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Martinez de Lapiscina I, Kouri C, Aurrekoetxea J, Sanchez M, Naamneh Elzenaty R, Sauter KS, Camats N, Grau G, Rica I, Rodriguez A, Vela A, Cortazar A, Alonso-Cerezo MC, Bahillo P, Bertholt L, Esteva I, Castaño L, Flück CE. Genetic reanalysis of patients with a difference of sex development carrying the NR5A1/SF-1 variant p.Gly146Ala has discovered other likely disease-causing variations. PLoS One 2023; 18:e0287515. [PMID: 37432935 DOI: 10.1371/journal.pone.0287515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/07/2023] [Indexed: 07/13/2023] Open
Abstract
NR5A1/SF-1 (Steroidogenic factor-1) variants may cause mild to severe differences of sex development (DSD) or may be found in healthy carriers. The NR5A1/SF-1 c.437G>C/p.Gly146Ala variant is common in individuals with a DSD and has been suggested to act as a susceptibility factor for adrenal disease or cryptorchidism. Since the allele frequency is high in the general population, and the functional testing of the p.Gly146Ala variant revealed inconclusive results, the disease-causing effect of this variant has been questioned. However, a role as a disease modifier is still possible given that oligogenic inheritance has been described in patients with NR5A1/SF-1 variants. Therefore, we performed next generation sequencing (NGS) in 13 DSD individuals harboring the NR5A1/SF-1 p.Gly146Ala variant to search for other DSD-causing variants and clarify the function of this variant for the phenotype of the carriers. Panel and whole-exome sequencing was performed, and data were analyzed with a filtering algorithm for detecting variants in NR5A1- and DSD-related genes. The phenotype of the studied individuals ranged from scrotal hypospadias and ambiguous genitalia in 46,XY DSD to opposite sex in both 46,XY and 46,XX. In nine subjects we identified either a clearly pathogenic DSD gene variant (e.g. in AR) or one to four potentially deleterious variants that likely explain the observed phenotype alone (e.g. in FGFR3, CHD7). Our study shows that most individuals carrying the NR5A1/SF-1 p.Gly146Ala variant, harbor at least one other deleterious gene variant which can explain the DSD phenotype. This finding confirms that the NR5A1/SF-1 p.Gly146Ala variant may not contribute to the pathogenesis of DSD and qualifies as a benign polymorphism. Thus, individuals, in whom the NR5A1/SF-1 p.Gly146Ala gene variant has been identified as the underlying genetic cause for their DSD in the past, should be re-evaluated with a NGS method to reveal the real genetic diagnosis.
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Affiliation(s)
- Idoia Martinez de Lapiscina
- Department of Pediatrics, Inselspital, Pediatric Endocrinology, Diabetology and Metabolism, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research, University of Bern, Bern, Switzerland
- Biocruces Bizkaia Health Research Institute, Research into the Genetics and Control of Diabetes and other Endocrine Disorders, Cruces University Hospital, Barakaldo, Spain
- Instituto de Salud Carlos III, CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Instituto de Salud Carlos III, CIBER de Enfermedades Raras (CIBERER), Madrid, Spain
- Endo-ERN, Amsterdam, The Netherlands
| | - Chrysanthi Kouri
- Department of Pediatrics, Inselspital, Pediatric Endocrinology, Diabetology and Metabolism, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Josu Aurrekoetxea
- Biocruces Bizkaia Health Research Institute, Research Group of Medical Oncology, Cruces University Hospital, Barakaldo, Spain
- University of the Basque Country (UPV-EHU), Leioa, Spain
| | - Mirian Sanchez
- Biocruces Bizkaia Health Research Institute, Research into the Genetics and Control of Diabetes and other Endocrine Disorders, Cruces University Hospital, Barakaldo, Spain
| | - Rawda Naamneh Elzenaty
- Department of Pediatrics, Inselspital, Pediatric Endocrinology, Diabetology and Metabolism, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Kay-Sara Sauter
- Department of Pediatrics, Inselspital, Pediatric Endocrinology, Diabetology and Metabolism, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Núria Camats
- Instituto de Salud Carlos III, CIBER de Enfermedades Raras (CIBERER), Madrid, Spain
- Vall d'Hebron Research Institute (VHIR), Growth and Development group, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Gema Grau
- Biocruces Bizkaia Health Research Institute, Research into the Genetics and Control of Diabetes and other Endocrine Disorders, Cruces University Hospital, Barakaldo, Spain
- Endo-ERN, Amsterdam, The Netherlands
- Department of Pediatric Endocrinology, Cruces University Hospital, Barakaldo Spain
| | - Itxaso Rica
- Biocruces Bizkaia Health Research Institute, Research into the Genetics and Control of Diabetes and other Endocrine Disorders, Cruces University Hospital, Barakaldo, Spain
- Instituto de Salud Carlos III, CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Instituto de Salud Carlos III, CIBER de Enfermedades Raras (CIBERER), Madrid, Spain
- Endo-ERN, Amsterdam, The Netherlands
- Department of Pediatric Endocrinology, Cruces University Hospital, Barakaldo Spain
| | - Amaia Rodriguez
- Biocruces Bizkaia Health Research Institute, Research into the Genetics and Control of Diabetes and other Endocrine Disorders, Cruces University Hospital, Barakaldo, Spain
- Department of Pediatric Endocrinology, Cruces University Hospital, Barakaldo Spain
| | - Amaia Vela
- Biocruces Bizkaia Health Research Institute, Research into the Genetics and Control of Diabetes and other Endocrine Disorders, Cruces University Hospital, Barakaldo, Spain
- Instituto de Salud Carlos III, CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Instituto de Salud Carlos III, CIBER de Enfermedades Raras (CIBERER), Madrid, Spain
- Endo-ERN, Amsterdam, The Netherlands
- Department of Pediatric Endocrinology, Cruces University Hospital, Barakaldo Spain
| | - Alicia Cortazar
- Instituto de Salud Carlos III, CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Endocrinology Department, Cruces University Hospital, Barakaldo, Spain
| | | | - Pilar Bahillo
- Department of Pediatrics, Pediatric Endocrinology Unit, x Clinic University Hospital of Valladolid, Valladolid, Spain
| | - Laura Bertholt
- Pediatric Endocrinology Department, Marques de Valdecilla University Hospital, Santander, Spain
| | - Isabel Esteva
- Endocrinology Section, Gender Identity Unit, Regional University Hospital of Malaga, Malaga, Spain
| | - Luis Castaño
- Biocruces Bizkaia Health Research Institute, Research into the Genetics and Control of Diabetes and other Endocrine Disorders, Cruces University Hospital, Barakaldo, Spain
- Instituto de Salud Carlos III, CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Instituto de Salud Carlos III, CIBER de Enfermedades Raras (CIBERER), Madrid, Spain
- Endo-ERN, Amsterdam, The Netherlands
- University of the Basque Country (UPV-EHU), Leioa, Spain
- Department of Pediatric Endocrinology, Cruces University Hospital, Barakaldo Spain
| | - Christa E Flück
- Department of Pediatrics, Inselspital, Pediatric Endocrinology, Diabetology and Metabolism, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research, University of Bern, Bern, Switzerland
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López-Ortega A, Sáenz de Viteri V, Alves SA, Mendoza G, Fuentes E, Mitran V, Cimpean A, Dan I, Vela A, Bayón R. Multifunctional TiO 2 coatings developed by plasma electrolytic oxidation technique on a Ti20Nb20Zr4Ta alloy for dental applications. Biomater Adv 2022; 138:212875. [PMID: 35913254 DOI: 10.1016/j.bioadv.2022.212875] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
A newly developed β-Ti alloy based on the Ti-Nb-Zr-Ta system (Ti20Nb20Zr4Ta) has been subjected to Plasma Electrolytic Oxidation (PEO) treatment to obtain a multifunctional ceramic-like (TiO2) coating with superior tribocorrosion (wear and corrosion) resistance and improved biocompatibility. For this aim, elements such as Ca, P, and Ag NPs have been incorporated into the oxide film to obtain bioactive and biocide properties. The chemical composition and morphology of the TiO2-PEO coating was characterized, and its multifunctionality was addressed by several means, including antibacterial activity assessment, formation of bone-like apatite, metallic ion release evaluation, in vitro cellular response analysis, and corrosion and tribocorrosion tests in artificial saliva. The developed coatings enhanced the corrosion and tribocorrosion resistance of the bare alloy and exhibited antibacterial ability with low cytotoxicity and negligible ion release. Furthermore, they were able to sustain MC3T3-E1 preosteoblast viability/proliferation and osteogenic differentiation. Altogether, the results obtained demonstrate the potential of the TiO2 coating incorporating Ca, P, and Ag NPs to be used for dental applications.
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Affiliation(s)
- A López-Ortega
- Tekniker, Basque Research and Technology Aliance (BRTA), Eibar, Spain.
| | | | - S A Alves
- Tekniker, Basque Research and Technology Aliance (BRTA), Eibar, Spain
| | - G Mendoza
- Tekniker, Basque Research and Technology Aliance (BRTA), Eibar, Spain
| | - E Fuentes
- Tekniker, Basque Research and Technology Aliance (BRTA), Eibar, Spain
| | - V Mitran
- University of Bucharest, Department of Biochemistry and Molecular Biology, Bucharest, Romania
| | - A Cimpean
- University of Bucharest, Department of Biochemistry and Molecular Biology, Bucharest, Romania
| | - I Dan
- R&D Consulting and Services SRL, Bucharest, Romania
| | - A Vela
- Mugape S.L., Mallabia, Spain
| | - R Bayón
- Tekniker, Basque Research and Technology Aliance (BRTA), Eibar, Spain
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Martínez de LaPiscina I, Mahmoud RAA, Sauter KS, Esteva I, Alonso M, Costa I, Rial-Rodriguez JM, Rodríguez-Estévez A, Vela A, Castano L, Flück CE. Variants of STAR, AMH and ZFPM2/FOG2 May Contribute towards the Broad Phenotype Observed in 46,XY DSD Patients with Heterozygous Variants of NR5A1. Int J Mol Sci 2020; 21:E8554. [PMID: 33202802 PMCID: PMC7696449 DOI: 10.3390/ijms21228554] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 10/29/2020] [Accepted: 11/09/2020] [Indexed: 12/21/2022] Open
Abstract
Variants of NR5A1 are often found in individuals with 46,XY disorders of sex development (DSD) and manifest with a very broad spectrum of clinical characteristics and variable sex hormone levels. Such complex phenotypic expression can be due to the inheritance of additional genetic hits in DSD-associated genes that modify sex determination, differentiation and organ function in patients with heterozygous NR5A1 variants. Here we describe the clinical, biochemical and genetic features of a series of seven patients harboring monoallelic variants in the NR5A1 gene. We tested the transactivation activity of novel NR5A1 variants. We additionally included six of these patients in a targeted diagnostic gene panel for DSD and identified a second genetic hit in known DSD-causing genes STAR, AMH and ZFPM2/FOG2 in three individuals. Our study increases the number of NR5A1 variants related to 46,XY DSD and supports the hypothesis that a digenic mode of inheritance may contribute towards the broad spectrum of phenotypes observed in individuals with a heterozygous NR5A1 variation.
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Affiliation(s)
- Idoia Martínez de LaPiscina
- Biocruces Bizkaia Health Research Institute, Cruces University Hospital, UPV/EHU, CIBERER, CIBERDEM, ENDO-ERN. Plaza de Cruces 12, 48903 Barakaldo, Spain; (I.M.d.L.); (A.R.-E.); (A.V.); (L.C.)
| | - Rana AA Mahmoud
- Department of Pediatrics, Endocrinology Section, Ain Shams University, 38 Abbasia, Nour Mosque, El-Mohamady, Al Waili, Cairo 11591, Egypt;
| | - Kay-Sara Sauter
- Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, Department of BioMedical Research, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, 3010 Bern, Switzerland;
| | - Isabel Esteva
- Endocrinology Section, Gender Identity Unit, Regional University Hospital of Malaga, Av. de Carlos Haya, s/n, 29010 Málaga, Spain;
| | - Milagros Alonso
- Pediatric Endocrinology Department, Ramon y Cajal University Hospital, Ctra. de Colmenar Viejo km. 9, 100, 28034 Madrid, Spain;
| | - Ines Costa
- Pediatric Department, Manises Hospital, Avda. Generalitat Valenciana 50, 46940 Manises, Spain;
| | - Jose Manuel Rial-Rodriguez
- Pediatric Endocrinology Department, Nuestra Señora de Candelaria University Hospital, Ctra general del Rosario 145, 38010 Santa Cruz de Tenerife, Spain;
| | - Amaia Rodríguez-Estévez
- Biocruces Bizkaia Health Research Institute, Cruces University Hospital, UPV/EHU, CIBERER, CIBERDEM, ENDO-ERN. Plaza de Cruces 12, 48903 Barakaldo, Spain; (I.M.d.L.); (A.R.-E.); (A.V.); (L.C.)
