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Marín L, Moya B, Peñalver MJ, Cabanillas B, Barranco R, García-Moguel I, Mielgo R, Fernández-Crespo J. Meropenem allergy testing performed at the bedside of hospitalized patients labelled with a penicillin allergy. Allergol Int 2023; 72:588-593. [PMID: 36894401 DOI: 10.1016/j.alit.2023.02.008] [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: 10/10/2022] [Revised: 01/25/2023] [Accepted: 02/08/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Meropenem is a widely prescribed beta-lactam for hospitalized patients. There are few data on meropenem allergy assessments in inpatients with a reported history of penicillin allergy who require a treatment with meropenem. This can lead to the use of less effective second-line antibiotics that may increase antibiotic resistances. We aimed to evaluate the clinical outcomes of a meropenem allergy assessment in admitted patients with a reported history of penicillin allergy that required meropenem for the treatment of an acute infection. METHODS A retrospective analysis was performed on 182 inpatients labelled with a penicillin-allergy who received meropenem after an allergy assessment. The allergy study was performed bedside if meropenem was required urgently. The study included skin prick tests (SPTs) followed by an intradermal skin test (IDT) to meropenem, and a meropenem drug challenge test (DCT). If a non-immediate reaction to a beta-lactam was suspected, it was initiated with patch tests. RESULTS The median age of the patients was 59.7 years (range 28-95) and 80 (44%) were women. A total of 196 sets of diagnostic workups were performed, with 189 (96.4%) of them being tolerated. Only two patients had a positive meropenem IV DCT, both presenting a non-severe cutaneous reaction that completely resolved after treatment. CONCLUSIONS This study evidenced that a bedside meropenem allergy assessment of hospitalized patients labelled with a 'penicillin allergy' who require a broad-spectrum antibiotic for empiric coverage is a safe and effective procedure, avoiding the use of second-line antimicrobial agents.
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Affiliation(s)
- Laura Marín
- Department of Allergy, Hospital Universitario, Madrid, Spain; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Beatriz Moya
- Department of Allergy, Hospital Universitario, Madrid, Spain; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.
| | - María José Peñalver
- Department of Allergy, Hospital Universitario, Madrid, Spain; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Beatriz Cabanillas
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Ruth Barranco
- Department of Allergy, Hospital Universitario, Madrid, Spain; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Ismael García-Moguel
- Department of Allergy, Hospital Universitario, Madrid, Spain; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Ruth Mielgo
- Department of Allergy, Hospital Universitario, Madrid, Spain; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Jesús Fernández-Crespo
- Department of Allergy, Hospital Universitario, Madrid, Spain; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
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Navarro-Correal E, Ibarz Casas A, Agustino Rodríguez S, Marín L, Murciano Gonzalo F. Knowledge, attitudes and behaviours on smoking cessation in nurses caring for patients with inflammatory bowel disease. Gastroenterol Hepatol 2023; 46:468-471. [PMID: 35868540 DOI: 10.1016/j.gastrohep.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/08/2022] [Indexed: 05/24/2023]
Affiliation(s)
- Ester Navarro-Correal
- PhD Student Programme Nurse and Health, Nurse and Physiotherapy Department at Universitat de Lleida, Doctoral School, Pl. Víctor Siurana, 1, 25003 Lleida, Spain; Nursing Department, Vall d'Hebron Hospital Universitari, Passeig de la Vall d'Hebron, 119-129, Barcelona 08035, Spain.
| | - Arantxa Ibarz Casas
- Nursing Department, Vall d'Hebron Hospital Universitari, Passeig de la Vall d'Hebron, 119-129, Barcelona 08035, Spain
| | - Sandra Agustino Rodríguez
- Nursing Department, Vall d'Hebron Hospital Universitari, Passeig de la Vall d'Hebron, 119-129, Barcelona 08035, Spain
| | - Laura Marín
- Department of Gastroenterology, Hospital Universitario Germans Trias i Pujol, Carretera de Canyet, s/n, Badalona, 08916 Barcelona, Spain
| | - Francisca Murciano Gonzalo
- Department of Gastroenterology, Hospital del Mar de Barcelona, Passeig Marítim 25-29, Barcelona 08003, Spain
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Castrillo A, Mendoza A, Caballero L, Cerdán D, Rodríguez MF, Guerrero P, Tabernero C, Ferrero M, Benito I, Marín L, Duarte J. Effectiveness of anti-CGRP monoclonal antibodies in the preventive treatment of migraine: A prospective study of 63 patients. Med Clin (Barc) 2023; 160:341-346. [PMID: 36623986 DOI: 10.1016/j.medcli.2022.09.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Calcitonine Gen-Related Peptide (CGRP) established a revolution in migraine pathophysiology knowledge and has led to the development of new drugs specifically targeting this disease. METHODS We present a prospective study in which 63 episodic and chronic migraine patients have been treated with anti-CGRP monoclonal antibodies describing their efficacy, security and relapses after their interruption. Response predictors have been analyzed such they can help us to create a better treatment plan. RESULTS Average age was 48.3 ± 11.81 years old, 84.1% of them being women. The average was of 15.59 migraine days per month (MDM). 63.5% of all patients suffered chronic migraine. The initial dose of Erenumab in all patient was 70 mg subcutaneous. This was increased to 140 mg in 47.6% of the patients. An MDM reduction between 49.85% and 59.53% was obtained within three to twelve months from the start of treatment. Constipation was present in 17.5% of the patients and 4.8% suffered injection site reaction. The treatment was changed to Galcanezumab in 17.9% of the patients. After interrupting the treatment, 23 patients relapsed with a good response on reintroduction of the treatment. It was not possible to establish a clear response predictor, however a statistically significant increase in the number of days of improvement was observed with more MDM at baseline level (p = 0.002). CONCLUSIONS Anti-CGRP monoclonal antibodies are effective, safe, and well tolerated drugs. We have observed that their discontinuation, in some cases can lead to frequent and early relapses so we strongly recommend to extend the treatment in those patients with a higher MDM.
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Affiliation(s)
- Ana Castrillo
- Sección de Neurología. Complejo Asistencial de Segovia.
| | | | | | - Débora Cerdán
- Sección de Neurología. Complejo Asistencial de Segovia
| | | | | | | | - Marta Ferrero
- Sección de Neurología. Complejo Asistencial de Segovia
| | - Inés Benito
- Sección de Neurología. Complejo Asistencial de Segovia
| | - Laura Marín
- Servicio de Farmacia. Complejo Asistencial de Segovia
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Calvet X, Panés J, Gallardo-Escudero J, de la Cuadra-Grande A, Bartolomé E, Marín L, de la Portilla F, Navarro-Correal E, Gutiérrez A, Nos P, Serrano R, Casado MÁ, Barreiro-de Acosta M. Multicriteria Decision Analysis for Updating of Quality Indicators for Inflammatory Bowel Disease Comprehensive Care Units in Spain. J Crohns Colitis 2022; 16:1663-1675. [PMID: 35551380 PMCID: PMC9683078 DOI: 10.1093/ecco-jcc/jjac068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS Management of inflammatory bowel disease [IBD] is complex and IBD Comprehensive Care Units [ICCUs] facilitate the delivery of quality care to IBD patients. The objective of this study was to update the existing set of quality indicators [QIs] for ICCUs, based on a nationwide quality certification programme carried out in Spain, from a multi-stakeholder perspective and using multicriteria decision analysis [MCDA] methodology. METHODS An MCDA comprising three different phases was conducted. In phase 1, a systematic literature review was performed, and after validation by a scientific committee comprising 11 experts, a preliminary set of QIs was developed. In phase 2, a larger group of 49 experts determined the relevance and relative importance of each QI by prioritising and weighing the preliminary set. Finally in phase 3, the scientific committee reviewed the results and made a final selection via a deliberative process. RESULTS The final set comprised 67 QIs, classified as Structure [23 QIs], Process [35 QIs] and Outcome [9 QIs], which were ranked according to their relative importance. Multidisciplinary management was the most important requirement in ICCUs, followed by continuity of care, standardisation of clinical care and, especially, the incorporation of patients' reported outcomes. CONCLUSIONS This updated set of QIs comprises a weighted and prioritised set of items that represent the essential minimum of criteria for ensuring appropriate quality of care in the management of IBD patients.
