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Belvís R, Santos-Lasaosa S, Irimia P, Blanco RL, Torres-Ferrús M, Morollón N, López-Bravo A, García-Azorín D, Mínguez-Olaondo A, Guerrero Á, Porta J, Giné-Ciprés E, Sierra Á, Latorre G, González-Oria C, Pascual J, Ezpeleta D. Telemedicine in the management of patients with headache: current situation and recommendations of the Spanish Society of Neurology's Headache Study Group. Neurologia 2023; 38:635-646. [PMID: 37858888 DOI: 10.1016/j.nrleng.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has caused an unexpected boost to telemedicine. We analyse the impact of the pandemic on telemedicine applied in Spanish headache consultations, review the literature, and issue recommendations for the implementation of telemedicine in consultations. METHOD The study comprised 3 phases: 1) review of the MEDLINE database since 1958 (first reported experience with telemedicine); 2) Google Forms survey sent to all members of the Spanish Society of Neurology's Headache Study Group (GECSEN); and 3) online consensus of GECSEN experts to issue recommendations for the implementation of telemedicine in Spain. RESULTS COVID-19 has increased waiting times for face-to-face consultations, increasing the use of all telemedicine modalities: landline telephone (from 75% before April 2020 to 97% after), mobile telephone (from 9% to 27%), e-mail (from 30% to 36%), and video consultation (from 3% to 21%). Neurologists are aware of the need to expand the availability of video consultations, which are clearly growing, and other e-health and m-health tools. CONCLUSIONS The GECSEN recommends and encourages all neurologists who assist patients with headaches to implement telemedicine resources, with the optimal objective of offering video consultation to patients under 60-65 years of age and telephone calls to older patients, although each case must be considered on an individual basis. Prior approval and advice must be sought from legal and IT services and the centre's management. Most patients with stable headache and/or neuralgia are eligible for telemedicine follow-up, after a first consultation that must always be held in person.
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Affiliation(s)
- R Belvís
- Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
| | - S Santos-Lasaosa
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
| | - P Irimia
- Servicio de Neurología, Clínica Universidad de Navarra, Pamplona, Spain
| | - R L Blanco
- Servicio Integrado de Neurología, Hospital Universitario Rey Juan Carlos, Móstoles, Spain; Hospital General de Villalba, Hospital Universitario Infanta Elena, Valdemoro, Spain
| | - M Torres-Ferrús
- Servicio de Neurología, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - N Morollón
- Departamento de Neurología, Hospital Reina Sofía, Tudela, Navarra, Spain
| | - A López-Bravo
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain; Departamento de Neurología, Hospital Reina Sofía, Tudela, Navarra, Spain
| | - D García-Azorín
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - Á Guerrero
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - J Porta
- Servicio de Neurología, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - E Giné-Ciprés
- Servicio de Neurología, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Á Sierra
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - G Latorre
- Departamento de Neurología, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - C González-Oria
- Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - J Pascual
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla e IDIVAL y Universidad de Cantabria, Santander, Spain
| | - D Ezpeleta
- Servicio de Neurología, Hospital Universitario Quirónsalud Madrid, Pozuelo de Alarcón, Madrid, Spain
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Santos-Lasaosa S, Belvís R, Cuadrado ML, Díaz-Insa S, Gago-Veiga A, Guerrero-Peral AL, Huerta M, Irimia P, Láinez JM, Latorre G, Leira R, Pascual J, Porta-Etessam J, Sánchez Del Río M, Viguera J, Pozo-Rosich P. Calcitonin gene-related peptide in migraine: from pathophysiology to treatment. Neurologia (Engl Ed) 2022; 37:390-402. [PMID: 35672126 DOI: 10.1016/j.nrleng.2019.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/07/2019] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION It has been observed in recent years that levels of such molecules as calcitonin gene-related peptide (CGRP) and, to a lesser extent, the pituitary adenylate cyclase-activating peptide are elevated during migraine attacks and in chronic migraine, both in the cerebrospinal fluid and in the serum. Pharmacological reduction of these proteins is clinically significant, with an improvement in patients' migraines. It therefore seems logical that one of the main lines of migraine research should be based on the role of CGRP in the pathophysiology of this entity. DEVELOPMENT The Spanish Society of Neurology's Headache Study Group decided to draft this document in order to address the evidence on such important issues as the role of CGRP in the pathophysiology of migraine and the mechanism of action of monoclonal antibodies and gepants; and to critically analyse the results of different studies and the profile of patients eligible for treatment with monoclonal antibodies, and the impact in terms of pharmacoeconomics. CONCLUSIONS The clinical development of gepants, which are CGRP antagonists, for the acute treatment of migraine attacks, and CGRP ligand and receptor monoclonal antibodies offer promising results for these patients.
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Affiliation(s)
- S Santos-Lasaosa
- Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain.
| | - R Belvís
- Unidad de Cefaleas, Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M L Cuadrado
- Unidad de Cefaleas, Servicio de Neurología, Instituto de Investigación Sanitaria San Carlos, Hospital Clínico San Carlos, Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - S Díaz-Insa
- Unidad de Cefaleas, Servicio de Neurología, Hospital Universitario La Fe, Valencia, Spain
| | - A Gago-Veiga
- Unidad de Cefaleas, Servicio de Neurología, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa, Madrid, Spain
| | - A L Guerrero-Peral
- Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Instituto de Investigación de Salamanca (IBSAL), Spain
| | - M Huerta
- Sección de Neurología, Hospital de Viladecans, Barcelona, Spain
| | - P Irimia
- Departamento de Neurología, Clínica Universidad de Navarra, Pamplona, Spain
| | - J M Láinez
- Servicio de Neurología, Hospital Clínico Universitario de Valencia, Universidad Católica de Valencia, Valencia, Spain
| | - G Latorre
- Unidad de Cefaleas, Servicio de Neurología, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, Madrid, Spain
| | - R Leira
- Servicio de Neurología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - J Pascual
- Hospital Universitario Marqués de Valdecilla e IDIVAL, Santander, Spain
| | - J Porta-Etessam
- Unidad de Cefaleas, Servicio de Neurología, Instituto de Investigación Sanitaria San Carlos, Hospital Clínico San Carlos, Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - M Sánchez Del Río
- Departamento de Neurología, Clínica Universidad de Navarra, Madrid, Spain
| | - J Viguera
- Consulta de Cefalea, Unidad de Gestión Clínica de Neurociencias, Servicio de Neurología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - P Pozo-Rosich
- Unidad de Cefalea, Servicio de Neurología, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Grupo de Investigación en Cefalea, VHIR, Universitat Autònoma de Barcelona, Barcelona, Spain
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Ametzazurra A, Pascual J, Del Rio L, Urigoitia A, Nagore D, Ruiz-Argüello MB. AB0356 THERAPEUTIC DRUG MONITORING: STANDARDIZATION OF PROMONITOR QUICK IFX AND PROMONITOR QUICK ADL POINT OF CARE TESTS WITH WHO INTERNATIONAL STANDARDS FOR THE QUANTIFICATION OF INFLIXIMAB AND ADALIMUMAB IN WHOLE BLOOD AND SERUM. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundPromonitor Quick IFX and Promonitor Quick ADL are rapid point of care lateral flow tests (LFT) based on a sandwich immunoassay for the quantification of infliximab (IFX) and adalimumab (ADL), respectively, in human whole blood (finger prick or venous) or serum. These tests are to be used as an aid in Therapeutic Drug Monitoring (TDM) of rheumatic and inflammatory bowel disease patients under anti-TNFα therapy. The international standards (IS) developed by World Health Organization (WHO) for IFX and ADL allow harmonization and comparability among different assays.ObjectivesThe aim of this study, was to show that Promonitor Quick IFX and Promonitor Quick ADL can measure either reference or biosimilar drugs, as well as to evaluate the agreement of Promonitor Quick IFX and Promonitor Quick ADL tests and the WHO IS.MethodsClinical and Laboratory Standards Institute EP10-A3 guidelines were followed to estimate the bias of Promonitor Quick assays when used to quantify IFX or ADL in samples containing the reference drugs, biosimilars or the WHO IS. Briefly, whole blood was spiked with four known concentrations of IFX or ADL, including current clinical decision levels. Ten replicates were measured of each level along two days.Promonitor Quick IFX was evaluated using the reference drug, SB2 and CT-P13 biosimilars, and the WHO IS (NIBSC 16/170).Promonitor Quick ADL was evaluated using the reference drug, ABP501 and SB5 biosimilars, and the WHO IS (NIBSC 17/236).Results were obtained in combination with the automated portable reader PQreader.ResultsBias was estimated by comparing the observed concentration of drug spiked whole blood samples. Each biosimilar was compared to the reference at the different drug levels tested. Results showed that Promonitor Quick IFX and Promonitor Quick ADL are able to measure equivalently any molecule (see Table 1).Table 1.Promonitor Quick IFX bias results in whole blood samples. Each molecule was compared to the reference drug.IFX concentration (μg/mL)Bias (%)CT-P13SB2GP1111WHO IS314%3%4%8%79%0%5%15%101%5%6%8%Promonitor Quick ADL bias results in whole blood samples.Each molecule was compared to the reference drug.ADL concentration (μg/mL)Bias (%)ABP501SB5WHO IS317%2%3%513%3%12%82%2%7%10517%2%Similar results were obtained when serum matrix was used.The accuracy or closeness of the agreement between the result provided by Promonitor Quick IFX and Promonitor Quick ADL and the true value of the measurand was assessed by measuring the IS developed by the WHO (see Table 1).ConclusionPromonitor Quick IFX and Promonitor Quick ADL allow monitoring of patients treated with IFX and ADL, respectively, with just a finger prick sample. Both tests can quantify reference and biosimilar drugs with equivalent results. Moreover, comparable results were obtained with the WHO IS, and thus, demonstrate that Promonitor Quick tests are suited to accurately determine drug levels at the clinical decision points in both whole blood and serum, proving to be an effective and valuable tool in TDM and immediate decision making in the doctor office or hospitals.Disclosure of InterestsAmagoia Ametzazurra Employee of: Employee of Progenika Biopharma - Grifols, Javier Pascual Employee of: Employee of Progenika Biopharma - Grifols, Lorena Del Rio Employee of: Employee of Progenika Biopharma - Grifols, Ane Urigoitia Employee of: Employee of Progenika Biopharma - Grifols, Daniel Nagore Employee of: Employee of Progenika Biopharma - Grifols, M. Begoña Ruiz-Argüello Employee of: Employee of Progenika Biopharma - Grifols
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Ruiz-Argüello MB, Pascual J, Del Rio L, Urigoitia A, Balo-Farto C, Fernández-López C, Mera Varela A, de-Toro-Santos FJ, Nagore D, Ametzazurra A. AB0369 CORRELATION OF THE FIRST LATERAL FLOW-BASED POINT OF CARE TEST TO QUANTIFY INFLIXIMAB AND ANTI-INFLIXIMAB ANTIBODIES IN A FINGER PRICK SAMPLE WITH THE REFERENCE ELISA TECHNIQUE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundCurrent techniques to monitor clinical response may require several days and centralised facilities, which may cause delays in effective therapeutic decisions. Therefore, the use of a rapid decentralized test will facilitate patient management and improve patient care.ObjectivesThe goal of this study was to validate the use of capillary blood in a real point-of-care (POC) setting for rheumatic patients under infliximab treatment by using Promonitor Quick lateral flow (LF) tests. Results were compared to the Promonitor ELISA reference technique in serum samples used by centralised laboratories.MethodsA prospective, observational study was designed to evaluate the performance of a rapid LF test (Promonitor Quick IFX, Progenika, Spain). 160 infliximab treated rheumatology consecutive patients (400 samples) were recruited in two hospitals in Galicia, Spain. Prior to the infusion, a finger prick sample was obtained and analysed. Anti-infliximab antibodies were also determined with Promonitor Quick ANTI-IFX1-4. Results were read with the automated portable PQreader instrument. Additionally, a serum sample was collected for subsequent comparative analysis with either LF or ELISA tests.Qualitative (positive (PPA) and negative (NPA) agreements) and quantitative (Pearson correlation and bias) performance of the LF test was compared to ELISA, as well as between different specimens following CLSI EP09-A3.ResultsOverall agreement between Promonitor Quick IFX finger prick and ELISA test was 91% (88% PPA; 100% NPA). The quantitative comparison showed a good correlation (Pearson correlation coefficient: 0.85 and observed bias: 25%) (Table 1).Table 1.Performance results: infliximab drugQualitative ComparisonN*PPANPAoverallPOC finger prick vs ELISA27488%100%91%POC serum vs ELISA28198%100%98%Quantitative ComparisonN*Pearson correlationBiasPOC finger prick vs ELISA1650.8525%POC serum vs ELISA1810.916%*Only samples in the common measurement range for both methods considered.Performance results: anti-infliximab anti-drug antibodiesQualitative ComparisonN*PPANPAoverallPOC finger prick visual vs. PQreader396100%99%99%POC serum visual vs PQreader398100%100%100%POC finger prick PQreader vs ELISA39390%99%98%POC serum PQreader vs ELISA39589%100%99%Similar results were also observed when serum was used with either the LF or the ELISA tests (98% overall agreement, 0.91 correlation coefficient; 6% bias) (Table 1).Overall agreements for visual and automated (PQreader) interpretations with Promonitor Quick ANTI-IFX were 99% and 100% for finger prick and serum specimens, respectively (Table 1).ConclusionPromonitor Quick can be used to reliably quantify infliximab in capillary blood samples and results are comparable to those obtained with the reference ELISA technique. The use of the rapid POC test with finger prick will allow clinicians to monitor their patients in a fully decentralized mode to aid in the decision making process. PQreader is a sensitive portable equipment to report drug as well as antibody levels in the patient samples.References[1]Atreya, R. et al. J Crohns Colitis. 2019;13:S391[2]Ametzazurra, A. et al. J Crohns Colitis. 2017;11:S335-S336[3]Fiorino, G. et al. J Crohns Colitis. 2017;11:S388[4]Facchin, A. et al. J Crohns Colitis. 2019;13:S349- S350Disclosure of InterestsM. Begoña Ruiz-Argüello Employee of: Employee of Progenika Biopharma - Grifols, Javier Pascual Employee of: Employee of Progenika Biopharma - Grifols, Lorena Del Rio Employee of: Employee of Progenika Biopharma - Grifols, Ane Urigoitia Employee of: Employee of Progenika Biopharma - Grifols, Cristina Balo-Farto: None declared, Carlos Fernández-López: None declared, ANTONIO MERA VARELA: None declared, Francisco Javier de-Toro-Santos: None declared, Daniel Nagore Employee of: Employee of Progenika Biopharma - Grifols, Amagoia Ametzazurra Employee of: Employee of Progenika Biopharma - Grifols