- Pediatric Endocrinology Department, Cruces University Hospital, Plaza de Cruces 12, 48903 Barakaldo, Spain
| | - Amaia Vela
- Biocruces Bizkaia Health Research Institute, Cruces University Hospital, UPV/EHU, CIBERER, CIBERDEM, ENDO-ERN. Plaza de Cruces 12, 48903 Barakaldo, Spain; (I.M.d.L.); (A.R.-E.); (A.V.); (L.C.)
- Pediatric Endocrinology Department, Cruces University Hospital, Plaza de Cruces 12, 48903 Barakaldo, Spain
| | - Luis Castano
- Biocruces Bizkaia Health Research Institute, Cruces University Hospital, UPV/EHU, CIBERER, CIBERDEM, ENDO-ERN. Plaza de Cruces 12, 48903 Barakaldo, Spain; (I.M.d.L.); (A.R.-E.); (A.V.); (L.C.)
- Pediatric Endocrinology Department, Cruces University Hospital, Plaza de Cruces 12, 48903 Barakaldo, Spain
| | - Christa E. Flück
- Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, Department of BioMedical Research, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, 3010 Bern, Switzerland;
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García-Castaño A, Madariaga L, Pérez de Nanclares G, Vela A, Rica I, Gaztambide S, Martínez R, Martinez de LaPiscina I, Urrutia I, Aguayo A, Velasco O, Castaño L. Response to Letter to the Editor: "Forty-One Individuals with Mutations in the AVP-NPII Gene Associated with Familial Neurohypophyseal Diabetes Insipidus. J Clin Endocrinol Metab 2020; 105:5835887. [PMID: 32392319 DOI: 10.1210/clinem/dgaa255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 05/06/2020] [Indexed: 11/19/2022]
Affiliation(s)
| | - Leire Madariaga
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
- Hospital Universitario Cruces, Barakaldo, Spain
- UPV/EHU, Leioa, Spain
| | - Gustavo Pérez de Nanclares
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
- Hospital Universitario Cruces, Barakaldo, Spain
| | - Amaia Vela
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
- Hospital Universitario Cruces, Barakaldo, Spain
- UPV/EHU, Leioa, Spain
| | - Itxaso Rica
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
- Hospital Universitario Cruces, Barakaldo, Spain
| | - Sonia Gaztambide
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
- Hospital Universitario Cruces, Barakaldo, Spain
- UPV/EHU, Leioa, Spain
| | - Rosa Martínez
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
| | | | - Inés Urrutia
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
| | - Anibal Aguayo
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
- Hospital Universitario Cruces, Barakaldo, Spain
| | - Olaia Velasco
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
| | - Luis Castaño
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
- Hospital Universitario Cruces, Barakaldo, Spain
- UPV/EHU, Leioa, Spain
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García-Castaño A, Madariaga L, Pérez de Nanclares G, Vela A, Rica I, Gaztambide S, Martínez R, Martinez de LaPiscina I, Urrutia I, Aguayo A, Velasco O, Castaño L. Forty-One Individuals With Mutations in the AVP-NPII Gene Associated With Familial Neurohypophyseal Diabetes Insipidus. J Clin Endocrinol Metab 2020; 105:5735194. [PMID: 32052034 DOI: 10.1210/clinem/dgaa069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/07/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Familial neurohypophyseal diabetes insipidus is a rare disease produced by a deficiency in the secretion of antidiuretic hormone and is caused by mutations in the arginine vasopressin gene. OBJECTIVE Clinical, biochemical, and genetic characterization of a group of patients clinically diagnosed with familial neurohypophyseal diabetes insipidus, 1 of the largest cohorts of patients with protein neurophysin II (AVP-NPII) gene alterations studied so far. DESIGN The AVP-NPII gene was screened for mutations by PCR followed by direct Sanger sequencing in 15 different unrelated families from Spain. RESULTS The 15 probands presented with polyuria and polydipsia as the most important symptoms at the time of diagnosis. In these patients, the disease was diagnosed at a median of 6 years of age. We observed 11 likely pathogenic variants. Importantly, 4 of the AVP-NPII variants were novel (p.(Tyr21Cys), p.(Gly45Ser), p.(Cys75Tyr), p.(Gly88Cys)). CONCLUSIONS Cytotoxicity seems to be due to consequences common to all the variants found in our cohort, which are not able to fold correctly and pass the quality control of the ER. In concordance, we found autosomal dominant familial neurohypophyseal diabetes insipidus in the 15 families studied.
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Affiliation(s)
| | - Leire Madariaga
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
- Hospital Universitario Cruces, Barakaldo, Spain
- UPV/EHU, Leioa, Spain
| | - Gustavo Pérez de Nanclares
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
- Hospital Universitario Cruces, Barakaldo, Spain
| | - Amaia Vela
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
- Hospital Universitario Cruces, Barakaldo, Spain
- UPV/EHU, Leioa, Spain
| | - Itxaso Rica
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
- Hospital Universitario Cruces, Barakaldo, Spain
| | - Sonia Gaztambide
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
- Hospital Universitario Cruces, Barakaldo, Spain
- UPV/EHU, Leioa, Spain
| | - Rosa Martínez
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
| | | | - Inés Urrutia
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
| | - Anibal Aguayo
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
- Hospital Universitario Cruces, Barakaldo, Spain
| | - Olaia Velasco
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
| | | | - Luis Castaño
- Biocruces Bizkaia Health Research Institute, CIBERDEM, CIBERER, Barakaldo, Spain
- Hospital Universitario Cruces, Barakaldo, Spain
- UPV/EHU, Leioa, Spain
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le Guevelou J, Trompier F, Villagrasa C, Vela A, Isambert A, Herault J, Thariat J. [Measurement of out-of-field dose to the uterus during proton therapy of the head and neck]. Cancer Radiother 2020; 24:138-142. [PMID: 32061532 DOI: 10.1016/j.canrad.2019.10.004] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022]
Abstract
The decision to irradiate during pregnancy is based on a risk benefit compromise of two kinds: maternal risk and fetal risk. The aim of this work is to determine the foetal risk, and uterine dose measurement in proton therapy. Foetal exposure during treatment is linked to two sources: the treatment phase, and the repositioning phase. An Alderson-Rando anthropomorphic ghost (170cm, 74kg) was positioned on the table in the treatment position. A tissue-equivalent proportional counter (TEPC), adapted to the analysis of complex radiation fields (neutron and photonics), was used to determine the irradiation related to the treatment phase. An AT1123 radiation survey meter was used to measure photons generated by X-ray radiation. I dosimetry was proposed using radio-photoluminescent dosimeters, allowing for a daily check of the dose received in the uterus. The treatment phase produces higher uterine doses than the positioning phase, but these remain very low. The equivalent dose received in the uterus for the entire treatment is estimated at 840 μSv. Using a methodology for measuring the out-of-field dose with pencil beam scanning proton therapy, the foetal dose in the first trimester was well below the acceptance dose of 100 mGy determined by the International Commission on Radiological Protection.
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Affiliation(s)
- J le Guevelou
- Service de radiothérapie, centre François Baclesse, avenue du Général-Harris, 14000 Caen, France
| | - F Trompier
- Laboratoire de dosimétrie des radiations ionisantes, Institut de radioprotection et de sûreté nucléaire (IRSN), 92262 Fontenay-aux-Roses, France
| | - C Villagrasa
- Laboratoire de dosimétrie des radiations ionisantes, Institut de radioprotection et de sûreté nucléaire (IRSN), 92262 Fontenay-aux-Roses, France
| | - A Vela
- Service de radiothérapie, centre François Baclesse, avenue du Général-Harris, 14000 Caen, France
| | - A Isambert
- Laboratoire de dosimétrie des radiations ionisantes, Institut de radioprotection et de sûreté nucléaire (IRSN), 92262 Fontenay-aux-Roses, France
| | - J Herault
- Centre Lacassagne, 33, avenue Valombrose, 06000 Nice, France
| | - J Thariat
- Service de radiothérapie, centre François Baclesse, avenue du Général-Harris, 14000 Caen, France.
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7
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Jouyaux F, Henry O, Biron E, Coste F, Danhier S, Benchalal M, Gesnouin P, Getain M, P. Le Dorze GL, Prince CL, Lecoeur P, Leleu C, Llagostera C, Vigouroux FL, Martin E, Martineau S, Palisson J, Perrot S, Prodhomme T, Vela A, Collet S. 22- A multi-center study of breast irradiation techniques. Phys Med 2019. [DOI: 10.1016/j.ejmp.2019.09.103] [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: 10/25/2022] Open
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8
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Beddok A, Vela A, Calugaru V, Tessonnier T, Kubes J, Dutheil P, Gérard A, Vidal M, Goudjil F, Florescu C, Kammerer E, Bénézery K, Hérault J, Bourhis J, Thariat J. Protonthérapie des carcinomes épidermoïdes des voies aérodigestives supérieures : de la physique à la clinique. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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9
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Beddok A, Vela A, Calugaru V, Tessonnier T, Kubes J, Dutheil P, Gérard A, Idal M, Goudjil F, Florescu C, Kammerer E, Bénézery K, Hérault J, Bourhis J, Thariat J. Protonthérapie des carcinomes épidermoïdes des voies aérodigestives supérieures : de la physique à la clinique. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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10
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Vela A, Pérez-Nanclares G, Ríos I, Rica I, Portillo N, Castaño L. Thyroid hormone resistance from newborns to adults: a Spanish experience. J Endocrinol Invest 2019; 42:941-949. [PMID: 30707410 DOI: 10.1007/s40618-019-1007-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 05/23/2018] [Accepted: 01/09/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Thyroid hormone resistance (RTH β) is a rare genetic disorder characterized by an altered response of target tissue to the action of thyroid hormone. Few studies on RTH β have been carried out in southern European populations. We aimed to describe the clinical and genetic characteristics at the time of diagnosis in a Spanish cohort of patients with genetically confirmed RTH β, with ages ranging from newborns to adults. METHODS Retrospective multicenter study of 28 patients who were genetically confirmed as RTH β. Clinical and biochemical data were collected from the reference centers, and the studied variables included age, sex, anthropometric data, clinical characteristics and biochemical results. In the Basque country, a simultaneous analysis of TSH and T4 is carried out in the program for the screening of inborn errors of metabolism. A molecular analysis of the thyroid hormone beta (THRB) gene was performed. RESULTS The total cohort included 20 adults and eight pediatric patients (six newborns). Of the total, 5 (17.8%) were diagnosed by clinical characteristics (goiter, hypertension or tachycardia), 13 (46.4%) were analyzed in the context of a family study and 10 (35.7%) were diagnosed after obtaining an altered fT4 and/or TSH level in a biochemical analysis performed due to clinical symptoms unrelated to RTH β. Four of the newborns included in the series were diagnosed by the result of neonatal screening, which allows us to estimate a minimum local incidence of RTH β of 1/18,750 live newborns. The genetic analysis showed the presence of 12 different heterozygous mutations in the THRB gene. CONCLUSIONS We report the clinical and genetic characteristics of a Spanish RTH β cohort, from neonates to adults. We also describe one novel mutation in the THRB gene as the cause of the disease. The simultaneous analysis of TSH and T4 carried out in the program for the screening of inborn errors of metabolism facilitates the early diagnosis of RTH β in newborns and has allowed us to estimate a minimum local incidence of RTH of 1/18,750 live newborns.