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Affiliation(s)
- Xavier Calvet
- Corresponding author: Xavier Calvet, Servei d’Aparell Digestiu, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, Spain.
| | - Julián Panés
- CIBERehd, Instituto de Salud Carlos III, Madrid, Spain,Gastroenterology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Javier Gallardo-Escudero
- Health Economics Department, Pharmacoeconomics & Outcomes Research Iberia [PORIB], Madrid, Spain
| | | | | | - Laura Marín
- Gastroenterology and Hepatology Department, Hospital Universitari Germans Trias I Pujol, Barcelona, Spain
| | - Fernando de la Portilla
- General Surgery and Digestive System Clinical Management Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - Ana Gutiérrez
- CIBERehd, Instituto de Salud Carlos III, Madrid, Spain,Gastroenterology Department, Hospital General de Alicante, Alicante, Spain,Instituto de Investigación Sanitaria y Biomédica de Alicante [ISABIAL], Alicante, Spain
| | - Pilar Nos
- Gastroenterology Unit, Hospital Universitario La Fe, Valencia, Spain
| | - Ruth Serrano
- Confederación de Asociaciones de Crohn y Colitis Ulcerosa, Madrid, Spain
| | - Miguel Ángel Casado
- Health Economics Department, Pharmacoeconomics & Outcomes Research Iberia [PORIB], Madrid, Spain
| | - Manuel Barreiro-de Acosta
- Gastroenterology Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
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Casellas F, Calvet X, Carpio D, Vera I, Saldaña R, Mínguez M, Marín L, Juliá B. Factors associated with quality of care in inflammatory bowel diseases: a view from patient's side using the IQCARO quality of care decalogue. BMC Gastroenterol 2021; 21:412. [PMID: 34715812 PMCID: PMC8555225 DOI: 10.1186/s12876-021-01968-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 10/13/2021] [Indexed: 11/29/2022] Open
Abstract
Background Quality of care (QoC) is a highly important topic in inflammatory bowel disease (IBD). We recently elaborated a decalogue of QoC indicators (IQCARO-QoC) developed by IBD patients. The aim of the present study was to assess the factors associated with patients’ evaluation of QoC in Spain using the IQCARO-QoC Decalogue recently developed by IBD patients. Methods A survey including patients’ socio-demographic and clinical characteristics, and the IQCARO-QoC Decalogue, was completed by IBD patients. We described patients’ assessment of QoC across Spanish patients. A univariable and multivariable analysis was performed to explore the associations between patients’ characteristics and QoC. Results Questionnaires from 788 participant patients were analysed. Participants’ mean age was 43.4 years, 63% were females and 58% had Crohn’s disease. The mean QoC score was 8.1 (± 2.4 SD) points out of a maximum of 10. Items with the lowest score were related to the provision of information and the implication of the medical team throughout the entire patient care. Factors associated with better QoC scores included: being employed better disease control, fewer numbers of unscheduled visits, and being followed by a gastroenterologist specialized in IBD. Conclusions Spanish patients’ reported QoC seems to be globally good although there is room for improvement, especially in providing adequate information to patients. Care provided by specialized IBD gastroenterologists seems to be related with higher QoC scores.
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Affiliation(s)
- F Casellas
- Digestive Diseases Unit, Corporació Sanitaria Universitària Parc Taulí, Parc del Taulí, 1. 08208 Sabadell, Barcelona, Spain
| | - Xavier Calvet
- Digestive Diseases Unit, Corporació Sanitaria Universitària Parc Taulí, Parc del Taulí, 1. 08208 Sabadell, Barcelona, Spain. .,Digestive Diseases Unit, Corporació Sanitaria Universitària Parc Taulí, Sabadell, Barcelona, Spain. .,Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. .,CIBEREHD, Instituto de Salud Carlos III, Madrid, Spain.
| | - D Carpio
- Complexo Hospitalario Universitario de Pontevedra, Instituto de Investigación Biomédica Galicia Sur (IBI), Pontevedra, Spain
| | - I Vera
- Servicio de Aparato Digestivo, Hospital Universitario de Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | - M Mínguez
- Hospital Clínico Universitario, University of Valencia, Valencia, Spain
| | - L Marín
- Servei de Malalties Digestives, Hospital Germans Trias I Pujol, Barcelona, Spain
| | - B Juliá
- Medical Department MSD, Madrid, Spain
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Calvet X, Casellas F, Saldaña R, Carpio D, Mínguez M, Vera I, Marín L, Juliá B. Patient-Evaluated Quality of Care is Related to Better Inflammatory Bowel Disease Outcomes: The IQCARO II Project. Patient 2021; 14:625-634. [PMID: 33709214 DOI: 10.1007/s40271-021-00500-8] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Measuring quality of care (QoC) from a patient's perspective is becoming increasingly important in inflammatory bowel disease. OBJECTIVE The objective of this study was to determine whether patients' evaluations of QoC correlate with better inflammatory bowel disease outcomes. METHODS A survey including patients' characteristics, a decalogue of QoC indicators, and self-reported disease outcomes was completed by Spanish patients with inflammatory bowel disease. A QoC index (QoCI) was constructed with the sum of the "yes" answers in the decalogue. We evaluated the correlation of QoCI with outcomes. A sub-analysis comparing patients with high QoCI vs those with low QoCI was performed (QoCI = 10 or ≤ 7). RESULTS Seven hundred and eighty-eight questionnaires were analyzed. Mean age of participants was 43.4 years (63% women). Mean QoCI was 8.1 (± 2.4). The QoCI correlated significantly with activity of the disease, number of flares, emergency/unscheduled visits, and disease control. Patients scoring in the first QoCI quartile reported a decreased rate of moderate/severe disease (34.8% vs 55.3%, p < 0.001), fewer numbers of flares (p < 0.001), and fewer emergency/unscheduled visits (p < 0.001) compared with those in the lower QoCI quartile. The high QoC group also reported better disease control. CONCLUSIONS Patient-evaluated QoC correlates with better outcomes. Evaluation of QoC by patients may be useful to detect inadequate care and improve inflammatory bowel disease outcomes.
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Affiliation(s)
- Xavier Calvet
- Digestive Diseases Unit, Corporació Sanitaria Universitària Parc Taulí, Sabadell, Spain
| | - Fransesc Casellas
- Crohn-Colitis Care Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Daniel Carpio
- Complexo Hospitalario Universitario de Pontevedra, Instituto de Investigación Biomédica Galicia Sur (IBI), Pontevedra, Spain
| | - Miguel Mínguez
- Hospital Clínico Universitario, University of Valencia, Valencia, Spain
| | - Isabel Vera
- Servicio de Aparato Digestivo, Hospital Universitario de Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Laura Marín
- Servei de Malalties Digestives, Hospital Germans Trias I Pujol, Barcelona, Spain
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Marín L, Gutiérrez-Del-Río I, Villar CJ, Lombó F. De novo biosynthesis of garbanzol and fustin in Streptomyces albus based on a potential flavanone 3-hydroxylase with 2-hydroxylase side activity. Microb Biotechnol 2021; 14:2009-2024. [PMID: 34216097 PMCID: PMC8449655 DOI: 10.1111/1751-7915.13874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/07/2021] [Accepted: 06/10/2021] [Indexed: 11/26/2022] Open
Abstract
Flavonoids are important plant secondary metabolites, which were shown to have antioxidant, anti-inflammatory or antiviral activities. Heterologous production of flavonoids in engineered microbial cell factories is an interesting alternative to their purification from plant material representing the natural source. The use of engineered bacteria allows to produce specific compounds, independent of soil, climatic or other plant-associated production parameters. The initial objective of this study was to achieve an engineered production of two interesting flavanonols, garbanzol and fustin, using Streptomyces albus as the production host. Unexpectedly, the engineered strain produced several flavones and flavonols in the absence of the additional expression of a flavone synthase (FNS) or flavonol synthase (FLS) gene. It turned out that the heterologous flavanone 3-hydroxylase (F3H) has a 2-hydroxylase side activity, which explains the observed production of 7,4'-dihydroxyflavone, resokaempferol, kaempferol and apigenin, as well as the biosynthesis of the extremely rare 2-hydroxylated intermediates 2-hydroxyliquiritigenin, 2-hydroxynaringenin and probably licodione. Other related metabolites, such as quercetin, dihydroquercetin and eriodictyol, have also been detected in culture extracts of this recombinant strain. Hence, the enzymatic versatility of S. albus can be conveniently exploited for the heterologous production of a large diversity of plant metabolites of the flavonoid family.
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Affiliation(s)
- Laura Marín
- Research Group BIONUC (Biotechnology of Nutraceuticals and Bioactive Compounds), Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, Oviedo, Principality of Asturias, Spain.,IUOPA (Instituto Universitario de Oncología del Principado de Asturias), Oviedo, Principality of Asturias, Spain.,ISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Oviedo, Principality of Asturias, Spain
| | - Ignacio Gutiérrez-Del-Río
- Research Group BIONUC (Biotechnology of Nutraceuticals and Bioactive Compounds), Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, Oviedo, Principality of Asturias, Spain.,IUOPA (Instituto Universitario de Oncología del Principado de Asturias), Oviedo, Principality of Asturias, Spain.,ISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Oviedo, Principality of Asturias, Spain
| | - Claudio Jesús Villar
- Research Group BIONUC (Biotechnology of Nutraceuticals and Bioactive Compounds), Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, Oviedo, Principality of Asturias, Spain.,IUOPA (Instituto Universitario de Oncología del Principado de Asturias), Oviedo, Principality of Asturias, Spain.,ISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Oviedo, Principality of Asturias, Spain
| | - Felipe Lombó
- Research Group BIONUC (Biotechnology of Nutraceuticals and Bioactive Compounds), Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, Oviedo, Principality of Asturias, Spain.,IUOPA (Instituto Universitario de Oncología del Principado de Asturias), Oviedo, Principality of Asturias, Spain.,ISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Oviedo, Principality of Asturias, Spain
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Toledo H, Sánchez CI, Marín L, Amich J, Calera JA. Regulation of zinc homeostatic genes by environmental pH in the filamentous fungus Aspergillus fumigatus. Environ Microbiol 2021; 24:643-666. [PMID: 33687784 DOI: 10.1111/1462-2920.15452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 11/30/2022]
Abstract
Aspergillus fumigatus can grow over a broad range of pH values even though zinc availability is greatly conditioned by ambient pH. It has been previously shown that regulation of zinc homeostatic genes in this fungus relies on the transcription factor ZafA. In addition, their expression is further modulated by the transcription factor PacC depending on ambient pH, which allows this fungus to grow in diverse types of niches, including soils and the lungs of immunosuppressed hosts. In this work the regulation by PacC of genes zrfB and zrfC that are expressed, respectively, under acidic and alkaline zinc-limiting conditions have been analysed in detail. Thus, data that extend the current model for PacC function, including the role of the full-length PacC72 protein and the PacC processed forms (PacC53 and PacC27 ) on gene expression has been provided, and a new mechanism for the repression of acid-expressed genes in alkaline media based on interference with the start of transcription has been described. Moreover, it was proposed that the transcription of both acid-expressed and alkaline-expressed genes under zinc-limiting conditions might also rely on a third factor (putatively Pontin/Reptin), which may be required to integrate the action of PacC and ZafA into gene specific transcriptional responses.