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Ametzazurra A, Pascual J, Del Rio L, Maguregui A, Nagore D, Ruiz-Argüello MB. AB0354 THERAPEUTIC DRUG MONITORING: PERFORMANCE OF THE FIRST LATERAL FLOW-BASED POINT OF CARE TEST FOR THE QUANTIFICATION OF INFLIXIMAB IN A FINGER PRICK. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPromonitor Quick IFX is a lateral flow test (LFT) for the quantification of infliximab (IFX) in human whole blood (finger prick or venous) or serum in 20 minutes. This LFT is based on a sandwich immunoassay to quantify either the reference IFX or biosimilars.ObjectivesThe objective of this study was to perform the required analytical studies to establish the specifications of the product.MethodsClinical and Laboratory Standards Institute (CLSI) guidelines were followed for the evaluation of the analytical specifications of the LFT in whole blood and serum matrices: Linearity (EP-06-A), Detection capability (EP17-A2), Interfering substances (EP07, 3rd Edition) and Intermediate precision (EP05-A3). Results were obtained in combination with the automated portable reader PQreader. A Datamatrix provided with each Promonitor Quick IFX kit contains the calibration information required for the PQreader to measure the Control and Test lines and report the IFX concentration.ResultsThe linear assay range was determined to be 1-58 µg/mL in whole-blood and 0.6-67 µg/mL in serum according to the processes indicated in the Package Insert. The Limit of Blank is 0.8 μg/mL, the Limit of Detection and Lower Limit of Quantification (LLoQ) are 1.1 μg/mL, and the Upper Limit of Quantification (ULoQ) is 15.4 μg/mL.There was no effect on assay performance when each of the following substances were added to samples with 0, 3, and 7 μg/mL of IFX: Haemoglobin (>1000 mg/dL), Bilirubin (>40 mg/dL), Triglycerides (>1500 mg/dL), HAMA (160 AU/mL), Rheumatoid factor (200 IU/mL), EDTA (5.4 mg/mL), Heparin (51 U/mL), Citrate (11.4%), Vedolizumab (60 μg/mL) and Adalimumab (20.25 μg/mL).Repeatability and within-device precision results obtained for the positive samples are shown in Table 1.Table 1.IFX theoretical concentration (μg/mL)Whole blood samplesSerum samplesMean observed IFX concentration (μg/mL)RepeatabilityWithin-device precisionMean observed IFX concentration (μg/mL)RepeatabilityWithin-device precisionSDCV%SDCV%SDCV%SDCV%33.20.6180.8253.60.5150.617771.3181.7248.31.4161.821109.81.8182.72810.91.8162.321The negative samples showed a negative result in all the measurements.ConclusionPromonitor Quick IFX is the first LFT available for true Point of Care testing of patients treated with IFX with just a finger prick sample. It provides quick turnaround time to facilitate therapeutic drug monitoring and aid immediate decision making in the doctor office or hospitals with an excellent analytical performance.Disclosure of InterestsAmagoia Ametzazurra Employee of: Employee of Progenika Biopharma - Grifols, Javier Pascual Employee of: Employee of Progenika Biopharma - Grifols, Lorena Del Rio Employee of: Employee of Progenika Biopharma - Grifols, Ainara Maguregui Employee of: Employee of Progenika Biopharma - Grifols, Daniel Nagore Employee of: Employee of Progenika Biopharma - Grifols, M. Begoña Ruiz-Argüello Employee of: Employee of Progenika Biopharma - Grifols
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Santos-Lasaosa S, Belvís R, Cuadrado ML, Díaz-Insa S, Gago-Veiga A, Guerrero-Peral AL, Huerta M, Irimia P, Láinez JM, Latorre G, Leira R, Pascual J, Porta-Etessam J, Sánchez Del Río M, Viguera J, Pozo-Rosich P. Calcitonin gene-related peptide in migraine: from pathophysiology to treatment. Neurologia 2022; 37:390-402. [PMID: 31326215 DOI: 10.1016/j.nrl.2019.03.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 12/20/2018] [Accepted: 03/07/2019] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION It has been observed in recent years that levels of such molecules as calcitonin gene-related peptide (CGRP) and, to a lesser extent, the pituitary adenylate cyclase-activating peptide are elevated during migraine attacks and in chronic migraine, both in the cerebrospinal fluid and in the serum. Pharmacological reduction of these proteins is clinically significant, with an improvement in patients' migraines. It therefore seems logical that one of the main lines of migraine research should be based on the role of CGRP in the pathophysiology of this entity. DEVELOPMENT The Spanish Society of Neurology's Headache Study Group decided to draft this document in order to address the evidence on such important issues as the role of CGRP in the pathophysiology of migraine and the mechanism of action of monoclonal antibodies and gepants; and to critically analyse the results of different studies and the profile of patients eligible for treatment with monoclonal antibodies, and the impact in terms of pharmacoeconomics. CONCLUSIONS The clinical development of gepants, which are CGRP antagonists, for the acute treatment of migraine attacks, and CGRP ligand and receptor monoclonal antibodies offer promising results for these patients.
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Affiliation(s)
- S Santos-Lasaosa
- Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto Aragonés de Ciencias de la Salud, Zaragoza, España.
| | - R Belvís
- Unidad de Cefaleas, Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - M L Cuadrado
- Unidad de Cefaleas, Servicio de Neurología, Instituto de Investigación Sanitaria San Carlos, Hospital Clínico San Carlos, Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - S Díaz-Insa
- Unidad de Cefaleas, Servicio de Neurología, Hospital Universitario La Fe, Valencia, España
| | - A Gago-Veiga
- Unidad de Cefaleas, Servicio de Neurología, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa, Madrid, España
| | - A L Guerrero-Peral
- Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España; Instituto de Investigación de Salamanca (IBSAL), España
| | - M Huerta
- Sección de Neurología, Hospital de Viladecans, Barcelona, España
| | - P Irimia
- Departamento de Neurología, Clínica Universidad de Navarra, Pamplona, España
| | - J M Láinez
- Servicio de Neurología, Hospital Clínico Universitario de Valencia. Universidad Católica de Valencia, Valencia, España
| | - G Latorre
- Unidad de Cefaleas, Servicio de Neurología, Hospital Universitario de Fuenlabrada. Universidad Rey Juan Carlos, Madrid, España
| | - R Leira
- Servicio de Neurología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - J Pascual
- Hospital Universitario Marqués de Valdecilla e IDIVAL, Santander, España
| | - J Porta-Etessam
- Unidad de Cefaleas, Servicio de Neurología, Instituto de Investigación Sanitaria San Carlos, Hospital Clínico San Carlos, Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - M Sánchez Del Río
- Departamento de Neurología, Clínica Universidad de Navarra, Madrid, España
| | - J Viguera
- Consulta de Cefalea, Unidad de Gestión Clínica de Neurociencias, Servicio de Neurología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - P Pozo-Rosich
- Unidad de Cefalea, Servicio de Neurología, Hospital Universitari Vall d'Hebron, Barcelona, España; Grupo de Investigación en Cefalea; VHIR; Universitat Autònoma de Barcelona, Barcelona, España
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Láinez-Andrés JM, Ashina M, Belvís R, Díaz-Insa S, Ezpeleta D, García-Azorín D, González-Oria C, Guerrero AL, Guillém A, Holle-Lee D, Huerta-Villanueva M, Irimia P, Leira R, Pascual J, Porta-Etessam J, Pozo-Rosich P, Rodríguez-Vico JS, Sánchez Del Río M, Santos-Lasaosa S, Silberstein S. 1st Post-European Headache Federation Meeting: a review of the latest developments presented at the 2020 European Headache Federation Congress. Rev Neurol 2021; 72:S1-S19. [PMID: 34180043 DOI: 10.33588/rn.72s02.2021155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION After the European Headache Federation (EHF) Congress, renowned Spanish neurologists specialised in migraine presented the most significant latest developments in research in this field at the Post-EHF Meeting. DEVELOPMENT The main data presented concerning the treatment of chronic and episodic migraine were addressed, with attention paid more specifically to those related to preventive treatments and real-life experience in the management of the disease. An important review was carried out of the new therapeutic targets and the possibilities they offer in terms of understanding the pathophysiology of migraine and its treatment. An update was also presented of the latest developments in the treatment of migraine with fremanezumab, a monoclonal antibody recently authorised by the European Medicines Agency. Participants were also given an update on the latest developments in basic research on the pathology, as well as an overview of the symptoms of migraine and COVID-19. Finally, the repercussions of migraine in terms of its burden on the care and economic resources of the health system were addressed, along with its impact on society. CONCLUSIONS The meeting summarised the content presented at the 14th EHF Congress, which took place in late June/early July 2020.
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Affiliation(s)
| | - M Ashina
- Rigshospitalet Glostrup, Glostrup, Dinamarca
| | - R Belvís
- Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, España
| | - S Díaz-Insa
- Hospital Universitario La Fe, Valencia, España
| | - D Ezpeleta
- Hospital Universitario Quirón Salud Madrid, Pozuelo de Alarcón, España
| | - D García-Azorín
- Hospital Universitario Clínico de Valladolid, Valladolid, España
| | | | - A L Guerrero
- Hospital Universitario Clínico de Valladolid, Valladolid, España
| | - A Guillém
- Hospital General Universitario Gregorio Marañón, Madrid, España
| | | | | | - P Irimia
- Clínica Universitaria de Navarra, 31008 Pamplona, España
| | - R Leira
- Hospital Clínico Universitario de Santiago de Compostela, A Coruña, España
| | - J Pascual
- Hospital Universitario Marqués de Valdecilla, Santander, España
| | | | - P Pozo-Rosich
- Hospital Universitari Vall d'Hebron, 08035 Barcelona, España
| | | | | | - S Santos-Lasaosa
- Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, España
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8
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Fierro A, Pérez-Rojí G, Blanco A, López P, Andrés M, González-Quintanilla V, Pérez-Pereda S, Fontanillas N, Pascual J. Headache as main reason for consultation to a hospital Emergency Department in Spain: a prospective study. Neurologia 2021; 38:S0213-4853(21)00089-X. [PMID: 34083062 DOI: 10.1016/j.nrl.2021.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/28/2021] [Accepted: 03/28/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Headache is common in the general population and a frequent reason for medical consultation. OBJECTIVES To describe the characteristics of patients attending the Emergency Department (ED) for headache. METHODS A descriptive study with prospective collection of 100 consecutive patients over 15 years old who attended our ED due to headache as the main complaint. RESULTS Headache accounted for 1,4% of ED visits. The most common age range is between 31 and 45 years and the majority of the patients are females (61%). We diagnosed 67 primary and 33 secondary headaches. The most frequent diagnosis was migraine, with 36% of cases. One out of 3 patients had a history of headache and 4 out of 5 consulted by their own decision. Only a small percentage of patients were admitted as inpatients (12%), and 3 out of 5 were referred to Primary Care. Complementary tests were performed on 84% of the patients. One CT scan was performed for every 3 patients. A total of 80% patients was correctly diagnosed by the ED physicians. CONCLUSIONS Headache is a frequent complaint in the ED, where primary headaches are the most common with migraine being the most frequent reason for consultation. In our setting, there is a good screening and diagnosis of headaches, as well as an adequate use of the available resources in the ED for their diagnosis and management.
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Affiliation(s)
- A Fierro
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla e IDIVAL y Universidad de Cantabria, Santander, España
| | - G Pérez-Rojí
- Servicio de Urgencias, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - A Blanco
- Servicio de Urgencias, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - P López
- Servicio de Urgencias, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - M Andrés
- Servicio de Urgencias, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - V González-Quintanilla
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla e IDIVAL y Universidad de Cantabria, Santander, España
| | - S Pérez-Pereda
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla e IDIVAL y Universidad de Cantabria, Santander, España
| | | | - J Pascual
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla e IDIVAL y Universidad de Cantabria, Santander, España.