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Affiliation(s)
- A Vela
- Biocruces Health Research Institute, Cruces University Hospital, CIBERER, CIBERDEM, UPV-EHU, Barakaldo, Basque Country, Spain
| | - G Pérez-Nanclares
- Biocruces Health Research Institute, Cruces University Hospital, CIBERER, CIBERDEM, UPV-EHU, Barakaldo, Basque Country, Spain
| | - I Ríos
- Biocruces Health Research Institute, Cruces University Hospital, CIBERER, CIBERDEM, UPV-EHU, Barakaldo, Basque Country, Spain
| | - I Rica
- Biocruces Health Research Institute, Cruces University Hospital, CIBERER, CIBERDEM, UPV-EHU, Barakaldo, Basque Country, Spain
| | - N Portillo
- Biocruces Health Research Institute, Alto Deba Hospital, Gipuzkoa, Basque Country, Spain
| | - L Castaño
- Biocruces Health Research Institute, Cruces University Hospital, CIBERER, CIBERDEM, UPV-EHU, Barakaldo, Basque Country, Spain.
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Beddok A, Vela A, Calugaru V, Tessonnier T, Kubes J, Dutheil P, Gérard A, Vidal M, Goudjil F, Florescu C, Kammerer E, Bénézery K, Hérault J, Bourhis J, Thariat J. [Proton therapy for head and neck squamous cell carcinomas: From physics to clinic]. Cancer Radiother 2019; 23:439-448. [PMID: 31358445 DOI: 10.1016/j.canrad.2019.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/09/2019] [Accepted: 05/16/2019] [Indexed: 11/17/2022]
Abstract
Intensity-modulated radiation therapy (IMRT) is presently the recommended technique for the treatment of locally advanced head and neck carcinomas. Proton therapy would allow to reduce the volume of irradiated normal tissue and, thus, to decrease the risk of late dysphagia, xerostomia, dysgeusia and hypothyroidism. An exhaustive research was performed with the search engine PubMed by focusing on the papers about the physical difficulties that slow down use of proton therapy for head and neck carcinomas. Range uncertainties in proton therapy (±3 %) paradoxically limit the use of the steep dose gradient in distality. Calibration uncertainties can be important in the treatment of head and neck cancer in the presence of materials of uncertain stoichiometric composition (such as with metal implants, dental filling, etc.) and complex heterogeneities. Dental management for example may be different with IMRT or proton therapy. Some uncertainties can be somewhat minimized at the time of optimization. Inter- and intrafractional variations and uncertainties in Hounsfield units/stopping power can be integrated in a robust optimization process. Additional changes in patient's anatomy (tumour shrinkage, changes in skin folds in the beam patch, large weight loss or gain) require rescanning. Dosimetric and small clinical studies comparing photon and proton therapy have well shown the interest of proton therapy for head and neck cancers. Intensity-modulated proton therapy is a promising treatment as it can reduce the substantial toxicity burden of patients with head and neck squamous cell carcinoma compared to IMRT. Robust optimization will allow to perform an optimal treatment and to use proton therapy in current clinical practice.
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Affiliation(s)
- A Beddok
- Département d'oncologie-radiothérapie, institut Curie, 25, rue d'Ulm, 75005 Paris, France
| | - A Vela
- Département d'oncologie-radiothérapie, centre François-Baclesse, Caen, 3, avenue du Général-Harris, 14000 Caen, France; Unicaen - Normandie Université, 14000 Caen, France; Advanced Resource Centre for Hadrontherapy in Europe (Archade), 3, avenue du Général-Harris, 14000 Caen, France
| | - V Calugaru
- Département d'oncologie-radiothérapie, institut Curie, 25, rue d'Ulm, 75005 Paris, France
| | - T Tessonnier
- Département d'oncologie-radiothérapie, centre François-Baclesse, Caen, 3, avenue du Général-Harris, 14000 Caen, France; Unicaen - Normandie Université, 14000 Caen, France; Advanced Resource Centre for Hadrontherapy in Europe (Archade), 3, avenue du Général-Harris, 14000 Caen, France
| | - J Kubes
- Proton Therapy Centre Czech, Prague, République tchèque
| | - P Dutheil
- Département d'oncologie-radiothérapie, centre François-Baclesse, Caen, 3, avenue du Général-Harris, 14000 Caen, France; Unicaen - Normandie Université, 14000 Caen, France; Advanced Resource Centre for Hadrontherapy in Europe (Archade), 3, avenue du Général-Harris, 14000 Caen, France
| | - A Gérard
- Centre Antoine-Lacassagne, département d'oncologie-radiothérapie, 33, avenue Valombrose, 06000 Nice, France
| | - M Vidal
- Centre Antoine-Lacassagne, département d'oncologie-radiothérapie, 33, avenue Valombrose, 06000 Nice, France
| | - F Goudjil
- Département d'oncologie-radiothérapie, institut Curie, 25, rue d'Ulm, 75005 Paris, France
| | - C Florescu
- Département d'oncologie-radiothérapie, centre François-Baclesse, Caen, 3, avenue du Général-Harris, 14000 Caen, France; Unicaen - Normandie Université, 14000 Caen, France; Advanced Resource Centre for Hadrontherapy in Europe (Archade), 3, avenue du Général-Harris, 14000 Caen, France
| | - E Kammerer
- Département d'oncologie-radiothérapie, centre François-Baclesse, Caen, 3, avenue du Général-Harris, 14000 Caen, France; Unicaen - Normandie Université, 14000 Caen, France; Advanced Resource Centre for Hadrontherapy in Europe (Archade), 3, avenue du Général-Harris, 14000 Caen, France
| | - K Bénézery
- Centre Antoine-Lacassagne, département d'oncologie-radiothérapie, 33, avenue Valombrose, 06000 Nice, France
| | - J Hérault
- Centre Antoine-Lacassagne, département d'oncologie-radiothérapie, 33, avenue Valombrose, 06000 Nice, France
| | - J Bourhis
- Département d'oncologie-radiothérapie, centre hospitalier universitaire vaudois, Lausanne, Suisse
| | - J Thariat
- Département d'oncologie-radiothérapie, centre François-Baclesse, Caen, 3, avenue du Général-Harris, 14000 Caen, France; Unicaen - Normandie Université, 14000 Caen, France; Advanced Resource Centre for Hadrontherapy in Europe (Archade), 3, avenue du Général-Harris, 14000 Caen, France; Laboratoire de physique corpusculaire IN2P3/Ensicaen - UMR6534, Unicaen - Normandie Université, 14000 Caen, France.
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- Département d'oncologie-radiothérapie, institut Curie, 25, rue d'Ulm, 75005 Paris, France; Département d'oncologie-radiothérapie, centre François-Baclesse, Caen, 3, avenue du Général-Harris, 14000 Caen, France; Unicaen - Normandie Université, 14000 Caen, France; Proton Therapy Centre Czech, Prague, République tchèque; Centre Antoine-Lacassagne, département d'oncologie-radiothérapie, 33, avenue Valombrose, 06000 Nice, France; Département d'oncologie-radiothérapie, centre hospitalier universitaire vaudois, Lausanne, Suisse; Laboratoire de physique corpusculaire IN2P3/Ensicaen - UMR6534, Unicaen - Normandie Université, 14000 Caen, France
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Martínez E, Portillo N, Lizarralde E, Grau G, Vela A, Rodríguez A, Rica I. For Debate: Paediatric T1DM: DKA is Still a Problem. Pediatr Endocrinol Rev 2018; 16:233-239. [PMID: 30556656 DOI: 10.17458/per.vol16.2018.mpr.fd.t1dmdka] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although the treatment of pediatric patients with T1DM has improved ketoacidosis (DKA) remains a frequent problem. OBJECTIVE To estimate temporal changes in the prevalence of DKA at diagnosis of T1DM and to explore the factors associated with its occurrence. METHODS Paediatric patients diagnosed at Cruces University Hospital (Spain) since 1997 were included. Clinical/analytical variables at diabetes onset, Hemoglobin A1c level during the first 2 years of evolution and the presence of the honeymoon phase were studied. RESULTS In 209 patients the prevalence of DKA was stable over time and high (35.4%) especially in the youngest. 8.5% of patients had a severe DKA with a higher risk in older than 10. Partial remission occurred in 26% patients, less frequent in the youngest and in the subgroup with DKA at diagnosis. CONCLUSION The frequency of DKA although stable, remains high and is associated with a worse evolution of the disease.
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Affiliation(s)
- Elena Martínez
- Paediatric Department, Centro de Salud Gamonal Antigua, Avd Eladio Perlado s/n, 09007 Burgos, Spain
| | - Nancy Portillo
- Paediatric Endocrinology, Hospital Alto Deba, Nafarroa Etorbidea, 16, 20500 Mondragón, Gipuzcoa, Spain
| | - Eneritz Lizarralde
- Paediatric Endocrinology, Hospital de Mendaro, Mendarozabal s/n, 20850 Mendaro, Guipuzcoa, Spain
| | - Gema Grau
- Paediatric Endocrinology, Hospital Universitario de Cruces, BIOCRUCES, Plaza Cruces s/n, 48903 Bizkaia,Spain
| | - Amaia Vela
- Paediatric Endocrinology, Hospital Universitario de Cruces, CIBERDEM, CIBERER, BIOCRUCES, Plaza Cruces s/n, 48903 Bizkaia, Spain
| | - Amaia Rodríguez
- Paediatric Endocrinology, Hospital Universitario de Cruces, BIOCRUCES, Plaza Cruces s/n, 48903 Bizkaia,Spain
| | - Itxaso Rica
- Hospital Universitario de Cruces, CIBERDEM, CIBERER, BIOCRUCES, Plaza Cruces s/n, 48903 Bizkaia, Spain, E-mail:
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Jouyaux F, Henry O, Biron E, Coste F, Danhier S, Delaby N, Gesnouin P, Le Dorze P, Le Prince C, Lecoeur P, Leleu C, Llagostera C, Martin É, Martineau S, Palisson J, Vela A, Collet S. Radiothérapie externe du sein et des aires ganglionnaires : étude dosimétrique multicentrique. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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14
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Estrada-Montaño AS, Reyes-López OR, González-López V, Leyva MA, Carrasco AL, Vela A, Rosales-Hoz MJ. The reactions of [(μ-H)M3(CO)9(CCSiMe3)] (M=Fe, Ru) with thiols: Cleavage of M-M and formation of M-S bonds in isomeric structures. J Organomet Chem 2017. [DOI: 10.1016/j.jorganchem.2017.07.002] [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: 11/28/2022]
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15
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Martínez R, Gutierrez-Nogués Á, Fernández-Ramos C, Velayos T, Vela A, Navas MÁ, Castaño L. Heterogeneity in phenotype of hyperinsulinism caused by activating glucokinase mutations: a novel mutation and its functional characterization. Clin Endocrinol (Oxf) 2017; 86:778-783. [PMID: 28247534 DOI: 10.1111/cen.13318] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 12/12/2016] [Accepted: 02/23/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Mutations in the GCK gene lead to different forms of glucokinase (GCK)-disease, activating mutations cause hyperinsulinaemic hypoglycaemia while inactivating mutations cause monogenic diabetes. Hyperinsulinism (HI) is a heterogeneous condition with a significant genetic component. The major causes are channelopathies, the other forms are rare and being caused by mutations in genes such as GCK. OBJECTIVE To describe the clinical and genetic presentation of four families with activating GCK mutations, and to explore the pathogenicity of the novel mutation identified through functional studies. RESULTS Four cases of HI with mutations in GCK were identified. These include one novel mutation (p.Trp99Cys). Functional analysis of the purified mutant fusion protein glutathione-S-transferase (GST)-GCK-p.Trp99Cys demonstrated that p.Trp99Cys is an activating mutation as it induces a higher affinity for glucose and increases the relative activity index more than 11 times. Moreover, the thermal stability of the mutant protein was similar to that of its wild type. All patients were responsive to diazoxide treatment. One of the mutations arose de novo, and two were dominantly inherited, although only one of them from an HI affected parent. The age of presentation in our cases varied widely from the neonatal period to adulthood. CONCLUSION The clinical phenotype of the GCK activating mutation carriers was heterogeneous, the severity of symptoms and age at presentation varied markedly between affected individuals, even within the same family. The novel activating GCK mutation (p.Trp99Cys) has a strong activating effect in vitro although it has been identified in one case of a milder and late-onset form of HI.