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Affiliation(s)
- Héctor Toledo
- Instituto de Biología Funcional y Genómica (IBFG-CSIC), Universidad de Salamanca, Salamanca, Spain.,Departamento de Microbiología y Genética, Universidad de Salamanca, Salamanca, Spain.,Servicio de Microbiología Clínica y Parasitología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Clara Inés Sánchez
- Instituto de Biología Funcional y Genómica (IBFG-CSIC), Universidad de Salamanca, Salamanca, Spain.,Departamento de Microbiología y Genética, Universidad de Salamanca, Salamanca, Spain.,Escuela de Microbiología, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Laura Marín
- Instituto de Biología Funcional y Genómica (IBFG-CSIC), Universidad de Salamanca, Salamanca, Spain
| | - Jorge Amich
- Instituto de Biología Funcional y Genómica (IBFG-CSIC), Universidad de Salamanca, Salamanca, Spain.,Departamento de Microbiología y Genética, Universidad de Salamanca, Salamanca, Spain.,Manchester Fungal Infection Group, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - José Antonio Calera
- Instituto de Biología Funcional y Genómica (IBFG-CSIC), Universidad de Salamanca, Salamanca, Spain.,Departamento de Microbiología y Genética, Universidad de Salamanca, Salamanca, Spain
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Iborra I, Puig M, Marín L, Calafat M, Cañete F, Quiñones C, González-González L, Cardona G, Mañosa M, Domènech E. Treatment Adherence and Clinical Outcomes of Patients with Inflammatory Bowel Disease on Biological Agents During the SARS-CoV-2 Pandemic. Dig Dis Sci 2021; 66:4191-4196. [PMID: 33469807 PMCID: PMC7814978 DOI: 10.1007/s10620-020-06807-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 12/22/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND The outbreak of COVID19 evolved rapidly into a global pandemic, forcing hospitals, including inflammatory bowel disease (IBD) referral units, to change their practices to ensure quality of care. AIMS To describe the clinical outcomes and the fulfilment of the treatment schedule of patients with IBD treated with biological agents in a single-center of a red-zone of the pandemic, and to report the patients' perceptions about COVID-19 and the measures adopted at our center. METHODS Therapeutic adherence and clinical outcomes were collected for all patients undergoing treatment with intravenous biologicals and subcutaneous biologicals at our center. A telephone survey was also performed to assess these patients' perceptions of the COVID pandemic and the related measures adopted at their IBD unit. RESULTS A total of 234 patients were included (117 on intravenous and 117 on subcutaneous biologicals). Only 10% of patients postponed intravenous infusions intentionally and 5% postponed the collection of subcutaneous biologicals at the hospital pharmacy. Only five confirmed COVID-19 cases were registered (2.1%), all of them of mild severity. One hundred and fifty-five patients participated in the survey (77 on intravenous and 78 on subcutaneous drugs). Fear of going to the hospital was the most common reason for postponing biological administrations. Among those on combination therapy, only 7% admitted to have withdrawn immunosuppressants. CONCLUSIONS Adherence to intravenous and subcutaneous biological therapies during the pandemic was high in a single-center cohort of IBD patients even though the cumulative incidence of confirmed COVID-19 was low.
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Affiliation(s)
- Ignacio Iborra
- grid.411438.b0000 0004 1767 6330Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, 08916 Badalona, Catalonia Spain
| | - Maria Puig
- grid.411438.b0000 0004 1767 6330Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, 08916 Badalona, Catalonia Spain
| | - Laura Marín
- grid.411438.b0000 0004 1767 6330Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, 08916 Badalona, Catalonia Spain
| | - Margalida Calafat
- grid.411438.b0000 0004 1767 6330Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, 08916 Badalona, Catalonia Spain ,grid.452371.60000 0004 5930 4607Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Catalonia, Spain
| | - Fiorella Cañete
- grid.411438.b0000 0004 1767 6330Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, 08916 Badalona, Catalonia Spain ,grid.452371.60000 0004 5930 4607Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Catalonia, Spain
| | - Carles Quiñones
- grid.411438.b0000 0004 1767 6330Pharmacy Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia Spain
| | - Laura González-González
- grid.411438.b0000 0004 1767 6330Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, 08916 Badalona, Catalonia Spain
| | - Glòria Cardona
- grid.411438.b0000 0004 1767 6330Pharmacy Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia Spain
| | - Míriam Mañosa
- grid.411438.b0000 0004 1767 6330Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, 08916 Badalona, Catalonia Spain ,grid.452371.60000 0004 5930 4607Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Catalonia, Spain
| | - Eugeni Domènech
- grid.411438.b0000 0004 1767 6330Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, 08916 Badalona, Catalonia Spain ,grid.452371.60000 0004 5930 4607Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Catalonia, Spain ,grid.7080.f0000 0001 2296 0625Departament de Medicina, Universitat Autònoma de Barcelona, Catalonia, Spain
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de Cáceres C, Martínez R, Bachiller P, Marín L, García JM. The effect of tocilizumab on cytokine release syndrome in COVID-19 patients. Pharmacol Rep 2020; 72:1529-1537. [PMID: 33165762 PMCID: PMC7650573 DOI: 10.1007/s43440-020-00186-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/15/2020] [Accepted: 10/26/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study was aimed to assess the efficacy and safety of tocilizumab (TCZ) and to investigate the factors related to the progress and mortality of patients with a secondary cytokine release syndrome caused by SARS-CoV-2. METHODS A retrospective descriptive observational study of hospitalised patients with a positive polymerase chain reaction (PCR) result for SARS-CoV-2 and whose clinical evolution required the administration of one or more doses of TCZ was conducted. Demographic variables, clinical evolution, radiologic progress and analytical parameters were analysed on days 1, 3 and 5 after administration the first dose of TCZ. RESULTS A total of 75 patients with a clinical history of Accurate Respiratory Distress Syndrome (ARDS) were analysed, among whom, 19 had mild ARDS (25.3%), 37 moderate ARDS (49.4%) and 19 severe ARDS (25.3%). Lymphocytopenia and high levels of PCR, D-Dimer and IL-6 were observed in almost all the patients (91.8%). Treatment with TCZ was associated with a reduction of lymphocytopenia, C-reactive protein (CRP) levels, severe ARDS cases and fever. Although a better evolution of PaO2/FiO2 was observed in patients who received two or more doses of TCZ (38/75), there was an increase in their mortality (47.4%) and ICU admission (86.8%). The 30-day mortality rate was 30.7% (20.5-42.4% CI) being hypertension, high initial D-dimer levels and ICU admission the only predictive factors found. CONCLUSION Based on our results, treatment with TCZ was associated with a fever, swelling and ventilator support improvement. However, there is no evidence that the administration of two or more doses of TCZ was related to a mortality decrease.
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Affiliation(s)
- Carmen de Cáceres
- Pharmacy Department, Hospital General de Segovia, C/Luis Erik Clavería Neurólogo S/N, 40002 Segovia, Spain
| | - Rodrigo Martínez
- Internal Medicine Department, Hospital General de Segovia, C/Luis Erik Clavería Neurólogo S/N, 40002 Segovia, Spain
| | - Pablo Bachiller
- Internal Medicine Department, Hospital General de Segovia, C/Luis Erik Clavería Neurólogo S/N, 40002 Segovia, Spain
| | - Laura Marín
- Pharmacy Department, Hospital General de Segovia, C/Luis Erik Clavería Neurólogo S/N, 40002 Segovia, Spain
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11
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Marín-Jiménez I, Zabana Y, Rodríguez-Lago I, Marín L, Barreiro-de Acosta M, Esteve M. COVID-19 and inflammatory bowel disease: Questions arising from patient care and follow-up during the initial phase of the pandemic (February–April 2020). Gastroenterología y Hepatología (English Edition) 2020. [PMCID: PMC7351401 DOI: 10.1016/j.gastre.2020.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was described in China in late 2019. There are currently more than three million diagnosed cases, constituting a pandemic which has caused a worldwide crisis. The devastating effects of this infection are due to its highly contagious nature and although mild forms predominate, in absolute values, the rates for severe forms and mortality are very high. The information on the characteristics of the infection in inflammatory bowel disease is of special interest, as these patients have higher attendance at health centres, which may increase their risk of infection. Furthermore, the treatments used to control the inflammatory activity may modify the disease course of COVID-19. The Spanish Working Group on Crohn’s Disease and Ulcerative Colitis and the Spanish Nurses Working Group on Inflammatory Bowel Disease have prepared this document as a practical response to some common questions about the treatment of these patients.
