lockdown period and 1 year after lockdown). RESULTS We observed a 46.9% decrease in the number of CRC diagnoses (95% confidence interval (CI): 45.1%-48.7%) during the lockdown and 29.7% decrease (95% CI: 28.1%-31.4%) in the year after the lockdown. The proportion of patients diagnosed at stage I significantly decreased during the pandemic (21.7% vs. 19.0%; p = 0.025). Centers that applied universal preprocedure SARS-CoV-2 PCR testing experienced a higher reduction in the number of colonoscopies performed during the pandemic post-lockdown (34.0% reduction; 95% CI: 33.6%-34.4% vs. 13.7; 95% CI: 13.4%-13.9%) and in the number of CRCs diagnosed (34.1% reduction; 95% CI: 31.4%-36.8% vs. 26.7%; 95% CI: 24.6%-28.8%). Curative treatment was received by 87.5% of patients diagnosed with rectal cancer prepandemic and 80.7% of patients during the pandemic post-lockdown period (p = 0.002). CONCLUSIONS The COVID-19 pandemic has led to a decrease in the number of diagnosed CRC cases and in the proportion of stage I CRC. The reduction in the number of colonoscopies and CRC diagnoses was higher in centers that applied universal SARS-CoV-2 PCR screening before colonoscopy. In addition, the COVID-19 pandemic has affected curative treatment of rectal cancers.
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Affiliation(s)
- Lucía Medina‐Prado
- Servicio de Medicina Digestiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria ISABIAL, Departamento de Medicina ClínicaUniversidad Miguel HernándezAlicanteSpain
| | - Noelia Sala‐Miquel
- Servicio de Medicina Digestiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria ISABIAL, Departamento de Medicina ClínicaUniversidad Miguel HernándezAlicanteSpain
| | | | | | | | | | | | - Lara Aguilera
- Hospital Vall d'Hebron. Gastroenterology department vall d'Hebron Research InstituteBarcelonaSpain
| | | | | | - Agustín Seoane
- Hospital del Mar Medical Research Institute (IMIM), Gastroenterology departmentBarcelonaSpain
| | - María‐José Domper‐Arnal
- Hospital Clínico Universitario Lozano Blesa. Instituto de investigación sanitaria de Aragón (IIS Aragón)ZaragozaSpain
| | - Cristina Borao‐Laguna
- Hospital Clínico Universitario Lozano Blesa. Instituto de investigación sanitaria de Aragón (IIS Aragón)ZaragozaSpain
| | | | - Adolfo Suárez
- Hospital Universitario Central de AsturiasOviedoSpain
| | | | | | | | | | - Pilar Esteban
- Hospital Morales Meseguer. Instituto Murciano de Investigación Biosanitaria (IMIB)MuricaSpain
| | | | - Marc Albert
- Hospital Universitari de Girona Doctor Josep TruetaGironaSpain
| | - Javier Lucas
- Hospital Universitario Fundación AlcorcónAlcorconSpain
| | | | | | | | | | | | - Pedro Zapater
- Servicio de Medicina Digestiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria ISABIAL, Departamento de Medicina ClínicaUniversidad Miguel HernándezAlicanteSpain
| | - Rodrigo Jover
- Servicio de Medicina Digestiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria ISABIAL, Departamento de Medicina ClínicaUniversidad Miguel HernándezAlicanteSpain
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Laserna-Mendieta EJ, Navarro P, Casabona-Francés S, Savarino EV, Amorena E, Pérez-Martínez I, Guagnozzi D, Blas-Jhon L, Betoré E, Guardiola-Arévalo A, Pellegatta G, Krarup AL, Perello A, Barrio J, Gutiérrez-Junquera C, Teruel Sánchez-Vegazo C, Fernández-Fernández S, Naves JE, Oliva S, Rodríguez-Oballe JA, Carrión S, Espina S, Llorente Barrio M, Masiques-Mas ML, Dainese R, Feo-Ortega S, Martín-Dominguez V, Fernández-Pacheco J, Pérez-Fernández MT, Ghisa M, Maniero D, Nantes-Castillejo Ó, Nicolay-Maneru J, Suárez A, Maray I, Llerena-Castro R, Ortega-Larrodé A, Alcedo J, Granja Navacerrada A, Racca F, Santander C, Arias Á, Lucendo AJ. Swallowed topical corticosteroids for eosinophilic esophagitis: Utilization and real-world efficacy from the EoE CONNECT registry. United European Gastroenterol J 2024. [PMID: 38284792 DOI: 10.1002/ueg2.12533] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/25/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Swallowed topical corticosteroids (tC) are common therapy for patients with eosinophilic esophagitis (EoE). Widely heterogeneous results have occurred due to their active ingredients, formulations and doses. OBJECTIVE To assess the effectiveness of topical corticosteroid therapy for EoE in real-world practice. METHODS Cross-sectional study analysis of the multicentre EoE CONNECT registry. Clinical remission was defined as a decrease of ≥50% in dysphagia symptom scores; histological remission was defined as a peak eosinophil count below 15 per high-power field. The effectiveness in achieving clinico-histological remission (CHR) was compared for the main tC formulations. RESULTS Overall, data on 1456 prescriptions of tC in monotherapy used in 866 individual patients were assessed. Of those, 904 prescriptions with data on formulation were employed for the induction of remission; 234 reduced a previously effective dose for maintenance. Fluticasone propionate formulations dominated the first-line treatment, while budesonide was more common in later therapies. A swallowed nasal drop suspension was the most common formulation of fluticasone propionate. Doses ≥0.8 mg/day provided a 65% CHR rate and were superior to lower doses. Oral viscous solution prepared by a pharmacist was the most common prescription of budesonide; 4 mg/day provided no benefit over 2 mg/day (CHR rated being 72% and 80%, respectively). A multivariate analysis revealed budesonide orodispersible tablets as the most effective therapy (OR 18.9, p < 0.001); use of higher doses (OR 4.3, p = 0.03) and lower symptom scores (OR 0.9, p = 0.01) were also determinants of effectiveness. CONCLUSION Reduced symptom severity, use of high doses, and use of budesonide orodispersible tablets particularly were all independent predictors of tC effectiveness.
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Affiliation(s)
- Emilio J Laserna-Mendieta
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Madrid, Spain
- Laboratory Medicine Department, Hospital Universitario de La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
| | - Pilar Navarro
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
| | - Sergio Casabona-Francés
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Edoardo V Savarino
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
- Gastroenterology Unit, Azienza Ospedaliera di Padova, Padova, Italy
| | - Edurne Amorena
- Department of Gastroenterology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Isabel Pérez-Martínez
- Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Danila Guagnozzi
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario Valld'Hebrón, Barcelona, Spain
| | | | - Elena Betoré
- Department of Gastroenterology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Gaia Pellegatta
- Endoscopic Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Anne Lund Krarup
- Department of Emergency Medicine and Trauma Care, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Antonia Perello
- Department of Gastroenterology, Hospital de Viladecans, Viladecans, Spain
| | - Jesús Barrio
- Department of Gastroenterology, Hospital Universitario Rio Hortega, Valladolid, Spain
| | - Carolina Gutiérrez-Junquera
- Pediatric Gastroenterology Unit, Hospital Universitario Puerta de Hierro Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | | | - Salvatore Oliva
- Pediatric Gastroenterology and Liver Unit, Maternal and Child Health Department, Sapienza - University of Rome, Rome, Italy
| | - Juan Armando Rodríguez-Oballe
- Department of Gastroenterology, Hospital Universitario Arnau de Vilanova & Hospital Universitario Santa María, Lérida, Spain
| | - Silvia Carrión
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
- Department of Gastroenterology, Hospital de Mataró, Mataró, Spain
| | - Silvia Espina
- Department of Gastroenterology, Hospital General de la Defensa, Zaragoza, Spain
| | | | | | - Raffaella Dainese
- Department of Gastroenterology, Centre Hospitalier d'Antibes Juan-les-Pins, Antibes, France
| | - Sara Feo-Ortega
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Department of Pediatrics, Hospital General de Tomelloso, Tomelloso, Spain
| | - Verónica Martín-Dominguez
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Jennifer Fernández-Pacheco
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Maria Teresa Pérez-Fernández
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Matteo Ghisa
- Gastroenterology Unit, Azienza Ospedaliera di Padova, Padova, Italy
| | - Daria Maniero
- Gastroenterology Unit, Azienza Ospedaliera di Padova, Padova, Italy
| | | | - Julia Nicolay-Maneru
- Department of Gastroenterology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Adolfo Suárez
- Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Iván Maray
- Department of Pharmacy, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ronald Llerena-Castro
- Department of Gastroenterology, Hospital Universitario Valld'Hebrón, Barcelona, Spain
| | | | - Javier Alcedo
- Department of Gastroenterology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Francesca Racca
- Personalized Medicine, Asthma and Allergy Clinic, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Cecilio Santander
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Ángel Arias
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
- Research Unit, Hospital General Mancha-Centro, Alcázar de San Juan, Spain
| | - Alfredo J Lucendo
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
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Brotons A, Mangas-Sanjuan C, Cubiella J, Cid-Gómez L, Díez-Redondo P, Seoane A, García-Mateo S, Suárez A, Nicolás-Pérez D, Lumbreras B, Mira JJ, Sola-Vera J, Jover R. Colonoscopy Satisfaction and Safety Questionnaire based on patient experience (CSSQP): A valuable quality tool for all colonoscopies. Gastroenterol Hepatol 2024; 47:1-13. [PMID: 36841528 DOI: 10.1016/j.gastrohep.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 02/06/2023] [Accepted: 02/11/2023] [Indexed: 02/25/2023]
Abstract
INTRODUCTION The Colonoscopy Satisfaction and Safety Questionnaire based on Patient experience (CSSQP) was recently developed and validated within a Bowel Cancer Screening Program. We aimed to identify factor related to patient experience through the CSSQP, including all indications for colonoscopy. Indicators of satisfaction and perceived safety with colonoscopy were also assessed to compare the different centers. METHODS Multicenter study in nine Spanish hospitals. Consecutive patients who had undergone a colonoscopy completed the CSSQP adding a novel item on bowel preparation. Factors related to patient experiences and data from non-respondents were analyzed. RESULTS Of 2200 patients, 1753 filled out the questionnaire (response rate 79.7%, sample error 2%). Patients whose colonoscopy indication was a primary colorectal cancer screening (OR: 1.68, 95% CI: 1.15-2.44, p=0.007) or due to a +FIT (OR: 1.73, 95% CI: 1.18-2.53) reported higher satisfaction than patients with gastrointestinal symptoms. In addition, college-educated patients (OR: 2.11, 95% CI: 1.25-3.56) were more likely to report better overall satisfaction than patients with lower education level. Significant differences were observed in the majority of the CSSQP items between centers. Safety incidents were reported by 35 (2%) patients, and 176 (10%) patients reported that they received insufficient information. CONCLUSION The CSSQP identifies several significant factors on satisfaction and perceived safety in patients referred for colonoscopy for any reason. The CSSQP also allows comparison of patient-identified colonoscopy quality indicators between centers.
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Affiliation(s)
- Alicia Brotons
- Department of Gastroenterology, Hospital General Universitario de Elche, Elche, Spain; Department of Gastroenterology, Vega Baja Hospital of Orihuela, Spain.
| | - Carolina Mangas-Sanjuan
- Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, Spain
| | - Joaquín Cubiella
- Department of Gastroenterology, Complexo Hospitalario de Ourense, Instituto de Investigación Sanitaria Galicia Sur, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Ourense, Spain
| | - Lucía Cid-Gómez
- Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Instituto de Investigación Biomédica, Xerencia Integrada de Vigo, Vigo, Spain
| | | | - Agustín Seoane
- Department of Gastroenterology, Parc de Salut Mar, Hospital del Mar, Barcelona, Spain
| | - Sandra García-Mateo
- Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Aragon Health Research Institute, Zaragoza, Spain
| | - Adolfo Suárez
- Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - David Nicolás-Pérez
- Department of Gastroenterology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Blanca Lumbreras
- Department of Public Health, Miguel Hernández University, Elche, Spain; CIBERESP, CIBER in Epidemiology and Public Health, Spain
| | - José Joaquín Mira
- Department of Health Psychology, Miguel Hernández University, Elche, Spain
| | - Javier Sola-Vera
- Department of Gastroenterology, Hospital General Universitario de Elche, Elche, Spain
| | - Rodrigo Jover
- Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, Spain
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Ruiz-Saavedra S, Arboleya S, Nogacka AM, González del Rey C, Suárez A, Diaz Y, Gueimonde M, Salazar N, González S, de los Reyes-Gavilán CG. Commensal Fecal Microbiota Profiles Associated with Initial Stages of Intestinal Mucosa Damage: A Pilot Study. Cancers (Basel) 2023; 16:104. [PMID: 38201530 PMCID: PMC10778549 DOI: 10.3390/cancers16010104] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
Progressive intestinal mucosal damage occurs over years prior to colorectal cancer (CRC) development. The endoscopic screening of polyps and histopathological examination are used clinically to determine the risk and progression of mucosal lesions. We analyzed fecal microbiota compositions using 16S rRNA gene-based metataxonomic analyses and the levels of short-chain fatty acids (SCFAs) using gas chromatography in volunteers undergoing colonoscopy and histopathological analyses to determine the microbiota shifts occurring at the early stages of intestinal mucosa alterations. The results were compared between diagnosis groups (nonpathological controls and polyps), between samples from individuals with hyperplastic polyps or conventional adenomas, and between grades of dysplasia in conventional adenomas. Some microbial taxa from the Bacillota and Euryarchaeota phyla were the most affected when comparing the diagnosis and histopathological groups. Deeper microbiota alterations were found in the conventional adenomas than in the hyperplastic polyps. The Ruminococcus torques group was enriched in both the hyperplastic polyps and conventional adenomas, whereas the family Eggerthellaceae was enriched only in the hyperplastic polyps. The abundance of Prevotellaceae, Oscillospiraceae, Methanobacteriaceae, Streptococcaceae, Christensenellaceae, Erysipelotrichaceae, and Clostridiaceae shifted in conventional adenomas depending on the grade of dysplasia, without affecting the major SCFAs. Our results suggest a reorganization of microbial consortia involved in gut fermentative processes.