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9
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Madera J, Sánchez-Soblechero A, Navarrete Solano P, Corro Verde U, Marco de Lucas E, Pacheco Baldor M, Prada PJ, Pascual J. Late vascular complications after cranial radiotherapy: A report of two illustrative cases. Cancer Radiother 2021; 25:786-789. [PMID: 33903008 DOI: 10.1016/j.canrad.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/23/2021] [Accepted: 04/06/2021] [Indexed: 11/15/2022]
Abstract
Cranial radiotherapy (CRT) is used to treat a large variety of benign and malignant disorders. We present two cases of late neurological complications after CRT and briefly discuss its diagnosis and their shared pathophysiological aspects. The first case is a patient with cognitive impairment associated to mineralizing microangiopathy ten years after CRT for nasopharyngeal carcinoma and the second one is a woman with Stroke-like Migraine Attacks after Radiation Therapy (SMART) syndrome two years after CRT for anaplastic meningioma. Nowadays, higher survival rates might cause an increase in appearance of late neurological complications after CTR. These reported cases show that late complications can mimic a wide variety of neurological conditions and the importance of magnetic resonance image (MRI) to get a diagnosis.
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Affiliation(s)
- J Madera
- Service of Neurology, University Hospital Marqués de Valdecilla, University of Cantabria and IDIVAL, Av. Valdecilla s/n, 39008 Santander, Spain
| | - A Sánchez-Soblechero
- Service of Neurology, University Hospital Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain
| | - P Navarrete Solano
- Service of Oncology and Radiotherapy, University Hospital Marqués de Valdecilla and IDIVAL, Av. Valdecilla s/n, 39008 Santander, Spain
| | - U Corro Verde
- Service of Oncology and Radiotherapy, University Hospital Marqués de Valdecilla and IDIVAL, Av. Valdecilla s/n, 39008 Santander, Spain
| | - E Marco de Lucas
- Service of Radiology, University Hospital Marqués de Valdecilla and IDIVAL, Av. Valdecilla s/n, 39008 Santander, Spain
| | - M Pacheco Baldor
- Service of Oncology and Radiotherapy, University Hospital Marqués de Valdecilla and IDIVAL, Av. Valdecilla s/n, 39008 Santander, Spain
| | - P J Prada
- Service of Oncology and Radiotherapy, University Hospital Marqués de Valdecilla and IDIVAL, Av. Valdecilla s/n, 39008 Santander, Spain
| | - J Pascual
- Service of Neurology, University Hospital Marqués de Valdecilla, University of Cantabria and IDIVAL, Av. Valdecilla s/n, 39008 Santander, Spain.
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10
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Belvís R, Santos-Lasaosa S, Irimia P, López Blanco R, Torres-Ferrús M, Morollón N, López-Bravo A, García-Azorín D, Mínguez-Olaondo A, Guerrero Á, Porta J, Giné-Ciprés E, Sierra Á, Latorre G, González-Oria C, Pascual J, Ezpeleta D. Telemedicine in the management of patients with headache: current situation and recommendations of the Spanish Society of Neurology's Headache Study Group. Neurologia 2021; 38:S0213-4853(21)00054-2. [PMID: 33867184 DOI: 10.1016/j.nrl.2021.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has caused an unexpected boost to telemedicine. We analyse the impact of the pandemic on telemedicine applied in Spanish headache consultations, review the literature, and issue recommendations for the implementation of telemedicine in consultations. METHOD The study comprised 3 phases: 1) review of the MEDLINE database since 1958 (first reported experience with telemedicine); 2) Google Forms survey sent to all members of the Spanish Society of Neurology's Headache Study Group (GECSEN); and 3) online consensus of GECSEN experts to issue recommendations for the implementation of telemedicine in Spain. RESULTS COVID-19 has increased waiting times for face-to-face consultations, increasing the use of all telemedicine modalities: landline telephone (from 75% before April 2020 to 97% after), mobile telephone (from 9% to 27%), e-mail (from 30% to 36%), and video consultation (from 3% to 21%). Neurologists are aware of the need to expand the availability of video consultations, which are clearly growing, and other e-health and m-health tools. CONCLUSIONS The GECSEN recommends and encourages all neurologists who assist patients with headaches to implement telemedicine resources, with the optimal objective of offering video consultation to patients under 60-65 years of age and telephone calls to older patients, although each case must be considered on an individual basis. Prior approval and advice must be sought from legal and IT services and the centre's management. Most patients with stable headache and/or neuralgia are eligible for telemedicine follow-up, after a first consultation that must always be held in person.
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Affiliation(s)
- R Belvís
- Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
| | - S Santos-Lasaosa
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria Aragón, Zaragoza, España
| | - P Irimia
- Servicio de Neurología, Clínica Universidad de Navarra, Pamplona, España
| | - R López Blanco
- Servicio Integrado de Neurología, Hospital Universitario Rey Juan Carlos, Móstoles, España; Hospital General de Villalba, Hospital Universitario Infanta Elena, Valdemoro, España
| | - M Torres-Ferrús
- Servicio de Neurología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - N Morollón
- Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - A López-Bravo
- Instituto de Investigación Sanitaria Aragón, Zaragoza, España; Departamento de Neurología, Hospital Reina Sofía, Tudela, Navarra, España
| | - D García-Azorín
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | | | - Á Guerrero
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - J Porta
- Servicio de Neurología, Hospital Clínico Universitario San Carlos, Madrid, España
| | - E Giné-Ciprés
- Servicio de Neurología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - Á Sierra
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - G Latorre
- Departamento de Neurología, Hospital Universitario de Fuenlabrada, Madrid, España
| | - C González-Oria
- Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - J Pascual
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla e IDIVAL y Universidad de Cantabria, Santander, España
| | - D Ezpeleta
- Servicio de Neurología, Hospital Universitario Quirónsalud Madrid, Pozuelo de Alarcón, Madrid, España
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11
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Teraoka J, Nguyen K, Hart D, Peace S, Leard L, Iyer G, Gordon D, Zuckerman B, Pascual J, Ponzo J, Perez A, Budanova N, Gesthalter Y, Trinh B, Kukreja J, Hays S, Venado A. Decreasing 30-day Readmissions for Pleural Effusions after Lung Transplant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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12
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Santos-Lasaosa S, Cuadrado M, Gago-Veiga A, Guerrero-Peral A, Irimia P, Láinez J, Leira R, Pascual J, Porta-Etessam J, Sánchez del Río M, Viguera Romero J, Pozo-Rosich P. Evidencia y experiencia del uso de onabotulinumtoxinA en neuralgia del trigémino y cefaleas primarias distintas de la migraña crónica. Neurologia 2020; 35:568-578. [DOI: 10.1016/j.nrl.2017.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 09/15/2017] [Accepted: 09/18/2017] [Indexed: 12/20/2022] Open
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13
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Perez-Pereda S, Toriello M, Gonzalez-Quintanilla V, Pascual J, Oterino A. [Real need for headache services and their resource consumption: a retrospective observational study on a cohort in Cantabria]. Rev Neurol 2020; 68:510-516. [PMID: 31173331 DOI: 10.33588/rn.6812.2018502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Headache services arise out of a need to improve care for patients with different types of headache; however, some important aspects of clinical management that demonstrate their efficiency remain unknown. AIM To estimate the need for headache services in our area. PATIENTS AND METHODS We conducted a retrospective study in two phases: identification of the first visits due to headache during three consecutive months and collection of care data during one year. The care criteria in headache services considered were: chronic migraine, rare headaches, need for special techniques and headaches with poor therapeutic response. RESULTS Of the 1,418 first visits, in 298 cases (20.38%) the reason for seeking medical attention was headache. Of these, 82.9% were from primary care. The distribution of the diagnoses was: 54%, migraine; 11%, tension-type headache; and 35%, other headaches. Altogether 108 patients met the criteria for referral to headache services: 63 for chronic migraine; 13 for nerve blocks; 9 for frequent migraine; 8 for trigeminal-autonomic cephalgias; 5 due to a need for botulinum toxin; and 10 for other reasons. The patients attended by headache services went to the emergency department less often than those who visited the general outpatient department, had fewer brain scans and more botulinum toxin was indicated. CONCLUSION Headache services are justified because they offer better management of patients with the most severe variants of headache. In our country, at least two visits a week are needed to cover an area of 350,000 users of the Spanish National Health System.
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Affiliation(s)
- S Perez-Pereda
- Hospital Universitario Marques de Valdecilla, Santander, Espana
| | - M Toriello
- Hospital Universitario Marques de Valdecilla, Santander, Espana
| | | | - J Pascual
- Hospital Universitario Marques de Valdecilla, Santander, Espana
| | - A Oterino
- Hospital Universitario Marques de Valdecilla, Santander, Espana
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14
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Pozo-Rosich P, Martin-Delgado J, Layos-Romero A, Pascual J, Bailón C, Guerrero-Peral AL, Ignacio E, Torres A, Mira JJ. [Specialised headache units, a feasible alternative in Spain]. Rev Neurol 2020; 71:199-204. [PMID: 32895902 DOI: 10.33588/rn.7106.2020269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Visits due to headaches are the most frequent cause of demand for neurological treatment in primary care and neurology services. Headache units improve the quality of care, reduce waiting lists, facilitate access to new treatments of proven efficacy and optimise healthcare expenditure. However, these units have not been implemented on a widespread basis in Spain due to the relatively low importance attributed to the condition and also the assumption that such units have a high cost. AIM To define the structure and minimum requirements of a headache unit with the intention of contributing to their expansion in hospitals in Spain. SUBJECTS AND METHODS We conducted a consensus study among professionals after reviewing the literature on the structure, functions and resources required by a headache unit designed to serve an area with 350,000 inhabitants. RESULTS Eight publications were taken as a reference for identifying the minimum resources needed for a headache unit. The panel of experts was made up of 12 professionals from different specialties. The main resource required to be able to implement these units is the professional staff (both supervisory and technical), which can mean an additional cost for the first year of around 107,287.19 euros. CONCLUSIONS If we bear in mind the direct and indirect costs due to losses in labour productivity per patient and compare them with the estimated costs involved in implementing these units and their expected results, everything points to the need for headache units to become generalised in Spain.
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Affiliation(s)
- P Pozo-Rosich
- Hospitals Vall d'Hebron, 08035 Barcelona, España.,Universitat Autónoma de Barcelona. Facultat de Medicina, 08931 Bellaterra, España
| | - J Martin-Delgado
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica, San Juan de Alicante, España
| | - A Layos-Romero
- Hospital General Universitario de Albacete, 02006 Albacete, España
| | - J Pascual
- Universidad de Cantabria. Facultad de Medicina, 39011 Santander, España.,Hospital Universitario Marqués de Valdecilla, Santander, España
| | - C Bailón
- Hospital Universitario Marqués de Valdecilla, Santander, España
| | | | - E Ignacio
- Universidad de Cadiz. Facultad de Ciencias de la Salud, Cádiz, España
| | - A Torres
- Agencia de Calidad Sanitaria de Andalucía, Sevilla, España
| | - J J Mira
- Universidad Miguel Hernández, Elche, España.,Departamento de Salud Alicante- Sant Joan, Alicante, España.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Alicante, España
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15
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Galvez-Carvajal L, Sánchez-Muñoz A, Álvarez M, Alba Linero E, del Rey M, Garrido A, Santoja Á, Moya A, Montes J, Chica-Parrado M, Sáez M, Aparicio J, González-Billalabeitia E, Terrasa Pons J, Méndez M, Luengo M, García del Muro J, Pascual J, Alba E. 789P A differential gene expression signature identifies a population of stage I testicular non-seminomatous germ cell tumours (NSGCT) at high risk of relapse. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.861] [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: 11/28/2022] Open
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16
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Pascual J, García S, Pedrosa I, Lapuente I, Lapuente B, Delgado A, Azema D, Raupp A, Oliveira M, Berthier A, Bastier S, Lapeyre Y, Teixeira P. eLearning Technologies on the follow-up of Young People with Chronic Diseases. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa040.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction Non-communicable diseases are increasing worldwide due mainly to rapidly changing lifestyles and socio-economic status affecting the well-being and the lives of young people along their whole life. Hence, there is a need to provide adequate and useful measures to support patients living with those diseases in order to foster youth emotional and physical health and improve their daily life.
Objectives The aim of this presentation is to demonstrate the use of eLearning content to empower families, communities and young patients in dealing with the daily routine of chronic diseases.
Methodology Based on a human centred design, 176 youngsters with asthma, obesity, and diabetes aged between 3-16 years old were assessed to gather information about perceived needs and preferences in relation to disease management. Ineffective communication, lack of knowledge/skills, poor adherence to treatment and low acceptance of the disease were the main aspects highlighted. Based on those results, participants were fully involved participating in the iterative development of eLearning package to face these needs, gathering specific information about its content, design and usability.
Results The project has generated eLearning modules, using Articulate technologies, providing practical information and learning content in three languages, in partnership with health research centres, hospitals and patient associations in Portugal, Spain and France. There are lots of packages: obesity, respiratory diseases and diabetes. In each of these, the content is provided using gamification strategies and role models. eLearning is one of the components of the follow up process, being complemented by a mobile application with an interactive support chat and fun games.
Conclusion ELearning tools, along with other online tools, contribute to generate a more positive perspective on the control of the disease and to support families and patients to get reliable information and connect with medical assistance.