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12
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Marín-Jiménez I, Zabana Y, Rodríguez-Lago I, Marín L, Barreiro-de Acosta M, Esteve M. COVID-19 and inflammatory bowel disease: questions arising from patient care and follow-up during the initial phase of the pandemic (February-April 2020). Gastroenterol Hepatol 2020; 43:408-413. [PMID: 32419715 PMCID: PMC7225721 DOI: 10.1016/j.gastrohep.2020.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was described in China in late 2019. There are currently more than three million diagnosed cases, constituting a pandemic which has caused a worldwide crisis. The devastating effects of this infection are due to its highly contagious nature and although mild forms predominate, in absolute values, the rates for severe forms and mortality are very high. The information on the characteristics of the infection in inflammatory bowel disease is of special interest, as these patients have higher attendance at health centres, which may increase their risk of infection. Furthermore, the treatments used to control the inflammatory activity may modify the disease course of COVID-19. The Spanish Working Group on Crohn's Disease and Ulcerative Colitis and the Spanish Nurses Working Group on Inflammatory Bowel Disease have prepared this document as a practical response to some common questions about the treatment of these patients.
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Affiliation(s)
- Ignacio Marín-Jiménez
- Centro de Enfermedades Inmunomediadas (CEIMI), Servicio de Aparato Digestivo, Hospital Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, España
| | - Yamile Zabana
- Servicio de Aparato Digestivo, Hospital Universitari Mútua Terrassa, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
| | - Iago Rodríguez-Lago
- Servicio de Aparato Digestivo, Hospital de Galdakao, Instituto de Investigación Sanitaria Biocruces Bizkaia
| | - Laura Marín
- Servicio de Aparato Digestivo, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | - Manuel Barreiro-de Acosta
- Servicio de Aparato Digestivo, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - Maria Esteve
- Servicio de Aparato Digestivo, Hospital Universitari Mútua Terrassa, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd).
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Marín L, Fioravanti G, Cristaldo E, Sereday CE, Merbilhaá O, Portas M. Hyperbaric oxygen therapy for a pediatric electrical burn: A case report. Burns Open 2020. [DOI: 10.1016/j.burnso.2020.05.001] [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: 10/24/2022] Open
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Calvet X, Saldaña R, Carpio D, Mínguez M, Vera I, Juliá B, Marín L, Casellas F. Improving Quality of Care in Inflammatory Bowel Disease Through Patients' Eyes: IQCARO Project. Inflamm Bowel Dis 2020; 26:782-791. [PMID: 31634907 DOI: 10.1093/ibd/izz126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Quality improvement is a major topic in inflammatory bowel disease (IBD) care, and measuring quality of care (QoC) is necessary for QoC improvement. Most QoC projects or consensus statements are designed from the health care professional point of view. Having QoC indicators designed for and fully evaluable by patients may provide a key tool for external evaluation of QoC improvement measures. The aim of the IQCARO project was to identify indicators to measure QoC from the IBD patient's point of view. METHODS An extensive review of the literature to identify indicators of QoC was performed; first the identified indicators were reviewed by a steering committee including patients, nurses, IBD specialists, and methodologists. Then 2 focus groups of IBD patients analyzed the QoC indicators to determine whether they could be understood and evaluated by patients. The final QoC indicators were selected by a group of IBD patients using a Delphi consensus methodology. RESULTS An initial list of 54 QoC indicators was selected by the steering committee. The QoC indicators were evaluated by 16 patients who participated in 2 focus groups. They identified 21 indicators that fulfilled the understandability and evaluability requirements. The 10 most relevant QoC indicators were selected by 26 patients with IBD using a Delphi consensus. The selected items covered important aspects of QoC, including professionalism, patients' autonomy, information, accessibility, and continuity of care. CONCLUSIONS The present Delphi consensus identified QoC indicators that are useful for developing and measuring improvement strategies in the management of IBD.
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Affiliation(s)
- Xavier Calvet
- Digestive Diseases Unit, Corporació Sanitaria Universitària Parc Taulí, Sabadell, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain.,CIBEREHD, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Daniel Carpio
- Complexo Hospitalario Universitario de Pontevedra, Instituto de Investigación Biomédica Galicia Sur (IBI), Pontevedra, Spain
| | - Miguel Mínguez
- Hospital Clínico Universitario, University of Valencia, Valencia, Spain
| | - Isabel Vera
- Servicio de Aparato Digestivo, Hospital Universitario de Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | - Laura Marín
- Servei de Malalties Digestives, Hospital Germans Trias I Pujol, Barcelona, Spain
| | - Fransesc Casellas
- Crohn-Colitis Care Unit, Hospital Universitari Valld`Hebron, Barcelona, Spain
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Maldonado EF, Nislin M, Martínez-Escribano A, Marín L, Enguix A, Alamo A, López C, Magarín A, Ortíz P, Muñoz M, García S. Association of salivary alpha-amylase and salivary flow rate with working memory functioning in healthy children. Stress 2019; 22:670-678. [PMID: 31084229 DOI: 10.1080/10253890.2019.1611777] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The aim of this study was to examine the association between auditory and visual working memory (WM) performance and salivary alpha-amylase (sAA) and salivary flow rate (SFR) in a sample of 63 children (38 boys). WM was assessed by means of WISC-V subtests: four auditory subtests (Digit Span and Letter-Number Sequencing) and one visual subtest (Picture Span). SAA activity, output, and SFR were measured at baseline (10 min prior to testing), one minute prior to testing, one minute after the end of the auditory WM subtests and one minute after the end of the visual WM subtest. Our statistical analyses showed an association among SAA activity, output and SFR levels and the number of recalled digits in the last attempt score in Letter-Number Sequencing subtest. Specifically, our results showed that working performance in this task was associated with a concurrent decrease in SFR (r(63) = -0.423, p < .05). This salivary measure was the best predictor of this specific index of working memory performance (β = -0.423, p < .05). These results show that the changes in SFR, which represents changes in parasympathetic tone, could be employed in future studies as a noninvasive marker of working memory performance in child studies.
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Affiliation(s)
| | - Mari Nislin
- Faculty of Education and Human Development, The Education University of Hong Kong , Hong Kong , China
| | | | - Laura Marín
- Department of Clinical Analysis, Virgen de la Victoria Hospital , Malaga , Spain
| | - Alfredo Enguix
- Department of Clinical Analysis, Virgen de la Victoria Hospital , Malaga , Spain
| | - Ana Alamo
- Clinical Neuropsychology Laboratory, School of Psychology, University of Malaga , Malaga , Spain
| | - Cristina López
- Clinical Neuropsychology Laboratory, School of Psychology, University of Malaga , Malaga , Spain
| | - Alba Magarín
- Clinical Neuropsychology Laboratory, School of Psychology, University of Malaga , Malaga , Spain
| | - Paula Ortíz
- Clinical Neuropsychology Laboratory, School of Psychology, University of Malaga , Malaga , Spain
| | - Marina Muñoz
- Clinical Neuropsychology Laboratory, School of Psychology, University of Malaga , Malaga , Spain
| | - Silvia García
- Clinical Neuropsychology Laboratory, School of Psychology, University of Malaga , Malaga , Spain
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Gely C, Marín L, Gordillo J, Mañosa M, Bertoletti F, Cañete F, González-Muñoza C, Calafat M, Domènech E, Garcia-Planella E. Impact of pain associated with the subcutaneous administration of adalimumab. Gastroenterol Hepatol 2019; 43:9-13. [PMID: 31492425 DOI: 10.1016/j.gastrohep.2019.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 05/01/2019] [Accepted: 06/14/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is limited information regarding the impact of patients' perception of injection pain on adherence to treatments, specifically in inflammatory bowel disease (IBD) patients. Therefore, we aimed to determine the impact of the pain associated with the subcutaneous administration of adalimumab in patients with IBD treated with the old formulation and the new low-volume/citrate-free formulation. METHODS A specifically-designed questionnaire was completed by 76 patients with IBD, who started treatment with adalimumab before the availability of the low-volume/citrate-free formulation and were switched to this new formulation. Intensity of pain was measured by using visual analog scales (VAS). RESULTS A total of 62 patients (82%) experienced injection-related pain with the initial formulation. The perception of pain was associated with a decreased adherence to the treatment (37%), an increase in pre-administration anxiety (25%) or, as a consequence, the patient required someone else to carry out the injection (21%). Younger age was the only factor associated with pain perception. After switching to the new formulation, perception of pain persisted only in 2 patients (3%). Among those who felt pain with the initial formulation, pre-administration anxiety disappeared in 44%; 32% and 42% stated that the new formulation eased adherence and self-administration. CONCLUSIONS The perception of pain related to the subcutaneous administration of therapy negatively impacts on treatment adherence in IBD patients. Improved formulations for subcutaneous administration of drugs can positively impact patients' convenience and adherence.
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Affiliation(s)
- Cristina Gely
- Hospital Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Laura Marín
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain
| | - Jordi Gordillo
- Hospital Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Míriam Mañosa
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (Ciberehd), Spain
| | | | - Fiorella Cañete
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (Ciberehd), Spain
| | | | - Margalida Calafat
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain
| | - Eugeni Domènech
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (Ciberehd), Spain.