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Affiliation(s)
- Sergio Ruiz-Saavedra
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain; (S.R.-S.); (S.A.); (A.M.N.); (M.G.); (N.S.)
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
| | - Silvia Arboleya
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain; (S.R.-S.); (S.A.); (A.M.N.); (M.G.); (N.S.)
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
| | - Alicja M. Nogacka
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain; (S.R.-S.); (S.A.); (A.M.N.); (M.G.); (N.S.)
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
| | - Carmen González del Rey
- Department of Anatomical Pathology, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain;
| | - Adolfo Suárez
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
- Digestive Service, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain
| | - Ylenia Diaz
- Digestive Service, Carmen and Severo Ochoa Hospital, 33819 Cangas del Narcea, Spain;
| | - Miguel Gueimonde
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain; (S.R.-S.); (S.A.); (A.M.N.); (M.G.); (N.S.)
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
| | - Nuria Salazar
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain; (S.R.-S.); (S.A.); (A.M.N.); (M.G.); (N.S.)
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
| | - Sonia González
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
- Department of Functional Biology, University of Oviedo, 33006 Oviedo, Spain
| | - Clara G. de los Reyes-Gavilán
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain; (S.R.-S.); (S.A.); (A.M.N.); (M.G.); (N.S.)
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
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7
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Ortiz-Hernández M, Salazar-Pereda V, Mendoza-Espinosa D, Gomez-Bonilla MA, Cristobal C, Ortega-Alfaro MC, Suárez A, Sandoval-Chavez CI. CH bond activation in aromatic ketones mediated by iridium-tris(pyrazolyl)borate complexes. Dalton Trans 2023. [PMID: 37997796 DOI: 10.1039/d3dt02849f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
Reaction of complex [TpMe2Ir(η4-CH2C(Me)C(Me)C2)] (1) with a series of aromatic ketones at 130 °C renders, by means of a selective ortho-CH activation, Ir(III)-metallacycles 2-5, which display an Ir-H bond. When [TpMe2Ir(C6H5)2N2] (6) is treated with 2-(trifluoromethyl)acetophenone and 2-fluoroacetophenone at 80 °C, the formation of dimeric (7) and trimeric architectures (8) is achieved through the meta- and para-CH activation of the aromatic ketone, respectively. The generation of complexes 2-5 is proposed to occur by the initial formation of Ir(III) η1-ketone adducts as key intermediates, followed by aromatic CH activations and the release of a butadiene ligand. The formation of complexes 7 and 8 involves an assisted process in which a metal center activation of the less sterically hindered C-H bond of the aromatic ketone takes place (releasing a benzene molecule), followed by the coordination of the carbonyl group, which generates the respective dimeric and trimeric structures. Complexes 7 and 8 are efficient catalysts for the transfer hydrogenation of ketones and aldehydes using isopropanol as the hydrogen source. All complexes have been fully characterized by NMR spectroscopy, FT-IR, elemental analysis and, in the cases of 7 and 8, X-ray crystallography. Details of the reaction conditions, isolation of the products, and proposals for the pathways of formation of complexes 2-5 and 7-8 are discussed.
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Affiliation(s)
- M Ortiz-Hernández
- Área Académica de Química, Universidad Autónoma del Estado de Hidalgo, Carretera Pachuca-Tulancingo Km. 4.5, Mineral de la Reforma, Hidalgo, 42090, Mexico.
| | - V Salazar-Pereda
- Área Académica de Química, Universidad Autónoma del Estado de Hidalgo, Carretera Pachuca-Tulancingo Km. 4.5, Mineral de la Reforma, Hidalgo, 42090, Mexico.
| | - D Mendoza-Espinosa
- Área Académica de Química, Universidad Autónoma del Estado de Hidalgo, Carretera Pachuca-Tulancingo Km. 4.5, Mineral de la Reforma, Hidalgo, 42090, Mexico.
| | - M A Gomez-Bonilla
- Área Académica de Química, Universidad Autónoma del Estado de Hidalgo, Carretera Pachuca-Tulancingo Km. 4.5, Mineral de la Reforma, Hidalgo, 42090, Mexico.
| | - C Cristobal
- Departamento de Química, División de Ciencias Naturales y Exactas, Universidad de Guanajuato, Campus Noria Alta, Guanajuato, 36050, Mexico
| | - M C Ortega-Alfaro
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Circuito Exterior, Cuidad Universitaria, Alcaldía Coyoacán, 04510, Mexico
| | - A Suárez
- Instituto de Investigaciones Químicas, Departamento de Química Inorgánica, CSIC-Universidad de Sevilla, Avda. Américo Vespucio 49, 41092, Sevilla, Spain
| | - C I Sandoval-Chavez
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Circuito Exterior, Cuidad Universitaria, Alcaldía Coyoacán, 04510, Mexico
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Carballo-Folgoso L, Cuevas Pérez J, Celada-Sendino M, Martínez Camblor L, Merino Baamonde S, García Alonso L, García Álvarez V, Suárez A. Small bowel cavernous hemangioma as an uncommon cause of iron-deficiency anemia. Rev Esp Enferm Dig 2023; 115:672-673. [PMID: 37539514 DOI: 10.17235/reed.2023.9778/2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Small bowel hemangiomas are benign congenital vascular lesions that can be asymptomatic or cause anemia, gastrointestinal bleeding, obstruction, or intestinal perforation. We report the case of a 75-year-old woman who, after years of study for iron-deficiency anemia, was diagnosed with a cavernous hemangioma of the jejunum by capsule endoscopy, which was confirmed after surgical resection.
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Affiliation(s)
| | | | | | | | | | | | | | - Adolfo Suárez
- Aparato Digestivo, Hospital Universitario Central de Asturias, España
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9
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Ruiz-Saavedra S, González Del Rey C, Suárez A, Díaz Y, Zapico A, Arboleya S, Salazar N, Gueimonde M, de Los Reyes-Gavilán CG, González S. Associations of dietary factors and xenobiotic intake with faecal microbiota composition according to the presence of intestinal mucosa damage. Food Funct 2023; 14:9591-9605. [PMID: 37740374 DOI: 10.1039/d3fo01356a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
Diet is a major modulator of gut microbiota, which plays a key role in the health status, including colorectal cancer (CRC) development. Several studies and meta-analyses have evidenced an association of certain dietary factors and xenobiotic intake with the incidence of CRC. Nevertheless, how these dietary factors impact the first stages of intestinal mucosa damage is still uncertain. This study aimed at exploring the associations of relevant dietary factors with the gut microbiota of control individuals and subjects diagnosed with intestinal polyps. A total of 60 volunteers were recruited, clinically classified according to colonoscopy criteria and interviewed using food frequency questionnaires (FFQs). The nutritional status of each volunteer was determined and the intake of dietary xenobiotics was quantified. The relative abundance of faecal microbiota taxonomic groups was obtained through 16S rRNA gene sequencing. The association of dietary factors and xenobiotics with faecal microbiota composition showed differences according to the clinical diagnosis group. Our results showed that the intake of red meat (≥50 g day-1) and total polycyclic aromatic hydrocarbons (PAHs) (≥0.75 μg day-1) was associated with a decreased abundance of the family Bacteroidaceae and an increased abundance of Coriobacteriaceae in control subjects. The intake of the heterocyclic amines 2-amino-1-methyl-6-phenylimidazo(4,5-b)pyridine (PhIP) (≥40 ng day-1) and 2-amino-3,8 dimethylimidazo(4,5,f) quinoxaline (MeIQx) (≥50 ng day-1) was associated with a decreased abundance of Akkermansiaceae in the control diagnosis group. Moreover, N-nitroso compounds (NOCs), nitrites (≥1.69 mg day-1) and N-nitrosodimethylamine (NDMA) (≥0.126 μg day-1) were associated with a decreased abundance of Bifidobacteriaceae. The intake of ethanol (≥12 g day-1) in the polyps group was associated with an increased abundance of Peptostreptococcaceae and a decreased abundance of Veillonellaceae. Moreover, linear regression analyses allowed us to identify ethanol, calcium, bioactive compounds such as flavonoids, stilbenes, cellulose, phenolic acids or total polyphenols, and dietary xenobiotics such as PhIP and MeIQx, the NOC N-nitrosopyrrolidine (NPYR) or the total PAHs as potential predictors of faecal microbiota group abundances. These results indicated that the consumption of milk, red meat, processed meat and ethanol and the intake of polyphenols, dietary PAHs, HAs and NOCs are associated with specific groups of the intestinal microbiota, depending on the clinical diagnosis group.
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Affiliation(s)
- Sergio Ruiz-Saavedra
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain.
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Carmen González Del Rey
- Anatomical Pathology Service, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain
| | - Adolfo Suárez
- Digestive Service, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain
| | - Ylenia Díaz
- Digestive Service, Carmen and Severo Ochoa Hospital, 33819 Cangas del Narcea, Spain
| | - Aida Zapico
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Department of Functional Biology, University of Oviedo, 33006 Oviedo, Spain
| | - Silvia Arboleya
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain.
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Nuria Salazar
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain.
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Miguel Gueimonde
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain.
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Clara G de Los Reyes-Gavilán
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain.
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Sonia González
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Department of Functional Biology, University of Oviedo, 33006 Oviedo, Spain
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10
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Guillén-González F, Sevillano-Castellano E, Suárez A. Fitting parameters and therapies of ODE tumor models with senescence and immune system. J Math Biol 2023; 87:67. [PMID: 37805974 PMCID: PMC10560657 DOI: 10.1007/s00285-023-02000-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/30/2023] [Accepted: 09/17/2023] [Indexed: 10/10/2023]
Abstract
This work is devoted to introduce and study two quasispecies nonlinear ODE systems that model the behavior of tumor cell populations organized in different states. In the first model, replicative, senescent, extended lifespan, immortal and tumor cells are considered, while the second also includes immune cells. We fit the parameters regulating the transmission between states in order to approximate the outcomes of the models to a real progressive tumor invasion. After that, we study the identifiability of the fitted parameters, by using two sensitivity analysis methods. Then, we show that an adequate reduced fitting process (only accounting to the most identifiable parameters) gives similar results but saving computational cost. Three different therapies are introduced in the models to shrink (progressively in time) the tumor, while the replicative and senescent cells invade. Each therapy is identified to a dimensionless parameter. Then, we make a fitting process of the therapies' parameters, in various scenarios depending on the initial tumor according to the time when the therapies started. We conclude that, although the optimal combination of therapies depends on the size of initial tumor, the most efficient therapy is the reinforcement of the immune system. Finally, an identifiability analysis allows us to detect a limitation in the therapy outcomes. In fact, perturbing the optimal combination of therapies under an appropriate therapeutic vector produces virtually the same results.
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Affiliation(s)
- F Guillén-González
- Dpto. Ecuaciones Diferenciales y Análisis Numérico and IMUS, Facultad de Matemáticas, Universidad de Sevilla, C/ Tarfia, S/N, 41012, Sevilla, Spain.
| | - E Sevillano-Castellano
- Dpto. Ecuaciones Diferenciales y Análisis Numérico and IMUS, Facultad de Matemáticas, Universidad de Sevilla, C/ Tarfia, S/N, 41012, Sevilla, Spain
| | - A Suárez
- Dpto. Ecuaciones Diferenciales y Análisis Numérico and IMUS, Facultad de Matemáticas, Universidad de Sevilla, C/ Tarfia, S/N, 41012, Sevilla, Spain
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11
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Mangas-Sanjuan C, de-Castro L, Cubiella J, Díez-Redondo P, Suárez A, Pellisé M, Fernández N, Zarraquiños S, Núñez-Rodríguez H, Álvarez-García V, Ortiz O, Sala-Miquel N, Zapater P, Jover R. Role of Artificial Intelligence in Colonoscopy Detection of Advanced Neoplasias : A Randomized Trial. Ann Intern Med 2023; 176:1145-1152. [PMID: 37639723 DOI: 10.7326/m22-2619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The role of computer-aided detection in identifying advanced colorectal neoplasia is unknown. OBJECTIVE To evaluate the contribution of computer-aided detection to colonoscopic detection of advanced colorectal neoplasias as well as adenomas, serrated polyps, and nonpolypoid and right-sided lesions. DESIGN Multicenter, parallel, randomized controlled trial. (ClinicalTrials.gov: NCT04673136). SETTING Spanish colorectal cancer screening program. PARTICIPANTS 3213 persons with a positive fecal immunochemical test. INTERVENTION Enrollees were randomly assigned to colonoscopy with or without computer-aided detection. MEASUREMENTS Advanced colorectal neoplasia was defined as advanced adenoma and/or advanced serrated polyp. RESULTS The 2 comparison groups showed no significant difference in advanced colorectal neoplasia detection rate (34.8% with intervention vs. 34.6% for controls; adjusted risk ratio [aRR], 1.01 [95% CI, 0.92 to 1.10]) or the mean number of advanced colorectal neoplasias detected per colonoscopy (0.54 [SD, 0.95] with intervention vs. 0.52 [SD, 0.95] for controls; adjusted rate ratio, 1.04 [99.9% CI, 0.88 to 1.22]). Adenoma detection rate also did not differ (64.2% with intervention vs. 62.0% for controls; aRR, 1.06 [99.9% CI, 0.91 to 1.23]). Computer-aided detection increased the mean number of nonpolypoid lesions (0.56 [SD, 1.25] vs. 0.47 [SD, 1.18] for controls; adjusted rate ratio, 1.19 [99.9% CI, 1.01 to 1.41]), proximal adenomas (0.94 [SD, 1.62] vs. 0.81 [SD, 1.52] for controls; adjusted rate ratio, 1.17 [99.9% CI, 1.03 to 1.33]), and lesions of 5 mm or smaller (polyps in general and adenomas and serrated lesions in particular) detected per colonoscopy. LIMITATIONS The high adenoma detection rate in the control group may limit the generalizability of the findings to endoscopists with low detection rates. CONCLUSION Computer-aided detection did not improve colonoscopic identification of advanced colorectal neoplasias. PRIMARY FUNDING SOURCE Medtronic.