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Affiliation(s)
- J Pascual
- Fundación CTIC, Centro Tecnológico, Asturias, Spain
| | - S García
- Fundación CTIC, Centro Tecnológico, Asturias, Spain
| | - I Pedrosa
- Fundación CTIC, Centro Tecnológico, Asturias, Spain
| | - I Lapuente
- Servicio Cántabro de Salud, Cantabria, Spain
| | - B Lapuente
- Instituto de Investigación Sanitaria Valdecilla, Cantabria, Spain
| | - A Delgado
- Servicio Cántabro de Salud, Cantabria, Spain
| | - D Azema
- creSco – Université Paul Sabatier, Toulouse, France
| | - A Raupp
- Association de prise en Charge Concertée des Obésités en Midi- Pyrénées (ACCOMIP-RéPPOP), Toulouse, France
| | - M Oliveira
- Future Balloons, Figueira da Foz, Portugal
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17
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Meilán A, Larrosa D, Ramón C, Cernuda‐Morollón E, Martínez‐Camblor P, Saiz A, Santamarta E, Pérez‐Pereda S, Pascual J. No association between migraine frequency, white matter lesions and silent brain infarctions: a study in a series of women with chronic migraine. Eur J Neurol 2020; 27:1689-1696. [DOI: 10.1111/ene.14284] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 04/10/2020] [Indexed: 01/02/2023]
Affiliation(s)
- A. Meilán
- Service of Radiology University Hospital Central de Asturias OviedoSpain
| | - D. Larrosa
- Service of Neurology University Hospital Central de Asturias OviedoSpain
| | - C. Ramón
- Service of Neurology University Hospital Central de Asturias OviedoSpain
| | | | | | - A. Saiz
- Service of Radiology University Hospital Central de Asturias OviedoSpain
| | - E. Santamarta
- Service of Radiology University Hospital Central de Asturias OviedoSpain
| | - S. Pérez‐Pereda
- Service of Neurology University Hospital Marqués de Valdecilla University of Cantabria and IDIVAL Santander Spain
| | - J. Pascual
- Service of Neurology University Hospital Marqués de Valdecilla University of Cantabria and IDIVAL Santander Spain
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18
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Larrosa-Campo D, Meilán-Martínez A, Ramón-Carbajo C, Santamarta-Liébana E, Saiz-Ayala A, Martínez-Camblor P, Cernuda-Morollón E, Pascual J. [Is there a relationship between white matter lesions associated with migraine and patent foramen ovale? Analysis of a series of patients with chronic migraine]. Rev Neurol 2020; 70:372-378. [PMID: 32390130 DOI: 10.33588/rn.7010.2019435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION White matter lesions are more prevalent in migraine patients than in the general population, especially those with a high frequency of attacks. A patent foramen ovale has been described as a possible link between migraine and white matter lesions. AIM To determine the existence of a possible relationship between a patent foramen ovale and white matter lesions in a series of patients with chronic migraine. PATIENTS AND METHODS Observational, single-centre, case-control study. Eighty-nine women with chronic migraine were selected. The persistence and characteristics of the patent foramen ovale were assessed by means of a transcranial Doppler study. The patent foramen ovale was classified as small, moderate or massive. Those detected at rest were considered permanent, and the others were classified as latent. The MRI protocol included T1-enhanced sagittal images, FLAIR-T2-enhanced axial images, and a proton density and T2-FSE combined sequence. The white matter lesions were classified as deep, periventricular or both. RESULTS The prevalence of patent foramen ovale (53.6% versus 48.5%; p = 0.80) and the proportion of massive, permanent patent foramen ovale were similar among patients with and without white matter lesions. Neither was there any difference in the prevalence (55.6% versus 52.6%; p = 1.00) or the characteristics of the patent foramen ovale as a function of the distribution of white matter lesions. CONCLUSION The results do not suggest that a patent foramen ovale intervenes in the pathophysiology of the white matter lesions observed in patients with migraine.
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Affiliation(s)
| | | | - C Ramón-Carbajo
- Hospital Universitario Central de Asturias, 33006 Oviedo, España
| | | | - A Saiz-Ayala
- Hospital Universitario Central de Asturias, Oviedo, España
| | - P Martínez-Camblor
- Gelsel School of Medicine at Dartmouth, Hanover, EE.UU.,Universidad Autónoma de Chile, Santiago de Chile, Chile
| | | | - J Pascual
- Hospital Universitario Central de Asturias, Oviedo, España.,Hospital Universitario Marqués de Valdecilla, Santander, España
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19
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Gordon D, Hays S, Singer J, Perez A, Venado A, Iyer G, Zuckerman B, Daulton C, Pascual J, Dewey K, Florez R, Shah R, Kolaitis N, Leard L, Kleinhenz M, Golden J, Trinh B, Deuse T, Kukreja J. Reducing Length of Stay after Lung Transplant through Implementation of Multi-Disciplinary Care Coordination Rounds. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Morales JC, Mustill AJ, Ribas I, Davies MB, Reiners A, Bauer FF, Kossakowski D, Herrero E, Rodríguez E, López-González MJ, Rodríguez-López C, Béjar VJS, González-Cuesta L, Luque R, Pallé E, Perger M, Baroch D, Johansen A, Klahr H, Mordasini C, Anglada-Escudé G, Caballero JA, Cortés-Contreras M, Dreizler S, Lafarga M, Nagel E, Passegger VM, Reffert S, Rosich A, Schweitzer A, Tal-Or L, Trifonov T, Zechmeister M, Quirrenbach A, Amado PJ, Guenther EW, Hagen HJ, Henning T, Jeffers SV, Kaminski A, Kürster M, Montes D, Seifert W, Abellán FJ, Abril M, Aceituno J, Aceituno FJ, Alonso-Floriano FJ, Ammler-von Eiff M, Antona R, Arroyo-Torres B, Azzaro M, Barrado D, Becerril-Jarque S, Benítez D, Berdiñas ZM, Bergond G, Brinkmöller M, Del Burgo C, Burn R, Calvo-Ortega R, Cano J, Cárdenas MC, Guillén CC, Carro J, Casal E, Casanova V, Casasayas-Barris N, Chaturvedi P, Cifuentes C, Claret A, Colomé J, Czesla S, Díez-Alonso E, Dorda R, Emsenhuber A, Fernández M, Fernández-Martín A, Ferro IM, Fuhrmeister B, Galadí-Enríquez D, Cava IG, Vargas MLG, Garcia-Piquer A, Gesa L, González-Álvarez E, Hernández JIG, González-Peinado R, Guàrdia J, Guijarro A, de Guindos E, Hatzes AP, Hauschildt PH, Hedrosa RP, Hermelo I, Arabi RH, Otero FH, Hintz D, Holgado G, Huber A, Huke P, Johnson EN, de Juan E, Kehr M, Kemmer J, Kim M, Klüter J, Klutsch A, Labarga F, Labiche N, Lalitha S, Lampón M, Lara LM, Launhardt R, Lázaro FJ, Lizon JL, Llamas M, Lodieu N, López Del Fresno M, Salas JFL, López-Santiago J, Madinabeitia HM, Mall U, Mancini L, Mandel H, Marfil E, Molina JAM, Martín EL, Martín-Fernández P, Martín-Ruiz S, Martínez-Rodríguez H, Marvin CJ, Mirabet E, Moya A, Naranjo V, Nelson RP, Nortmann L, Nowak G, Ofir A, Pascual J, Pavlov A, Pedraz S, Medialdea DP, Pérez-Calpena A, Perryman MAC, Rabaza O, Ballesta AR, Rebolo R, Redondo P, Rix HW, Rodler F, Trinidad AR, Sabotta S, Sadegi S, Salz M, Sánchez-Blanco E, Carrasco MAS, Sánchez-López A, Sanz-Forcada J, Sarkis P, Sarmiento LF, Schäfer S, Schlecker M, Schmitt JHMM, Schöfer P, Solano E, Sota A, Stahl O, Stock S, Stuber T, Stürmer J, Suárez JC, Tabernero HM, Tulloch SM, Veredas G, Vico-Linares JI, Vilardell F, Wagner K, Winkler J, Wolthoff V, Yan F, Osorio MRZ. A giant exoplanet orbiting a very-low-mass star challenges planet formation models. Science 2019; 365:1441-1445. [PMID: 31604272 DOI: 10.1126/science.aax3198] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 08/27/2019] [Indexed: 01/03/2023]
Abstract
Surveys have shown that super-Earth and Neptune-mass exoplanets are more frequent than gas giants around low-mass stars, as predicted by the core accretion theory of planet formation. We report the discovery of a giant planet around the very-low-mass star GJ 3512, as determined by optical and near-infrared radial-velocity observations. The planet has a minimum mass of 0.46 Jupiter masses, very high for such a small host star, and an eccentric 204-day orbit. Dynamical models show that the high eccentricity is most likely due to planet-planet interactions. We use simulations to demonstrate that the GJ 3512 planetary system challenges generally accepted formation theories, and that it puts constraints on the planet accretion and migration rates. Disk instabilities may be more efficient in forming planets than previously thought.
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Affiliation(s)
- J C Morales
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain. .,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - A J Mustill
- Lund Observatory, Department of Astronomy and Theoretical Physics, Lund University, Box 43, SE-221 00 Lund, Sweden
| | - I Ribas
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - M B Davies
- Lund Observatory, Department of Astronomy and Theoretical Physics, Lund University, Box 43, SE-221 00 Lund, Sweden
| | - A Reiners
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - F F Bauer
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - D Kossakowski
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - E Herrero
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - E Rodríguez
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - M J López-González
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - C Rodríguez-López
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - V J S Béjar
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - L González-Cuesta
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - R Luque
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - E Pallé
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - M Perger
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - D Baroch
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - A Johansen
- Lund Observatory, Department of Astronomy and Theoretical Physics, Lund University, Box 43, SE-221 00 Lund, Sweden
| | - H Klahr
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - C Mordasini
- Physikalisches Institut, Universität Bern, CH-3012 Bern, Switzerland
| | - G Anglada-Escudé
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,School of Physics and Astronomy, Queen Mary University of London, London E1 4NS, UK
| | - J A Caballero
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - M Cortés-Contreras
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - S Dreizler
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - M Lafarga
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - E Nagel
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - V M Passegger
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - S Reffert
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - A Rosich
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - A Schweitzer
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - L Tal-Or
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany.,Department of Geophysics, Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - T Trifonov
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - M Zechmeister
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - A Quirrenbach
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - P J Amado
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - E W Guenther
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - H-J Hagen
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - T Henning
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - S V Jeffers
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - A Kaminski
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - M Kürster
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - D Montes
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - W Seifert
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - F J Abellán
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Departamento de Astronomía y Astrofísica, Universidad de Valencia, E-46100 Burjassot, Spain
| | - M Abril
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - J Aceituno
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - F J Aceituno
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - F J Alonso-Floriano
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Leiden Observatory, Leiden University, 2300 RA Leiden, Netherlands
| | - M Ammler-von Eiff
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany.,Max Planck Institute for Solar System Research, D-37077 Göttingen, Germany
| | - R Antona
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - B Arroyo-Torres
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - M Azzaro
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - D Barrado
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - S Becerril-Jarque
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - D Benítez
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - Z M Berdiñas
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,Departamento de Astronomía, Universidad de Chile, Camino El Observatorio, 1515 Las Condes, Santiago, Chile
| | - G Bergond
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - M Brinkmöller
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - C Del Burgo
- Instituto Nacional de Astrofísica, Óptica y Electrónica, Santa María Tonantzintla, Puebla, Mexico
| | - R Burn
- Physikalisches Institut, Universität Bern, CH-3012 Bern, Switzerland
| | - R Calvo-Ortega
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - J Cano
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - M C Cárdenas
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - C Cardona Guillén
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - J Carro
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - E Casal
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - V Casanova
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - N Casasayas-Barris
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - P Chaturvedi
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - C Cifuentes
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain.,Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - A Claret
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - J Colomé
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - S Czesla
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - E Díez-Alonso
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Departamento de Explotación y Prospeción de Minas, Escuela de Minas, Energía y Materiales, Universidad de Oviedo, E-33003 Oviedo, Asturias, Spain
| | - R Dorda
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain.,Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - A Emsenhuber
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ 85721, USA
| | - M Fernández
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - A Fernández-Martín
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - I M Ferro
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - B Fuhrmeister
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - D Galadí-Enríquez
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - I Gallardo Cava
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Observatorio Astronómico Nacional (OAN-Instituto Geográfico Nacional), E-28803 Alcalá de Henares, Spain
| | | | - A Garcia-Piquer
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - L Gesa
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - E González-Álvarez
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), E-28850 Torrejón de Ardoz, Madrid, Spain
| | - J I González Hernández
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - R González-Peinado
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - J Guàrdia
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - A Guijarro
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - E de Guindos
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - A P Hatzes
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - P H Hauschildt
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - R P Hedrosa
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - I Hermelo
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - R Hernández Arabi
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - F Hernández Otero
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - D Hintz
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - G Holgado
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain.,Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - A Huber
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - P Huke