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Casellas F, Navarro E, Amil P, Barber C, Marín L, Guardiola J, Espín E, Sainz E, Aldeguer X, Gallego M, Murciano F, García-Planella E, Martín-de-Carpi J, Mendive JM, González-Mestre A. Development and validation of the QUECOMIICAT questionnaire: a tool to assess disease-related knowledge in patients with inflammatory bowel disease. Rev Esp Enferm Dig 2019; 111:586-592. [PMID: 31317762 DOI: 10.17235/reed.2019.6298/2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION adequate knowledge of inflammatory bowel disease (IBD) is essential for a successful patient-centered management of IBD. OBJECTIVE due to the scarcity of up-to-date tools for measuring IBD literacy, this single-center, prospective study aimed to develop and validate a new questionnaire to assess IBD-related knowledge. MATERIAL AND METHODS the study included patients followed up at the Crohn-Colitis Care Unit (UACC) at the Hospital Vall d'Hebron (Barcelona, Spain). Patients admitted to the UACC for the first time were subsequently enrolled into a standard IBD educational program. A pilot questionnaire was developed and validated in 92 IBD patients by determining the internal consistency reliability (Cronbach's α test), feasibility, construct validity (correlation with the Crohn's and Colitis Knowledge [CCKNOW] questionnaire and a knowledge visual analog scale [VAS]) and sensitivity (score change before and after a standard IBD educational program). The questionnaire, named "Qüestionari Coneixements Malaltia Inflamatòria Intestinal Catalunya" (IBD-knowledge questionnaire Catalonia) (QUECOMIICAT) was written in Spanish and had 25 items addressing six dimensions: general concepts, clinic, treatment, surgery, habits and social context. RESULTS the median (interquartile range) completion time was 15 (10-20) minutes and the floor and ceiling effects were 1.1% and 2.1%, respectively. The Cronbach's α coefficient was α = 0.75. QUECOMIICAT significantly correlated with the VAS (rho = 0.34, p < 0.01) and CCKNOW questionnaires (rho = 0.74, p < 0.01). Patient knowledge significantly increased 24 hours after attending a standard IBD educational program and remained statistically significant one month later (Pearson's test-retest correlation coefficient r = 0.81, p < 0.001). CONCLUSION in conclusion, the QUECOMIICAT questionnaire is a new up-to-date tool to assess IBD-related knowledge with good feasibility and validation results for use in the routine clinical practice.
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Affiliation(s)
| | - Ester Navarro
- Unitat Atenció Crohn-Colitis, Hospital Universitari Vall d'Hebrón
| | - Paloma Amil
- Programa Pacient Expert Catalunya®. Programa de pr, Direcció General de Planificació en Salut. Departament de Salut, Generalitat de Catalunya, Spain
| | - Claudia Barber
- Unitat Atenció Crohn-Colitis. , Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Laura Marín
- Hospital Universitari Germans Trias i Pujol. Badalona, Spain
| | - Jordi Guardiola
- Hospital Universitari de Bellvitge. L'Hospitalet de Llobregat, Spain
| | - Eloy Espín
- Unitat d'Atenció Crohn-Colitis, Hospital Universitari Vall d'Hebron. Barcelona, Spain
| | - Empar Sainz
- Hospital Universitari Arnau de Vilanova. Lleida, Spain
| | | | - Marta Gallego
- Hospital Clínic i Provincial de Barcelona. Barcelona, Spain
| | | | | | | | - Juan Manuel Mendive
- CAP la Mina. SAP Litoral. Gerència d'Atenció Primària de Barcelona. Barcelona, Spain
| | - Assumpció González-Mestre
- Programa Pacient Expert Catalunya®. Programa de pr, Direcció General de Planificació en Salut. Departament de Salut, Generalitat de Catalunya, Spain
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Vicentefranqueira R, Leal F, Marín L, Sánchez CI, Calera JA. The interplay between zinc and iron homeostasis in
Aspergillus fumigatus
under zinc‐replete conditions relies on the iron‐mediated regulation of alternative transcription units of
zafA
and the basal amount of the ZafA zinc‐responsiveness transcription factor. Environ Microbiol 2019; 21:2787-2808. [DOI: 10.1111/1462-2920.14618] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 04/03/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Rocío Vicentefranqueira
- Instituto de Biología Funcional y Genómica (IBFG‐CSIC)Universidad de Salamanca Salamanca Spain
| | - Fernando Leal
- Instituto de Biología Funcional y Genómica (IBFG‐CSIC)Universidad de Salamanca Salamanca Spain
- Departamento de Microbiología y GenéticaUniversidad de Salamanca Salamanca Spain
| | - Laura Marín
- Instituto de Biología Funcional y Genómica (IBFG‐CSIC)Universidad de Salamanca Salamanca Spain
| | - Clara Inés Sánchez
- Instituto de Biología Funcional y Genómica (IBFG‐CSIC)Universidad de Salamanca Salamanca Spain
| | - José Antonio Calera
- Instituto de Biología Funcional y Genómica (IBFG‐CSIC)Universidad de Salamanca Salamanca Spain
- Departamento de Microbiología y GenéticaUniversidad de Salamanca Salamanca Spain
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Marín L, Gutiérrez-del-Río I, Entrialgo-Cadierno R, Villar CJ, Lombó F. De novo biosynthesis of myricetin, kaempferol and quercetin in Streptomyces albus and Streptomyces coelicolor. PLoS One 2018; 13:e0207278. [PMID: 30440014 PMCID: PMC6237366 DOI: 10.1371/journal.pone.0207278] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 10/29/2018] [Indexed: 01/16/2023] Open
Abstract
Flavonols are a flavonoid subfamily widely distributed in plants, including several ones of great importance in human and animal diet (apple, tomato, broccoli, onion, beans, tea). These polyphenolic nutraceuticals exert potent antimicrobial (membrane potential disruptors), antioxidant (free-radical scavengers), pharmacokinetic (CYP450 modulators), anti-inflammatory (lipoxygenase inhibitors), antiangiogenic (VEGF inhibitors) and antitumor (cyclin inhibitors) activities. Biotechnological production of these nutraceuticals, for example via heterologous biosynthesis in industrial actinomycetes, is favored since in plants these polyphenols appear as inactive glycosylated derivatives, in low concentrations or as part of complex mixtures with other polyphenolic compounds. In this work, we describe the de novo biosynthesis of three important flavonols, myricetin, kaempferol and quercetin, in the industrially relevant actinomycetes Streptomyces coelicolor and S. albus. De novo biosynthesis of kaempferol, myricetin and quercetin in actinomycetes has not been described before.
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Affiliation(s)
- Laura Marín
- Research Group BIONUC (Biotechnology of Nutraceuticals and Bioactive Compounds), Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, Oviedo, Principality of Asturias, Spain
- IUOPA (Instituto Universitario de Oncología del Principado de Asturias) Principality of Asturias, Spain
- ISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Principality of Asturias, Spain
| | - Ignacio Gutiérrez-del-Río
- Research Group BIONUC (Biotechnology of Nutraceuticals and Bioactive Compounds), Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, Oviedo, Principality of Asturias, Spain
- IUOPA (Instituto Universitario de Oncología del Principado de Asturias) Principality of Asturias, Spain
- ISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Principality of Asturias, Spain
| | - Rodrigo Entrialgo-Cadierno
- Research Group BIONUC (Biotechnology of Nutraceuticals and Bioactive Compounds), Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, Oviedo, Principality of Asturias, Spain
- IUOPA (Instituto Universitario de Oncología del Principado de Asturias) Principality of Asturias, Spain
- ISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Principality of Asturias, Spain
| | - Claudio J. Villar
- Research Group BIONUC (Biotechnology of Nutraceuticals and Bioactive Compounds), Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, Oviedo, Principality of Asturias, Spain
- IUOPA (Instituto Universitario de Oncología del Principado de Asturias) Principality of Asturias, Spain
- ISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Principality of Asturias, Spain
| | - Felipe Lombó
- Research Group BIONUC (Biotechnology of Nutraceuticals and Bioactive Compounds), Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, Oviedo, Principality of Asturias, Spain
- IUOPA (Instituto Universitario de Oncología del Principado de Asturias) Principality of Asturias, Spain
- ISPA (Instituto de Investigación Sanitaria del Principado de Asturias), Principality of Asturias, Spain
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Gutiérrez-del-Río I, Marín L, Fernández J, Álvarez San Millán M, Ferrero FJ, Valledor M, Campo JC, Cobián N, Méndez I, Lombó F. Development of a biosensor protein bullet as a fluorescent method for fast detection of Escherichia coli in drinking water. PLoS One 2018; 13:e0184277. [PMID: 29304041 PMCID: PMC5755745 DOI: 10.1371/journal.pone.0184277] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 08/21/2017] [Indexed: 11/23/2022] Open
Abstract
Drinking water can be exposed to different biological contaminants from the source, through the pipelines, until reaching the final consumer or industry. Some of these are pathogenic bacteria and viruses which may cause important gastrointestinal or systemic diseases. The microbiological quality of drinking water relies mainly in monitoring three indicator bacteria of faecal origin, Escherichia coli, Enterococcus faecalis and Clostridium perfringens, which serve as early sentinels of potential health hazards for the population. Here we describe the analysis of three chimeric fluorescent protein bullets as biosensor candidates for fast detection of E. coli in drinking water. Two of the chimeric proteins (based on GFP-hadrurin and GFP-pb5 chimera proteins) failed with respect to specificity and/or sensitivity, but the GFP-colS4 chimera protein was able to carry out specific detection of E. coli in drinking water samples in a procedure encompassing about 8 min for final result and this biosensor protein was able to detect in a linear way between 20 and 103 CFU of this bacterium. Below 20 CFU, the system cannot differentiate presence or absence of the target bacterium. The fluorescence in this biosensor system is provided by the GFP subunit of the chimeric protein, which, in the case of the better performing sensor bullet, GFP-colS4 chimera, is covalently bound to a flexible peptide bridge and to a bacteriocin binding specifically to E. coli cells. Once bound to the target bacteria, the excitation step with 395 nm LED light causes emission of fluorescence from the GFP domain, which is amplified in a photomultiplier tube, and finally this signal is converted into an output voltage which can be associated with a CFU value and these data distributed along mobile phone networks, for example. This method, and the portable fluorimeter which has been developed for it, may contribute to reduce the analysis time for detecting E. coli presence in drinking water.