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Affiliation(s)
- Carolina Mangas-Sanjuan
- Department of Gastroenterology, Hospital General Universitario Dr. Balmis, Servicio de Medicina Digestiva, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Spain (C.M., N.S.)
| | - Luisa de-Castro
- Department of Gastroenterology, Hospital Álvaro Cunqueiro, Digestive Pathology Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain (L. de-C., N.F.)
| | - Joaquín Cubiella
- Department of Gastroenterology, Hospital Universitario de Ourense, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Ourense, Spain (J.C., S.Z.)
| | - Pilar Díez-Redondo
- Department of Gastroenterology, Hospital Río-Hortega, Valladolid, Spain (P.D., H.N.)
| | - Adolfo Suárez
- Department of Gastroenterology, Hospital Central de Asturias, Oviedo, Spain (A.S., V.A.)
| | - María Pellisé
- Department of Gastroenterology, Hospital Clínic Barcelona, Barcelona, Spain (M.P., O.O.)
| | - Nereida Fernández
- Department of Gastroenterology, Hospital Álvaro Cunqueiro, Digestive Pathology Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain (L. de-C., N.F.)
| | - Sara Zarraquiños
- Department of Gastroenterology, Hospital Universitario de Ourense, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Ourense, Spain (J.C., S.Z.)
| | - Henar Núñez-Rodríguez
- Department of Gastroenterology, Hospital Río-Hortega, Valladolid, Spain (P.D., H.N.)
| | | | - Oswaldo Ortiz
- Department of Gastroenterology, Hospital Clínic Barcelona, Barcelona, Spain (M.P., O.O.)
| | - Noelia Sala-Miquel
- Department of Gastroenterology, Hospital General Universitario Dr. Balmis, Servicio de Medicina Digestiva, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Spain (C.M., N.S.)
| | - Pedro Zapater
- Hospital General Universitario Dr. Balmis, Clinical Pharmacology Department, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Departamento de Farmacología, Universidad Miguel Hernández, Alicante, CIBERehd, Spain (P.Z.)
| | - Rodrigo Jover
- Department of Gastroenterology, Hospital General Universitario Dr. Balmis, Servicio de Medicina Digestiva, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Departamento de Medicina Clínica, Universidad Miguel Hernández, Alicante, Spain (R.J.)
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12
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Mangas‐Sanjuan C, Seoane A, Alvarez‐Gonzalez MA, Luè A, Suárez A, Álvarez‐García V, Bujanda L, Portillo I, González N, Cid‐Gomez L, Cubiella J, Rodríguez‐Camacho E, Ponce M, Díez‐Redondo P, Herráiz M, Pellisé M, Ono A, Baile‐Maxía S, Medina‐Prado L, O M, Zapater P, Jover R. Factors associated with lesion detection in colonoscopy among different indications. United European Gastroenterol J 2022; 10:1008-1019. [PMID: 36300971 PMCID: PMC9731659 DOI: 10.1002/ueg2.12325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/13/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Different factors may influence colonoscopy performance measures. We aimed to analyze procedure- and endoscopist-related factors associated with detection of colorectal lesions and whether these factors have a similar influence in the context of different colonoscopy indications: positive fecal immunochemical test (+FIT) and post-polypectomy surveillance colonoscopies. METHODS This multicenter cross-sectional study included adults aged 40-80 years. Endoscopists (N = 96) who had performed ≥50 examinations were assessed for physician-related factors. Adenoma detection rate (ADR), adenomas per colonoscopy rate (APCR), advanced ADR, serrated polyp detection (SDR), and serrated polyps per colonoscopy rate (SPPCR) were calculated. RESULTS We included 12,932 procedures, with 4810 carried out after a positive FIT and 1967 for surveillance. Of the 96 endoscopists evaluated, 43.8% were women, and the mean age was 41.9 years. The ADR, advanced ADR, and SDR were 39.7%, 17.7%, and 12.8%, respectively. Adenoma detection rate was higher in colonoscopies after a +FIT (50.3%) with a more than doubled advanced ADR compared to non-FIT procedures (27.6% vs. 13.0%) and similar results in serrated lesions (14.7% vs. 13.5%). Among all the detection indicators analyzed, withdrawal time was the only factor independently related to improvement (p < 0.001). Regarding FIT-positive and surveillance procedures, for both indications, withdrawal time was also the only factor associated with a higher detection of adenomas and serrated polyps (p < 0.001). Endoscopist-related factors (i.e., weekly hours dedicated to endoscopy, annual colonoscopy volume and lifetime number of colonoscopies performed) had also impact on lesion detection (APCR, advanced ADR and SPPCR). CONCLUSIONS Withdrawal time was the factor most commonly associated with improved detection of colonic lesions globally and in endoscopies for + FIT and post-polypectomy surveillance. Physician-related factors may help to address strategies to support training and service provision. Our results can be used for establishing future benchmarking and quality improvement in different colonoscopy indications.
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Affiliation(s)
- Carolina Mangas‐Sanjuan
- Department of GastroenterologyHospital General Universitario de AlicanteInstituto de Investigación Sanitaria y Biomédica de Alicante, ISABIALAlicanteSpain
| | - Agustin Seoane
- Department of GastroenterologyParc de Salut MarHospital del MarBarcelonaSpain
| | | | - Alberto Luè
- Department of GastroenterologyHospital Clínico Universitario Lozano BlesaAragon Health Research InstituteIIS AragonZaragozaSpain
| | - Adolfo Suárez
- Department of GastroenterologyHospital Universitario Central de AsturiasOviedoSpain
| | | | - Luis Bujanda
- Department of GastroenterologyBiodonostia Medical Research InstituteSan SebastiánSpain
| | - Isabel Portillo
- Basque Country Colorectal Cancer Screening ProgrammeOsakidetza, Basque Health ServiceBilbaoSpain
| | - Natalia González
- Department of GastroenterologyHospital Universitario de CanariasInstituto Universitario de Tecnologías Biomédicas & Centro de Investigación Biomédica de Canarias (CIBICAN)Santa Cruz de TenerifeSpain
| | - Lucía Cid‐Gomez
- Department of GastroenterologyComplexo Hospitalario Universitario de VigoInstituto de Investigación BiomédicaXerencia de Xestión Integrada de VigoVigoSpain
| | - Joaquín Cubiella
- Department of GastroenterologyComplexo Hospitalario de OurenseInstituto de Investigación Biomédica de OurensePontevedra y VigoOurenseSpain
| | | | - Marta Ponce
- Department of GastroenterologyHospital Universitario La FeValenciaSpain
| | | | - Maite Herráiz
- Department of GastroenterologyClínica Universitaria and Medical SchoolUniversity of NavarraNavarraSpain
| | - María Pellisé
- Department of GastroenterologyHospital ClínicCIBERehdIDIBAPSUniversity of BarcelonaBarcelonaSpain
| | - Akiko Ono
- Unidad de Gestión Clínica de DigestivoHospital Universitario Virgen de la ArrixacaInstituto Murciano de Investigación BiosanitariaMurciaSpain
| | - S. Baile‐Maxía
- Department of GastroenterologyHospital General Universitario de AlicanteInstituto de Investigación Sanitaria y Biomédica de Alicante, ISABIALAlicanteSpain
| | - L. Medina‐Prado
- Department of GastroenterologyHospital General Universitario de AlicanteInstituto de Investigación Sanitaria y Biomédica de Alicante, ISABIALAlicanteSpain
| | - Murcia O
- Department of GastroenterologyHospital General Universitario de AlicanteInstituto de Investigación Sanitaria y Biomédica de Alicante, ISABIALAlicanteSpain
| | - Pedro Zapater
- Unit of Clinical PharmacologyHospital General Universitario de AlicanteInstituto de Investigación Sanitaria y Biomédica de Alicante, ISABIALAlicanteSpain
| | - Rodrigo Jover
- Department of GastroenterologyHospital General Universitario de AlicanteInstituto de Investigación Sanitaria y Biomédica de Alicante, ISABIALAlicanteSpain
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Vega Novillo V, Chacón F, Suárez A, Marcacuzco A, Caso O, Loinaz C, Jiménez C, Rivas Duarte C, Justo I. P-119 A MODIFIED CHEVREL AS AN ALTERNATIVE WALL CLOSURE TECHNIQUE FOR PATIENTS WITH ABDOMINAL HYPERTENSION. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Abdominal compartment syndrome is a pontentially life-threatening condition seen in critically ill patients, and most often caused by acute pancreatitis, postoperative abdominal vacular thrombosis or mesenteric ischemia. A descompressive laparotomy is sometimes required, often resulting in hernias, and subsequent definitive wall closure is challenging.
Aim
This study aims to describe short term results after a modified Chevrel technique for midline incisional repair in patients witch abdominal hypertension.
Materials & Methods
We performed a modified Chevrel as an abdominal closure technique in 9 patients between January 2016 and January 2022. All patients presented varying degrees of abdominal hypertension.
Results
Nine patients were treated with new technique (6 male and 3 female), all of whom had conditions that precluded unfolding the contralateral side as a means for closure. The reasons for this were diverse, including presence of ileostomies, intra-abdominal drainages, Kher tubes or an inverted T scar from previous transplant. The use of mesh was initially dismissed in 6 of the patients (66.7%) because they required subsequent abdominal surgeries. None of the patients developed a hernia, although two died 6 months after the procedure. Only one patient developed buldging. A decrease in intrabdominal pressure was achieved in all patients.
Conclusion
The modified Chevrel technique can be used as a closure option for midline ventral hernias in cases where the entire abdominal wall cannot be used.
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Affiliation(s)
- V Vega Novillo
- General Surgery, Hospital Universitario 12 de octubre , Madrid , Spain
| | - F Chacón
- General Surgery, Hospital Universitario 12 de octubre , Madrid , Spain
| | - A Suárez
- General Surgery, Hospital Universitario 12 de octubre , Madrid , Spain
| | - A Marcacuzco
- General Surgery, Hospital Universitario 12 de octubre , Madrid , Spain
| | - O Caso
- General Surgery, Hospital Universitario 12 de octubre , Madrid , Spain
| | - C Loinaz
- General Surgery, Hospital Universitario 12 de octubre , Madrid , Spain
| | - C Jiménez
- General Surgery, Hospital Universitario 12 de octubre , Madrid , Spain
| | - C Rivas Duarte
- Thoracic Surgery, Hospital Universitario de Salamanca , Salamanca , Spain
| | - I Justo
- General Surgery, Hospital Universitario 12 de octubre , Madrid , Spain
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14
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Ruiz-Saavedra S, Zapico A, del Rey CG, Gonzalez C, Suárez A, Díaz Y, de los Reyes-Gavilán CG, González S. Dietary Xenobiotics Derived from Food Processing: Association with Fecal Mutagenicity and Gut Mucosal Damage. Nutrients 2022; 14:nu14173482. [PMID: 36079735 PMCID: PMC9458229 DOI: 10.3390/nu14173482] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 12/03/2022] Open
Abstract
Whereas the mechanisms underlying the association of toxic dietary xenobiotics and cancer risk are not well established, it is plausible that dietary pattern may affect the colon environment by enhancing or reducing exposure to mutagens. This work aimed to investigate the association between xenobiotics intake and different stages of intestinal mucosal damage and colorectal cancer (CRC) screening and examine whether these associations may be mediated by altered intestinal mutagenicity. This was a case control study with 37 control subjects, 49 patients diagnosed with intestinal polyps, and 7 diagnosed with CRC. Lifestyle, dietary, and clinical information was registered after colonoscopy. For xenobiotics intake estimation the European Prospective Investigation into Cancer (EPIC) and the Computerized Heterocyclic Amines Resource for Research in Epidemiology of Disease (CHARRED) databases were used. The mutagenicity of fecal supernatants was assayed by the Ames test and light microscopy was used for the presence of aberrant crypt formation. Among all the potential carcinogens studied, the polyp group showed higher intakes of ethanol and dibenzo (a) anthracene (DiB(a)A). Besides, intakes between 0.75 and 1.29 µg/d of total polycyclic aromatic hydrocarbons (PAHs) were related with a higher risk of belonging to the polyp group. On the contrary, an intake of wholegrain cereals greater than 50 g/d was associated with a reduction in the relative risk of belonging to the polyp group. Heterocyclic amines (HAs) such as 2-amino-1-methyl-6-phenylimidazo (4,5,b) pyridine (PhIP) were associated with an increased level of mutagenicity in polyps. This study is of great interest for the identification of possible therapeutic targets for the early prevention of colon cancer through diet.
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Affiliation(s)
- Sergio Ruiz-Saavedra
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Aida Zapico
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Department of Functional Biology, University of Oviedo, 33006 Oviedo, Spain
| | - Carmen González del Rey
- Anatomical Pathology Service, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain
| | - Celestino Gonzalez
- Department of Functional Biology, University of Oviedo, 33006 Oviedo, Spain
| | - Adolfo Suárez
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Digestive Service, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain
| | - Ylenia Díaz
- Digestive Service, Carmen and Severo Ochoa Hospital, 33819 Cangas del Narcea, Spain
| | - Clara G. de los Reyes-Gavilán
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Correspondence: (C.G.d.l.R.-G.); (S.G.); Tel.: +34-985-985-89-33-35 (C.G.d.l.R.-G.); +34-985-104-209 (S.G.)
| | - Sonia González
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Department of Functional Biology, University of Oviedo, 33006 Oviedo, Spain
- Correspondence: (C.G.d.l.R.-G.); (S.G.); Tel.: +34-985-985-89-33-35 (C.G.d.l.R.-G.); +34-985-104-209 (S.G.)