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - E N Johnson
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - E de Juan
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - M Kehr
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - J Kemmer
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - M Kim
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany.,Institut für Theoretische Physik und Astrophysik, D-24118 Kiel, Germany
| | - J Klüter
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany.,Zentrum für Astronomie der Universität Heidelberg, Astronomisches Rechen-Institut, D-69120 Heidelberg, Germany
| | - A Klutsch
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Institut für Astronomie und Astrophysik, Eberhard Karls Universität, D-72076 Tübingen, Germany
| | - F Labarga
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - N Labiche
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - S Lalitha
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - M Lampón
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - L M Lara
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - R Launhardt
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - F J Lázaro
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - J-L Lizon
- European Organisation for Astronomical Research in the Southern Hemisphere, D-85748 Garching bei München, Germany
| | - M Llamas
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - N Lodieu
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - M López Del Fresno
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - J F López Salas
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - J López-Santiago
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Department of Signal Theory and Communications, Universidad Carlos III de Madrid, E-28911 Leganés, Madrid, Spain.,Gregorio Marañón Health Research Institute, E-28007 Madrid, Spain
| | - H Magán Madinabeitia
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - U Mall
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - L Mancini
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany.,Department of Physics, University of Rome Tor Vergata, I-00133 Roma, Italy.,Istituto Nazionale di Astrofisica-Osservatorio Astrofisico di Torino, I-10025 Pino Torinese, Italy.,International Institute for Advanced Scientific Studies, I-84019 Vietri sul Mare (SA), Italy
| | - H Mandel
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - E Marfil
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - J A Marín Molina
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - E L Martín
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), E-28850 Torrejón de Ardoz, Madrid, Spain
| | - P Martín-Fernández
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - S Martín-Ruiz
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - H Martínez-Rodríguez
- Departamento de Física de la Tierra y Astrofísica, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Instituto de Física de Partículas y del Cosmos, Facultad de Ciencias Físicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.,Department of Physics and Astronomy and Pittsburgh Particle Physics, Astrophysics and Cosmology Center, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - C J Marvin
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - E Mirabet
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain.,Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - A Moya
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain.,School of Physics and Astronomy, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.,Stellar Astrophysics Centre, Department of Physics and Astronomy, Aarhus University, DK-8000 Aarhus C, Denmark
| | - V Naranjo
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - R P Nelson
- School of Physics and Astronomy, Queen Mary University of London, London E1 4NS, UK
| | - L Nortmann
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - G Nowak
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - A Ofir
- Department of Earth and Planetary Sciences, Weizmann Institute of Science, Rehovot 76100, Israel
| | - J Pascual
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - A Pavlov
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - S Pedraz
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - D Pérez Medialdea
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | | | - M A C Perryman
- School of Physics, University College Dublin, Belfield Downs, Dublin D14 YH57, Ireland
| | - O Rabaza
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,Dpto. Ingeniería Civil, Universidad de Granada, E-18071 Granada, Spain
| | - A Ramón Ballesta
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - R Rebolo
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain.,Departamento de Astrofísica, Universidad de La Laguna, E-38206 La Laguna, Tenerife, Spain
| | - P Redondo
- Instituto de Astrofísica de Canarias, E-38205 La Laguna, Tenerife, Spain
| | - H-W Rix
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - F Rodler
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain.,European Southern Observatory, Vitacura, Casilla 19001, Santiago de Chile
| | - A Rodríguez Trinidad
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - S Sabotta
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - S Sadegi
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany.,Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - M Salz
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | | | - M A Sánchez Carrasco
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - A Sánchez-López
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - J Sanz-Forcada
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - P Sarkis
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - L F Sarmiento
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - S Schäfer
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - M Schlecker
- Max-Planck-Institut für Astronomie, D-69117 Heidelberg, Germany
| | - J H M M Schmitt
- Hamburger Sternwarte, Universität Hamburg, D-21029 Hamburg, Germany
| | - P Schöfer
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - E Solano
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), European Space Astronomy Centre Campus (European Space Agency), E-28692 Villanueva de la Cañada, Spain
| | - A Sota
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain
| | - O Stahl
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - S Stock
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - T Stuber
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - J Stürmer
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany.,Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL 60637, USA
| | - J C Suárez
- Instituto de Astrofísica de Andalucía (Consejo Superior de Investigaciones Científicas), E-18008 Granada, Spain.,Dpto. Física Teórica y del Cosmos, Universidad de Granada, E-18071 Granada, Spain
| | - H M Tabernero
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), E-28850 Torrejón de Ardoz, Madrid, Spain
| | - S M Tulloch
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, UK
| | - G Veredas
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - J I Vico-Linares
- Centro Astronómico Hispano-Alemán (Consejo Superior de Investigaciones Científicas-Max-Planck-Gesellschaft), Observatorio Astronómico de Calar Alto, Sierra de los Filabres, E-04550 Gérgal, Almería, Spain
| | - F Vilardell
- Institut de Ciències de l'Espai (Consejo Superior de Investigaciones Científicas), Campus Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain.,Institut d'Estudis Espacials de Catalunya, E-08034 Barcelona, Spain
| | - K Wagner
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - J Winkler
- Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg, Germany
| | - V Wolthoff
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, D-69117 Heidelberg, Germany
| | - F Yan
- Institut für Astrophysik, Georg-August-Universität, D-37077 Göttingen, Germany
| | - M R Zapatero Osorio
- Centro de Astrobiología (Consejo Superior de Investigaciones Científicas-Instituto Nacional de Técnica Aeroespacial), E-28850 Torrejón de Ardoz, Madrid, Spain
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21
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Gago-Veiga A, Santos-Lasaosa S, Cuadrado M, Guerrero Á, Irimia P, Láinez J, Leira R, Pascual J, Sanchez del Río M, Viguera J, Pozo-Rosich P. Evidence and experience with onabotulinumtoxinA in chronic migraine: Recommendations for daily clinical practice. Neurología (English Edition) 2019. [DOI: 10.1016/j.nrleng.2019.02.008] [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: 10/27/2022] Open
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22
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Abstract
Triple-negative breast cancer (TNBC) is characterised by poor outcomes and a historical lack of targeted therapies. Dysregulation of signalling through the phosphoinositide 3 (PI3)-kinase and AKT signalling pathway is one of the most frequent oncogenic aberrations of TNBC. Although mutations in individual genes occur relatively rarely, combined activating mutations in PIK3CA and AKT1, with inactivating mutations in phosphatase and tensin homologue, occur in ∼25%‒30% of advanced TNBC. Recent randomised trials suggest improved progression-free survival (PFS) with AKT-inhibitors in combination with first-line chemotherapy for patients with TNBC and pathway genetic aberrations. We review the evidence for PI3K pathway activation in TNBC, and clinical trial data for PI3K, AKT and mammalian target of rapamycin inhibitors in TNBC. We discuss uncertainty over defining which cancers have pathway activation and the future overlap between immunotherapy and pathway targeting.
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Affiliation(s)
- J Pascual
- Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London
| | - N C Turner
- Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London; Breast Unit, The Royal Marsden Hospital, London, UK.
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23
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Moreno-Mayordomo R, Ruiz M, Pascual J, Gallego de la Sacristana M, Vidriales I, Sobrado M, Cernuda-Morollon E, Gago-Veiga AB, Garcia-Azorin D, Telleria JJ, Guerrero AL. CALCA and TRPV1 genes polymorphisms are related to a good outcome in female chronic migraine patients treated with OnabotulinumtoxinA. J Headache Pain 2019; 20:39. [PMID: 31014225 PMCID: PMC6734474 DOI: 10.1186/s10194-019-0989-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 03/29/2019] [Indexed: 01/03/2023] Open
Abstract
Background Some variables have been proposed as predictors of efficacy of OnabotulinumtoxinA in chronic migraine patients, but data available are inconclusive. We aimed to analyse the influence of single nucleotide polymorphisms in the response to OnabotulinumtoxinA. Methods We included 156 female patients treated with OnabotulinumtoxinA accordingly to PREEMPT paradigm in three headache units. OnabotulinumtoxinA was offered to patients that had not responded to topiramate and at least one other preventative. Age at first procedure was 43.7 ± 11.8 years (16–74). Patients with a reduction of at least 50% in the number of migraine days after two OnabotulinumtoxinA procedures were considered as responders. We analysed 25 polymorphisms selected for their relevance regarding migraine pathophysiology and their association with migraine according to previously published genome-wide association studies. Genotyping was performed using KASP probes and a LightCycler-480 (Roche-Diagnostics). Allelic, genotypic frequencies and dominance/recesivity hypothesis of the allelic variants were compared between responders and non-responders by Fisher’s exact test. Results Response to treatment with OnabotulinumtoxinA was achieved in 120 patients (76,9%). Two polymorphisms showed differences: CALCA rs3781719, where allele C represents 26.9% in responders and 40.9% in non-responders (p = 0.007, OR = 3.11 (1.33–7.26)); and TRPV1 rs222749, where allele A represents 4.17% in responders and 12.5% in non-responders (p = 0.013, OR = 3.29 (1.28–8.43)). No significant differences in rest of polymorphisms or clinical or demographic variables were found. Conclusions Polymorphic variations of CALCA and TRPV1 genes might play a role as prognostic markers of efficacy of OnabotulinumtoxinA in chronic migraine female patients in our population.
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Affiliation(s)
- R Moreno-Mayordomo
- Clinical Analysis Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - M Ruiz
- Headache Unit, Neurology Department, Hospital Clínico Universitario de Valladolid, Avda. Ramón y Cajal 3, 47005, Valladolid, Spain
| | - J Pascual
- Neurosciences Department, Hospital Universitario Central de Asturias, Oviedo, Spain.,Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - I Vidriales
- Clinical Analysis Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - M Sobrado
- Neurology Department. Hospital Universitario de La Princesa, Madrid, Spain
| | - E Cernuda-Morollon
- Neurosciences Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - A B Gago-Veiga
- Neurology Department. Hospital Universitario de La Princesa, Madrid, Spain
| | - D Garcia-Azorin
- Headache Unit, Neurology Department, Hospital Clínico Universitario de Valladolid, Avda. Ramón y Cajal 3, 47005, Valladolid, Spain.
| | - J J Telleria
- Instituto de Biología y Genética Molecular, University of Valladolid, Valladolid, Spain.,Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - A L Guerrero
- Headache Unit, Neurology Department, Hospital Clínico Universitario de Valladolid, Avda. Ramón y Cajal 3, 47005, Valladolid, Spain.,Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
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24
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Carrillo I, Pozo-Rosich P, Guilabert M, Ignacio E, Pascual J, Porta-Etessam J, Guerrero-Peral AL, Mira JJ. [Portfolio of services and basic table of quality indicators for Headache Units: a consensus study]. Rev Neurol 2019; 68:118-122. [PMID: 30687919] [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: 06/09/2023]
Abstract
AIM To develop a proposal for a portfolio of services and a set of indicators for Headache Units. DEVELOPMENT Qualitative study that applied techniques of consensus with the participation of 15 professionals who are experts in the treatment of headaches (experience of 15 years) and in quality assurance. The description of the indicators included: statement, definition, standard, type of indicator, dimension, source, level of evidence, and clarification of terms. The proposal for a portfolio of services included the following areas: clinical management, patient-centered care, community involvement, knowledge management, translational research, and social dissemination. The proposal converged in 13 indicators exploring five dimensions. CONCLUSIONS This proposal contributes to ensure and assess the level of quality of a Headache Unit or outpatient clinic.
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Affiliation(s)
- I Carrillo
- Universidad Miguel Hernandez, Elche, Espana
| | | | | | - E Ignacio
- Universidad de Cadiz. Facultad de Ciencias de la Salud, Cadiz, Espana
| | - J Pascual
- Hospital Universitario Marques de Valdecilla, Santander, Espana
| | | | | | - J J Mira
- Universidad Miguel Hernandez, Elche, Espana
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25
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Montero M, Mir M, Sulleiro E, Avalos Esquivel JL, García López E, Molina-Morant D, López Montesinos I, Sorlí L, Veliz Espinosa G, Mounteis Oliva E, Crespo M, Monge I, Horcajada JP, Grau S, Pascual J. High-dose benznidazole in a 62-year-old Bolivian kidney transplant recipient with Chagas central nervous system involvement. Int J Infect Dis 2018; 78:103-106. [PMID: 30391324 DOI: 10.1016/j.ijid.2018.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/16/2018] [Accepted: 10/19/2018] [Indexed: 10/28/2022] Open
Abstract
There is little published data on benznidazole dosing, or levels in cerebrospinal fluid. In this report, we describe the clinical course of an immunosuppressed patient with Chagas central nervous system involvement. He was treated successfully with larger benznidazole doses than are recommended, in order to reach therapeutically effective concentrations in the brain.