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Affiliation(s)
- Rosa Martínez
- Endocrinology and Diabetes Research Group, BioCruces Health Research Institute, UPV-EHU, CIBERDEM, CIBERER, Cruces University Hospital, Barakaldo, Spain
| | - Ángel Gutierrez-Nogués
- Department of Biochemistry and Molecular Biology III, Faculty of Medicine, CIBERDEM and Hospital Clínico San Carlos Health Research Institute, Complutense University of Madrid, Madrid, Spain
| | - Concepción Fernández-Ramos
- Pediatric Endocrinology Section, BioCruces Health Research Institute, UPV/EHU, Basurto University Hospital, Bilbao, Spain
| | - Teresa Velayos
- Endocrinology and Diabetes Research Group, BioCruces Health Research Institute, UPV-EHU, CIBERDEM, CIBERER, Cruces University Hospital, Barakaldo, Spain
| | - Amaia Vela
- Pediatric Endocrinology Section, BioCruces Health Research Institute, UPV/EHU, Cruces University Hospital, CIBERDEM, CIBERER, Barakaldo, Bizkaia, Spain
| | - María-Ángeles Navas
- Department of Biochemistry and Molecular Biology III, Faculty of Medicine, CIBERDEM and Hospital Clínico San Carlos Health Research Institute, Complutense University of Madrid, Madrid, Spain
| | - Luis Castaño
- Endocrinology and Diabetes Research Group, BioCruces Health Research Institute, UPV-EHU, CIBERDEM, CIBERER, Cruces University Hospital, Barakaldo, Spain
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16
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Fernández-Ramos C, Arana-Arri E, Jiménez-Huertas P, Vela A, Rica I. Incidence of childhood-onset type 1 diabetes in Biscay, Spain, 1990-2013. Pediatr Diabetes 2017; 18:71-76. [PMID: 26782628 DOI: 10.1111/pedi.12354] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 10/08/2015] [Revised: 12/02/2015] [Accepted: 12/11/2015] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To identify the incidence rate (IR) and epidemiologic trends of childhood type 1 diabetes mellitus (T1DM) in children aged 0 to 14-yr-old from 1990 to 2013, in the north of Spain (Biscay). SUBJECTS AND METHODS A prospective-retrospective study was performed. Capture-recapture method was used: primary cases were ascertained from hospital register and a secondary independent data source was obtained from diabetes associations and public health plan database. Age and sex-standardized incidence rates were calculated using direct method, assuming an equal distribution in each age/sex group. In order to identify and analyse trends the period studied was divided into two (1990-2001 and 2002-2013) 11-year periods. The 95% confidence interval (CI) was estimated assuming the Poisson distribution. RESULTS A total of 399 new cases were identified throughout the study. Mean age at diagnosis was 8.9 ± 3.7 yr. Completeness of ascertainment was 99.1%. Mean annual age-standardized IR was 10.7 (95% CI: 9.6-11.7). The mean incidence for the 0-4, 5-9 and 10-14 age groups was 5.1, 14.6 and 13.2 per 100,000 children/yr, respectively. The incidence rate trend in the whole group was not statistically significant. In the 10-14 age group we found a yearly average increase (2.5% [CI 95% 0.4-4.6]; P < 0.05) and analysing by sex, this statistically significant incidence trend was observed only in boys. We did not find a seasonal onset pattern. CONCLUSIONS The IR did not increase in this population during the period studied unlike the results in other Spanish regions and European Countries.
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Affiliation(s)
- Concepción Fernández-Ramos
- Paediatric Endocrinology Unit, Basurto University Hospital, Bilbao, Spain.,BioCruces Health Research Institute.,University of the Basque Country (EHU/UPV)
| | - Eunate Arana-Arri
- Clinical Epidemiology Unit, Cruces University Hospital, Baracaldo, Spain.,BioCruces Health Research Institute
| | - Paloma Jiménez-Huertas
- Paediatric Endocrinology Unit, Cruces University Hospital, Baracaldo, Spain.,BioCruces Health Research Institute
| | - Amaia Vela
- Paediatric Endocrinology Unit, Cruces University Hospital, Baracaldo, Spain.,BioCruces Health Research Institute.,University of the Basque Country (EHU/UPV).,CIBERDEM
| | - Itxaso Rica
- Paediatric Endocrinology Unit, Cruces University Hospital, Baracaldo, Spain.,BioCruces Health Research Institute.,CIBERDEM
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Martínez R, Fernández-Ramos C, Vela A, Velayos T, Aguayo A, Urrutia I, Rica I, Castaño L. Clinical and genetic characterization of congenital hyperinsulinism in Spain. Eur J Endocrinol 2016; 174:717-26. [PMID: 27188453 DOI: 10.1530/eje-16-0027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/07/2016] [Indexed: 12/30/2022]
Abstract
CONTEXT Congenital hyperinsulinism (CHI) is a clinically and genetically heterogeneous disease characterized by severe hypoglycemia caused by inappropriate insulin secretion by pancreatic β-cells. OBJECTIVE To characterize clinically and genetically CHI patients in Spain. DESIGN AND METHODS We included 50 patients with CHI from Spain. Clinical information was provided by the referring clinicians. Mutational analysis was carried out for KCNJ11, ABCC8, and GCK genes. The GLUD1, HNF4A, HNF1A, UCP2, and HADH genes were sequenced depending on the clinical phenotype. RESULTS We identified the genetic etiology in 28 of the 50 CHI patients tested: 21 had a mutation in KATP channel genes (42%), three in GLUD1 (6%), and four in GCK (8%). Most mutations were found in ABCC8 (20/50). Half of these patients (10/20) were homozygous or compound heterozygous, with nine being unresponsive to diazoxide treatment. The other half had heterozygous mutations in ABCC8, six of them being unresponsive to diazoxide treatment and four being responsive to diazoxide treatment. We identified 22 different mutations in the KATP channel genes, of which ten were novel. Notably, patients with ABCC8 mutations were diagnosed earlier, with lower blood glucose levels and required higher doses of diazoxide than those without a genetic diagnosis. CONCLUSIONS Genetic analysis revealed mutations in 56% of the CHI patients. ABCC8 mutations are the most frequent cause of CHI in Spain. We found ten novel mutations in the KATP channel genes. The genetic diagnosis is more likely to be achieved in patients with onset within the first week of life and in those who fail to respond to diazoxide treatment.
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Affiliation(s)
- R Martínez
- Endocrinology and Diabetes Research GroupBioCruces Health Research Institute, Cruces University Hospital, CIBERDEM, CIBERER, UPV-EHU, Barakaldo, Spain
| | - C Fernández-Ramos
- Pediatric Endocrinology SectionBasurto University Hospital, BioCruces Health Research Institute, UPV/EHU, Bilbao, Spain
| | - A Vela
- Pediatric Endocrinology SectionCruces University Hospital, BioCruces Health Research Institute, CIBERDEM, CIBERER, UPV/EHU, Barakaldo, Spain
| | - T Velayos
- Endocrinology and Diabetes Research GroupBioCruces Health Research Institute, Cruces University Hospital, CIBERDEM, CIBERER, UPV-EHU, Barakaldo, Spain
| | - A Aguayo
- Endocrinology and Diabetes Research GroupBioCruces Health Research Institute, Cruces University Hospital, CIBERDEM, CIBERER, UPV-EHU, Barakaldo, Spain
| | - I Urrutia
- Endocrinology and Diabetes Research GroupBioCruces Health Research Institute, Cruces University Hospital, CIBERDEM, CIBERER, UPV-EHU, Barakaldo, Spain
| | - I Rica
- Pediatric Endocrinology SectionCruces University Hospital, BioCruces Health Research Institute, CIBERDEM, CIBERER, UPV/EHU, Barakaldo, Spain
| | - L Castaño
- Endocrinology and Diabetes Research GroupBioCruces Health Research Institute, Cruces University Hospital, CIBERDEM, CIBERER, UPV-EHU, Barakaldo, Spain
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Lafond C, Chiavassa S, Boussion N, Chapel N, Coste F, Crespin S, Dy G, Faye P, Chapron L, Leleu C, Madec L, Mesgouez J, Palisson J, Vela A, Delpon G. Dosimetric Evaluation of Modulated ArcTherapy (DEMAT). Phys Med 2015. [DOI: 10.1016/j.ejmp.2015.10.016] [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] Open
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Díaz-Delgado J, Arbelo M, Sierra E, Vela A, Domínguez M, Paz Y, Andrada M, Domínguez L, Fernández A. Fatal Erysipelothrix rhusiopathiae septicemia in two Atlantic dolphins (Stenella frontalis and Tursiops truncatus). Dis Aquat Organ 2015; 116:75-81. [PMID: 26378410 DOI: 10.3354/dao02900] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We describe gross, histopathologic, ultrastructural, immunohistochemical, and microbiologic features of acute septicemia by Erysipelothrix rhusiopathiae in an Atlantic spotted dolphin Stenella frontalis and an Atlantic bottlenose dolphin Tursiops truncatus. Generalized lymphadenomegaly and widespread hemorrhages were the most consistent macroscopic findings. Tricavitary effusion and icterus were noted in one individual. Histologically, all organs examined showed numerous variably sized bacillary bacterial emboli (Gram-positive; Ziehl-Neelsen-negative), typically associated with systemic congestion, edema, hemorrhages, and fibrinocellular thrombi. These bacteria were frequently intravascular, either extracellular or intramonocytic/macrophagic, and to a lesser extent, free within the interstitium of parenchymal organs. In both cases, microbiological analysis yielded E. rhusiopathiae. A primary anti-E. rhusiopathiae antibody created in mice from one of the strains isolated allowed positive immunohistochemical detection. Electron microscopy and dual immunohistochemistry with lysozyme and MAC387 antibodies confirmed the intramacrophagic location of the bacilli. E. rhusiopathiae, a known multispecies and zoonotic agent, should be considered as a potential etiologic agent in septicemia cases in free-ranging individuals of these dolphin species.
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Affiliation(s)
- J Díaz-Delgado
- Veterinary Histology and Pathology, Institute of Animal Health, Veterinary College, University of Las Palmas de Gran Canaria, Trasmontana s/n, Arucas 35413, Las Palmas de Gran Canaria, Spain
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Grau G, Aguayo A, Vela A, Aniel-Quiroga A, Espada M, Miranda G, Martinez-Indart L, Martul P, Castaño L, Rica I. Normal intellectual development in children born from women with hypothyroxinemia during their pregnancy. J Trace Elem Med Biol 2015; 31:18-24. [PMID: 26004887 DOI: 10.1016/j.jtemb.2015.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 01/29/2015] [Accepted: 02/21/2015] [Indexed: 10/23/2022]
Abstract
Proper maternal thyroid function is known to be essential for neural differentiation and migration in the fetus during the first half of pregnancy. The objectives of this study were to assess the relationship between thyroxin levels, in pregnant women with no thyroid disease and the intellectual development of their offspring in a non-iodine-deficient area, and to know specifically whether or not isolated hypothyroxinemia during pregnancy was associated with a lower intelligence in the offspring. Previously we had publicated values TSH, FT4, free T3 (FT3), anti-thyroid peroxidase antibodies (TPO Abs) and urinary iodine concentration (UIC) in 1322 pregnant women in our hospital area. Now we presented results of intelligence quotient in children born from these pregnancies. We assessed 455 children at one year of age using Brunet-Lezine scale. Of these, 289 children were evaluated again at 6-8 years of age using the WISC-IV. From the total group of children recruited, we established as control subgroup, children born of rigorously normal pregnancies (women with UIC > 150 μg/L, FT4>10th percentile and TPO-Ab negative in both trimesters). The remaining children were divided into two subgroups: those born to mothers with FT4 below the 10th percentile and the rest. No correlation was found between FT4 maternal levels, in either of trimesters studied, and the intellectual scores of offspring. No differences were found in intellectual scores comparing children born to mothers with hypothyroxinemia and those whose mothers were euthyroxinemic in both trimesters, or with the control subgroup. As conclusions we did not find any association between the levels of maternal FT4 during pregnancy and the subsequent intellectual development the offspring from these pregnancies. We attribute this result to the fact that all the pregnant women included had normal thyroid function.