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15
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Rodríguez-Carrio J, Alperi-López M, López P, Pérez-Álvarez Á, Suárez A. Reduced circulating angiogenic T-cell frequency can predict subclinical vascular stiffness during the earliest stage of rheumatoid arthritis. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Rodríguez-Carrio J, Alperi-López M, López P, Pérez-Álvarez Á, Suárez A. POS0600 ANGIOGENIC T-CELL DEPLETION OCCURS DURING THE EARLIEST PHASES OF RHEUMATOID ARTHRITIS LINKED TO SUBCLINICAL VASCULAR STIFFNESS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2350] [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
Backgroundvascular insult accounts for the cardiovascular (CV) risk excess in rheumatoid arthritis (RA). Angiogenic T cells (Tang), which are responsible of vascular repair, have been described to be reduced in established RA with overt CV disease. However, whether Tang are altered during the earliest stage of the disease and related to subclinical CV findings is unknown.Objectivesto evaluate circulating Tang levels in the very early stage of RA, including clinically suspect arthralgia (CSA), and their associations with subclinical CV endpoints (subclinical atherosclerosis and vascular stiffness).Methods84 RA patients (2010 EULAR/ACR classification criteria), 14 CSA individuals (EULAR criteria) and 28 matched healthy controls (HC) were recruited. All patients were untreated at the time of sampling. Tang (CD3+CD31+CXCR4+) frequency was assessed by flow cytometry in peripheral blood samples. Plaque occurrence, cIMT and stiffness parameters were analyzed by Doppler ultrasound in internal carotid, middle cerebral and basilar arteries. Lipoprotein analyses were performed by NMR.ResultsTang were decreased in RA and CSA groups compared to HC (both p<0.010). Whereas Tang frequency was negatively correlated with very low density lipoproteins features (cholesterol and triglyceride content, size distribution and particle number) in HC and positively with HDL (cholesterol content and particle number), these associations were lacking in RA and CSA groups. Tang levels were not related to individual traditional CV risk factors, body mass index, wait circumference (all p>0.050) nor with the modified SCORE (r=-0.070, p=0.542) or Framingham Risk Score (r=-0.013, p=0.907). On the contrary, disease activity accounted for the Tang depletion observed in RA (b[95% CI]; DAS28: -0.436 [-0.306, -0.109], p=<0.001; SDAI: -0.020 [-0.032, -0.008], p=0.002). Tang levels were unrelated to the duration of the symptoms both in RA and CSA.In RA patients, Tang frequency was not associated with atherosclerosis plaque occurrence (p=0.556) or cIMT (r=0.136, p=0.245). However, Tang paralleled stiffness parameters: vascular strain (VS, r=0.373, p=0.013), vascular distensibility (VD, r=0.479, p=0.004), vascular stiffness (VSf, r=-0.400, p=0.007) and pressure-strain elastic modulus (PSEM, r=-0.373, p=0.013). Finally, Tang frequency was an independent predictor of stiffness parameters after adjusting for mSCORE, body mass index, DAS28, RF and ACPA positivity: VS (β=0.415, p=0.035), VD (β =0.361, p=0.028), VSf (β =-0.322, p=0.033) and PSEM (β =-0.346, p=0.016).ConclusionTang depletion is an early event along RA development, associated with disease-related parameters and unrelated to traditional risk factors. Tang may be the missing, functional link between disease activity and CV outcomes. Altered Tang levels may be an early biomarker of premature vascular stiffness during the first stages of the disease.REFERENCESDisclosure of InterestsNone declared
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Cecchi I, Radin M, Barinotti A, Foddai SG, Rubini E, Suárez A, Roccatello D, Sciascia S, Rodríguez-Carrio J. POS0092 HETEROGENEITY OF THE TYPE I INTERFERON SIGNATURE AMONG ANTIPHOSPHOLIPID SYNDROME PATIENTS: A CLUSTER AND CORRESPONDENCE ANALYSIS APPROACH. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4631] [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: 11/03/2022]
Abstract
BackgroundType I Interferons (IFN) are central players in the pathogenesis, disease activity and evolution of several autoimmune conditions. To date, a limited number of evidences is available on the specific role of IFN activation in antiphospholipid antibodies (aPL) positive patients, including aPL carriers, primary antiphospholipid syndrome (PAPS) and those APS subjects who presented with an associated autoimmune disease (secondary APS, SAPS), such as systemic lupus erythematosus (SLE).ObjectivesThe aim of this study was to evaluate the differential expression of IFN stimulated genes (ISG) among different subsets of aPL positive subjects and SLE patients.MethodsFor the purpose of the study, a total of 112 patients attending the San Giovanni Bosco Hospital (Turin, Italy) were enrolled, including 31 PAPS, 25 SAPS, 27 SLE patients without aPL, 29 aPL carriers (mean age 48.3±13.3 years, 76% female)1,2. Nineteen subjects were also recruited as healthy controls (HCs). Complete demographic, clinical, and laboratory data were collected at the time of the inclusion. Gene expression was evaluated by RT-PCR in whole blood for the following genes: IFI6, IFI44, IFI44L, MX1,IFI27, OAS1 and RSAD2. Normalized gene expression levels (Z-scores) were averaged into a global IFN signature (IFN score). Differences were measured by Kruskal-Wallis tests and associations among genes were studied by cluster and correspondence analyses. Correlations among genes were plotted by network analyses.ResultsAn overall activation of ISG was noted across APS subsets, but certain differences were noted among genes. Whereas some ISG were already upregulated in the aPL positive group compared to HC (IFI44, IFI44L, MX1, IFI27, OAS1 and RSAD2, all p<0.050), other ISG were only in increased SLE (IFI6), MX1 differed between SLE and SAPS, and IFI27 and OAS1 showed differences between PAPS and SAPS. The composite IFN score revealed quantitative differences in the IFN pathway activation across APS subsets, being elevated in aPL carriers/PAPS groups compared to HCs (both p<0.050) and increasing in SAPS (p<0.010) and SLE (p<0.001) groups. Network analyses (Figure 1A) revealed qualitative differences in the gene-gene correlation networks: (i) weaker structures were found in HCs and aPL carriers, compared to stronger and higher-degree networks in SAPS and SLE groups; and (ii) the influence of each node was different across groups. Unsupervised cluster analysis identified 3 clusters (I to III) based on ISG patterns (Figure 1B). Clusters usage differed among APS subsets, thus correlating clinical status (Figure 1C). Distinct groups of ISG positively correlate to aPS/PT IgG titre in aPL carriers and PAPS groups (all rho>0.500), whereas no associations were retrieved in SAPS or SLE. No associations with previous thrombotic events were observed in any subset, although IFN composite score and several ISG correlate with the number of thrombotic recurrences under anticoagulation (all rho>0.400). No associations with GAPSS were observed.Figure 1.ConclusionAn overall IFN pathway activation has been observed in aPL positive patients and across all APS subsets. Qualitative and quantitative differences across the APS spectrum can be identified, leading to the identification of distinct IFN signatures with different clinical value.References[1]Miyakis S, et al. J Thromb Haemost (2006). 2. Aringer M, et al. Arthritis Rheumatol (2019).Disclosure of InterestsNone declared
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Navarro P, Laserna-Mendieta EJ, Casabona S, Savarino E, Pérez-Fernández MT, Ghisa M, Pérez-Martínez I, Guagnozzi D, Perelló A, Guardiola-Arévalo A, Racca F, Betoré E, Blas-Jhon L, Krarup AL, Martín-Domínguez V, Maniero D, Suárez A, Llerena-Castro R, de la Peña-Negro L, Navacerrada AG, Pellegatta G, Alcedo J, de Hurtado Mendoza-Guena L, Feo-Ortega S, Barrio J, Gutiérrez-Junquera C, Fernández-Fernández S, De la Riva S, E Navés J, Carrión S, Ciriza de Los Ríos C, García-Morales N, Rodríguez-Oballe JA, Dainese R, Rodríguez-Sánchez A, Masiques-Mas ML, Palomeque MT, Santander C, Tamarit-Sebastián S, Arias Á, Lucendo AJ. Accurate and timely diagnosis of Eosinophilic Esophagitis improves over time in Europe. An analysis of the EoE CONNECT Registry. United European Gastroenterol J 2022; 10:507-517. [PMID: 35578565 PMCID: PMC9189464 DOI: 10.1002/ueg2.12240] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/24/2022] [Indexed: 12/29/2022] Open
Abstract
Background Poor adherence to clinical practice guidelines for eosinophilic esophagitis (EoE) has been described and the diagnostic delay of the disease continues to be unacceptable in many settings. Objective To analyze the impact of improved knowledge provided by the successive international clinical practice guidelines on reducing diagnostic delay and improving the diagnostic process for European patients with EoE. Methods Cross‐sectional analysis of the EoE CONNECT registry based on clinical practice. Time periods defined by the publication dates of four major sets of guidelines over 10 years were considered. Patients were grouped per time period according to date of symptom onset. Results Data from 1,132 patients was analyzed and median (IQR) diagnostic delay in the whole series was 2.1 (0.7‐6.2) years. This gradually decreased over time with subsequent release of new guidelines (p < 0.001), from 12.7 years up to 2007 to 0.7 years after 2017. The proportion of patients with stricturing of mixed phenotypes at the point of EoE diagnosis also decreased over time (41.3% vs. 16%; p < 0.001), as did EREFS scores. The fibrotic sub‐score decreased from a median (IQR) of 2 (1‐2) to 0 (0‐1) when patients whose symptoms started up to 2007 and after 2017 were compared (p < 0.001). In parallel, symptoms measured with the Dysphagia Symptoms Score reduced significantly when patients with symptoms starting before 2007 and after 2012 were compared. A reduction in the number of endoscopies patients underwent before the one that achieved an EoE diagnosis, and the use of allergy testing as part of the diagnostic workout of EoE, also reduced significantly over time (p = 0.010 and p < 0.001, respectively). Conclusion The diagnostic work‐up of EoE patients improved substantially over time at the European sites contributing to EoE CONNECT, with a dramatic reduction in diagnostic delay.
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Affiliation(s)
- Pilar Navarro
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain.,Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.,Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Tomelloso, Spain
| | - Emilio J Laserna-Mendieta
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain.,Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.,Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Tomelloso, Spain.,Laboratory Medicine Department. Hospital Universitario de La Princesa, Madrid, Spain
| | - Sergio Casabona
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.,Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Edoardo Savarino
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology Unit, Azienza Ospedaliera di Padova, Padova, Italy
| | - María Teresa Pérez-Fernández
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.,Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Matteo Ghisa
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology Unit, Azienza Ospedaliera di Padova, Padova, Italy
| | - Isabel Pérez-Martínez
- Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain.,Diet, Microbiota and Health Group. Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Danila Guagnozzi
- Department of Gastroenterology, Hospital Universitario Valld'Hebrón, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Madrid, Spain
| | - Antonia Perelló
- Department of Gastroenterology, Hospital de Viladecans, Viladecans, Spain
| | | | - Francesca Racca
- Personalized Medicine, Asthma and Allergy. IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Elena Betoré
- Department of Gastroenterology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Leonardo Blas-Jhon
- Department of Gastroenterology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Anne Lund Krarup
- Department of Medicine and Department of Clinical Medicine. The North Danish Regional Hospital, Hjoerring and Aalborg University, Aalborg, Denmark
| | - Verónica Martín-Domínguez
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.,Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Daria Maniero
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology Unit, Azienza Ospedaliera di Padova, Padova, Italy
| | - Adolfo Suárez
- Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain.,Diet, Microbiota and Health Group. Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Ronald Llerena-Castro
- Department of Gastroenterology, Hospital Universitario Valld'Hebrón, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | - Gaia Pellegatta
- Endoscopy Unit. IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Javier Alcedo
- Department of Gastroenterology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Sara Feo-Ortega
- Laboratory Medicine Department. Hospital Universitario de La Princesa, Madrid, Spain.,Pediatric Gastroenterology Unit. Hospital General de Tomelloso, Tomelloso, Spain
| | - Jesús Barrio
- Department of Gastroenterology, Hospital Universitario Rio Hortega, Valladolid, Spain
| | - Carolina Gutiérrez-Junquera
- Department of Pediatric Gastroenterology, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | - Susana De la Riva
- Department of Gastroenterology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Juan E Navés
- Department of Gastroenterology, Parc de Salut Mar, Barcelona, Spain
| | - Silvia Carrión
- Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Madrid, Spain.,Department of Gastroenterology, Hospital de Mataró, Mataró, Spain
| | - Constanza Ciriza de Los Ríos
- Department of Gastroenterology. Hospital Clínico Universitario San Carlos, Instituto de Investigacion Sanitaria San Carlos (IdISSC), Madrid, Spain.,Universidad Complutense, Madrid, Spain
| | | | - Juan Armando Rodríguez-Oballe
- Department of Gastroenterology, Hospital Universitario Arnau de Vilanova & Hospital Universitario Santa María, Lérida, Spain
| | - Raffaela Dainese
- Department of Gastroenterology, Centre Hospitalier d'Antibes Juan-les-Pins, Antibes, France
| | | | | | | | - Cecilio Santander
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.,Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain.,Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Madrid, Spain
| | - Sonsoles Tamarit-Sebastián
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain.,Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Tomelloso, Spain
| | - Ángel Arias
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.,Laboratory Medicine Department. Hospital Universitario de La Princesa, Madrid, Spain.,Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Madrid, Spain.,Research Unit. Hospital General Mancha-Centro, Alcázar de San Juan, Alcázar de San Juan, Spain
| | - Alfredo J Lucendo
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain.,Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.,Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Tomelloso, Spain.,Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Madrid, Spain
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Lucendo AJ, Santander C, Savarino E, Guagnozzi D, Pérez-Martínez I, Perelló A, Guardiola-Arévalo A, Barrio J, Elena Betoré-Glaria M, Gutiérrez-Junquera C, Ciriza de los Ríos C, Racca F, Fernández-Fernández S, Blas-Jhon L, Lund Krarup A, de la Riva S, Naves JE, Carrión S, Rodríguez Oballe JA, García-Morales N, Tamarit-Sebastián S, Navarro P, Arias Á, Laserna-Mendieta EJ, Casabona-Francés S, Pérez-Fernández T, Llerena Castro R, Ghisa M, Manie D, Pellegatta G, Suárez A, Alcedo J, Gil Simón P, Teresa Palomeque M, Asensio T, Granja-Navacerrada A, de Mendoza Guena LH, Rodríguez Sánchez A, Masiques Mas L, Dainese R, Feo-Ortega S. EoE CONNECT, the European Registry of Clinical, Environmental, and Genetic Determinants in Eosinophilic Esophagitis: rationale, design, and study protocol of a large-scale epidemiological study in Europe. Therap Adv Gastroenterol 2022; 15:17562848221074204. [PMID: 35126668 PMCID: PMC8814964 DOI: 10.1177/17562848221074204] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/27/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The growing prevalence of eosinophilic esophagitis (EoE) represents a considerable burden to patients and health care systems. Optimizing cost-effective management and identifying mechanisms for disease onset and progression are required. However, the paucity of large patient cohorts and heterogeneity of practice hinder the defining of optimal management of EoE. METHODS EoE CONNECT is an ongoing, prospective registry study initiated in 2016 and currently managed by EUREOS, the European Consortium for Eosinophilic Diseases of the Gastrointestinal Tract. Patients are managed and treated by their responsible specialists independently. Data recorded using a web-based system include demographic and clinical variables; patient allergies; environmental, intrapartum, and early life exposures; and family background. Symptoms are structurally assessed at every visit; endoscopic features and histological findings are recorded for each examination. Prospective treatment data are registered sequentially, with new sequences created each time a different treatment (active principle, formulation, or dose) is administered to a patient. EoE CONNECT database is actively monitored to ensure the highest data accuracy and the highest scientific and ethical standards. RESULTS EoE CONNECT is currently being conducted at 39 centers in Europe and enrolls patients of all ages with EoE. In its aim to increase knowledge, to date EoE CONNECT has provided evidence on the effectiveness of first- and second-line therapies for EoE in clinical practice, the ability of proton pump inhibitors to induce disease remission, and factors associated with improved response. Drug effects to reverse fibrous remodeling and endoscopic features of fibrosis in EoE have also been assessed. CONCLUSION This prospective registry study will provide important information on the epidemiological and clinical aspects of EoE and evidence as to the real-world and long-term effectiveness and safety of therapy. These data will potentially be a vital benchmark for planning future EoE health care services in Europe.