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Affiliation(s)
- M Montero
- Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain.
| | - M Mir
- Department of Nephrology, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - E Sulleiro
- Microbiology Department, H. Universitari Vall d´Hebron. PROSICS Barcelona (International Health Program of the Catalan Health Institute), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J L Avalos Esquivel
- Department of Nephrology, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - E García López
- Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - D Molina-Morant
- Tropical Medicine Unit, Infectious Diseases Department, PROSICS Barcelona (International Health Program of the Catalan Health Institute), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I López Montesinos
- Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - L Sorlí
- Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - G Veliz Espinosa
- Department of Nephrology, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - E Mounteis Oliva
- Tropical Medicine Unit, Infectious Diseases Department, PROSICS Barcelona (International Health Program of the Catalan Health Institute), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Crespo
- Department of Nephrology, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - I Monge
- Department of Pharmacy, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - J P Horcajada
- Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - S Grau
- Department of Pharmacy, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - J Pascual
- Department of Nephrology, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain
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26
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Marcén R, Gallego N, Orofino L, Sabater J, Pascual J, Teruel JL, Liaño F, Ortuño J. Influence of cyclosporin A (CyA) on renal handling of urate. Transpl Int 2018. [DOI: 10.1111/tri.1992.5.s1.81] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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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Pascual J, Marcén R, Orofino L, Quereda C, Teruel JL, Mampaso F, Liaño F, Villafruela JJ, Ortuño J. Long-term beneficial effects of azathioprine addition to ongoing cyclosporine-prednisone protocol in renal transplantation. Transpl Int 2018. [DOI: 10.1111/tri.1992.5.s1.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Portoles J, Perez-Saez MJ, Hernandez D, Espi J, Navarro D, Juega J, Mazuecos MA, Maruri-Kareaga N, Moreso F, Melilli E, de Sousa E, Ruiz JC, Llamas F, Guirado L, Gutierrez A, Martin Moreno P, Perez-Flores I, Serrano Salazar ML, Jimenez C, Gavela E, Ramos A, Pascual J. SP686DELAYED GRAFT FUNCTION AND DONOR SELECTION CRITERIA ASSOCIATE A LOWER BEST-EGFR AFTER KIDNEY TRANSPLANTATION WITH CONTROLLED CIRCULATORY DEATH DONOR (cDCD). Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.sp686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | - J Espi
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - D Navarro
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - J Juega
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - M A Mazuecos
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | | | - F Moreso
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - E Melilli
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - E de Sousa
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - J C Ruiz
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - F Llamas
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - L Guirado
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - A Gutierrez
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - P Martin Moreno
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - I Perez-Flores
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | | | - C Jimenez
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - E Gavela
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - Ana Ramos
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - J Pascual
- Nephrology, HU del Mar, Barcelona, Spain
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Pascual J, Teruel J, Marcén R, LiañO F, Moya J, Jiménez M, Ortuño J. Hemodynamic and Cardiac Effects of Erythropoietin in Patients on Regular Dialysis. Int J Artif Organs 2018. [DOI: 10.1177/039139889201500606] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The long-term impact of erythropoietin (EPO) treatment on cardiac structures and function was prospectively studied in eight hypertensive (Group I) and seven normotensive (Group II) patients on hemodialysis (HD). Doppler-echocardiograms were done before EPO and at two and twelve months of treatment. Mean hemoglobin (± SD) before EPO was 6.4 ± 0.9; it rose significantly up to two months and then remained constant. At two months, cardiac index (CI) had significantly decreased, while peripheral vascular resistances increased. Five patients required increased antihypertensive drug treatment. No changes were seen in myocardial parameters at this short follow-up. After one year, left ventricular mass index (LVMi) decreased (p < 0.05) in both groups concomitantly with a decrease in diastolic diameter and septum and posterior wall thicknesses. Basal LVMi was higher in Group I than in Group II, and after one year the regression was more marked in Group II. Left cardiac work showed prompt and steady improvement in both groups. Maintained partial correction of anemia with EPO during one year was associated with a return to normal of high CI, decreased left cardiac work and impressive regression of left ventricular hypertrophy.
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Affiliation(s)
- J. Pascual
- Departments of Nephrology and Madrid - Spain
| | - J.L. Teruel
- Departments of Nephrology and Madrid - Spain
| | - R. Marcén
- Departments of Nephrology and Madrid - Spain
| | - F. LiañO
- Departments of Nephrology and Madrid - Spain
| | - J.L. Moya
- Cardiology, Hospital Ramon y Cajal, Madrid - Spain
| | - M. Jiménez
- Cardiology, Hospital Ramon y Cajal, Madrid - Spain
| | - J. Ortuño
- Departments of Nephrology and Madrid - Spain
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Abstract
It is not known whether recombinant human erythropoietin has a direct, clinically apparent pressor effect in hemodialysis patients or whether hypertension developing or aggravated in these patients merely reflects increased hematocrit. We compared blood pressure after three different methods of partial correction of anemia in hemodialysis patients with similar baseline hematocrits (erythropoietin n=12, intravenous iron alone n=10, androgens n=9). Shortly after the start of treatment and with a minimally increased hematocrit, the need for antihypertensive medication increased in the erythropoietin group. No such pressor effect was observed with iron or androgens. These data suggest a direct hypertensive effect of erythropoietin in some patients on hemodialysis.
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Affiliation(s)
- J. Pascual
- Department of Nephrology, Ramon y Cajal Hospital, Madrid - Spain
| | - J.L. Teruel
- Department of Nephrology, Ramon y Cajal Hospital, Madrid - Spain
| | - R. Marcén
- Department of Nephrology, Ramon y Cajal Hospital, Madrid - Spain
| | - F. Ortuño
- Department of Nephrology, Ramon y Cajal Hospital, Madrid - Spain
| | - J. Liaño
- Department of Nephrology, Ramon y Cajal Hospital, Madrid - Spain
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Anguiano L, Riera M, Pascual J, Soler MJ. Circulating ACE2 in Cardiovascular and Kidney Diseases. Curr Med Chem 2017; 24:3231-3241. [PMID: 28413960 DOI: 10.2174/0929867324666170414162841] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 04/06/2017] [Accepted: 04/10/2017] [Indexed: 11/22/2022]
Abstract
Angiotensin converting enzyme (ACE) 2 is a homologue of ACE that catalyzes the conversion of Angiotensin (Ang) II into Ang1-7, which induces vasodilation, anti-fibrotic, anti-proliferative and anti-inflammatory effects. Given that ACE2 counterbalances the effects of Ang II, it has been proposed as a biomarker in kidney disease patients. Circulating ACE2 has been studied in human and experimental studies under physiological and pathological conditions and different techniques have been assessed to determine its enzymatic activity. In patients with cardiovascular (CV) disease circulating ACE2 has been shown to be increased. In addition, hypertensive and diabetic patients have also shown higher circulating ACE2 activities. A study in type 1 diabetes patients found a negative association between circulating ACE2 and estimated glomerular filtration rate in male and female patients. Recently, it has been demonstrated that circulating ACE2 is increased in male patients with chronic kidney disease (CKD) and that it is independently associated with other classical CV risk factors, such as advanced age and diabetes. Furthermore, circulating ACE2 has been shown to be associated with silent atherosclerosis and CV outcomes in CKD patients. In diabetic nephropathy, experimental studies have demonstrated an increase in circulating ACE2 activity both at early and late stages of the disease, as well as a direct association with increased urinary albumin excretion, suggesting that it may be increased as a renoprotective mechanism in these patients. In this paper we will review the measurement of circulating ACE2 and its role in kidney disease, as well as its potential role as a renal and CV biomarker.
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Affiliation(s)
- L Anguiano
- IMIM (Hospital del Mar Medical Research Institute), Barcelona. Spain
| | - M Riera
- IMIM (Hospital del Mar Medical Research Institute), Barcelona. Spain
| | - J Pascual
- IMIM (Hospital del Mar Medical Research Institute), Barcelona. Spain
| | - M J Soler
- Department of Nephrology, Hospital del Mar, Passeig Maritim 25-29, 08003 Barcelona. Spain
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Fiorino G, Correale C, Radice S, Allocca M, Furfaro F, Gilardi D, Nagore D, Del Rio L, Pascual J, Martínez A, Danese S. Letter: immunogenicity of infliximab originator vs. CT-P13 in IBD patients. Aliment Pharmacol Ther 2017; 46:903-905. [PMID: 29023889 DOI: 10.1111/apt.14262] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 07/21/2017] [Accepted: 07/22/2017] [Indexed: 12/11/2022]
Affiliation(s)
- G Fiorino
- Department of Gastroenterology, IBD Centre, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - C Correale
- Department of Gastroenterology, IBD Centre, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - S Radice
- Department of Gastroenterology, IBD Centre, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - M Allocca
- Department of Gastroenterology, IBD Centre, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - F Furfaro
- Department of Gastroenterology, IBD Centre, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - D Gilardi
- Department of Gastroenterology, IBD Centre, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - D Nagore
- R&D Department, Progenika SA, Derio, Spain
| | - L Del Rio
- R&D Department, Progenika SA, Derio, Spain
| | - J Pascual
- R&D Department, Progenika SA, Derio, Spain
| | - A Martínez
- R&D Department, Progenika SA, Derio, Spain
| | - S Danese
- Department of Gastroenterology, IBD Centre, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
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Pascual J, Rojas-Garcia B, Peg V, Diaz-Botero S, Zamora E, Muñoz Couselo E, Oliveira M, Gomez Pardo P, Perez Garcia J, Ruiz-Pace F, Viaplana C, Escrivá S, Garrigos L, Arumi M, Espinosa-Bravo M, Cortés J, Rubio I, Saura C, Dienstmann R, Bellet Ezquerra M. Prognostic estimates of Ki-67 percentage drop after neoadjuvant chemotherapy (NAC) in luminal B (lumB) and triple negative breast cancer (TNBC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx364.001] [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: 11/12/2022] Open
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Pérez-Sáez MJ, Herrera S, Prieto-Alhambra D, Vilaplana L, Nogués X, Vera M, Redondo-Pachón D, Mir M, Güerri R, Crespo M, Díez-Pérez A, Pascual J. Bone density, microarchitecture, and material strength in chronic kidney disease patients at the time of kidney transplantation. Osteoporos Int 2017; 28:2723-2727. [PMID: 28497224 DOI: 10.1007/s00198-017-4065-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 04/19/2017] [Indexed: 10/19/2022]
Abstract
UNLABELLED Bone health is assessed by bone mineral density (BMD). Other techniques such as trabecular bone score and microindentation could improve the risk of fracture's estimation. Our chronic kidney disease (CKD) patients presented worse bone health (density, microarchitecture, mechanical properties) than controls. More than BMD should be done to evaluate patients at risk of fracture. INTRODUCTION BMD measured by dual-energy X-ray absorptiometry (DXA) is used to assess bone health in end-stage renal disease (ESRD) patients. Recently, trabecular bone score (TBS) and microindentation that can measure microarchitectural and mechanical properties of bone have demonstrated better correlation with fractures than DXA in different populations. We aimed to characterize bone health (BMD, TBS, and strength) and calcium/phosphate metabolism in a cohort of 53 ESRD patients undergoing kidney transplantation (KT) and 94 controls with normal renal function. METHODS Laboratory workout, lumbar spine/hip BMD measurements (using DXA), lumbar spine TBS, and bone strength were carried out. The latter was assessed with an impact microindentation device, standardized as percentage of a reference value, and expressed as bone material strength index (BMSi) units. Multivariable linear regression was used to study differences between cases and controls adjusted by age, gender, and body mass index. RESULTS Among cases, serum calcium was 9.6 ± 0.7 mg/dl, phosphorus 4.4 ± 1.2 mg/dl, and intact parathyroid hormone 214 pg/ml [102-390]. Fourteen patients (26.4%) had prevalent asymptomatic fractures in spinal X-ray. BMD was significantly lower among ESRD patients compared to controls: lumbar 0.966 ± 0.15 vs 0.982 ± 0.15 (adjusted p = 0.037), total hip 0.852 ± 0.15 vs 0.902 ± 0.13 (adjusted p < 0.001), and femoral neck 0.733 ± 0.15 vs 0.775 ± 0.12 (adjusted p < 0.001), as were TBS (1.20 [1.11-1.30] vs 1.31 [1.19-1.43] (adjusted p < 0.001)) and BMSi (79 [71.8-84.2] vs 82. [77.5-88.9] (adjusted p = 0.005)). CONCLUSIONS ESRD patients undergoing transplant surgery have damaged bone health parameters (density, microarchitecture, and mechanical properties) despite acceptably controlled hyperparathyroidism. Detecting these abnormalities may assist in identifying patients at high risk of post-transplantation fractures.
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Affiliation(s)
- M J Pérez-Sáez
- Department of Nephrology, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- REDINREN, Instituto Carlos III, Madrid, Spain
| | - S Herrera
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- Department of Internal Medicine, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- RETICEF, Instituto Carlos III, Madrid, Spain
| | - D Prieto-Alhambra
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- RETICEF, Instituto Carlos III, Madrid, Spain
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7HE, UK
| | - L Vilaplana
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- Department of Internal Medicine, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- RETICEF, Instituto Carlos III, Madrid, Spain
| | - X Nogués
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- Department of Internal Medicine, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- RETICEF, Instituto Carlos III, Madrid, Spain
| | - M Vera
- Department of Nephrology, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
| | - D Redondo-Pachón
- Department of Nephrology, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- REDINREN, Instituto Carlos III, Madrid, Spain
| | - M Mir
- Department of Nephrology, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
| | - R Güerri
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- Department of Internal Medicine, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- RETICEF, Instituto Carlos III, Madrid, Spain
| | - M Crespo
- Department of Nephrology, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- REDINREN, Instituto Carlos III, Madrid, Spain
| | - A Díez-Pérez
- Institut Mar d'Investigacions Mediques, Barcelona, Spain.
- Department of Internal Medicine, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain.
- RETICEF, Instituto Carlos III, Madrid, Spain.
| | - J Pascual
- Department of Nephrology, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain.
- Institut Mar d'Investigacions Mediques, Barcelona, Spain.
- REDINREN, Instituto Carlos III, Madrid, Spain.