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Affiliation(s)
- Ignacio Gutiérrez-del-Río
- Research Group BIONUC, Departamento de Biología Funcional, Área de Microbiología, University of Oviedo, Oviedo, Principality of Asturias, Spain
| | - Laura Marín
- Research Group BIONUC, Departamento de Biología Funcional, Área de Microbiología, University of Oviedo, Oviedo, Principality of Asturias, Spain
| | - Javier Fernández
- Research Group BIONUC, Departamento de Biología Funcional, Área de Microbiología, University of Oviedo, Oviedo, Principality of Asturias, Spain
| | - María Álvarez San Millán
- Research Group BIONUC, Departamento de Biología Funcional, Área de Microbiología, University of Oviedo, Oviedo, Principality of Asturias, Spain
| | - Francisco Javier Ferrero
- Department of Electric, Electronic, Computer and Systems Engineering, University of Oviedo, Campus of Gijón, Gijón, Principality of Asturias, Spain
| | - Marta Valledor
- Department of Electric, Electronic, Computer and Systems Engineering, University of Oviedo, Campus of Gijón, Gijón, Principality of Asturias, Spain
| | - Juan Carlos Campo
- Department of Electric, Electronic, Computer and Systems Engineering, University of Oviedo, Campus of Gijón, Gijón, Principality of Asturias, Spain
| | | | | | - Felipe Lombó
- Research Group BIONUC, Departamento de Biología Funcional, Área de Microbiología, University of Oviedo, Oviedo, Principality of Asturias, Spain
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Calafat M, Lobatón T, Mañosa M, Marín L, Caballero N, Larraín M, Cabré E, Domènech E. Therapeutic requirements in active ulcerative proctitis: A single-centre study. Gastroenterol Hepatol 2017; 40:663-668. [PMID: 28666605 DOI: 10.1016/j.gastrohep.2017.05.006] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 04/29/2017] [Accepted: 05/19/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Ulcerative proctitis (UP) presents distinctive clinical characteristics, outcomes and therapeutic approaches as compared to left-sided and extensive ulcerative colitis (UC). AIM To describe the current therapeutic requirements and clinical outcomes in patients with active UP. METHODS Retrospective observational study conducted in a referral IBD centre. Patients with UP in follow-up between 1989 and 2014 were included. The clinical characteristics, as well as the different treatments and drug formulations administered to treat flares, were recorded. RESULTS Out of 687 UC patients, 101 patients (15%) with UP were included. Median follow-up was 8 years (IQR 3-14) and 49% of patients presented disease activity during the study period. Topical mesalazine monotherapy (90%) was the most commonly administered treatment for disease activity (mostly as suppositories), followed by topical steroids (47%) and oral mesalazine (56%) in monotherapy or combination therapy. Only 14% and 16% of patients required oral prednisone and beclomethasone, respectively. CONCLUSIONS In clinical practice, active UP presents mostly favourable outcomes. Mesalazine suppositories are by far the most used treatment for these patients.
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Affiliation(s)
- Margalida Calafat
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain
| | - Triana Lobatón
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain
| | - Míriam Mañosa
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Ciberehd, Spain
| | - Laura Marín
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Ciberehd, Spain
| | - Noemí Caballero
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain
| | - Macarena Larraín
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain
| | - Eduard Cabré
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Ciberehd, Spain
| | - Eugeni Domènech
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Ciberehd, Spain.
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Gordillo J, Zabana Y, Garcia-Planella E, Mañosa M, Llaó J, Gich I, Marín L, Szafranska J, Sáinz S, Bessa X, Cabré E, Domènech E. Prevalence and risk factors for colorectal adenomas in patients with ulcerative colitis. United European Gastroenterol J 2017; 6:322-330. [PMID: 29511562 DOI: 10.1177/2050640617718720] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 06/08/2017] [Indexed: 12/18/2022] Open
Abstract
Background Patients with ulcerative colitis (UC) have an increased risk of colorectal cancer. Scarce data regarding the development of adenomas in these patients are available both for normal and colitic mucosa. Objective The objective of this article is to evaluate the prevalence of adenomatous polyps and associated risk factors in patients with UC. Methods Patients with UC were identified from the databases of two tertiary referral centers. Medical, endoscopic and histologic reports were reviewed. Results A total of 403 patients were included (53% male; 33% extensive colitis) and 1065 colonoscopies (median per patient, 2) were recorded and analyzed. Seventy-four adenomas in 47 patients (11.7%) and three cases of colorectal cancer were found during a median follow-up of 6.3 years. The cumulative risk of colorectal adenoma was 4.7%, 16.7%, 23.6% and 34.4% at 10, 20, 30 and 40 years from UC diagnosis, respectively. The cumulative risk of developing metachronous colorectal adenoma was 66.7%, 87.9%, and 90.9% at 5, 10, and 15 years from first adenoma detection. Older age at UC diagnosis and longer disease duration were independent risk factors for colorectal adenoma development. Conclusions The prevalence of colorectal adenomas among UC patients seems to be higher than previously reported, although lower than in the background population.
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Affiliation(s)
- Jordi Gordillo
- Gastroenterology and Hepatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Spain
| | - Yamile Zabana
- Gastroenterology and Hepatology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain
| | - Esther Garcia-Planella
- Gastroenterology and Hepatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Míriam Mañosa
- Gastroenterology and Hepatology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain
| | - Jordina Llaó
- Gastroenterology and Hepatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Ignasi Gich
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Catalonia, Spain
| | - Laura Marín
- Gastroenterology and Hepatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain.,Gastroenterology and Hepatology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain
| | - Justyna Szafranska
- Department of Pathology, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Sergio Sáinz
- Gastroenterology and Hepatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Xavier Bessa
- Department of Gastroenterology, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Catalonia, Spain
| | - Eduard Cabré
- Gastroenterology and Hepatology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain
| | - Eugeni Domènech
- Gastroenterology and Hepatology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain
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23
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Marín L, Gutiérrez-del-Río I, Yagüe P, Manteca Á, Villar CJ, Lombó F. De Novo Biosynthesis of Apigenin, Luteolin, and Eriodictyol in the Actinomycete Streptomyces albus and Production Improvement by Feeding and Spore Conditioning. Front Microbiol 2017; 8:921. [PMID: 28611737 PMCID: PMC5447737 DOI: 10.3389/fmicb.2017.00921] [Citation(s) in RCA: 44] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 05/08/2017] [Indexed: 12/23/2022] Open
Abstract
Nutraceutical compounds as plant flavonoids play an important role in prevention and modulation of diverse heath conditions, as they exert interesting antifungal, antibacterial, antioxidant, and antitumor effects. They also possess anti-inflammatory activities in arthritis, cardiovascular disease or neurological diseases, as well as modulatory effects on the CYP450 activity on diverse drugs. Most flavonoids are bioactive molecules of plant origin, but their industrial production is sometimes hindered due to reasons as low concentration in the plant tissues, presence in only some species or as a complex mixture or inactive glycosides in plant vacuolae. In this work, we describe the de novo biosynthesis of two important flavones, apigenin and luteolin, and one known flavanone, eriodictyol. Their plant biosynthetic pathways have been reconstructed for heterologous expression in Streptomyces albus, an actinomycete bacterium manageable at industrial production level. Also, production levels for apigenin have been improved by feeding with naringenin precursor, and timing for settlement of secondary metabolism has been advanced by spore conditioning. In the cases of eriodictyol and luteolin, their production in this important type of biotechnology-prone bacteria, the actinomycetes, had not been described in the literature yet.
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Affiliation(s)
| | | | | | | | | | - Felipe Lombó
- Biotechnology in Nutraceuticals and Bioactive Compounds-BIONUC, Departamento de Biología Funcional, Área de Microbiología, University of OviedoOviedo, Spain
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Planelles D, Vilches C, González-Escribano F, Muro M, González-Fernández R, Sánchez F, Gonzalo Ocejo J, Eiras A, Caro JL, Palou E, Campillo JA, de Juan MD, Montes O, Balas A, Marín L, Torío A, Fernández-Arquero M, González-Roiz C, López-Vázquez A, Cisneros E, Abad-Molina C, López R, Abad-Alastruey ML, Serra C, García-Alonso AM, Vicario JL. Report From the First and Second Spanish Killer Immunoglobulin-Like Receptor Genotyping Workshops: External Quality Control for Natural Killer Alloreactive Donor Selection in Haploidentical Stem Cell Transplantation. Transplant Proc 2017; 48:3043-3045. [PMID: 27932143 DOI: 10.1016/j.transproceed.2016.07.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 07/27/2016] [Indexed: 11/26/2022]
Abstract
An important factor affecting the success in the setting of related haploidentical hematopoietic stem cell transplantation (HSCT) is the graft-versus-leukemia effect mediated by natural killer (NK) cells when the donor displays NK alloreactivity versus the recipient. NK cell function is regulated by killer immunoglobulin-like receptors (KIR) and it has been described that donor KIR genotype influences transplantation outcome. This has led to a requirement of laboratories to have a quality assurance program for validation and control of their KIR genotyping methods. The goal of the 1st and 2nd Spanish KIR Genotyping Workshops was to provide an external proficiency testing program in KIR genotyping for Spanish immunology and transplant laboratories. These workshops were conducted during the years 2014-2016 and consisted of 17 participating laboratories typing a set of 20 samples. The presence/absence of 16 mandatory KIR loci (2DL1, 2DL2, 2DL3, 2DL4, 2DL5, 2DS1, 2DS2, 2DS3, 2DS4, 2DS5, 2DP1, 3DL1, 3DL2, 3DL3, 3DS1, and 3DP1) was evaluated per sample. Methods for KIR genotyping included polymerase chain reaction with the use of sequence-specific primers and sequence-specific oligoprobes. Consensus typing was reached in all samples, and the performance of laboratories in external proficiency testing was satisfactory in all cases. The polymorphism detected in the small sample studied in both workshops is indicative of an ample variety of KIR gene profiles in the Spanish population.