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Affiliation(s)
| | - Cecilio Santander
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain,Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain,Department of Gastroenterology, Hospital Universitario La Princesa, Madrid, Spain
| | - Edoardo Savarino
- Department of Surgery, Oncology and Gastroenterology, Università di Padova, Padova, Italy
| | - Danila Guagnozzi
- Department of Gastroenterology, Hospital Universitario Vall d’Hebron, Barcelona, Spain,Digestive System Research Unit, Unitat de Fisiología I Fisiopatología Digestiva, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Isabel Pérez-Martínez
- Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Antonia Perelló
- Department of Gastroenterology, Hospital de Viladecans, Barcelona, Spain
| | - Antonio Guardiola-Arévalo
- Department of Gastroenterology, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain; Instituto de Investigación Sanitaria La Paz (IdiPAZ), Madrid, Spain
| | - Jesús Barrio
- Department of Gastroenterology, Hospital Universitario Río Hortega, Valladolid, Spain
| | | | | | - Constanza Ciriza de los Ríos
- Department of Gastroenterology, Hospital Clínico San Carlos, Universidad Complutense, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Francesca Racca
- Personalized Medicine, Asthma and Allergy Clinic, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Sonia Fernández-Fernández
- Pediatric Gastroenterology, Hepatology and Nutrition, University Hospital Severo Ochoa, Leganés, Spain
| | - Leonardo Blas-Jhon
- Department of Gastroenterology, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Anne Lund Krarup
- Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark,Department of Acute Medicine and Trauma Care, Aalborg University Hospital, Aalborg, Denmark,Faculty of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Susana de la Riva
- Department of Gastroenterology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Juan E. Naves
- Gastroenterology Unit, Hospital Universitari Germans Trias i Pujol, CIBERehd, Badalona, Spain
| | - Silvia Carrión
- Gastrointestinal Motility Laboratory, Department of Surgery, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - Juan Armando Rodríguez Oballe
- Department of Gastroenterology, University Hospital Santa María and University Hospital Arnau de Vilanova, Lleida, Spain
| | | | - Sonsoles Tamarit-Sebastián
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Spain
| | - Pilar Navarro
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Spain
| | - Ángel Arias
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain,Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain,Research Unit, Hospital General Mancha Centro, Alcázar de San Juan, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Spain
| | - Emilio J. Laserna-Mendieta
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Spain,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain,Clinical Laboratory, Hospital Universitario de La Princesa, Madrid, Spain
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20
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Carballo-Folgoso L, García Álvarez V, Celada-Sendino M, Suárez A. Ileal neuroendocrine tumour as an uncommon cause of obscure gastrointestinal bleeding. Rev Esp Enferm Dig 2022; 114:616-618. [DOI: 10.17235/reed.2022.8641/2022] [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: 11/20/2022]
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21
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Torrallardona-Murphy O, Pericàs JM, Rabaneda-Lombarte N, Cubedo M, Cucchiari D, Calvo J, Serralabós J, Alvés E, Agelet A, Hidalgo J, Alves E, García L, Sala M, Pereta I, Castells E, Suárez A, Carbonell A, Seijas N, Feu F, Alcaraz A, Hernández C, Coloma E, Nicolás D. Medicalized Hotel as an Alternative to Hospital Care for Management of Noncritical COVID-19. Ann Intern Med 2021; 174:1338-1340. [PMID: 34125576 PMCID: PMC8252829 DOI: 10.7326/m21-1873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Juan M Pericàs
- Hospital Clínic de Barcelona and Vall d'Hebron Institute for Research, Barcelona, Spain
| | | | | | | | - Júlia Calvo
- Hospital Clínic de Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | - Marta Sala
- Hospital Clínic de Barcelona, Barcelona, Spain
| | | | | | | | | | | | - Faust Feu
- Hospital Clínic de Barcelona, Barcelona, Spain
| | | | | | - Emmanuel Coloma
- Hospital Clínic de Barcelona and University of Barcelona, Barcelona, Spain
| | - David Nicolás
- Hospital Clínic de Barcelona and University of Barcelona, Barcelona, Spain
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22
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González-Bernardo O, Riestra S, Vivas S, de Francisco R, Pérez-Martínez I, Castaño-García A, Jiménez-Beltrán V, Rollé V, Suárez P, Suárez A. Chromoendoscopy With Indigo Carmine vs Virtual Chromoendoscopy (iSCAN 1) for Neoplasia Screening in Patients With Inflammatory Bowel Disease: A Prospective Randomized Study. Inflamm Bowel Dis 2021; 27:1256-1262. [PMID: 33169787 DOI: 10.1093/ibd/izaa291] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Indexed: 01/05/2023]
Abstract
INTRODUCTION The risk of colon cancer is greater in patients with inflammatory bowel disease (IBD) than in the general population. Chromoendoscopy with dye (CE) is the currently recommended method for detecting dysplasia in screening colonoscopies in IBD patients; however, the role of virtual chromoendoscopy (VC) is not yet well defined. OBJECTIVE The object of this study was to compare CE and VC with the iSCAN 1 system in the detection of neoplastic lesions in IBD patients. DESIGN We conducted a prospective, single-center, randomized study in IBD patients who underwent a colonoscopy for colon cancer screening. A total of 129 patients were included and were randomized to undergo a CE (n = 67) or a VC (n = 62). The rates of detection of neoplastic lesions by the 2 endoscopic techniques were compared. RESULTS A total of 19 neoplastic lesions (9 adenomas and 10 low-grade dysplasias [LGD]) was detected in 16 patients, 12 lesions in the CE group (17.9%), and 7 lesions in the VC group (11.3%; P = 0.2); no differences were found in the overall rate of detection of lesions (neoplastic or nonneoplastic; P = 1). The median of the total examination time and endoscope withdrawal time (minutes) was significantly lower in the VC group than in the CE group (15 vs 20 and 10 vs 14, respectively; P < 0.001). CONCLUSION No differences occurred in the rate of detection of neoplastic lesions between CE and VC with iSCAN 1. The time spent on the technique with VC is significantly less than that with CE.
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Affiliation(s)
- Oscar González-Bernardo
- Gastroenterology Department, Central University Hospital of Asturias, Oviedo, Spain.,Biomedicine and Health Sciences Department, University of León, León, Spain
| | - Sabino Riestra
- Gastroenterology Department, Central University Hospital of Asturias, Oviedo, Spain.,Health Research Institute of the Principality of Asturias, Oviedo, Spain
| | - Santiago Vivas
- Gastroenterology Department, León University Hospital, León, Spain
| | - Ruth de Francisco
- Gastroenterology Department, Central University Hospital of Asturias, Oviedo, Spain.,Health Research Institute of the Principality of Asturias, Oviedo, Spain
| | - Isabel Pérez-Martínez
- Gastroenterology Department, Central University Hospital of Asturias, Oviedo, Spain.,Health Research Institute of the Principality of Asturias, Oviedo, Spain
| | | | | | - Valeria Rollé
- Biostatistics and Epidemiology Platform of the Health Research Institute of the Principality of Asturias, Oviedo, Spain
| | - Patricio Suárez
- Biostatistics and Epidemiology Platform of the Health Research Institute of the Principality of Asturias, Oviedo, Spain
| | - Adolfo Suárez
- Gastroenterology Department, Central University Hospital of Asturias, Oviedo, Spain.,Health Research Institute of the Principality of Asturias, Oviedo, Spain
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Carballo-Folgoso L, Rodríguez-Peláez M, Suárez A. Diffuse hemorrhagic gastropathy as an infrequent complication of necrotizing acute pancreatitis. Rev Esp Enferm Dig 2020; 113:620. [PMID: 33371693 DOI: 10.17235/reed.2020.7571/2020] [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: 11/20/2022]
Abstract
Acute hemorrhagic gastropathy is characterized by the presence of acute gastrointestinal mucosal lesions (AGML) induced by irritation or ischemia due to exogenous or endogenous factors. Most frequent endoscopy findings include mucosal congestion, hyperemia, petechiae, acute hemorrhagic erosions and superficial ulceration. We report the case of diffuse hemorrhagic gastropathy caused by necrotizing acute pancreatitis.
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Affiliation(s)
| | | | - Adolfo Suárez
- Aparato Digestivo, Hospital Universitario Central de Asturias, España
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24
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Rodríguez-Carrio J, Carrillo-López N, Ulloa C, Martín-Carro B, Rodríguez-Suárez C, Arcidiacono M, Fernández-Mariño B, Cannata-Andía J, Suárez A, Dusso A. Angiogenic T cells as predictive markers of early vascular dysfunction and atherosclerosis in chronic kidney disease. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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25
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Rodríguez-Carrio J, Alperi-López M, López P, Gil M, Amigo N, Pérez-Álvarez Á, Benavente L, Suárez A. GlycA as a biomarker of inflammation and subclinical atherosclerosis in very early rheumatoid arthritis. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Rodríguez-Carrio J, Coras R, Alperi-López M, López P, Ballina-García FJ, Guma M, Suárez A. THU0065 OXYLIPIN PROFILING DURING THE VERY EARLY PHASE OF RHEUMATOID ARTHRITIS: ASSOCIATIONS WITH DISEASE STAGE, CLINICAL FEATURES AND TREATMENT RESPONSE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3236] [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
Background:traditional approaches and lipidomics support the relevance of eicosanoids in rheumatic conditions, such as rheumatoid arthritis (RA). Previous studies from our group and others have revealed altered levels of arachidonic acid in RA, pointing to a possible consumption or enhanced metabolisation. However, the potential alterations of its actual metabolites are difficult to assess with conventional approaches, and new, untargeted, high-throughput technologies are needed. More importantly, whether these alterations are related to the disease course and could be found at the very early stage of the disease is unknown.Objectives:to characterize the eicosanoid profiles during the earliest stages of RA and their potential clinical associations.Methods:60 very early RA patients (50 recruited at diagnosis and treatment-naïve) fulfilling 2010 ACR/EULAR criteria, 11 clinical suspect arthralgia (CSA) individuals and 28 healthy controls (HC) were recruited. Samples were collected at the moment of the diagnosis. Serum oxylipins profiles were analyzed by mass spectrometry (LC-MS/MS). Treatment-naïve patients underwent csDMARD treatment and were followed for 6 (n=49) and 12 months (n=38). Data analysis was performed in R and MetaboAnalyst.Results:A total of 75 oxylipins, mostly derived from arachidonic (AA), eicosapentanoic (EPA) and linoleic (LA) acid, were identified. No effect was observed for age, gender or BMI. Correlation and network analyses revealed different patterns among oxylipins across RA patients, CSA and HC (Figure 1A). The 8-HETrE, PGE3 and 20-HETE showed the pattern (linear increase) HC→CSA→RA (p=1.47·10-4, 5.34·10-4 and 5.68·10-4, respectively; and adjusted FDR<0.050) (Figure 1B). A PLS-DA (explaining 12.3% of the total variance, with a 71.0% cross-validation accuracy and permutation p=5·10-4) confirmed that oxylipins profiles differ among groups, although a certain overlap existed. A total of 22 oxylipins had VIP scores>1 (Figure 1C), which allowed the identification of two clusters (I and II). Cluster usage (I/II) differed among groups (p=0.003): HC (27/1), CSA (7/4) and RA (37/23). Patients exhibiting cluster II showed higher VAS global assessment (p=0.016) and pain (p=0.003) than their cluster I-counterparts. More importantly, cluster II patients were less likely to achieve DAS28 remission at 6 (12/17 vs 10/32, p=0.008) and 12 months (6/9 vs 9/29, p=0.066) upon conventional DMARD treatment compared to those showing cluster I.OPLS-DA analyses revealed a good discrimination between CSA and HC groups, and 7 compounds (13-HODE, PGB2, 9-oxo-ODE, 12-oxo-ETE, 19,20-di-HDPA, 5-HETrE and 15-HEPE) were associated with the course HC->CSA. Different precursors (2 LA, 3 AAA, 1 EPA and 1 DHA) and pathways were noted (3 LOX, 4 CYP450). Regarding RA subsets, differences were noted by seropositivity. Whereas 9 compounds were associated with the pattern HC→seronegative RA (8-HETrE, PGE3, 20-HETE, 19,20-di-HDPA, PGEM, PGJ2, 12-oxo-LTB4, 14,15-EET and LTB4), a distinct set was observed for the pattern HC→seropositive RA (PGE3, 20-oh-PGE2, 5-HETE, PGE2, 12-oxo-ETE, 20-HETE, PGEM, 4-HDoHE, LTB4, 9-oxo-ODE, 12-oxo-LTB4, 8,9-EET). No differences in the major pathways were noted.Conclusion:Oxylipin networks differ across disease stages during the very early phase of RA, and can inform on specific signatures related to the disease progression. Oxylipins can delineate profiles with clinical relevance and are able to predict treatment response.Figure:Disclosure of Interests:None declared
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27
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Mangas-Sanjuan C, Santana E, Cubiella J, Rodríguez-Camacho E, Seoane A, Alvarez-Gonzalez MA, Suárez A, Álvarez-García V, González N, Luè A, Cid-Gomez L, Ponce M, Bujanda L, Portillo I, Pellisé M, Díez-Redondo P, Herráiz M, Ono A, Pizarro Á, Zapater P, Jover R. Variation in Colonoscopy Performance Measures According to Procedure Indication. Clin Gastroenterol Hepatol 2020; 18:1216-1223.e2. [PMID: 31446179 DOI: 10.1016/j.cgh.2019.08.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 08/02/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Most fulfillment and benchmarking information for colonoscopy quality indicators has been obtained from studies of primary screening colonoscopies. We analyzed differences in the fulfillment of colonoscopy quality indicators based on the indication for endoscopy. METHODS We performed an observational, multicenter, cross-sectional study of 14,867 patients who underwent endoscopy procedures for gastrointestinal symptoms (40.3%), a positive result from a fecal immunochemical test (36.0%), postpolypectomy surveillance (15.3%), or primary screening (8.4%), from February 2016 through December 2017 at 14 centers in Spain. We evaluated rates of adequate colon cleansing, cecal intubation, adenoma detection, and colorectal cancer detection, among others. We used findings from primary screening colonoscopies as the reference standard. RESULTS Fewer than 90% of patients had adequate bowel preparation; 83.1% of patients with gastrointestinal symptoms had adequate bowel preparation (odds ratio [OR] compared with patients with primary screening colonoscopies, 0.62; 95% CI, 0.49-0.78) and 85.3% of patients receiving postpolypectomy surveillance had adequate bowel preparation (OR, 0.71; 95% CI, 0.55-0.91). The cecal intubation rate was also lower in patients with gastrointestinal symptoms (93.1%) (OR, 0.34; 95% CI, 0.22-0.52). The adenoma detection rate was higher in patients with a positive result from a fecal immunochemical test (46.4%) (OR, 2.01; 95% CI, 1.71-2.35) and in patients undergoing postpolypectomy surveillance (48.2%) (OR, 1.41; 95% CI, 1.20-1.67). The highest proportion of patients with colorectal cancer was in the gastrointestinal symptom group (5.1%) (OR, 5.24; 95% CI, 2.30-11.93) and the lowest was in patients undergoing surveillance (0.8%) (OR, 0.83; 95% CI, 0.32-2.14). CONCLUSIONS Fulfillment of colonoscopy performance measures varies substantially by indication. Policies addressing performance measures beyond colonoscopy screening procedures should be developed. Benchmarking recommendations could be adjusted according to colonoscopy indication.