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Oliva Fernández L, Márquez-Aragonés M, Romero-Laorden N, Pajares Hachero B, Moreno I, Ruiz Vico M, Duran Ogaya G, Muriel C, Pascual J, Fernández de Souza C, Dominguez Recio M, Grau G, Sáez M, Montesa A, Correa R, Olmos Hidalgo D. Limited value of currently used germline brca mutations predictive tools in prostate cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx370.042] [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: 11/14/2022] Open
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36
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Conejos J, Aboal J, Loma-Osorio P, Nunez M, Bosch D, Iglesies J, Pascual J, Fluvia P, Brugada R. P4695Transient ST-elevation ECG pattern in acute coronary syndrome: friend or foe? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Iglesies Grau J, Loma Osorio P, Nunez Torras M, Aboal J, Conejos J, Olivet J, Fontquerni A, Ruiz De Morales E, Fluvia P, Muntaner L, Pascual J, Kassem H, Vilardell P, Brugada R. P2765Public-access defibrillation programme in a geographically disperse region: a 5-year analysis of the first experience in spain. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fluvia P, Loma Osorio P, Pascual J, Aboal J, Nunez M, Conejos J, Iglesias J, Bosch D, Brugada R. P3667Evaluation of the diagnostic precision of a single determination of high sensitivity troponin in the screening of acute coronary syndrome in the emergency room. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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de Fijter JW, Holdaas H, Øyen O, Sanders JS, Sundar S, Bemelman FJ, Sommerer C, Pascual J, Avihingsanon Y, Pongskul C, Oppenheimer F, Toselli L, Russ G, Wang Z, Lopez P, Kochuparampil J, Cruzado JM, van der Giet M. Early Conversion From Calcineurin Inhibitor- to Everolimus-Based Therapy Following Kidney Transplantation: Results of the Randomized ELEVATE Trial. Am J Transplant 2017; 17:1853-1867. [PMID: 28027625 DOI: 10.1111/ajt.14186] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 12/20/2016] [Indexed: 01/25/2023]
Abstract
In a 24-month, multicenter, open-label, randomized trial, 715 de novo kidney transplant recipients were randomized at 10-14 weeks to convert to everolimus (n = 359) or remain on standard calcineurin inhibitor (CNI) therapy (n = 356; 231 tacrolimus; 125 cyclosporine), all with mycophenolic acid and steroids. The primary endpoint, change in estimated glomerular filtration rate (eGFR) from randomization to month 12, was similar for everolimus versus CNI: mean (standard error) 0.3(1.5) mL/min/1.732 versus -1.5(1.5) mL/min/1.732 (p = 0.116). Biopsy-proven acute rejection (BPAR) at month 12 was more frequent under everolimus versus CNI overall (9.7% vs. 4.8%, p = 0.014) and versus tacrolimus-treated patients (2.6%, p < 0.001) but similar to cyclosporine-treated patients (8.8%, p = 0.755). Reporting on de novo donor-specific antibodies (DSA) was limited but suggested more frequent anti-HLA Class I DSA under everolimus. Change in left ventricular mass index was similar. Discontinuation due to adverse events was more frequent with everolimus (23.6%) versus CNI (8.4%). In conclusion, conversion to everolimus at 10-14 weeks posttransplant was associated with renal function similar to that with standard therapy overall. Rates of BPAR were low in all groups, but lower with tacrolimus than everolimus.
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Affiliation(s)
- J W de Fijter
- Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands
| | - H Holdaas
- Section of Nephrology, Department of Transplant Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - O Øyen
- Section of Transplant Surgery, Department of Transplant Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - J-S Sanders
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - S Sundar
- Department of Nephrology, Columbia Asia Hospitals, Malleshwaram West, Bangalore, India
| | - F J Bemelman
- Department of Nephrology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - C Sommerer
- Department of Nephrology, Heidelberg University Hospital, Heidelberg, Germany
| | - J Pascual
- Department of Nephrology, Hospital del Mar, Barcelona, Spain
| | - Y Avihingsanon
- Faculty of Medicine, Chulalongkorn University and Excellent Center of Organ Transplantation, King Chulalongkorn Memorial Hospital, Patumwan, Bangkok, Thailand
| | - C Pongskul
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - F Oppenheimer
- Department of Nephrology and Kidney Transplantation, Hospital Clínic de Barcelona, Barcelona, Spain
| | - L Toselli
- Kidney, Liver and Pancreas Transplant Unit, CRAI Norte, Ministry of Health, Buenos Aires, Argentina
| | - G Russ
- University of Adelaide and Central and Northern Adelaide Renal and Transplant Service, Royal Adelaide Hospital, North Terrace, Adelaide, Australia
| | - Z Wang
- Biometrics and Statistical Science, Novartis Pharmaceuticals, East Hanover, NJ
| | - P Lopez
- Research and Development, Novartis Pharma AG, Basel, Switzerland
| | - J Kochuparampil
- Research and Development, Novartis Pharma AG, Basel, Switzerland
| | - J M Cruzado
- Department of Nephrology, University Hospital of Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M van der Giet
- Department of Nephrology, Charité - Universitätsmedizin, Berlin, Germany
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Portolés J, Perez-Saez MJ, Sanchez-Sobrino B, Hernandez D, Rodriguez-Ferrero ML, Moreso F, Lafuente O, Valero R, Mazuecos MA, Juega J, Alonso A, Jimenez C, Ramos A, Melilli E, Pascual J. SP776EXPANDED CRITERIA DONORS AFTER CARDIAC DEATH: AN INCREASING AND USEFUL SOURCE FOR KIDNEY TRANSPLANTATION. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx158.sp776] [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: 11/15/2022] Open
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41
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Portolés J, Perez-Saez MJ, Melilli E, Maruri Kareaga N, Navarro D, de Souza E, Janeiro D, Llamas F, Martin Moreno P, Espi J, Lopez Oliva M, Gavela E, Rodriguez-Ferrero ML, Hernandez D, Pascual J. SO055CLINICAL OUTCOMES OF A NATIONWIDE STRATEGY OF KIDNEY TRANSPLANTATION WITH CONTROLLED CARDIAC DEATH DONORS (CDCD). SPANISH MULTICENTER SENTRA-GEODAS GROUP. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx109.so055] [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: 11/13/2022] Open
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Ortuño VM, Gutiérrez M, Pascual J, Ruiz S. Taxonomía, sistemática y biología de un nuevo Trechus (Coleoptera, Carabidae, Trechini) hipogeo del karst cantábrico (Cantabria, España). Anim Biodiv Conserv 2017. [DOI: 10.32800/abc.2017.40.0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Pascual J, Leira R, Láinez JM. Combined Therapy for Migraine Prevention? Clinical Experience with A β-Blocker Plus Sodium Valproate in 52 Resistant Migraine Patients. Cephalalgia 2016; 23:961-2. [PMID: 14984228 DOI: 10.1046/j.1468-2982.2003.00615.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim was to explore whether combining a β-blocker and sodium valproate could lead to an advantage in efficacy in patients with migraine previously resistant to the two medications in monotherapy. Fifty-two patients (43 women) with a history of episodic migraine with or without aura, and previously unresponsive to β-blockers and sodium valproate in monotherapy, were treated with a combination of propranolol or nadolol and sodium valproate in an open-label fashion. Eight patients (15%) discontinued due to adverse events. Fifteen (29%) did not respond. The remaining 29 cases (56%) showed response (>50% reduction in migraine days). The response was excellent in nine (17%). From this open trial, combination therapy with a β-blocker and sodium valproate appears to be a good migraine preventative in some previously resistant migraine cases. Controlled trials are now necessary to determine the true advantage in efficacy of this combination in difficult to treat migraineurs.
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Affiliation(s)
- J Pascual
- Service of Neurology, Department of Medicine (UC), University Hospital 'Marqués de Valdecilla', Santander, Spain.
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López-Medrano F, Fernández-Ruiz M, Silva JT, Carver PL, van Delden C, Merino E, Pérez-Saez MJ, Montero M, Coussement J, de Abreu Mazzolin M, Cervera C, Santos L, Sabé N, Scemla A, Cordero E, Cruzado-Vega L, Martín-Moreno PL, Len Ó, Rudas E, de León AP, Arriola M, Lauzurica R, David M, González-Rico C, Henríquez-Palop F, Fortún J, Nucci M, Manuel O, Paño-Pardo JR, Montejo M, Muñoz P, Sánchez-Sobrino B, Mazuecos A, Pascual J, Horcajada JP, Lecompte T, Moreno A, Carratalà J, Blanes M, Hernández D, Fariñas MC, Andrés A, Aguado JM. Clinical Presentation and Determinants of Mortality of Invasive Pulmonary Aspergillosis in Kidney Transplant Recipients: A Multinational Cohort Study. Am J Transplant 2016; 16:3220-3234. [PMID: 27105907 DOI: 10.1111/ajt.13837] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 03/24/2016] [Accepted: 04/17/2016] [Indexed: 01/25/2023]
Abstract
The prognostic factors and optimal therapy for invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT) remain poorly studied. We included in this multinational retrospective study 112 recipients diagnosed with probable (75.0% of cases) or proven (25.0%) IPA between 2000 and 2013. The median interval from transplantation to diagnosis was 230 days. Cough, fever, and expectoration were the most common symptoms at presentation. Bilateral pulmonary involvement was observed in 63.6% of cases. Positivity rates for the galactomannan assay in serum and bronchoalveolar lavage samples were 61.3% and 57.1%, respectively. Aspergillus fumigatus was the most commonly identified species. Six- and 12-week survival rates were 68.8% and 60.7%, respectively, and 22.1% of survivors experienced graft loss. Occurrence of IPA within the first 6 months (hazard ratio [HR]: 2.29; p-value = 0.027) and bilateral involvement at diagnosis (HR: 3.00; p-value = 0.017) were independent predictors for 6-week all-cause mortality, whereas the initial use of a voriconazole-based regimen showed a protective effect (HR: 0.34; p-value = 0.007). The administration of antifungal combination therapy had no apparent impact on outcome. In conclusion, IPA entails a dismal prognosis among KT recipients. Maintaining a low clinical suspicion threshold is key to achieve a prompt diagnosis and to initiate voriconazole therapy.
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Affiliation(s)
- F López-Medrano
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain.
| | - M Fernández-Ruiz
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
| | - J T Silva
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
| | - P L Carver
- University of Michigan Health System, Ann Harbor, MI
| | - C van Delden
- Service of Infectious Diseases, Department of Medical Specialities, University Hospitals Geneva, Geneva, Switzerland
| | - E Merino
- Unit of Infectious Diseases, Hospital Universitario General, Alicante, Spain
| | - M J Pérez-Saez
- Department of Nephrology, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - M Montero
- Department of Infectious Diseases, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - J Coussement
- Department of Nephrology, Dialysis and Kidney Transplantation, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - M de Abreu Mazzolin
- Division of Nephology, Department of Medicine, Universidade Federal de São Paulo-UNIFESP and Hospital do Rim e Hipertensão, Fundação Oswaldo Ramos, São Paulo, Brazil
| | - C Cervera
- Department of Infectious Diseases, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
| | - L Santos
- Unit of Renal Transplantation, Department of Urology and Kidney Transplantation, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - N Sabé
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - A Scemla
- Service de Néphrologie et Transplantation Adulte, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, RTRS Centaure, Paris, France
| | - E Cordero
- Unit of Infectious Diseases, Hospitales Universitarios "Vigen del Rocío", Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain
| | - L Cruzado-Vega
- Department of Nephrology, Hospital Universitario "La Fe", Valencia, Spain
| | - P L Martín-Moreno
- Department of Nephrology, Clínica Universitaria de Navarra, Pamplona, Spain
| | - Ó Len
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebrón, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - E Rudas
- Department of Nephrology, Hospital Universitario "Carlos Haya", Málaga, Spain
| | - A P de León
- Department of Transplantation, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", México DF, México
| | - M Arriola
- Clínica de Nefrología, Urología y Enfermedades Cardiovasculares, Santa Fe, Argentina
| | - R Lauzurica
- Department of Nephrology, University Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - M David
- Department of Microbiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - C González-Rico
- Department of Infectious Diseases, University Hospital "Marqués de Valdecilla", Santander, Spain
| | - F Henríquez-Palop
- Department of Nephrology, University Hospital "Doctor Negrín", Las Palmas de Gran Canaria, Spain
| | - J Fortún
- Department of Infectious Diseases, University Hospital "Ramón y Cajal", Madrid, Spain
| | - M Nucci
- Department of Internal Medicine, Hematology Service and Mycology Laboratory, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - O Manuel
- Department of Infectious Diseases and Transplantation Center, University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - J R Paño-Pardo
- Department of Internal Medicine, Hospital Universitario "La Paz", School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - M Montejo
- Department of Infectious Diseases, Hospital Universitario Cruces, Barakaldo, Bilbao, Spain
| | - P Muñoz
- Department of Microbiology and Infectious Diseases, Hospital General Universitario "Gregorio Marañón", Madrid, Spain
| | - B Sánchez-Sobrino
- Department of Nephrology, Hospital Universitario Puerta de Hierro-Majadahonda, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - A Mazuecos
- Department of Nephrology, Hospital Universitario "Puerta del Mar", Cádiz, Spain
| | - J Pascual
- Department of Nephrology, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - J P Horcajada
- Department of Infectious Diseases, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - T Lecompte
- Service of Infectious Diseases, Department of Medical Specialities, University Hospitals Geneva, Geneva, Switzerland
| | - A Moreno
- Department of Infectious Diseases, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
| | - J Carratalà
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - M Blanes
- Unit of Infectious Diseases, Hospital Universitario "La Fe", Valencia, Spain
| | - D Hernández
- Department of Nephrology, Hospital Universitario "Carlos Haya", Málaga, Spain
| | - M C Fariñas
- Department of Infectious Diseases, University Hospital "Marqués de Valdecilla", Santander, Spain
| | - A Andrés
- Department of Nephrology, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
| | - J M Aguado
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
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Sales MA, Pascual J. P21.01 Primary intracranial round cell sarcoma in an HIV patient: a case report. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.289] [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: 11/14/2022] Open
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Pérez-Sáez MJ, Arcos E, Comas J, Crespo M, Lloveras J, Pascual J. Survival Benefit From Kidney Transplantation Using Kidneys From Deceased Donors Aged ≥75 Years: A Time-Dependent Analysis. Am J Transplant 2016; 16:2724-33. [PMID: 27004984 DOI: 10.1111/ajt.13800] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [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: 09/21/2015] [Revised: 02/26/2016] [Accepted: 03/13/2016] [Indexed: 01/25/2023]
Abstract
Patients with end-stage renal disease have longer survival after kidney transplantation than they would by remaining on dialysis; however, outcome with kidneys from donors aged ≥75 years and the survival of recipients of these organs compared with their dialysis counterparts with the same probability of obtaining an organ is unknown. In a longitudinal mortality study, 2040 patients on dialysis were placed on a waiting list, and 389 of them received a first transplant from a deceased donor aged ≥75 years. The adjusted risk of death and survival were calculated by non-proportional hazards analysis with being transplanted as a time-dependent effect. Projected years of life since placement on the waiting list was almost twofold higher for transplanted patients. Nonproportional adjusted risk of death after transplantation was 0.44 (95% confidence interval [CI] 0.61-0.32; p < 0.001) in comparison with those that remained on dialysis. Stratifying by age, adjusted hazard ratios for death were 0.17 (95% CI 0.47-0.06; p = 0.001) for those aged <65 years, 0.56 (95% CI 0.92-0.34; p = 0.022) for those aged 65-69 years and 0.82 (95% CI 1.28-0.52; p = 0.389) for those aged ≥70 years. Although kidney transplantation from elderly deceased donors is associated with reduced graft survival, transplanted patients have lower mortality than those remaining on dialysis.