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Affiliation(s)
- Gema Grau
- Paediatric Endocrinology Unit, BioCruces Health Research Institute, Hospital Universitario Cruces, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Plaza de Cruces s/n, 48903 Barakaldo, Bizkaia, Spain.
| | - Anibal Aguayo
- Paediatric Endocrinology Unit, BioCruces Health Research Institute, Hospital Universitario Cruces, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Plaza de Cruces s/n, 48903 Barakaldo, Bizkaia, Spain; CIBERER (Center for Biomedical Research on Rare Diseases), Carlos III Health Institute, Madrid, Spain
| | - Amaia Vela
- Paediatric Endocrinology Unit, BioCruces Health Research Institute, Hospital Universitario Cruces, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Plaza de Cruces s/n, 48903 Barakaldo, Bizkaia, Spain; CIBERER (Center for Biomedical Research on Rare Diseases), Carlos III Health Institute, Madrid, Spain
| | - Angeles Aniel-Quiroga
- Biochemistry Laboratory, BioCruces Health Research Institute, Hospital Universitario Cruces, UPV/EHU, BioCruces, Plaza de Cruces s/n, 48903 Barakaldo, Bizkaia, Spain; CIBERER (Center for Biomedical Research on Rare Diseases), Carlos III Health Institute, Madrid, Spain
| | - Mercedes Espada
- Public Health Laboratory Standards, Basque Government Department of Health, Parque Tecnológico de Bizkaia, Ibaizabal Bidea, 48160 Derio, Bizkaia, Spain
| | | | - Lorea Martinez-Indart
- Clinical Epidemiologic Unit, BioCruces Health Research Institute, Hospital Universitario Cruces, Plaza de Cruces s/n, 48903 Barakaldo, Bizkaia, Spain
| | - Pedro Martul
- Paediatric Endocrinology Unit, BioCruces Health Research Institute, Hospital Universitario Cruces, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Plaza de Cruces s/n, 48903 Barakaldo, Bizkaia, Spain; CIBERER (Center for Biomedical Research on Rare Diseases), Carlos III Health Institute, Madrid, Spain
| | - Luis Castaño
- Research Unit, BioCruces Health Research Institute, Hospital Universitario Cruces, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Plaza de Cruces s/n, 48903 Barakaldo, Bizkaia, Spain; CIBERER (Center for Biomedical Research on Rare Diseases), Carlos III Health Institute, Madrid, Spain
| | - Itxaso Rica
- Paediatric Endocrinology Unit, BioCruces Health Research Institute, Hospital Universitario Cruces, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Plaza de Cruces s/n, 48903 Barakaldo, Bizkaia, Spain; CIBERER (Center for Biomedical Research on Rare Diseases), Carlos III Health Institute, Madrid, Spain
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Mazzara C, Bertaut C, Dadoun J, Vela A, Le Prince C, Madec L, Batalla A. Correlation between the gamma index of a VMAT patient quality control and a modulation index calculated from RT Plans. Phys Med 2014. [DOI: 10.1016/j.ejmp.2014.10.036] [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: 10/24/2022] Open
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Martos-Moreno GÁ, Gil-Campos M, Bueno G, Bahillo P, Bernal S, Feliu A, Lechuga-Sancho AM, Palomo E, Ruiz R, Vela A. [Obesity associated metabolic impairment is evident at early ages: Spanish collaborative study]. NUTR HOSP 2014; 30:787-93. [PMID: 25335663 DOI: 10.3305/nh.2014.30.4.7661] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
UNLABELLED The objectives of this study are to provide a description of the demographic, anthropometric characteristics and metabolic abnormalities in children with early-onset (< 10 years) and of very-early-onset obesity (< 5 years). We also evaluate the diagnostic ability using the definition of metabolic syndrome (MS) according to different criteria. METHODS It is a retrospective, case-control, cross-sectional, multicenter study. A total of 10 Pediatric Endocrinology Units in different Spanish hospitals were involved. A group of 469 children with early-onset obesity and another group of 30 children with very early-onset obesity were studied. The control group consisted of 224 healthy children younger than 10 years. Anthropometric and analytical determination of carbohydrates metabolism parameters and the lipid profile were performed. RESULTS The presence of metabolic alterations associated with obesity in children and adolescents in Spain is remarkable, either on their own, or encompassed within the definition of MS. This prevalence increases substantially when considering the peripheral resistance to insulin action as a diagnostic criterion. It also shows how children who could not be diagnosed with MS according to the definition provided by the International Diabetes Federation (IDF) due to age below 10 years, these alterations are already present in a remarkable percentage. In fact, metabolic abnormalities are already present in the very-early-onset obese children ( <5 years). CONCLUSION In Spanish children there are metabolic alterations associated with obesity in the infant-juvenile stages alone or encompassed within the definition of MS,and are already present at earlier ages.
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Affiliation(s)
- Gabriel Á Martos-Moreno
- Servicio de Endocrinología, Hospital Infantil Universitario Niño Jesús. Instituto de Investigación La Princesa. Universidad Autónoma de Madrid. CIBERobn, ISCIII..
| | - Mercedes Gil-Campos
- Unidad de Metabolismo Infantil. Hospital Universitario Reina Sofía, IMIBIC, Universidad de Córdoba..
| | - Gloria Bueno
- Unidad de Endocrinología Pediátrica. Hospital Clínico Universitario Lozano Blesa de Zaragoza..
| | - Pilar Bahillo
- Unidad de Endocrinología-Pediátrica. Hospital Clínico Universitario de Valladolid..
| | - Susana Bernal
- Unidad de Endocrinología Pediátrica. Hospital Virgen Macarena de Sevilla..
| | - Albert Feliu
- Unidad de Endocrinología Pediátrica. Hospital Universitario Sant Joan de Reus..
| | - Alfonso M Lechuga-Sancho
- Departamento Materno Infantil y Radiología. U.G.C. de Pediatría. Hospital Universitario Puerta del Mar. Universidad de Cádiz..
| | | | - Rafael Ruiz
- Unidad de Endocrinología Pediátrica. Complejo Hospitalario Universitario de Albacete..
| | - Amaia Vela
- Unidad de Endocrinología Infantil. Hospital Universitario de Cruces de Barakaldo España..
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Salomón-Estébanez MA, Grau G, Vela A, Rodríguez A, Morteruel E, Castaño L, Rica I. Is routine endocrine evaluation necessary after paediatric traumatic brain injury? J Endocrinol Invest 2014; 37:143-8. [PMID: 24497213 DOI: 10.1007/s40618-013-0020-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 11/17/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) is a common event in childhood. It is a recognised cause of hypopituitarism both in adult and paediatric patients. Routine endocrine evaluation has been proposed for adult TBI-survivors; nevertheless, incongruous data have been reported in children. AIM The goal of this study was to describe the prevalence of pituitary dysfunction after TBI in a cohort of children. MATERIAL/SUBJECTS AND METHODS This is a cross-sectional study comprising retrospective medical record review and prospective testing. Children with brain injury discharged from the Paediatric Intensive Care Unit from year 2004 to 2009 were recruited. Height and weight were recorded, systemic examination was performed and baseline pituitary function tests were undertaken. Provocative tests were performed only if abnormal basal levels were detected. RESULTS Thirty-six patients were collected; the mean age at assessment was 7.2 years and the mean interval since injury 3.3 years. All patients had skull fracture or intracranial haemorrhage; 36.6 % of them had moderate to severe TBI. No abnormalities were found on examination. Low serum IGF 1 levels were detected in four patients and two patients had low serum cortisol levels with inappropriately normal plasma ACTH concentrations. No evidence of pituitary dysfunction was observed in these patients after clinical follow-up, repeated baseline hormone levels or dynamic function tests. CONCLUSIONS No endocrine sequelae have been detected in this population. The routine endocrine evaluation in children with mild to moderate TBI might not be justified, according to our findings.
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Affiliation(s)
- M A Salomón-Estébanez
- Department of Paediatric Endocrinology, Cruces University Hospital, Plaza de Cruces s/n, 48903, Barakaldo, Biscay, Spain
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Gomez-Pinedo U, Yáñez M, Matías-Guiu J, Galán L, Guerrero-Sola A, Benito-Martin MS, Vela A, Arranz-Tagarro JA, García AG. Cellular changes in motor neuron cell culture produced by cytotoxic cerebrospinal fluid from patients with amyotrophic lateral sclerosis. Neurologia 2013; 29:346-52. [PMID: 24144827 DOI: 10.1016/j.nrl.2013.08.001] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 08/15/2013] [Accepted: 08/20/2013] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The neurotoxic effects of cerebrospinal fluid (CSF) from patients with amyotrophic lateral sclerosis (ALS) have been reported by various authors who have attributed this neurotoxicity to the glutamate in CSF-ALS. MATERIAL AND METHODS Cultures of rat embryonic cortical neurons were exposed to CSF from ALS patients during an incubation period of 24 hours. Optical microscopy was used to compare cellular changes to those elicited by exposure to 100μm glutamate, and confocal microscopy was used to evaluate immunohistochemistry for caspase-3, TNFα, and peripherin. RESULTS In the culture exposed to CSF-ALS, we observed cells with nuclear fragmentation and scarce or null structural modifications to the cytoplasmic organelles or to plasma membrane maintenance. This did not occur in the culture exposed to glutamate. The culture exposed to CSF-ALS also demonstrated increases in caspase-3, TNFα, and in peripherin co-locating with caspase-3, but not with TNFα, suggesting that TNFα may play an early role in the process of apoptosis. CONCLUSIONS CFS-ALS cytotoxicity is not related to glutamate. It initially affects the nucleus without altering the cytoplasmic membrane. It causes cytoplasmic apoptosis that involves an increase in caspase-3 co-located with peripherin, which is also overexpressed.
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Affiliation(s)
- U Gomez-Pinedo
- Instituto de Neurociencias, IdISSC, Hospital Clínico San Carlos, Universidad Complutense, Madrid, España.
| | - M Yáñez
- Instituto Teófilo Hernando, Departamento de Farmacología, Universidad Autónoma de Madrid, Madrid, España
| | - J Matías-Guiu
- Instituto de Neurociencias, IdISSC, Hospital Clínico San Carlos, Universidad Complutense, Madrid, España
| | - L Galán
- Instituto de Neurociencias, IdISSC, Hospital Clínico San Carlos, Universidad Complutense, Madrid, España
| | - A Guerrero-Sola
- Instituto de Neurociencias, IdISSC, Hospital Clínico San Carlos, Universidad Complutense, Madrid, España
| | - M S Benito-Martin
- Instituto de Neurociencias, IdISSC, Hospital Clínico San Carlos, Universidad Complutense, Madrid, España
| | - A Vela
- Instituto de Neurociencias, IdISSC, Hospital Clínico San Carlos, Universidad Complutense, Madrid, España
| | - J A Arranz-Tagarro
- Instituto Teófilo Hernando, Departamento de Farmacología, Universidad Autónoma de Madrid, Madrid, España
| | - A G García
- Instituto Teófilo Hernando, Departamento de Farmacología, Universidad Autónoma de Madrid, Madrid, España
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Aguayo A, Grau G, Vela A, Aniel-Quiroga A, Espada M, Martul P, Castaño L, Rica I. Urinary iodine and thyroid function in a population of healthy pregnant women in the North of Spain. J Trace Elem Med Biol 2013; 27:302-6. [PMID: 23992867 DOI: 10.1016/j.jtemb.2013.07.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [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: 04/22/2013] [Revised: 05/30/2013] [Accepted: 07/06/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Iodine is an essential trace element for the synthesis of thyroid hormones, which are keys in maternal metabolism during pregnancy as well as in neurological development during fetal and postnatal life. This was a prospective study on iodine status and thyroid function in women during pregnancy in the Basque country to assess whether there was any relationship among maternal urinary iodine, maternal thyroid function and thyrotropin (TSH) in newborns, and to explore any difference in women experiencing miscarriages. METHODS We analyzed TSH, free T(4) (FT(4)), free T(3) (FT(3)), thyroid peroxidase antibody (TPO-Ab) titers in serum and urinary iodine concentrations (UIC) in 2104 women in the first trimester of pregnancy and in 1322 of them in their second trimester. We obtained neonatal TSH levels in 1868 cases. RESULTS In the first (T1) and second trimesters (T2), the median UICs were 88.5 μg/L and 140 μg/L, respectively. No relationship was found between UIC and FT4, or maternal and neonatal TSH. In T1 and T2, 9.7% and 7.5% of women were TPO-Ab positive, respectively. The total miscarriage rate was 10%. The percentage of miscarriages in healthy women was 8.9%, lower than in women with overt hypothyroidism (21.2%; p < 0.001) and than in women with subclinical hypothyroidism (15.6%; p < 0.025). The miscarriage rate was not higher in TPO-Ab-positive women. CONCLUSIONS In this study most women had iodine deficiency during pregnancy. Neonatal TSH is not correlated with maternal UIC during pregnancy. Pregnant women with hypothyroidism have a higher rate of miscarriages.