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Affiliation(s)
- Carolina Mangas-Sanjuan
- Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria and Biomédica de Alicante, ISABIAL, Alicante, Spain
| | - Enrique Santana
- Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria and Biomédica de Alicante, ISABIAL, Alicante, Spain
| | - Joaquín Cubiella
- Department of Gastroenterology, Complexo Hospitalario de Ourense, Instituto de Investigación Biomédica de Ourense, Pontevedra y Vigo, Ourense, Spain
| | | | - Agustín Seoane
- Department of Gastroenterology, Parc de Salut Mar, Hospital del Mar, Barcelona, Spain
| | | | - Adolfo Suárez
- Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Natalia González
- Department of Gastroenterology, Hospital Universitario de Canarias, Instituto Universitario de Tecnologías Biomédicas and Centro de Investigación Biomédica de Canarias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - Alberto Luè
- Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Aragon Health Research Institute, Zaragoza, Spain
| | - Lucía Cid-Gomez
- Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Instituto de Investigación Biomédica, Xerencia de Xestión Integrada de Vigo, Vigo, Spain
| | - Marta Ponce
- Department of Gastroenterology, Hospital Universitario La Fe, Valencia, Spain
| | - Luis Bujanda
- Department of Gastroenterology, Biodonostia Medical Research Institute, San Sebastián, Spain
| | - Isabel Portillo
- BioCruces Health Research Institute, Colorectal Screening Program, Basque Health Service, Barakaldo, Spain
| | - María Pellisé
- Department of Gastroenterology, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Maite Herráiz
- Department of Gastroenterology, Clínica Universitaria and Medical School, University of Navarra, Navarra, Spain
| | - Akiko Ono
- Unidad de Gestión Clínica de Digestivo, Hospital Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria, Murcia, Spain
| | - Ángeles Pizarro
- Department of Gastroenterology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Pedro Zapater
- Unit of Clinical Pharmacology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL) Alicante, Spain
| | - Rodrigo Jover
- Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria and Biomédica de Alicante, ISABIAL, Alicante, Spain.
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Gómez Outomuro A, González-Bernardo Ó, Pérez Martinez I, Castaño-García A, Rodríguez-Escaja C, de Francisco R, Riestra S, Suárez A. Efficacy and safety of the SB Knife™ Jr. for the treatment of Zenker's diverticulum: a case series. Rev Esp Enferm Dig 2020; 112:216-218. [PMID: 31960683 DOI: 10.17235/reed.2020.6373/2019] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS the stag-beetle knife is a new scissor-like endoscopic device that can be used for the treatment of Zenker's diverticulum, although experience is limited. The aim of this study was to evaluate the efficacy and safety of the SB Knife™ for the endoscopic treatment of Zenker's diverticulum. METHODS a single-center prospective study of 16 patients was performed between May 2017 and April 2019. The rate of complications and symptom changes was evaluated. RESULTS the median age was 78 years and 62.5% of the patients were male. All had dysphagia, 43.8% choking, 31.3% regurgitation and 6.3% respiratory symptoms. The median size of the diverticulum was 20 mm and the median follow-up was 281 days. There were no intra-procedure complications and only one major post-procedure complication was reported that was a microperforation. All patients had clinical improvement. Two patients had relapsing symptoms and were successfully treated with the same method. CONCLUSIONS the SB Knife™ seems to be a safe and effective technique for the treatment of Zenker's diverticulum.
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Affiliation(s)
| | | | | | | | | | | | | | - Adolfo Suárez
- Digestivo, Hospital Universitario Central de Asturias
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de Mendoza C, Roc L, Fernández‐Alonso M, Soriano V, Rodríguez C, Vera M, del Romero J, Marcaida G, Ocete M, Caballero E, Molina I, Aguilera A, Rodríguez‐Calviño J, Navarro D, Rivero C, Vilariño M, Benito R, Algarate S, Gil J, Ortiz de Lejarazu R, Rojo S, Eirós J, San Miguel A, Manzardo C, Miró J, García J, Paz I, Poveda E, Calderón E, Escudero D, Trigo M, Diz J, García‐Campello M, Rodríguez‐Iglesias M, Hernández‐Betancor A, Martín A, Ramos J, Gimeno A, Gutiérrez F, Rodríguez J, Sánchez V, Gómez‐Hernando C, Cilla G, Pérez‐Trallero E, López‐Aldeguer J, Fernández‐Pereira L, Niubó J, Hernández M, López‐Lirola A, Gómez‐Sirvent J, Force L, Cifuentes C, Pérez S, Morano L, Raya C, González‐Praetorius A, Pérez J, Peñaranda M, Hernáez‐Crespo S, Montejo J, Roc L, Martínez‐Sapiña A, Viciana I, Cabezas T, Lozano A, Fernández J, García‐Bermejo I, Gaspar G, García R, Górgolas M, Vegas C, Blas J, Miralles P, Valeiro M, Aldamiz T, Margall N, Guardia C, do Pico E, Polo I, Aguinaga A, Ezpeleta C, Sauleda S, Pirón M, González R, Barea L, Jiménez A, Blanco L, Suárez A, Rodríguez‐Avial I, Pérez‐Rivilla A, Parra P, Fernández M, Fernández‐Alonso M, Treviño A, Requena S, Benítez‐Gutiérrez L, Cuervas‐Mons V, de Mendoza C, Barreiro P, Soriano V, Corral O, Gómez‐Gallego F. HTLV testing of solid organ transplant donors. Clin Transplant 2019; 33:e13670. [DOI: 10.1111/ctr.13670] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/06/2019] [Accepted: 07/08/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Carmen de Mendoza
- Internal Medicine Laboratory Puerta de Hierro Research Institute & University Hospital Madrid Spain
- Microbiology section, Pharmaceutical and Health Science Department Pablo-CEU University Madrid Spain
| | - Lourdes Roc
- Microbiology Department Hospital Miguel Servet Zaragoza Spain
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Rodríguez-Carrio J, Alperi-López M, López P, Pérez-Álvarez Á, Benavente L, Ballina-García F, Suárez A. Angiogenic T Cells Are Independent Predictors Of Vascular Stiffness In Very Early Rheumatoid Arthritis Patients. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Rodríguez-Carrio J, Alperi-López M, López P, Pérez-Álvarez Á, Benavente L, Ballina-García F, Suárez A. Monocyte Subsets And Ace Expression Are Associated With Subclinical Atherosclerosis In Very Early Rheumatoid Arthritis Patients. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Rodríguez-Carrio J, Martínez-Zapico A, Cabezas-Rodríguez I, Benavente L, Pérez-Álvarez ÁI, López P, Cannata-Andía JB, Naves-Díaz M, Suárez A. Clinical and subclinical cardiovascular disease in female SLE patients: Interplay between body mass index and bone mineral density. Nutr Metab Cardiovasc Dis 2019; 29:135-143. [PMID: 30559042 DOI: 10.1016/j.numecd.2018.09.007] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/27/2018] [Accepted: 09/18/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS Since accelerated atherosclerosis has been reported in systemic lupus erythematosus (SLE), predictive biomarkers of cardiovascular disease (CVD) are needed. Among non-traditional risk factors, bone mineral density (BMD) has been related to CVD. However, its role in SLE remains controversial. This study aims to analyze the associations of subclinical atherosclerosis with traditional and non-traditional CV risk factors. METHODS AND RESULTS In a cross-sectional study, atherosclerosis burden was compared between 112 female SLE patients and 31 controls. Plaque number and carotid intima-media wall thickness (cIMT) were assessed by ultrasonography. In a retrospective study, BMD determinations obtained 5-years before the ultrasonography assessment were analyzed in a subgroup of 62 patients. Plaque frequency was increased in SLE, even in patients without CV events or carotid wall thickening. cIMT was increased in patients with CVD, positively correlated with body mass index (BMI). Interestingly, a paradoxical effect of BMI on carotid parameters was observed. Whereas underweight patients (BMI < 20) showed increased prevalence of carotid plaques with low cIMT, those with BMI > 30 showed higher cIMT and plaque burden. Overweight patients (25 < BMI<30) exhibited both elevated cIMT and plaque number. BMI was an independent predictor of BMD. In our retrospective study, patients with either clinical or subclinical CVD exhibited lower BMD levels than their CV-free counterparts. A low lumbar spine BMD independently predicted CVD development after adjusting for confounders. CONCLUSION SLE was associated with a higher subclinical atherosclerosis burden, a bimodal effect being observed for BMI. Decreased BMD can be a CV risk biomarker in SLE.
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Affiliation(s)
- J Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain; Bone and Mineral Research Unit, Instituto Reina Sofía de Investigación Nefrológica, REDinREN del ISCIII, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - A Martínez-Zapico
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - I Cabezas-Rodríguez
- Bone and Mineral Research Unit, Instituto Reina Sofía de Investigación Nefrológica, REDinREN del ISCIII, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - L Benavente
- Department of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Á I Pérez-Álvarez
- Department of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - P López
- Area of Immunology, Department of Functional Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - J B Cannata-Andía
- Bone and Mineral Research Unit, Instituto Reina Sofía de Investigación Nefrológica, REDinREN del ISCIII, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - M Naves-Díaz
- Bone and Mineral Research Unit, Instituto Reina Sofía de Investigación Nefrológica, REDinREN del ISCIII, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - A Suárez
- Area of Immunology, Department of Functional Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.
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Pérez-Ciria L, Mitjana O, Falceto M, Suárez A, Miana-Mena F, Fondevila M, Latorre M. PSX-23 Influence of immunocastration on genital organs and sex hormones of heavy gilts. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.1060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - O Mitjana
- Universidad de Zaragoza,Zaragoza, Spain
| | - M Falceto
- Universidad de Zaragoza,Zaragoza, Spain
| | - A Suárez
- Universidad de Zaragoza,Zaragoza, Spain
| | | | | | - M Latorre
- Universidad de Zaragoza,Zaragoza, Spain
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de Francisco R, Castaño-García A, Martínez-González S, Pérez-Martínez I, González-Huerta AJ, Morais LR, Fernández-García MS, Jiménez S, Díaz-Coto S, Flórez-Díez P, Suárez A, Riestra S. Impact of Epstein-Barr virus serological status on clinical outcomes in adult patients with inflammatory bowel disease. Aliment Pharmacol Ther 2018; 48:723-730. [PMID: 30095176 DOI: 10.1111/apt.14933] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 04/25/2018] [Accepted: 07/15/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Little is known about the impact of Epstein-Barr virus (EBV) infection on clinical outcomes in adults with inflammatory bowel disease (IBD). AIM To evaluate seroprevalence, seroconversion rate and complications associated with EBV infection in an adult IBD cohort attending a tertiary care hospital in Spain between 2006 and 2016. METHODS EBV serological status was determined. In seronegative patients, the seroconversion rate was evaluated. The complications associated with primary and latent EBV infection are described. RESULTS One thousand four hundred and eighty-three patients over the age of 17 were included in the study (mean age at EBV serological status determination was 48.3). Overall seroprevalence of EBV was 97.4% (95% CI: 96.6%-98.2%). The seroconversion rate was 29.7% (95% CI: 16.2-45.9) after a mean of 47.5 months. There were no differences in seroconversion rates between patients 35 years or younger and patients older than 35 years. A 66-year-old man, on treatment with thiopurines, developed lymphoma and a hemophagocytic syndrome during a primary EBV infection. Overall, six patients (one with primary infection and five with prior EBV infection) developed lymphoma. In three of five patients with lymphoma and thiopurine use, EBV was associated to the development of lymphoma. CONCLUSIONS There is a small percentage of adults with IBD at risk of primary EBV infection. The risks of seroconversion and its complications remain through adulthood. Our results suggest that, when considering the use of thiopurines in IBD, the information on EBV serological status should be taken into account at any age.