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Affiliation(s)
- M J Pérez-Sáez
- Department of Nephrology, Hospital del Mar, Barcelona, Spain.,Institut Mar d'Investigacions Médiques, Barcelona, Spain
| | - E Arcos
- Organització Catalana de Trasplantaments, Barcelona, Spain
| | - J Comas
- Organització Catalana de Trasplantaments, Barcelona, Spain
| | - M Crespo
- Department of Nephrology, Hospital del Mar, Barcelona, Spain.,Institut Mar d'Investigacions Médiques, Barcelona, Spain
| | - J Lloveras
- Department of Nephrology, Hospital del Mar, Barcelona, Spain
| | - J Pascual
- Department of Nephrology, Hospital del Mar, Barcelona, Spain.,Institut Mar d'Investigacions Médiques, Barcelona, Spain
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López-Medrano F, Silva JT, Fernández-Ruiz M, Carver PL, van Delden C, Merino E, Pérez-Saez MJ, Montero M, Coussement J, de Abreu Mazzolin M, Cervera C, Santos L, Sabé N, Scemla A, Cordero E, Cruzado-Vega L, Martín-Moreno PL, Len Ó, Rudas E, de León AP, Arriola M, Lauzurica R, David M, González-Rico C, Henríquez-Palop F, Fortún J, Nucci M, Manuel O, Paño-Pardo JR, Montejo M, Muñoz P, Sánchez-Sobrino B, Mazuecos A, Pascual J, Horcajada JP, Lecompte T, Lumbreras C, Moreno A, Carratalà J, Blanes M, Hernández D, Hernández-Méndez EA, Fariñas MC, Perelló-Carrascosa M, Morales JM, Andrés A, Aguado JM. Risk Factors Associated With Early Invasive Pulmonary Aspergillosis in Kidney Transplant Recipients: Results From a Multinational Matched Case-Control Study. Am J Transplant 2016; 16:2148-57. [PMID: 26813515 DOI: 10.1111/ajt.13735] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 01/13/2016] [Indexed: 01/25/2023]
Abstract
Risk factors for invasive pulmonary aspergillosis (IPA) after kidney transplantation have been poorly explored. We performed a multinational case-control study that included 51 kidney transplant (KT) recipients diagnosed with early (first 180 posttransplant days) IPA at 19 institutions between 2000 and 2013. Control recipients were matched (1:1 ratio) by center and date of transplantation. Overall mortality among cases was 60.8%, and 25.0% of living recipients experienced graft loss. Pretransplant diagnosis of chronic pulmonary obstructive disease (COPD; odds ratio [OR]: 9.96; 95% confidence interval [CI]: 1.09-90.58; p = 0.041) and delayed graft function (OR: 3.40; 95% CI: 1.08-10.73; p = 0.037) were identified as independent risk factors for IPA among those variables already available in the immediate peritransplant period. The development of bloodstream infection (OR: 18.76; 95% CI: 1.04-339.37; p = 0.047) and acute graft rejection (OR: 40.73, 95% CI: 3.63-456.98; p = 0.003) within the 3 mo prior to the diagnosis of IPA acted as risk factors during the subsequent period. In conclusion, pretransplant COPD, impaired graft function and the occurrence of serious posttransplant infections may be useful to identify KT recipients at the highest risk of early IPA. Future studies should explore the potential benefit of antimold prophylaxis in this group.
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Affiliation(s)
- F López-Medrano
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i + 12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
| | - J T Silva
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i + 12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
| | - M Fernández-Ruiz
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i + 12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
| | - P L Carver
- University of Michigan Health System, Ann Arbor, MI
| | - C van Delden
- Service of Infectious Diseases, Department of Medical Specialities, University Hospitals Geneva, Geneva, Switzerland
| | - E Merino
- Unit of Infectious Diseases, Hospital Universitario General, Alicante, Spain
| | - M J Pérez-Saez
- Department of Nephrology, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - M Montero
- Department of Infectious Diseases, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - J Coussement
- Department of Nephrology, Dialysis and Kidney Transplantation, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - M de Abreu Mazzolin
- Division of Nephology, Department of Medicine, Universidade Federal de São Paulo-UNIFESP and Hospital do Rim e Hipertensão, Fundação Oswaldo Ramos, São Paulo, Brazil
| | - C Cervera
- Department of Infectious Diseases, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
| | - L Santos
- Unit of Renal Transplantation, Department of Urology and Kidney Transplantation, Coimbra Hospital and Universitary Centre, Coimbra, Portugal
| | - N Sabé
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - A Scemla
- Service de Néphrologie et Transplantation Adulte, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, RTRS Centaure, Paris, France
| | - E Cordero
- Unit of Infectious Diseases, Hospitales Universitarios "Vigen del Rocío", Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain
| | - L Cruzado-Vega
- Department of Nephrology, Hospital Universitario "La Fe", Valencia, Spain
| | - P L Martín-Moreno
- Department of Nephrology, Clínica Universitaria de Navarra, Pamplona, Spain
| | - Ó Len
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebrón, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - E Rudas
- Department of Nephrology, Hospital Universitario "Carlos Haya", Málaga, Spain
| | - A Ponce de León
- Department of Transplantation, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", México DF, México
| | - M Arriola
- Clínica de Nefrología, Urología y Enfermedades Cardiovasculares, Santa Fe, Argentina
| | - R Lauzurica
- Department of Nephrology, University Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - M David
- Department of Microbiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - C González-Rico
- Department of Infectious Diseases, University Hospital "Marqués de Valdecilla", Santander, Spain
| | - F Henríquez-Palop
- Department of Nephrology, University Hospital "Doctor Negrín", Las Palmas de Gran Canaria, Spain
| | - J Fortún
- Department of Infectious Diseases, University Hospital "Ramón y Cajal", Madrid, Spain
| | - M Nucci
- Department of Internal Medicine, Hematology Service and Mycology Laboratory, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - O Manuel
- Department of Infectious Diseases and Transplantation Center, University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - J R Paño-Pardo
- Department of Internal Medicine, Hospital Universitario "La Paz", School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - M Montejo
- Department of Infectious Diseases, Hospital Universitario Cruces, Barakaldo, Bilbao, Spain
| | - P Muñoz
- Department of Microbiology and Infectious Diseases, Hospital General Universitario "Gregorio Marañón", Madrid, Spain
| | - B Sánchez-Sobrino
- Department of Nephrology, Hospital Universitario Puerta de Hierro-Majadahonda, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - A Mazuecos
- Department of Nephrology, Hospital Universitario "Puerta del Mar", Cádiz, Spain
| | - J Pascual
- Department of Nephrology, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - J P Horcajada
- Department of Infectious Diseases, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - T Lecompte
- Service of Infectious Diseases, Department of Medical Specialities, University Hospitals Geneva, Geneva, Switzerland
| | - C Lumbreras
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i + 12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
| | - A Moreno
- Department of Infectious Diseases, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain
| | - J Carratalà
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - M Blanes
- Unit of Infectious Diseases, Hospital Universitario "La Fe", Valencia, Spain
| | - D Hernández
- Department of Nephrology, Hospital Universitario "Carlos Haya", Málaga, Spain
| | - E A Hernández-Méndez
- Department of Transplantation, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", México DF, México
| | - M C Fariñas
- Department of Infectious Diseases, University Hospital "Marqués de Valdecilla", Santander, Spain
| | - M Perelló-Carrascosa
- Department of Nephrology, Hospital Universitari Vall d'Hebrón, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - J M Morales
- Department of Nephrology, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i + 12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
| | - A Andrés
- Department of Nephrology, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i + 12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
| | - J M Aguado
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i + 12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
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Oterino A, Valle N, Bravo Y, Muñoz P, Sánchez-Velasco P, Ruiz-Alegría C, Castillo J, Leyva-Cobián F, Vadillo A, Pascual J. MTHFR T677 Homozygosis Influences the Presence of Aura in Migraineurs. Cephalalgia 2016; 24:491-4. [PMID: 15154859 DOI: 10.1111/j.1468-2982.2004.00692.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
It has been suggested that folate metabolism could be involved in migraine pathogenesis. We analysed the 5′, 10′ -methylenetetrahydrofolate reductase (MTHFR) genotypic distribution in a large migraine sample. We genotyped 230 migraine patients (152 migraine without aura (MO) and 78 migraine with aura (MA)) and 204 nonheadache controls. The incidence of TT homozygosis for migraine in general (12%), MO (9%) and MA (18%) did not significantly differ from that found in healthy controls (13%). Differences were significant when the frequency of TT homozygosis between MA and MO ( P = 0.03, OR = 2.34, 95% CI = 1.04-5.26) was compared. There was a tendency for a higher frequency of the MTHFR T allele in the MA group (42%) as compared to MO (29%) and controls (36%). These differences were significant only in the case of MA vs. MO ( P = 0.006, OR = 1.75, 95% CI = 1.15-2.65). These results could indicate that the MTHFR C677T polymorphism, causing mild hyperhomocystinaemia, might be a genetic risk factor for experiencing aura among migraineurs. Overall, however, there was no association between migraine and the C677T MTHFR polymorphism.
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Affiliation(s)
- A Oterino
- Service of Neurology, University Hospital Marqués de Valdecilla, Santander, Spain.
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Oterino A, Ruiz-Alegría C, Castillo J, Valle N, Bravo Y, Cayón A, Alonso A, Tejera P, Ruiz-Lavilla N, Muñoz P, Pascual J. GNAS1 T393C Polymorphism is Associated With Migraine. Cephalalgia 2016; 27:429-34. [PMID: 17388805 DOI: 10.1111/j.1468-2982.2007.01305.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 11/27/2022]
Abstract
Migraineurs have an interictal sympathetic nervous system (SNS) hypofunctionality and hypersensitivity to adrenergic amines. The GNAS1 T393C polymorphism has been associated with a distinct SNS sensitivity in healthy subjects. We tested GNAS1 T393C variant in two independent sets of subjects. In the case-control subset, 365 migraine patients [194 with aura (MA)] vs. 347 healthy controls were studied. A significant excess of the CC genotype was found in migraneurs (31.2%) as opposed to controls (20.2%; P = 0.003). Using a logistic regression model corrected for sex, the CC genotype conferred a general risk for migraine twice [odds ratio (OR) 1.79, 95% confidence interval (CI) 1.27-2.53; P = 0.001] higher than CT/TT genotypes. Using parents from 117 migraine families, a marginally significant trend for association could be observed ( P = 0.025), but the transmission disequilibrium test for alleles maternally transmitted failed to demonstrate familial association. In this subgroup, CC genotype conferred a risk for migraine over twice (OR 2.20; 95% CI 1.14-4.40; P = 0.019) higher than TT/TC genotypes. In conclusion, the GNAS1 T393C variant is associated with migraine, which suggests a genetic basis for its higher SNS sensitivity.
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Affiliation(s)
- A Oterino
- Service of Neurology, University Hospital Marqués de Valdecilla (UC), Santander, Spain.
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Abstract
The nosology of migraine premonitory (PS) and resolution (RS) symptoms was studied in 100 migraineurs consulting their general physician. They were asked to fill in, for three attacks, a PS and RS questionnaire. ‘True’ PS/RS were those experienced the day before (or the day after) the headache had started only if they were not present in a questionnaire completed in a pain-free period. True PS and RS were experienced by 84± and 80±, respectively, of subjects for the first attack. The mean and range (per patient) of PS were 6.8 and 0–21 and of RS 4.7 and 0–15. Anxiety, phonophobia, irritability, unhappiness and yawning were the commonest PS, whereas asthenia, tiredness, somnolence and concentration difficulties were the most common RS. Gender, age and Migraine Disability Assessment scores did not influence PS and RS. Both PS and RS were more frequent in migraine with aura subjects. Patients on preventatives showed a decreased frequency of PS and, to a lesser degree, of RS. Severity of headache was associated with a higher frequency of RS. Individual RS and especially PS were quite consistent after three attacks. Almost two-thirds of the symptoms were noticed in at least two out of three attacks, while more than a half of PS and more than a quarter of RS repeated in three out of three attacks. In conclusion, around 80± of unselected migraineurs experience RS and PS. Migraine with aura and severe pain are risk factors for experiencing PS and RS, while preventatives were protective, especially for PS.
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Affiliation(s)
- E Quintela
- Health Centre of Astillero, University Hospital, Salamanca, Spain
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