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Affiliation(s)
- D Planelles
- Histocompatibility, Centro de Transfusión de la Comunidad Valenciana, Valencia, Spain.
| | - C Vilches
- Immunogenetics and Histocompatibility, Instituto de Investigación Sanitaria Puerta de Hierro, Madrid, Spain
| | | | - M Muro
- Immunology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | - F Sánchez
- Immunology, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | - J Gonzalo Ocejo
- Immunology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - A Eiras
- Molecular Biology and Histocompatibility, Centro de Transfusión de Galicia, Santiago de Compostela, Spain
| | - J L Caro
- Histocompatibility and Immunogenetics, Banc de Sang i Teixits, Barcelona, Spain
| | - E Palou
- Immunology, Hospital Clínic Universitari, Barcelona, Spain
| | - J A Campillo
- Immunology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - M D de Juan
- Immunology, Hospital Universitario Donostia, San Sebastián, Spain
| | - O Montes
- Immunology, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain
| | - A Balas
- Histocompatibility, Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain
| | - L Marín
- Molecular Biology-Hematology, Hospital Clínico Universitario, Salamanca, Spain
| | - A Torío
- Immunology, Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | | | - C González-Roiz
- Immunology and Genetics, Hospital Infanta Cristina, Badajoz, Spain
| | - A López-Vázquez
- Immunology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - E Cisneros
- Immunogenetics and Histocompatibility, Instituto de Investigación Sanitaria Puerta de Hierro, Madrid, Spain
| | - C Abad-Molina
- Immunology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - R López
- Immunology, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | - M L Abad-Alastruey
- Molecular Biology and Histocompatibility, Centro de Transfusión de Galicia, Santiago de Compostela, Spain
| | - C Serra
- Immunology, Hospital Clínic Universitari, Barcelona, Spain
| | - A M García-Alonso
- Immunology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - J L Vicario
- Histocompatibility, Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain
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Villamizar-Rodríguez G, Fernández J, Marín L, Muñiz J, González I, Lombó F. Multiplex detection of nine food-borne pathogens by mPCR and capillary electrophoresis after using a universal pre-enrichment medium. Front Microbiol 2015; 6:1194. [PMID: 26579100 PMCID: PMC4630290 DOI: 10.3389/fmicb.2015.01194] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/13/2015] [Indexed: 12/31/2022] Open
Abstract
Routine microbiological quality analyses in food samples require, in some cases, an initial incubation in pre-enrichment medium. This is necessary in order to ensure that small amounts of pathogenic strains are going to be detected. In this work, a universal pre-enrichment medium has been developed for the simultaneous growth of Bacillus cereus, Campylobacter jejuni, Clostridium perfringens, Cronobacter sakazakii, Escherichia coli, Enterobacteriaceae family (38 species, 27 genera), Listeria monocytogenes, Staphylococcus aureus, Salmonella spp. (two species, 13 strains). Growth confirmation for all these species was achieved in all cases, with excellent enrichments. This was confirmed by plating on the corresponding selective agar media for each bacterium. This GVUM universal pre-enrichment medium could be useful in food microbiological analyses, where different pathogenic bacteria must be detected after a pre-enrichment step. Following, a mPCR reaction for detection of all these pathogens was developed, after designing a set of nine oligonucleotide pairs from specific genetic targets on gDNA from each of these bacteria, covering all available strains already sequenced in GenBank for each pathogen type. The detection limits have been 1 Genome Equivalent (GE), with the exception of the Fam. Enterobacteriaceae (5 GEs). We obtained amplification for all targets (from 70 to 251 bp, depending on the bacteria type), showing the capability of this method to detect the most important industrial and sanitary food-borne pathogens from a universal pre-enrichment medium. This method includes an initial pre-enrichment step (18 h), followed by a mPCR (2 h) and a capillary electrophoresis (30 min); avoiding the tedious and long lasting growing on solid media required in traditional analysis (1–4 days, depending on the specific pathogen and verification procedure). An external testing of this method was conducted in order to compare classical and mPCR methods. This evaluation was carried out on five types of food matrices (meat, dairy products, prepared foods, canned fish, and pastry products), which were artificially contaminated with each one of the microorganisms, demonstrating the equivalence between both methods (coincidence percentages between both methods ranged from 78 to 92%).
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Affiliation(s)
- Germán Villamizar-Rodríguez
- Research Unit "Biotechnology and Experimental Therapy Based in Nutraceuticals-BITTEN," Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo Oviedo, Spain
| | - Javier Fernández
- Research Unit "Biotechnology and Experimental Therapy Based in Nutraceuticals-BITTEN," Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo Oviedo, Spain
| | - Laura Marín
- Research Unit "Biotechnology and Experimental Therapy Based in Nutraceuticals-BITTEN," Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo Oviedo, Spain
| | - Juan Muñiz
- Área de Microbiología, ALCE Calidad S.L. Llanera Llanera, Spain
| | - Isabel González
- Departamento I+D+i, Industrias Lácteas Asturianas, S.A. (Reny Picot) Navia, Spain
| | - Felipe Lombó
- Research Unit "Biotechnology and Experimental Therapy Based in Nutraceuticals-BITTEN," Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo Oviedo, Spain
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Puig N, Conde I, Jiménez C, Sarasquete ME, Balanzategui A, Alcoceba M, Quintero J, Chillón MC, Sebastián E, Corral R, Marín L, Gutiérrez NC, Mateos MV, González-Díaz M, San-Miguel JF, García-Sanz R. The predominant myeloma clone at diagnosis, CDR3 defined, is constantly detectable across all stages of disease evolution. Leukemia 2015; 29:1435-7. [DOI: 10.1038/leu.2015.7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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27
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Llaó J, Naves JE, Ruiz-Cerulla A, Marín L, Mañosa M, Rodríguez-Alonso L, Cabré E, Garcia-Planella E, Guardiola J, Domènech E. Intravenous corticosteroids in moderately active ulcerative colitis refractory to oral corticosteroids. J Crohns Colitis 2014; 8:1523-8. [PMID: 25066954 DOI: 10.1016/j.crohns.2014.06.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 06/24/2014] [Accepted: 06/27/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Oral corticosteroids remain the mainstay of treatment for moderately active ulcerative colitis (UC). In patients who fail to respond to oral corticosteroids, attempting the intravenous route before starting rescue therapies is an alternative, although no evidence supports this strategy. AIM To evaluate clinical outcomes after a course of intravenous corticosteroids for moderate attacks of UC according to the failed oral corticosteroids or not. METHODS All episodes of active UC admitted to three university hospitals between January 2005 and December 2011 were identified and retrospectively reviewed. Only moderately active episodes treated with intravenous corticosteroids were included. Treatment outcome was compared between episodes which failed to outpatient oral corticosteroids for the index flare and those directly treated by intravenous corticosteroids. RESULTS 110 episodes were included, 45% of which failed to outpatient oral corticosteroids (median dose 60mg/day [IQR 50-60], median length of course 10days [IQR 7-17]). Initial response (defined as mild severity or inactive disease at day 7 after starting intravenous corticosteroids, without rescue therapy) was achieved in 75%, with no between-group differences (78% vs. 75%). After a median follow-up of 12months (IQR 4-24), 35% of the initial responders developed steroid-dependency and up to 13% required colectomy. Unsuccessful response to oral corticosteroids was the only factor associated with steroid-dependency in the long term (P=0.001). CONCLUSIONS Intravenous corticosteroids are efficient for inducing remission in moderately active UC unresponsive to oral corticosteroids, but almost half of these patients develop early steroid-dependency. Alternative therapeutic strategies should be assessed in this clinical setting.
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Affiliation(s)
- Jordina Llaó
- Hospital de la Santa Creu i Sant Pau (Barcelona), Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Juan E Naves
- Hospital Universitari Germans Trias i Pujol (Badalona), CiberEHD, Catalonia, Spain
| | - Alexandra Ruiz-Cerulla
- Hospital Universitari de Bellvitge, IDIBELL (L'Hospitalet de Llobregat), Catalonia, Spain
| | - Laura Marín
- Hospital de la Santa Creu i Sant Pau (Barcelona), Universitat Autònoma de Barcelona, Catalonia, Spain; Hospital Universitari Germans Trias i Pujol (Badalona), CiberEHD, Catalonia, Spain
| | - Míriam Mañosa
- Hospital Universitari Germans Trias i Pujol (Badalona), CiberEHD, Catalonia, Spain
| | | | - Eduard Cabré
- Hospital Universitari Germans Trias i Pujol (Badalona), CiberEHD, Catalonia, Spain
| | - Esther Garcia-Planella
- Hospital de la Santa Creu i Sant Pau (Barcelona), Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Jordi Guardiola
- Hospital Universitari de Bellvitge, IDIBELL (L'Hospitalet de Llobregat), Catalonia, Spain
| | - Eugeni Domènech
- Hospital Universitari Germans Trias i Pujol (Badalona), CiberEHD, Catalonia, Spain.