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Affiliation(s)
- Ruth de Francisco
- Gastroenterology Department, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Andrés Castaño-García
- Gastroenterology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Susana Martínez-González
- Gastroenterology Department, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Isabel Pérez-Martínez
- Gastroenterology Department, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | | | - Lucía R Morais
- Hematology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Santiago Jiménez
- Pediatrics Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Pablo Flórez-Díez
- Gastroenterology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Adolfo Suárez
- Gastroenterology Department, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Sabino Riestra
- Gastroenterology Department, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
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Savarino F, Lo Gullo A, Carrìo J, Aragona C, Suárez A, Atzeni F, Saitta A, Mandraffino G. Subclinical impairment of myocardial and endothelial functionality in very early psoriatic and rheumatoid arthritis patients: Association with vitamin D, inflammation and activity. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nogacka AM, Ruas-Madiedo P, Gómez E, Solís G, Fernández N, Suárez M, Suárez A, Salazar N, de Los Reyes-Gavilán CG, Gueimonde M. Real-time monitoring of HT29 epithelial cells as an in vitro model for assessing functional differences among intestinal microbiotas from different human population groups. J Microbiol Methods 2018; 152:210-216. [PMID: 30006229 DOI: 10.1016/j.mimet.2018.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/06/2018] [Accepted: 07/09/2018] [Indexed: 12/15/2022]
Abstract
Several in vitro screening tests have been used for selecting probiotic strains; however they often show low predictive value and only a limited number of strains have demonstrated functionality in vivo. The most used in vitro tests represent a very simplified version of the gut environment, especially since they do not consider the accompanying microbiota. Therefore, there is a need to develop sensitive and discriminating in vitro models including the microbiota. Here we developed an in vitro model to discriminate among microbiotas/fecal waters from different population groups. To this end samples were obtained from seven healthy adults, five IBD-patients, ten full-term and ten preterm newborns. Fecal microbiotas were purified and their impact, as well as that of the fecal waters, on HT29 cells was continuously monitored for 22 h using a real-time cell analyzer (RTCA). The composition of the purified microbiotas was assessed by 16S rRNA gene profiling and qPCR and the levels of short chain fatty acids (SCFA) determined by gas chromatography. The microbiota fractions and SCFA concentrations obtained from IBD-patients, full-term and preterm babies, showed clear differences with regard to those of the control group (healthy adults). Moreover, the purified intestinal microbiotas and fecal waters also differed from the control group in the response induced on the HT29 cells assay developed. In short, we have developed a real-time, impedance-based in vitro model for assessing the functional response induced by purified microbiotas and fecal waters upon intestinal epithelial cells. The capability of the assay for discriminating the functional responses induced, by microbiotas or fecal waters from different human groups, promises to be of help on the search for compounds/strains to restore the functionality of the microbiota-host's interaction.
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Affiliation(s)
- A M Nogacka
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Asturias, Spain; Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain
| | - P Ruas-Madiedo
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Asturias, Spain
| | - E Gómez
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Asturias, Spain
| | - G Solís
- Pediatrics Service, Asturias Central University Hospital (HUCA), SESPA, Oviedo, Asturias, Spain
| | - N Fernández
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Pediatrics Service, Asturias Central University Hospital (HUCA), SESPA, Oviedo, Asturias, Spain
| | - M Suárez
- Pediatrics Service, Asturias Central University Hospital (HUCA), SESPA, Oviedo, Asturias, Spain
| | - A Suárez
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain; Digestive Service, Asturias Central University Hospital (HUCA), SESPA, Oviedo, Asturias, Spain
| | - N Salazar
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Asturias, Spain; Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain
| | - C G de Los Reyes-Gavilán
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Asturias, Spain; Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain
| | - M Gueimonde
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Asturias, Spain; Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain.
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Suárez A. Cómo improvisar nuestro propio material de laboratorio. Actual Biol 2018. [DOI: 10.17533/udea.acbi.330724] [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] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Varias son las razones por las cuales la enseñanza de las Ciencias Naturales en nuestro medio no tiene el carácter científico y pedagógico deseado. Entre todas, la escasez y la dificultad para obtener el material de laboratorio deseado para las diferentes prácticas, son comúnmente las más denunciadas por los educadores.
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Roldán P. G, Builes J, Trujillo CM, Suárez A. Efectos de la contaminación industrial y doméstica sobre la fauna béntica del Río Medellín. Actual Biol 2018. [DOI: 10.17533/udea.acbi.330730] [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] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Los ecosistemas acuáticos naturales se caracterizan por poseer pocas especies con muchos individuos o muchas especies con pocos individuos por especie. Cuando una condición desfavorable, tal como la contaminación, se hace presente, se manifiestan cambios detectables en la estructura de la comunidad biótica. Para detectar cuáles han sido los cambios que se han operado en el Río Medellín, debido a la contaminación industrial y doméstica, se establecieron siete estaciones desde la Primavera hasta El Pescador y se hicieron en cada una de ellas durante un año mediciones bimensuales fisicoquímicas y biológicas. El estudio fisicoquímico se hizo con la ayuda de un Colorímetro Hach y el biológico se llevó a cabo mediante el análisis de las comunidades de macroinvertebrados que habitan en el fondo del Río. Durante el estudio se pudo comprobar como a medida que las condiciones de contaminación se iban haciendo más drásticas, la diversidad de especies comenzaba a disminuir, hasta llegar al punto de aparecer una nueva comunidad propia de aguas contaminadas.
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Hernández-Juárez M, López-Serrano J, González-Herrero P, Rendón N, Álvarez E, Paneque M, Suárez A. Hydrogenation of an iridium-coordinated imidazol-2-ylidene ligand fragment. Chem Commun (Camb) 2018; 54:3843-3846. [DOI: 10.1039/c8cc00420j] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The unprecedented hydrogenation of a metal-coordinated imidazolylidene to imidazolidinylidene is observed under mild conditions in an iridium complex containing a metalated lutidine derived CNP ligand.
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Affiliation(s)
- M. Hernández-Juárez
- Instituto de Investigaciones Químicas (IIQ)
- Departamento de Química Inorgánica
- Centro de Innovación en Química Avanzada (ORFEO-CINQA)
- CSIC
- Universidad de Sevilla
| | - J. López-Serrano
- Instituto de Investigaciones Químicas (IIQ)
- Departamento de Química Inorgánica
- Centro de Innovación en Química Avanzada (ORFEO-CINQA)
- CSIC
- Universidad de Sevilla
| | - P. González-Herrero
- Departamento de Química Inorgánica
- Facultad de Química
- Universidad de Murcia
- Murcia
- Spain
| | - N. Rendón
- Instituto de Investigaciones Químicas (IIQ)
- Departamento de Química Inorgánica
- Centro de Innovación en Química Avanzada (ORFEO-CINQA)
- CSIC
- Universidad de Sevilla
| | - E. Álvarez
- Instituto de Investigaciones Químicas (IIQ)
- Departamento de Química Inorgánica
- Centro de Innovación en Química Avanzada (ORFEO-CINQA)
- CSIC
- Universidad de Sevilla
| | - M. Paneque
- Instituto de Investigaciones Químicas (IIQ)
- Departamento de Química Inorgánica
- Centro de Innovación en Química Avanzada (ORFEO-CINQA)
- CSIC
- Universidad de Sevilla
| | - A. Suárez
- Instituto de Investigaciones Químicas (IIQ)
- Departamento de Química Inorgánica
- Centro de Innovación en Química Avanzada (ORFEO-CINQA)
- CSIC
- Universidad de Sevilla
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Riestra S, de Francisco R, Arias-Guillén M, Saro C, García-Alvarado M, Duque JM, Palacios JJ, Muñoz F, Blanco L, Castaño O, Pérez-Martínez I, Martínez-Camblor P, Pérez Hernández D, Suárez A. Risk factors for tuberculosis in inflammatory bowel disease: anti-tumor necrosis factor and hospitalization. Rev Esp Enferm Dig 2017; 108:541-9. [PMID: 27604582 DOI: 10.17235/reed.2016.4440/2016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To determine risk factors for active tuberculosis in patients with inflammatory bowel diseases. METHODS Retrospective, case-control study at 4 referral hospitals in Spain. Cases developed tuberculosis after a diagnosis of inflammatory bowel disease. Controls were inflammatory bowel disease patients who did not develop tuberculosis. For each case, we randomly selected 3 controls matched for sex, age (within 5 years) and time of inflammatory bowel disease diagnosis (within 3 years). Inflammatory bowel disease characteristics, candidate risk factors for tuberculosis and information about the tuberculosis episode were recorded. Multivariate analysis and a Chi-squared automatic interaction detector were used. RESULTS Thirty-four cases and 102 controls were included. Nine of the 34 cases developed active tuberculosis between 1989 and 1999, and 25 became ill between 2000 and 2012. Multivariate regression showed an association between active tuberculosis and anti-TNF (tumor necrosis factor) therapy in the previous 12 months (OR 7.45; 95% CI, 2.39-23.12; p = .001); hospitalization in the previous 6 months (OR 4.38; 95% CI, 1.18-16.20; p = .027); and albumin levels (OR 0.88; 95% CI, 0.81-0.95; p = .001). The median time between the start of biologic therapy and the onset of active tuberculosis was 13 (interquartile range, 1-58) months. Tuberculosis developed after a year of anti-TNF therapy in 53%, and late reactivation occurred in at least 3 of 8 patients. CONCLUSIONS The main risks factors for developing tuberculosis were anti-TNF therapy and hospitalization. Over half the cases related to anti-TNF treatment occurred after a year.
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Affiliation(s)
- Sabino Riestra
- Digestivo, Hospital Universitario Central de Asturias, España
| | | | | | | | | | | | | | - Fernando Muñoz
- Aparato digestivo, Complejo Asistencial Universitario de León., España
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Morales A, Ibarra N, Chávez M, Gómez T, Suárez A, Valle JA, Camacho RL, Cervantes M. Effect of feed intake level and dietary protein content on the body temperature of pigs housed under thermo neutral conditions. J Anim Physiol Anim Nutr (Berl) 2017; 102:e718-e725. [DOI: 10.1111/jpn.12824] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 08/31/2017] [Indexed: 12/14/2022]
Affiliation(s)
- A. Morales
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
| | - N. Ibarra
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
| | - M. Chávez
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
| | - T. Gómez
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
| | - A. Suárez
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
| | - J. A. Valle
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
| | - R. L. Camacho
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
| | - M. Cervantes
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
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Aguilera A, Navarro D, Rodríguez-Frias F, Viciana I, Martínez-Sapiña AM, Rodríguez MJ, Martró E, Lozano MC, Coletta E, Cardeñoso L, Suárez A, Trigo M, Rodríguez-Granjer J, Montiel N, de la Iglesia A, Alados JC, Vegas C, Bernal S, Fernández-Cuenca F, Pena MJ, Reina G, García-Bujalance S, Echevarria MJ, Benítez L, Pérez-Castro S, Ocete D, García-Arata I, Guerrero C, Rodríguez-Iglesias M, Casas P, García F. Prevalence and distribution of hepatitis C virus genotypes in Spain during the 2000-2015 period (the GEHEP 005 study). J Viral Hepat 2017; 24:725-732. [PMID: 28248445 DOI: 10.1111/jvh.12700] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 10/11/2016] [Accepted: 02/09/2017] [Indexed: 12/11/2022]
Abstract
We report the largest study on the prevalence and distribution of HCV genotypes in Spain (2000-2015), and we relate them with clinical, epidemiological and virological factors. Patients from 29 hospitals in 10 autonomous communities (Andalusia, Aragon, Castilla-Leon, Catalonia, Galicia, Canary Islands, Madrid Community, Valencian Community, Murcia Region and Basque Country) have been studied. Annual distribution of HCV genotypes and subtypes, as well as gender, age, transmission route, HIV and/or HBV coinfection, and treatment details were recorded. We included 48595 chronically HCV-infected patients with the following characteristics: median age 51 years (IQR, 44-58), 67.9% male, 19.1% HIV-coinfected, 23.5% HBV-coinfected. Parenteral transmission route was the most frequent (58.7%). Genotype distribution was 66.9% GT1 (24.9% subtype 1a and 37.9% subtype 1b), 2.8% GT2, 17.3% GT3, 11.4% GT4 and 0.1% GT5 and 0.02% GT6. LiPA was the most widely HCV genotyping test used (52.4%). HCV subtype 1a and genotypes 3 and 4 were closely associated with male gender, parenteral route of infection and HIV and HBV coinfection; in contrast, subtype 1b and genotype 2 were associated with female gender, nonparenteral route and mono-infection. Age was related to genotype distribution, and different patterns of distribution and biodiversity index were observed between different geographical areas. Finally, we describe how treatment and changes in transmission routes may have affected HCV genotype prevalence and distribution patterns. We present the most recent data on molecular epidemiology of hepatitis C virus in Spain. This study confirms that genotype distributions vary with age, sex, HIV and HBV coinfection and within geographical areas and epidemiological groups.