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Affiliation(s)
- Anibal Aguayo
- Paediatric Endocrinology Section, Cruces University Hospital, UPV/EHU, Plaza de Cruces s/n, 48903 Barakaldo-Bizkaia, Spain; CIBERER (Center for Biomedical Research on Rare Diseases), Instituto de Salud Carlos III, Barcelona, Spain
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Aguayo A, Vela A, Aniel-Quiroga A, Blarduni E, Fernández C, Grau G, Núñez J, Martul P, Castaño L, Rica I. Absence of diabetes mellitus type 2 in obese children and adolescents in the north of Spain. J Pediatr Endocrinol Metab 2013; 26:25-9. [PMID: 23329743 DOI: 10.1515/jpem-2012-0200] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [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: 06/21/2012] [Accepted: 10/05/2012] [Indexed: 11/15/2022]
Abstract
BACKGROUND The worldwide epidemic of childhood obesity has been accompanied by an increase in the incidence of carbohydrate metabolism disorders. OBJECTIVE To determine the prevalence of type 2 diabetes mellitus (T2DM) and other carbohydrate metabolism disorders in obese young people in the Basque Country (Spain). DESIGN Prospective observational study. PATIENTS We studied 136 obese Caucasian children and adolescents (body mass index ≥2 SDS above the mean). MEASUREMENTS Their severity of obesity was classified as mild <3 SDS or moderate-to-severe ≥3 SDS. Data were collected on clinical and metabolic parameters; insulin resistance (IR) was calculated using the homeostasis model assessment, and an oral glucose tolerance test (OGTT) was carried out. RESULTS T2DM was not found. Impaired glucose tolerance (IGT) was found in 9.6% of patients being higher in moderate-to-severe obesity (12.8% vs. 2.4%; p=0.048) and in patients with acanthosis nigricans (27.8% vs. 6.8%; p=0.016). No differences were detected by sex or pubertal development in metabolic results as a function of OGTT's response. IR (13.5%) was higher among those with moderate-to-severe obesity, in patients with acanthosis nigricans and was associated with other cardiovascular disease risk factors. CONCLUSIONS We found no children with T2DM. The prevalence of IGT and IR was related to severity of obesity, to the association of acanthosis nigricans and was associated with cardiovascular risk.
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Vela A, Galán L, Valencia C, de la Torre P, Cuadrado L, Esteban J, Guerrero A, García-Redondo A, Matías-Guiu J. SOD1-N196 mutation in a family with amyotrophic lateral sclerosis. Neurología (English Edition) 2012. [DOI: 10.1016/j.nrleng.2011.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Giménez A, Cibrián RM, Girón S, Zamarreño T, Sendra JJ, Vela A, Daumal F. Questionnaire Survey to Qualify the Acoustics of Spanish Concert Halls. ACTA ACUST UNITED AC 2011. [DOI: 10.3813/aaa.918477] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Gabilondo I, Saiz A, Galán L, González V, Jadraque R, Sabater L, Sans A, Sempere A, Vela A, Villalobos F, Viñals M, Villoslada P, Graus F. Analysis of relapses in anti-NMDAR encephalitis. Neurology 2011; 77:996-9. [PMID: 21865579 DOI: 10.1212/wnl.0b013e31822cfc6b] [Citation(s) in RCA: 163] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The clinical characteristics of patients with relapsing anti-NMDA receptor (NMDAR) encephalitis are not well-defined. In this study, we report the clinical profile and outcome of relapses in a series of anti-NMDAR encephalitis. METHODS We did a retrospective review of relapses that occurred in 25 patients with anti-NMDAR encephalitis. Relapses were defined as any new psychiatric or neurologic syndrome, not explained by other causes, which improved after immunotherapy or, less frequently, spontaneously. RESULTS A total of 13 relapses were identified in 6 patients. Four of them had several, 2 to 4, relapses. There was a median delay of 2 years (range 0.5 to 13 years) for the first relapse. Median relapse rate was 0.52 relapses/patient-year. Relapse risk was higher in patients who did not receive immunotherapy in the first episode (p = 0.009). Most cases (53%) presented partial syndromes of the typical anti-NMDAR encephalitis. Main symptoms of relapses were speech dysfunction (61%), psychiatric (54%), consciousness-attention disturbance (38%), and seizures (31%). Three relapses (23%) presented with isolated atypical symptoms suggestive of brainstem-cerebellar involvement. An ovarian teratoma was detected at relapse in only 1 patient (17%). Relapses did not add residual deficit to that caused by the first episode. CONCLUSIONS Relapses in anti-NMDAR encephalitis are common (24%). They may occur many years after the initial episode. Relapses may present with partial aspects or with isolated symptoms of the full-blown syndrome. Immunotherapy at first episode reduces the risk of relapses.
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Affiliation(s)
- I Gabilondo
- Center for Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d’Investigació Biomèdica August Pi i Sunyer, Barcelona, Spain
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Vela A, Galán L, Valencia C, Torre PDL, Cuadrado ML, Esteban J, Guerrero A, García-Redondo A, Matías-Guiu J. [SOD1-N196 mutation in a family with amyotrophic lateral sclerosis]. Neurologia 2011; 27:11-5. [PMID: 21549454 DOI: 10.1016/j.nrl.2011.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Accepted: 02/08/2011] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION N19S mutation is produced by substitution in the 139 position of SOD1 and was described by Mayeux in a patient with amyotrophic lateral sclerosis (ALS). He suggested that it did not have a causal effect as it was found in asymptomatic and sporadic cases. Other authors in later articles did not agree. MATERIAL AND METHODS We describe a family with 4 members with ALS patients and attempt to find the carrier of the N19S mutation of the propositus. Molecular studies were performed on 15 members of the family of a different order. RESULTS The ALS cases were found in the maternal line of the propositus. The presence of the mutation was detected in 3 people, the other two were asymptomatic. One of patients with ALS in the family, who died previously, did not have the mutation. Two of the sons of this case and another of the other case did not show it. On the other hand, N19S mutation was only present in paternal branch of the propositus, where there were no cases. CONCLUSION The described family supports the hypothesis by Mayeux and against that mutation N19S has pathological consequences, since mutation is only in the family line where there are no cases with ALS. In consequence, although the described case is included as a familiar form, it cannot be attributed to the mutation, and its relationship with N19S should be considered as casual.
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Affiliation(s)
- A Vela
- Servicio de Neurología, Hospital Clínico San Carlos, Madrid, España
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de las Heras J, Garin I, de Nanclares GP, Aguayo A, Rica I, Castaño L, Vela A. Familial hyperinsulinism-hyperammonemia syndrome in a family with seizures: case report. J Pediatr Endocrinol Metab 2010; 23:827-30. [PMID: 21073125 DOI: 10.1515/jpem.2010.132] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hyperinsulinism-hyperammonemia (HI/HA) syndrome is the second most frequent cause of congenital hyperinsulinism (CHI) and it is characterized by recurrent symptomatic hypoglycemia and persistent hyperammonemia. We describe the familial case of a 2-year-old child and her 32-year-old mother who, having suffered from tonic-clonic seizures since infancy, had both been diagnosed with epilepsy and treated with sodium valproate. Hypoglycemia was identified in the child in routine analysis. Six days after admission, a complete study of hypoglycemia showed test results compatible with hyperinsulinemic hypoglycemia and hyperammonemia. A mutation in the GDH gene (Arg269His) confirmed the diagnosis in both the mother and the child. An important peculiarity of this case is the diagnosis of a 32-year-old woman, previously diagnosed with epilepsy through her daughter's diagnosis at a Pediatric Endocrinology Department and subsequently treated ineffectively with sodium valproate. We conclude that, as hypoglycemia may be subtle, the diagnosis of HI/HA should be considered in children or adults with seizures/epilepsy and hyperammonemia, serum ammonia being a simple screening test for the disease.
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Affiliation(s)
- Javier de las Heras
- Endocrinology and Diabetes Research Group, Cruces Hospital, CIBERDEM CIBERER Barakaldo, Vizcaya, Spain
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García-Ramos R, García-Morales I, Vela A, Galán L, Serna C, Matías-Guíu J. [Analysis of hospital consultations to Neurology in a tertiary hospital.]. Neurologia 2009; 24:835-840. [PMID: 20340059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Introduction. Neurology consultations requested by other services in in-patients are performed through intrahospital consultations. This study aims to make a descriptive study of the intrahospital consultations (IHC) requests received by a Neurology service. Material and methods. We conducted a retrospective study of the requests for consultations received in the Neurology Service in the Hospital Universitario Clínico San Carlos in Madrid during the year 2007. The following endpoints were analyzed: number of consultations, number of visits made, date, delay in attention, specialties involved, syndromic diagnosis, final diagnosis and complementary tests requested. Results. A total of 390 intrahospital consultations corresponding to 351 patients were made. Total number of visits was 687. Internal Medicine was the specialty making the most requests with 31%, followed by Psychiatry (13.4 %) and Oncology (8 %). The most frequent syndromic diagnoses were neurological deficit (31.6%), seizures (18.2%) and awareness level disturbance (11.7%). The most frequent final diagnoses were epilepsy (19.9 %), cerebrovascular disease (15%) and movement disorders (10.5 %). Complementary tests were requested for 37% of the patients, the most common ones being cranial and spinal magnetic resonance imaging, Head CT and EEG. Conclusions. Because of its complexity and care load, intrahospital consultation should be considered an independent unit in the organization of a neurological service. As it involves a significant number of patients, it should be subject to evaluation and quality improvement programs.
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Vela A, Medel V, Trickey SB. Variable Lieb–Oxford bound satisfaction in a generalized gradient exchange-correlation functional. J Chem Phys 2009; 130:244103. [DOI: 10.1063/1.3152713] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Collomb-Patton V, Boher P, Leroux T, Fontbonne JM, Vela A, Batalla A. The DOSIMAP, a high spatial resolution tissue equivalent 2D dosimeter for LINAC QA and IMRT verification. Med Phys 2009; 36:317-28. [PMID: 19291971 DOI: 10.1118/1.3013703] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The continual need for more accurate and effective techniques in radiation therapy makes it necessary to devise new control means combining high spatial resolution as well as high dose accuracy. Intensity modulated radio therapy (IMRT) allows highly conformed fields with high spatial gradient and therefore requires a precise monitoring of all the multileaf positions. In response to this need, the authors have developed a new 2D tissue equivalent dosimeter with high spatial resolution. A plastic scintillator sheet is sandwiched between two polystyrene blocks and the emitted light is captured by a high resolution camera. A newly developed procedure described herein allows efficient discrimination of the scintillation from the parasitic Cerenkov radiation. This processing is applied on the cumulated image from a sequence of images taken during an irradiation field at a rate of 10 images/s. It provides a high resolution mapping of the cumulated dose in quasireal time. The dosimeter is tissue equivalent (ICRU-44) and works both for electrons and photons without complex parameter adjustment since phantom and detector materials are identical. Instrument calibration is simple and independent of the irradiation conditions (energy, fluence, quality, ...). In this article, the authors present the principle of the dosimeter and its calibration procedure. They compare the results obtained for photons and electron beams with ionization chamber measurements in polystyrene. Technical specifications such as accuracy and repeatability are precisely evaluated and discussed. Finally, they present different IMRT field measurements and compare DOSIMAP measurements to TPS simulations and dosimetric film profiles. The results confirm the excellent spatial resolution of the instrument and its capacity to inspect the leaf positions for each segment of a given field.
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Collomb-Patton V, Boher P, Leroux T, Fontbonne JM, Batalla A, Vela A. DOSIMAP: a high-resolution 2-D tissue equivalent dosemeter for linac QA and IMRT verification. Radiat Prot Dosimetry 2008; 131:100-109. [PMID: 18757897 DOI: 10.1093/rpd/ncn228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
New generation of radiation therapy accelerators requires highly accurate dose measurements with high spatial resolution patterns. IMRT is especially demanding since the positioning accuracy of all the multi-leafs should be verified for each applied field and at any incidence. A new 2-D tissue equivalent dosemeter is presented with high spatial resolution that can fulfil these tasks. A plastic scintillator sheet is sandwiched between two polystyrene cubes, and the emitted light is observed by a high-resolution camera. A patented procedure allows efficient discrimination of the scintillation proportional to the dose from the parasitic Cerenkov radiation. This extraction made on the cumulated images taken during an irradiation field at a rate of 10 images s(-1) provides high-resolution mapping of the dose rate and cumulated dose in quasi real time. The dosemeter is tissue equivalent (ICRU-44) and works both for electrons and photons without complex parameter adjustment, since phantom and detector materials are identical. The calibration is simple and independent of the irradiation conditions (energy, fluence, quality and so on). The principle of the dosemeter and its calibration procedure are discussed in this paper. The results and, in particular, the dose depth profiles are compared with standard ionisation chamber measurements in polystyrene for both photons and electrons. Finally, the detector specifications are summarised and one example of complex IMRT field is discussed.
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Frelin AM, Fontbonne JM, Ban G, Colin J, Labalme M, Batalla A, Vela A, Boher P, Braud M, Leroux T. The DosiMap, a new 2D scintillating dosimeter for IMRT quality assurance: characterization of two Cerenkov discrimination methods. Med Phys 2008; 35:1651-62. [PMID: 18561640 DOI: 10.1118/1.2897966] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
New radiation therapy techniques such as IMRT present significant efficiency due to their highly conformal dose distributions. A consequence of the complexity of their dose distributions (high gradients, small irradiation fields, low dose distribution, ...) is the requirement for better precision quality assurance than in classical radiotherapy in order to compare the conformation of the delivered dose with the planned dose distribution and to guarantee the quality of the treatment. Currently this control is mostly performed by matrices of ionization chambers, diode detectors, dosimetric films, portal imaging, or dosimetric gels. Another approach is scintillation dosimetry, which has been developed in the last 15 years mainly through scintillating fiber devices. Despite having many advantages over other methods it is still at an experimental level for routine dosimetry because the Cerenkov radiation produced under irradiation represents an important stem effect. A new 2D water equivalent scintillating dosimeter, the DosiMap, and two different Cerenkov discrimination methods were developed with the collaboration of the Laboratoire de Physique Corpusculaire of Caen, the Comprehensive Cancer Center François Baclesse, and the ELDIM Co., in the frame of the MAESTRO European project. The DosiMap consists of a plastic scintillating sheet placed inside a transparent polystyrene phantom. The light distribution produced under irradiation is recorded by a CCD camera. Our first Cerenkov discrimination technique is subtractive. It uses a chessboard pattern placed in front of the scintillator, which provides a background signal containing only Cerenkov light. Our second discrimination technique is colorimetric. It performs a spectral analysis of the light signal, which allows the unfolding of the Cerenkov radiation and the scintillation. Tests were carried out with our DosiMap prototype and the performances of the two discrimination methods were assessed. The comparison of the dose measurements performed with the DosiMap and with dosimetric films for three different irradiation configurations showed discrepancies smaller than 3.5% for a 2 mm spatial resolution. Two innovative discrimination solutions were demonstrated to separate the scintillation from the Cerenkov radiation. It was also shown that the DosiMap, which is water equivalent, fast, and user friendly, is a very promising tool for radiotherapy quality assurance.
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Affiliation(s)
- A M Frelin
- Laboratoire de Physique Corpusculaire, 6 Bd du Maréchal Juin, F14050 Caen, France.
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Matías-Guiu J, Barcia JA, García-Verdugo JM, Galán L, Vela A, García-Ramos R. [Cellular therapy in amyotrophic lateral sclerosis]. Neurologia 2008; 23:226-237. [PMID: 18307053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
INTRODUCTION The possible role of stem cells transplantation in therapy for traumatic lesions or for diseases has been outlined in recent years. Amyotrophic lateral sclerosis (ALS) is one of the diseases where cellular therapy may be useful. DEVELOPMENT The authors make an analytic review of the studies carried out in humans with ALS and in G93A transgenic rodent model of ALS to evaluate the effect of stem cell transplantation. They also review cellular responses from NSC-EZ cells in the spinal cord. CONCLUSIONS Research on the potential uses of cellular therapy for ALS is on-going, however, the different studies are not homogeneous. Thus, many questions need to be answered, such as which is the most appropriate type of cells or which should be the volume of cells to implant, which is the best method for the transplantation and in the case of spinal cord implant which is the best target for the implant, or if it is necessary to administer concomitant substances, such as immunosuppressant drugs.
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Affiliation(s)
- J Matías-Guiu
- Servicio de Neurología, Instituto de Neurociencias, Hospital Clinico San Carlos, Universidad Complutense, Madrid, Spain.
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Matías-Guiu J, García-Ramos G, Galán L, Vela A, Guerrero A. [Analytic epidemiological information of amyotrophic lateral sclerosis]. Neurologia 2008; 23:168-178. [PMID: 18370336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
INTRODUCTION The analytical epidemiological information on amyotrophic lateral sclerosis (ALS) is extensive and is based on case-control studies, selective patient series and few cohort studies that analyze the risk factors for the disease. REVIEW The studies found in the literature on analytical epidemiology have been reviewed in an attempt to analyze the methodology, compare their results and comment on the possible biases and confounding factors such as the different roles of the risk factors. CONCLUSION In spite of the extensive information available, the analytical epidemiology of ALS has still not clarified the etiological factors of the disease. This may be due to the influence of the genetic factors, but also to the variability of the methodological designs. However, the analytical factor that has the greatest consistency is that of exhibition to heavy metals. Greater physical activity or increased frequency in special situations such as is the cases from the first Gulf War could be suggested as a more than casual precipitating factor.
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Affiliation(s)
- J Matías-Guiu
- Servicio de Neurología, Hospital Clínico San Carlos, Facultad de Medicina, Universidad Complutense, Madrid.
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Matias-Guiu J, Galán L, Garcia-Ramos R, Vela A, Guerrero A. [Descriptive epidemiology of amyotrophic lateral sclerosis]. Neurologia 2007; 22:368-80. [PMID: 17610165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
INTRODUCTION ALS descriptive epidemiological information is wide, and is based on hospital registries, selective patients series and community studies of incidence, prevalence and mortality rates. REVIEW It has been revised studies found in the literature trying to analyse the methodology looking for approaches for a systematic review on the ALS descriptive epidemiology. The analysed works include on incidence, prevalence and mortality rates studies and we discuss possible biases and confounding factors. CONCLUSIONS Systematic review of ALS descriptive epidemiology should be based on the following criteria: community studies in non-selective geographic areas excluding aggregated cases zones, determination of crude prevalence rate and sex-age specific and standard population adjusted prevalence rates, presented with confidence intervals, selection of the cases should fulfil El Escorial criteria, sample size of source population greater than one hundred thousands in habitants, study period greater than five years and the dates should be accessible through Medline or other bibliographic sources.
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Affiliation(s)
- J Matias-Guiu
- Servicio de Neurología, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid.
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Galán L, Vela A, Guerrero A, Barcia JA, García-Verdugo JM, Matias-Guiu J. [Experimental models of amyotrophic lateral sclerosis]. Neurologia 2007; 22:381-8. [PMID: 17610166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
INTRODUCTION Amyotrophic lateral sclerosis (ALS) is a serious neurodegenerative disease that affects almost selectively motor neurons. Its ethiopathogeny is not fully understood, although there are several mechanisms that could play a role. It has no curative treatment and just a drug (riluzole) and mechanical ventilation has demonstrated to improve survival of these patients. In the last decades experimental models have been developed which have led us to better understand this disease and to design possible therapeutic strategies. METHOD We reviewed published articles concerning experimental models for ALS and neurodegeneratives diseases using the PubMed database. RESULTS Several experimental models for ALS have been described, from animal models (mainly transgenic animals for human mutations in superoxidedismutase [SOD1]) to cellular models, each of them with advantages and objections. CONCLUSIONS ALS experimental models have implied a great advance in the knowledge of this disease and the design of new therapeutic strategies.
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Affiliation(s)
- L Galán
- Unidad de Enfermedades Neuromuscular, Servicio de Neurologia, Hospital Clínico San Carlos, Madrid.
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Meaney E, Lara-Esqueda A, Ceballos-Reyes GM, Asbun J, Vela A, Martínez-Marroquín Y, López V, Meaney A, de la Cabada-Tamez E, Velázquez-Monroy O, Tapia-Conyer R. Cardiovascular risk factors in the urban Mexican population: The FRIMEX study. Public Health 2007; 121:378-84. [PMID: 17292427 DOI: 10.1016/j.puhe.2006.11.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2006] [Revised: 09/18/2006] [Accepted: 11/20/2006] [Indexed: 11/20/2022]
Abstract
BACKGROUND Atherosclerotic ischaemic heart disease is the second leading cause of general mortality in Mexico due to the growing prevalence of atherosclerotic risk factors in our society. The data of the FRIMEX study (Factores de Riesgo en México, Risk Factors in Mexico), considered together with those of other contemporary epidemiological surveys, will aid in our comprehension of the current state of cardiovascular epidemics in Mexico. METHODS Frequencies of obesity, hypertension and smoking, and total cholesterol and glucose in capillary blood were estimated in a non-probabilistic sample comprised of 140017 individuals (aged 44+/-13 years; 42% men and 58% women), from six Mexican cities (Mexico City, Guadalajara, Monterrey, Puebla, Leon and Tijuana). RESULTS Obesity or overweight status was found in 71.9% of participants. Hypertension was found in 26.5%, and the proportions of awareness, treatment and control for this disease were 49.3, 73 and 36%, respectively. Prevalence of hypertension increased with age; while it was higher in men under 60 years of age, in the more aged individuals it was higher in women. Hypercholesterolaemia was found in 40% of the individuals and cholesterolaemia > or =240 mg/dl was significantly higher in women. Thirty-five and a half percent of men and 18.1% of women were smokers. Type 2 diabetes mellitus was found in 10.4% of participants. There was significant Pearson's correlation between body mass index and blood pressure, between hypertension and glucose levels, and between hypertension and total cholesterol concentrations. CONCLUSIONS We conclude that this population has a high cardiovascular risk profile and a high probability of the occurrence of metabolic syndrome.
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Affiliation(s)
- E Meaney
- Cardiovascular Unit, Hospital Regional 1o de Octubre, ISSSTE, Ave. Politécnico 1669, Col. Magdalena de las Salinas, Delegación Gustavo A. Madero, Mexico City DF 07300, Mexico.
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Abstract
OBJECTIVE Mutations in the genes encoding pituitary transcription factors (mainly PROP1, POUF1 and HESX1) are responsible for familial combined pituitary hormone deficiency (CPHD) and septo-optic dysplasia (SOD) while only a low percentage of mutations are the cause of sporadic forms. Indeed, it has been suggested that environmental rather than genetic factors could be important in the pathogenesis of CPHD. PATIENTS AND METHODS Thirty-six sporadic patients diagnosed with CPHD or SOD were included in the study. All coding exons and intron-exon boundary regions of PROP1, POUF1 and HESX1 were amplified by PCR and subsequently sequenced. RESULTS Two novel missense mutations in the HESX1 gene (Q117P, K176T) were identified in two patients. Polymorphisms in PIT1 and PROP1 were also detected. A higher percentage of breech delivery in male patients with CPHD versus females was observed. CONCLUSIONS The low percentage of mutations found in the most common transcription factors involved in CPHD show that a better characterization of hormonal and morphological phenotypes is necessary for patients with CPHD included in genetic studies, and other genetic or non-genetic factors have to be taken into account.
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Affiliation(s)
- R Coya
- Section of Paediatric Endocrinology, Hospital de Cruces, Barakaldo-Bizkaia, Basque Country, Spain
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Martul P, Rica I, Vela A, Aguayo A. Clinical evaluation and health care in childhood and adolescent obesity. J Pediatr Endocrinol Metab 2005; 18 Suppl 1:1207-13. [PMID: 16398451 DOI: 10.1515/jpem.2005.18.s1.1207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- P Martul
- Department of Pediatric Endocrinology, Hospital de Cruces, Cruces, Barakaldo (Vizcaya), Spain.
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Frelin AM, Fontbonne JM, Ban G, Colin J, Labalme M, Batalla A, Isambert A, Vela A, Leroux T. Spectral discrimination of Čerenkov radiation in scintillating dosimeters. Med Phys 2005; 32:3000-6. [PMID: 16266114 DOI: 10.1118/1.2008487] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.5] [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: 11/07/2022] Open
Abstract
Radiation therapy accelerators require highly accurate dose deposition and the output must be monitored frequently and regularly. Ionization chambers are the primary tool for this control, but their size, their high voltage needed, and the correction needed for electrons make them unsuitable for use during patient treatment. We have developed a small (1-mm-diam and 1-mm-long active part), flexible, and water-equivalent dosimeter. It is suitable for photon and electron beams without corrections, and performs on line dose measurements. This detector is based on only one scintillating fiber and a CCD camera. A new signal processing is used to remove the effect of Cerenkov radiation background, which only requires a preliminary calibration. Central-axis depth-dose distribution comparisons have been achieved with standard ionization chambers, over a range from 8 to 25 MV photons and from 6 to 21 MeV electrons in order to validate this calibration. Results show a very good agreement, with less than 1% difference between the two detectors.