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Affiliation(s)
- A Aguilera
- Complexo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
| | - D Navarro
- Complexo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
| | | | - I Viciana
- Hospital Clínico Universitario Virgen de la Victoria, Malaga, Spain
| | | | | | - E Martró
- Hospital Universitari Germans Trías i Pujol, Badalona, CIBER en Epidemiología y Salud Pública, Barcelona, Spain
| | - M C Lozano
- Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - E Coletta
- Hospital Clínico Universitario Valladolid, Valladolid, Spain
| | - L Cardeñoso
- Hospital Universitario de la Princesa, Madrid, Spain
| | - A Suárez
- Hospital Clínico San Carlos, Madrid, Spain
| | - M Trigo
- Complexo Hospitalario de Pontevedra, Pontevedra, Spain
| | | | - N Montiel
- Hospital Costa del Sol, Marbella, Spain
| | - A de la Iglesia
- Complejo Hospitalario Universitario de Huelva, Huelva, Spain
| | - J C Alados
- Hospital del SAS de Jerez de la Frontera, Sevilla, Spain
| | - C Vegas
- Fundación Jiménez Díaz, Madrid, Spain
| | - S Bernal
- Hospital Universitario Virgen de Valme, Sevilla, Spain
| | | | - M J Pena
- Hospital Doctor Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - G Reina
- Clínica Universitaria de Navarra, Pamplona, Spain
| | | | | | - L Benítez
- Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | | | - D Ocete
- Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - I García-Arata
- Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
| | - C Guerrero
- Hospital General Universitario Morales Meseguer, Murcia, Spain
| | | | - P Casas
- Hospital Universitario San Cecilio, Instituto de Investigación Ibs-Granada, Granada, Spain
| | - F García
- Hospital Universitario San Cecilio, Instituto de Investigación Ibs-Granada, Granada, Spain
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43
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Kartashev V, Döring M, Nieto L, Coletta E, Kaiser R, Sierra S, Guerrero A, Stoiber H, Paar C, Vandamme A, Nevens F, Ranst MV, Cuypers L, Braun P, Ehret R, Obermeier M, Schneeweiss S, Scholten S, Römer K, Isernhagen K, Qurashi N, Heger E, Knops E, Neumann-Fraune M, Timm J, Walker A, Lübke N, Wedemeyer H, Wiesch JSZ, Lütgehetmann M, Polywka S, Däumer M, Hoffmann D, Protzer U, Marascio N, Foca A, Liberto M, Barreca G, Galati L, Torti C, Pisani V, Perno C, Ceccherini-Silberstein F, Cento V, Ciotti M, Zazzi M, Rossetti B, Luca A, Caudai C, Mor O, Devaux C, Staub T, Araujo F, Gomes P, Cabanas J, Markin N, Khomenko I, Govorukhina M, Lugovskaya G, Dontsov D, Mas A, Martró E, Saludes V, Rodríguez-Frías F, García F, Casas P, Iglesia ADL, Alados J, Pena-López M, Rodríguez M, Galán J, Suárez A, Cardeñoso L, Guerrero M, Vegas-Dominguez C, Blas-Espada J, García R, García-Bujalance S, Benítez-Gutiérrez L, Mendoza CD, Montiel N, Santos J, Viciana I, Delgado A, Martínez-Sanchez P, Fernández-Alonso M, Reina G, Trigo M, Echeverría M, Aguilera A, Navarro D, Bernal S, Lozano M, Fernández-Cuenca F, Orduña A, Eiros J, Lejarazu ROD, Martínez-Sapiña A, García-Díaz A, Haque T. New findings in HCV genotype distribution in selected West European, Russian and Israeli regions. J Clin Virol 2016; 81:82-9. [DOI: 10.1016/j.jcv.2016.05.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 05/17/2016] [Accepted: 05/19/2016] [Indexed: 02/06/2023]
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López P, Mozo L, Gutiérrez C, Suárez A. Epidemiology of systemic lupus erythematosus in a northern Spanish population: gender and age influence on immunological features. Lupus 2016; 12:860-5. [PMID: 14667105 DOI: 10.1191/0961203303lu469xx] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The present work was planned to research epidemiological and immunological features of systemic lupus erythematosus (SLE) in a Caucasian population from the north of Spain (Asturias). There is only one specialized immunology laboratory in this region where samples from all patients with a plausible or a firm diagnosis of SLE are referred for immunological analysis. Since 1992 we have reviewed registered data from samples submitted to the immunology laboratory with a firm, definitive diagnosis of SLE, based on the fulfillment of the American College of Rheumatology (ACR) criteria. We have constructed a database, which included 367 SLE patients. The point prevalencewas 34.12/100 000 (95% CI: 30.63-37.61/100 000), whereas the incidence rate calculated during the last five years was 2.15/100 000/year (95% CI: 1.76-2.54/100 000/year). The female/male ratio varied according to the age at diagnosis, being maximum (50: 1) between 22 and 28 years. The median age at diagnostis was significantly lower in females than in males. Immunological features also yielded sex and age peculiarities. The percentage of patients with anti-SSa antibodies yielded significant differences between males (18.6%) and females (34.6%). Anti-RNP and anti-Sm antibodies were more frequently present in childhood-onset patients, the difference with the oldest-onset group being statistically significant. Other analyses did not show significant differences, although, as a whole, we observed a trend towards a higher presence of autoantibodies related to an early disease onset.
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Affiliation(s)
- P López
- Department of Functional Biology, Area of Immunology, University of Oviedo, Oviedo, Spain
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Rodríguez-Carrio J, Alperi-Lόpez M, Lόpez P, Ballina-García F, Suárez A. FRI0005 A Distinct Profile of Serum Free Fatty Acids Is Associated with Clinical Features and Skewed Th1 Response in Rheumatoid Arthritis Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1721] [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: 11/04/2022]
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46
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Rodríguez-Carrio J, Lόpez-Mejías R, Alperi-Lόpez M, Lόpez P, Ballina-García F, González-Gay M, Suárez A. THU0079 HDL, IGG anti-HDL Antibodies and PON1 Axis in Rheumatoid Arthritis Patients: A New Target for CV Disease. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1718] [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: 11/04/2022]
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Villar-Vázquez R, Padilla G, Fernández-Aceñero MJ, Suárez A, Fuente E, Pastor C, Calero M, Barderas R, Casal JI. Development of a novel multiplex beads-based assay for autoantibody detection for colorectal cancer diagnosis. Proteomics 2016; 16:1280-90. [DOI: 10.1002/pmic.201500413] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/29/2016] [Accepted: 02/16/2016] [Indexed: 01/05/2023]
Affiliation(s)
- Roi Villar-Vázquez
- Functional Proteomics Laboratory; Centro de Investigaciones Biológicas (CIB-CSIC); Madrid Spain
| | - Guillermo Padilla
- Bioinformatics and Biostatistics Service; Centro de Investigaciones Biológicas (CIB-CSIC); Madrid Spain
| | | | | | | | - Carlos Pastor
- Department of General and Digestive Surgery; Fundación Jiménez Díaz; Madrid Spain
| | - Miguel Calero
- Alzheimer's Disease Centre; Reina Sofia Foundation; Madrid Spain
- CIBERNED; National Institute of Health Carlos III; Majadahonda Spain
| | - Rodrigo Barderas
- Biochemistry and Molecular Biology Department I; Facultad de Ciencias Químicas; Universidad Complutense de Madrid; Madrid Spain
| | - J. Ignacio Casal
- Functional Proteomics Laboratory; Centro de Investigaciones Biológicas (CIB-CSIC); Madrid Spain
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Gonzalez-Anleo C, Gomez AM, Gonzalez-Barcia M, Suárez A, Lamas MJ, Perri L. DI-089 New approach to the management of the hereditary fructose intolerance hypoglycaemia: Treatment with oral mannose. Eur J Hosp Pharm 2016. [DOI: 10.1136/ejhpharm-2016-000875.355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Guadamuro L, Jiménez-Girón AM, Delgado S, Flórez AB, Suárez A, Martín-Álvarez PJ, Bartolomé B, Moreno-Arribas MV, Mayo B. Profiling of Phenolic Metabolites in Feces from Menopausal Women after Long-Term Isoflavone Supplementation. J Agric Food Chem 2016; 64:210-216. [PMID: 26690567 DOI: 10.1021/acs.jafc.5b05102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Phenolic compounds were screened by UPLC-ESI-MS/MS in the feces of 15 menopausal women before and after long-term isoflavone treatment. In total, 44 compounds were detected. Large intertreatment, interindividual, and intersample variations were observed in terms of the number of compounds and their concentration. Four compounds, the aglycones daidzein and genistein and the daidzein derivatives dihydrodaidzein and O-desmethylangolensin, were associated with isoflavone metabolism; these were identified only after the isoflavone treatment. In addition, 4-ethylcatechol, 3-hydroxyphenylacetic acid, and 3-phenylpropionic acid differed significantly in pre- and postintervention samples, whereas the concentration of 4-hydroxy-5-phenylvaleric acid showed a trend toward increasing over the treatment. The phenolic profiles of equol-producing and -non-producing groups were similar, with the exceptions of 3-hydroxyphenylacetic acid and 3-phenylpropionic acid, which showed higher concentrations in equol-non-producing women. These findings may help to trace isoflavone-derived metabolites in feces during isoflavone interventions and to design new studies to address their biological effects.
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Affiliation(s)
- Lucía Guadamuro
- Departamento de Microbiología y Bioquı́mica de Productos Lácteos, Instituto de Productos Lácteos de Asturias (IPLA-CSIC) , Paseo Rı́o Linares s/n, 33300 Villaviciosa, Asturias, Spain
- Instituto de Investigación en Ciencias de la Alimentación (CIAL), CSIC-UAM, CEI UAM+CSIC , c/Nicolás Cabrera 9, 28049 Madrid, Spain
| | - Ana M Jiménez-Girón
- Instituto de Investigación en Ciencias de la Alimentación (CIAL), CSIC-UAM, CEI UAM+CSIC , c/Nicolás Cabrera 9, 28049 Madrid, Spain
| | - Susana Delgado
- Departamento de Microbiología y Bioquı́mica de Productos Lácteos, Instituto de Productos Lácteos de Asturias (IPLA-CSIC) , Paseo Rı́o Linares s/n, 33300 Villaviciosa, Asturias, Spain
| | - Ana Belén Flórez
- Departamento de Microbiología y Bioquı́mica de Productos Lácteos, Instituto de Productos Lácteos de Asturias (IPLA-CSIC) , Paseo Rı́o Linares s/n, 33300 Villaviciosa, Asturias, Spain
| | - Adolfo Suárez
- Servicio de Digestivo, Hospital de Cabueñes , Calle Los Prados 395, 33394 Gijón, Spain
| | - Pedro J Martín-Álvarez
- Instituto de Investigación en Ciencias de la Alimentación (CIAL), CSIC-UAM, CEI UAM+CSIC , c/Nicolás Cabrera 9, 28049 Madrid, Spain
| | - Begoña Bartolomé
- Instituto de Investigación en Ciencias de la Alimentación (CIAL), CSIC-UAM, CEI UAM+CSIC , c/Nicolás Cabrera 9, 28049 Madrid, Spain
| | - M Victoria Moreno-Arribas
- Instituto de Investigación en Ciencias de la Alimentación (CIAL), CSIC-UAM, CEI UAM+CSIC , c/Nicolás Cabrera 9, 28049 Madrid, Spain
| | - Baltasar Mayo
- Departamento de Microbiología y Bioquı́mica de Productos Lácteos, Instituto de Productos Lácteos de Asturias (IPLA-CSIC) , Paseo Rı́o Linares s/n, 33300 Villaviciosa, Asturias, Spain
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50
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Guadamuro L, Delgado S, Redruello B, Flórez AB, Suárez A, Martínez-Camblor P, Mayo B. Equol status and changes in fecal microbiota in menopausal women receiving long-term treatment for menopause symptoms with a soy-isoflavone concentrate. Front Microbiol 2015; 6:777. [PMID: 26300856 PMCID: PMC4525046 DOI: 10.3389/fmicb.2015.00777] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [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: 05/19/2015] [Accepted: 07/15/2015] [Indexed: 01/19/2023] Open
Abstract
The knowledge regarding the intestinal microbial types involved in isoflavone bioavailability and metabolism is still limited. The present work reports the influence of a treatment with isoflavones for 6 months on the fecal bacterial communities of 16 menopausal women, as determined by culturing and culture-independent microbial techniques. Changes in fecal communities were analyzed with respect to the women's equol-producing phenotype. Compared to baseline, at 1 and 3 months the counts for all microbial populations in the feces of equol-producing women had increased strongly. In contrast, among the non-producers, the counts for all microbial populations at 1 month were similar to those at baseline, and decreased significantly by 3 and 6 months. Following isoflavone intake, major bands in the denaturing gradient gel electrophoresis (DGGE) profiles appeared and disappeared, suggesting important changes in majority populations. In some women, increases were seen in the intensity of specific DGGE bands corresponding to microorganisms known to be involved in the metabolism of dietary phytoestrogens (Lactonifactor longoviformis, Faecalibacterium prausnitzii, Bifidobacterium sp., Ruminococcus sp.). Real-Time quantitative PCR revealed that the Clostridium leptum and C. coccoides populations increased in equol producers, while those of bifidobacteria and enterobacteria decreased, and vice versa in the non-producers. Finally, the Atopobium population increased in both groups, but especially in the non-producers at three months. As the main findings of this study, (i) variations in the microbial communities over the 6-month period of isoflavone supplementation were large; (ii) no changes in the fecal microbial populations that were convincingly treatment-specific were seen; and (iii) the production of equol did not appear to be associated with the presence of, or increase in the population of, any of the majority bacterial types analyzed.
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Affiliation(s)
- Lucía Guadamuro
- Departamento de Microbiología y Bioquímica, Instituto de Productos Lácteos de Asturias - Consejo Superior de Investigaciones Científicas Villaviciosa, Spain
| | - Susana Delgado
- Departamento de Microbiología y Bioquímica, Instituto de Productos Lácteos de Asturias - Consejo Superior de Investigaciones Científicas Villaviciosa, Spain
| | - Begoña Redruello
- Servicios Científico-Técnicos, Instituto de Productos Lácteos de Asturias - Consejo Superior de Investigaciones Científicas Villaviciosa, Spain
| | - Ana B Flórez
- Departamento de Microbiología y Bioquímica, Instituto de Productos Lácteos de Asturias - Consejo Superior de Investigaciones Científicas Villaviciosa, Spain
| | - Adolfo Suárez
- Servicio de Digestivo, Hospital de Cabueñes Gijón, Spain
| | - Pablo Martínez-Camblor
- Consorcio de Apoyo a la Investigación Biomédica en Red, Hospital Universitario Central de Asturias Oviedo, Spain ; Facultad de Ciencias de la Educación, Universidad Autónoma de Chile Santiago, Chile
| | - Baltasar Mayo
- Departamento de Microbiología y Bioquímica, Instituto de Productos Lácteos de Asturias - Consejo Superior de Investigaciones Científicas Villaviciosa, Spain
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