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Affiliation(s)
- A M Frelin
- Laboratoire de Physique Corpusculaire, 6 Bd du Maréchal Juin, F14050 Caen, France.
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Ramírez-Solís A, Poteau R, Vela A, Daudey JP. Comparative studies of the spectroscopy of CuCl2: DFT versus standard ab initio approaches. J Chem Phys 2005; 122:164306. [PMID: 15945683 DOI: 10.1063/1.1883167] [Citation(s) in RCA: 23] [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: 11/14/2022] Open
Abstract
The X2Pi g-2Sigma g+, X2Pi g-2Delta g, X2Pi g-2Sigma u+, X2Pi g-2Pi u transitions on CuCl2 have been studied using several exchange-correlation functionals from the various types of density functional theory (DFT) approaches like local density approximation (LDA), generalized gradient approximation (GGA), hybrid and meta-GGA. The results are compared with the experience and with those coming from the most sophisticated nondynamic and dynamic electronic correlation treatments using the same relativistic effective core potentials and especially developed basis sets to study the electronic structure of the five lowest states and the corresponding vertical and adiabatic transition energies. The calculated transition energies for three of the hybrid functionals (B3LYP, B97-2, and PBE0) are in very good agreement with the benchmark ab initio results and experimental figures. All of the other functionals largely overestimate the X2Pi g-2Sigma g+ and X2Pi g-2Delta g transition energies, many of them even placing the 2Delta g ligand field state above the charge transfer 2Pi u and 2Sigma u+ states. The relative weight of the Hartree-Fock exchange in the definition of the functional used appears to play a key role in the accurate description of the LambdaSSigma density defined by the orientation of the 3d hole (sigma, pi, or delta) on Cu in the field of both chlorine atoms, but no simple connection of this weight with the quality of the spectra has been found. Mulliken charges and spin densities are carefully analyzed; a possible link between the extent of spin density on the metal for the X2Pi g state and the performance of the various functionals was observed, suggesting that those that lead to the largest values (close to 0.65) are the ones that best reproduce these four transitions. Most functionals lead to a remarkably low ionicity for the three ligand field states even for the best performing functionals, compared to the complete active space (SCF) (21, 14) ab initio values. These findings show that not only large variational ab initio calculations can produce reliable spectroscopic results for extremely complex systems where delicate electronic correlation effects have to be carefully dealt with. However, those functionals that were recently shown to perform best for a series of molecular properties [J. Chem. Phys. 121 3405 (2004)] are not the ones that produce the best transition energies for this complex case.
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Affiliation(s)
- A Ramírez-Solís
- Laboratoire de Physique Quantique, IRSAMC, UMR 5626 du CNRS, Université Paul Sabatier, 118, Route de Narbonne, Toulouse, Cedex 31062, France.
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Coya R, Algorta J, Boguszewski CL, Vela A, Carlsson LMS, Aniel-Quiroga A, Busturia MA, Martul P. Circulating non-22 kDa growth hormone isoforms after a repeated GHRH stimulus in normal subjects. Growth Horm IGF Res 2005; 15:123-129. [PMID: 15809015 DOI: 10.1016/j.ghir.2004.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2003] [Revised: 09/29/2004] [Accepted: 09/29/2004] [Indexed: 11/22/2022]
Abstract
The aim of this study was to evaluate the proportion of non-22 kDa GH isoforms in relation to total GH concentration after a repeated GHRH stimulus in healthy subjects. We studied 25 normal volunteers (12 males and 13 females, mean age 13.1 years, range 6-35), who received two GHRH bolus (1.5 mug/kg body weight, i.v.) administered separately by an interval of 120 minutes. The proportion of non-22 kDa GH was determined by the 22 kDa GH exclusion assay (GHEA), which is based on immunomagnetic extraction of monomeric and dimeric 22 kDa GH from serum, and quantitation of non-22 kDa GH isoforms using a polyclonal GH assay. Samples were collected at baseline and at 15-30 min intervals up to 240 min for total GH concentration. Non-22 kDa GH isoforms were measured in samples where peak GH after GHRH was observed. Total GH peaked after the first GHRH bolus in all subjects (median 37.2 ng/ml; range: 10.4-94.6). According to GH response to the second GHRH stimulus, the study group was divided in "non-responders" (n=7; 28%), with GH peak levels lower than 10 ng/ml (median GH: 8.7 ng/ml; range 7.3-9.6) and "responders" (n=18; 72%), who showed a GH response greater than 10 ng/ml (median 17 ng/ml; range 10.1-47.0). The median proportion of non-22 kDa GH on the peak of GH secretion after the first GHRH administration was similar in both groups ("responders" median: 8.6%, range 7-10.9%; "non-responders" median: 8.7%, range 6.7-10.3%), independently of the type of response after the second GHRH. In contrast, the median proportion of non-22 kDa GH was greater at time of GH peak after the second GHRH bolus in the "non-responders" (median 11.4%; range 9.1-14.3%) in comparison with the "responders" (median 9.1%; range 6.7-11.9%; p=0.003). A significant negative correlation between the total GH secreted and the percentage of non-22 kDa isoforms was seen in the "non-responders" (p=0.003). These differences in GH response to repeated GHRH stimulation and in the pattern of GH isoforms at GH peak among subjects might be due to distinct recovery patterns of somatrotrophic function and/or differences in metabolic clearance of GH isoforms.
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Affiliation(s)
- R Coya
- Laboratorio de Hormonas, Hospital de Cruces, Baracaldo, Spain
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Albert A, Cruz O, Montaner A, Vela A, Badosa J, Castañón M, Morales L. [Congenital solid tumors. A thirteen-year review]. Cir Pediatr 2004; 17:133-6. [PMID: 15503950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
UNLABELLED Tumors diagnosed during the first month of life are infrequent: 0.5 to 2% of all childhood neoplasms. This is an interesting group of tumors because their type, relative incidence, natural history and response to treatment differ from those seen in older children. AIM To contribute the experience of our institution in congenital tumors the last 13 years. MATERIAL AND METHODS The records of all neonates (< 31 days old) diagnosed with solid tumors since January 1990 to December 2002 have been retrospectively reviewed. RESULTS Twenty-seven neonates have been diagnosed with tumors in the last 13 years. Thirteen patients (48%) were prenatally diagnosed. Nine babies were diagnosed at the initial neonatal exam (40% of those diagnosedd after birth). Neuroblastoma was the commonest tumor (10 cases, 37%), of which 4 were stage I, 4 stage IV-S and 2 stage III. There were 8 teratomas (3 sacrocoxigeal, 1 retroperitoneal, 1 in the CNS, 1 orbitary and two oronasal), two hepatic tumors (1 hepatoblastoma, 1 hemangioendothelioma, two CNS tumors, two giant nevus (one on a hamartoma), and one each Wilms tumor, infantile fibrosarcoma and myofibroblastic tumor. Treatment was surgical resection alone in 17 cases (68%) and surgery + chemotherapy in 8 (32%) (5 neuroblastomas, one CNS tumor, one Wilms tumor and one presacral teratoma who developed a yolk sac tumor); 3 patients died (11%): one at surgery, one of tumoural airway obstruction at birth and one with craniopharyngioma. Among the 14 tumors that were initially not malignant, two can be locally agressive, one was an immature teratoma, the giant nevus with hamartoma developed in situ melanoma, the other nevus had meningeal melanosis with hydrocephalus, and one mature presacral teratoma developed a yolk sac tumor. CONCLUSIONS Diagnosis of congenital tumors is performed earlier in recent years due to the wide use of prenatal ultrasound. Their natural history is more benign than in other age groups, except for CNS tumors and very large or obstructing tumors. The histological patern is not determinant of the outcome. Complete surgical excision is the treatment of choice, most cases not need adjuvant chemotherapy. We ought to pass this message on to our colleagues in prenatal diagnosis, so parents get reliable information.
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Affiliation(s)
- A Albert
- Servicio de Cirugía Pediátrica, Unitat Integrada Hospital Sant Joan de Déu-H. Clínic, Universitat de Barcelon, Barcelona
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Vela A, Algorta J, Martul P, Coya R, Rica I, Aniel-Quiroga MA, Busturia MA. Dual growth hormone (GH) response to repeated GH releasing hormone stimulus in children and adults. J Pediatr Endocrinol Metab 2004; 17:743-8. [PMID: 15237709 DOI: 10.1515/jpem.2004.17.5.743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/15/2022]
Abstract
Several authors have demonstrated that plasma growth hormone (GH) levels as response to acute GH releasing hormone (GHRH) stimulation in adults are decreased by a previous GHRH injection whereas they are maintained in children. Probably the most accepted hypothesis for this finding is the increase in the somatostatinergic tone. The aim of the present study was to evaluate the dual GH response to repeated GHRH stimuli to clarify the possible influence of somatostatinergic activity in the type of response. Eighteen healthy prepubertal children, mean age 9.2 years (range: 6.0-12.9 years) and 19 healthy adult volunteers, mean age 25.5 years (range: 17-35 years) were studied with the GHRH test. An additional group of 10 normal adults with similar characteristics (mean age 31 years, range 25-35 years) were also recruited as a control group for somatostatinergic assessment. The GH response to the first GHRH bolus was similar in both children and adults. However, while children showed a preserved response to the second stimulus, it was diminished in adults. As expected, thyroid stimulating hormone (TSH) was within the normal range in all subjects. When the evolution of TSH was compared between the group of non-responders and the control group, no significant differences were found either at basal time or at 120 min, showing a similar decreasing trend for serum TSH level. The variation of TSH levels were also expressed as the proportion of TSH response after 2 hours compared to the basal level (TSH-120/TSH-0) but no significant differences were found (GHRH non-responders group mean: 73.6%, range: 51.3-93.7; control group mean: 70.7%, range: 62.9-92.5). In conclusion, the results confirm that in adults but not in children, the somatotrope responsiveness to GHRH is inhibited by a previous bolus of GHRH. The finding that the plasma TSH level diminishes in a similar manner in both non-responders and the control group is in agreement with the rejection of the hypothesis of the influence of somatostatin.
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Affiliation(s)
- A Vela
- Department of Pediatric Endocrinology, Hospital de Cruces, Baracaldo, Spain
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López Calvo S, Vela A, Castro A, Cid A, Aguilera A, Vega P, Hermida M, Regueiro BJ, Pedreira JD. [GB virus C: lack of association with transaminases levels, CD4 and HIV viral load in aids patients]. An Med Interna 2003; 20:175-8. [PMID: 12768829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To study the prevalence of GBV-C-RNA in sera of HIV-infected patients and determine whether differences in immunological condition and hepatic disease exist between GBV-C positive and negative patients. METHODS The presence of GBV-C-RNA was determined in sera of 222 HIV-positive patients by semi-automated RT-PCR. A comparison of GBV-C-RNA positive and negative patients was made by studying a series of clinical and analytical parameters. This same comparison was made in particular between those coinfected with HCV and GBV-C and those who only presented GBV-C. RESULTS Prevalence of GBV-C-RNA was 28.8%. The most frequent hepatotropic virus was HCV, appearing in 71.6% of cases. Coinfection with HCV and HGV was present in 17% and 8.6% only had GBV-C. Patients positive for GBV-C-RNA showed clinical and analytical characteristics similar to those found in GBV-C-RNA negative patients. Among the HCV-GBV-C coinfected and those presenting HGV as the only virus it was observed that the coinfected group presented alterations in transaminases and predominance of parenteral transmission as a risk factor for HIV, whereas the GBV-C group presented normal transaminases and predominance of sexual transmission. No differences were perceived in mean CD4 and HIV-RNA values in both groups. CONCLUSIONS Being positive for GBV-C in HIV-positive patients does not influence the presence of hepatic disease that in these patients is frequently accompanied by coinfection with other hepatotropic viruses. Moreover, it does not seem to influence the viremia of the HIV nor the CD4 cell counts.
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Affiliation(s)
- S López Calvo
- Servicio de Medicina Interna, Departamento de Medicina, Hospital Juan Canalejo, Universidad de A Coruña, A Coruña.
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