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Zabana Y, Mañosa M, Cabré E, Bernal I, Marín L, Lorenzo-Zúñiga V, Moreno V, Boix J, Domènech E. Addition of mesalazine for subclinical post-surgical endoscopic recurrence of Crohn's disease despite preventive thiopurine therapy: A case-control study. J Gastroenterol Hepatol 2014; 29:1413-7. [PMID: 24627958 DOI: 10.1111/jgh.12579] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIM Thiopurines prevent Crohn's disease (CD) endoscopic recurrence (ER) at least in 50% of patients 1 year after surgery. This study aimed to evaluate the value of adding mesalazine in patients with subclinical ER despite preventive thiopurine therapy. METHODS Crohn's disease patients with ileocecal resection treated with thiopurines for postsurgical recurrence prevention in whom mesalazine was added (cases) to treat ER without clinical recurrence (CR) were identified and compared with those in whom no treatment was added to thiopurines (controls). All patients were followed up for at least 1 year from the index endoscopy. Development of CR as well as evolution of mucosal lesions was evaluated. RESULTS Thirty-seven patients were included (19 cases and 18 controls). Initial Rutgeerts' score was i2 in 16 patients (9 cases and 7 controls), and i3 in 21 patients (10 cases and 11 controls). After a median clinical follow-up of 59 months (interquartile range 22-100) from the index endoscopy, six cases (32%) and two controls (11%) developed CR (P = 0.2). After a median time to last endoscopic follow-up of 23 months (interquartile range 17-71), 18 patients (49%) showed improvement in Rutgeerts' score, 11 patients (30%) demonstrated progression of mucosal lesions, and 8 (22%) had no changes, with no differences between study groups. CONCLUSIONS The addition of mesalazine seems to be of no benefit in patients with subclinical endoscopic recurrence while on thiopurine prevention. Moderate endoscopic postsurgical recurrence while on thiopurines may even revert with no additional therapy in some patients.
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Affiliation(s)
- Yamile Zabana
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Badalona, Catalonia, Spain
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Fernández J, Marín L, Alvarez-Alonso R, Redondo S, Carvajal J, Villamizar G, Villar CJ, Lombó F. Biosynthetic modularity rules in the bisintercalator family of antitumor compounds. Mar Drugs 2014; 12:2668-99. [PMID: 24821625 PMCID: PMC4052310 DOI: 10.3390/md12052668] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 04/09/2014] [Accepted: 04/11/2014] [Indexed: 12/05/2022] Open
Abstract
Diverse actinomycetes produce a family of structurally and biosynthetically related non-ribosomal peptide compounds which belong to the chromodepsipeptide family. These compounds act as bisintercalators into the DNA helix. They give rise to antitumor, antiparasitic, antibacterial and antiviral bioactivities. These compounds show a high degree of conserved modularity (chromophores, number and type of amino acids). This modularity and their high sequence similarities at the genetic level imply a common biosynthetic origin for these pathways. Here, we describe insights about rules governing this modular biosynthesis, taking advantage of the fact that nowadays five of these gene clusters have been made public (thiocoraline, triostin, SW-163 and echinomycin/quinomycin). This modularity has potential application for designing and producing novel genetic engineered derivatives, as well as for developing new chemical synthesis strategies. These would facilitate their clinical development.
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Affiliation(s)
- Javier Fernández
- Research Group BITTEN, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, C/Julián Clavería 7, Facultad de Medicina, Oviedo 33006, Spain.
| | - Laura Marín
- Research Group BITTEN, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, C/Julián Clavería 7, Facultad de Medicina, Oviedo 33006, Spain.
| | - Raquel Alvarez-Alonso
- Research Group BITTEN, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, C/Julián Clavería 7, Facultad de Medicina, Oviedo 33006, Spain.
| | - Saúl Redondo
- Research Group BITTEN, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, C/Julián Clavería 7, Facultad de Medicina, Oviedo 33006, Spain.
| | - Juan Carvajal
- Research Group BITTEN, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, C/Julián Clavería 7, Facultad de Medicina, Oviedo 33006, Spain.
| | - Germán Villamizar
- Research Group BITTEN, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, C/Julián Clavería 7, Facultad de Medicina, Oviedo 33006, Spain.
| | - Claudio J Villar
- Research Group BITTEN, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, C/Julián Clavería 7, Facultad de Medicina, Oviedo 33006, Spain.
| | - Felipe Lombó
- Research Group BITTEN, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, C/Julián Clavería 7, Facultad de Medicina, Oviedo 33006, Spain.
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Calvet X, Panés J, Alfaro N, Hinojosa J, Sicilia B, Gallego M, Pérez I, Lázaro y de Mercado P, Gomollón F, Aldeguera X, Alós R, Andreu M, Barreiro M, Bermejo F, Casis B, Domenech E, Espín E, Esteve M, García-Sánchez V, López-Sanromán A, Martínez-Montiel P, Luis Mendoza J, Gisbert JP, Vera M, Dosal A, Sánchez E, Marín L, Sanromán L, Pinilla P, Murciano F, Torrejón A, Ramón García J, Ortega M, Roldán J. Delphi consensus statement: Quality Indicators for Inflammatory Bowel Disease Comprehensive Care Units. J Crohns Colitis 2014; 8:240-51. [PMID: 24295646 DOI: 10.1016/j.crohns.2013.10.010] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [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: 09/06/2013] [Revised: 10/21/2013] [Accepted: 10/29/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS While it is commonly accepted that Inflammatory bowel disease (IBD) Comprehensive Care Units (ICCUs) facilitate the delivery of quality care to Crohn's disease and ulcerative colitis patients, it remains unclear how an ICCU should be defined or evaluated. The aim of the present study was to develop a comprehensive set of Quality Indicators (QIs) of structure, process, and outcomes for defining and evaluating an ICCU. METHODS A Delphi consensus-based approach with a standardized three-step process was used to identify a core set of QIs. The process included an exhaustive search using complementary approaches to identify potential QIs, and two Delphi voting rounds to select the QIs defining the core requirements for an ICCU. RESULTS The consensus selected a core set of 56 QIs (12 structure, 20 process and 24 outcome). Structure and process QIs highlighted the need for multidisciplinary management and continuity of care. The minimal IBD team should include an IBD nurse, gastroenterologists, radiologists, surgeons, endoscopists and stoma management specialists. ICCUs should be able to provide both outpatient and inpatient care and admission should not break the continuity of care. Outcome QIs focused on the adequate prophylaxis of disease complication and drug adverse events, the need to monitor appropriateness of treatment and the need to reinforce patient autonomy by providing adequate information and facilitating the patients' participation in their own care. CONCLUSIONS The present Delphi consensus identified a set of core QIs that may be useful for evaluating and certifying ICCUs.
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Affiliation(s)
- Xavier Calvet
- Servei de Malaties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, Departament de Medicina, Universitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Spain
| | - Julián Panés
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Spain; Hospital Clínic, Barcelona, Spain.
| | - Noelia Alfaro
- Técnicas Avanzadas de Investigación en Servicios de Salud (TAISS), Spain
| | | | - Beatriz Sicilia
- Servicio de Gastroenterología, Hospital Universitario de Burgos, Spain
| | | | - Ildefonso Pérez
- Asociación de pacients de Crohn y Colitis Ulcerosa (ACCU), Spain
| | | | - Fernando Gomollón
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Spain; Servicio de Aparato Digestivo, Hospital Clínico "Lozano Blesa" de Zaragoza, Spain
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Fernandez-Garcia B, Eiró N, Marín L, González-Reyes S, González LO, Lamelas ML, Vizoso FJ. Expression and prognostic significance of fibronectin and matrix metalloproteases in breast cancer metastasis. Histopathology 2013; 64:512-22. [PMID: 24117661 DOI: 10.1111/his.12300] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 09/26/2013] [Indexed: 12/11/2022]
Abstract
AIMS Fibronectin (FN) has attracted interest in cancer research, owing to its role in tumour progression. The aims of this study were to investigate the expression and clinical relevance of FN in breast cancer, and to explore its relationship with the expression of matrix metalloproteases (MMPs) and their inhibitors (TIMPs). METHODS AND RESULTS An immunohistochemical study was performed using tumours from 110 breast cancer patients, with tissue arrays and specific antibodies against FN, MMP-7, MMP-9, MMP-11, TIMP-1, and TIMP-2. The results indicated that FN expression was related to tumour size, histological grade, and MMP-9 expression. Tumours with high FN expression by tumour cells were significantly associated with a higher probability of metastasis, poorer overall survival, and expression of MMP-7, MMP-9, MMP-11, TIMP-1 and TIMP-2 by mononuclear inflammatory cells (MICs). In addition, the combination of FN expression by tumour cells and MMP-11 by MICs was strongly associated with distant metastasis development. CONCLUSIONS Breast carcinomas with distant metastasis frequently have tumour cells expressing intracellular FN. There is a strong association between FN expression by tumour cells and MMP or TIMP expression by stromal MICs, and this may represent crosstalk that is of prognostic relevance in breast cancer.
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Puig N, Sarasquete ME, Balanzategui A, Martínez J, Paiva B, García H, Fumero S, Jiménez C, Alcoceba M, Chillón MC, Sebastián E, Marín L, Montalbán MA, Mateos MV, Oriol A, Palomera L, de la Rubia J, Vidriales MB, Bladé J, Lahuerta JJ, González M, Miguel JFS, García-Sanz R. Critical evaluation of ASO RQ-PCR for minimal residual disease evaluation in multiple myeloma. A comparative analysis with flow cytometry. Leukemia 2013; 28:391-7. [DOI: 10.1038/leu.2013.217] [Citation(s) in RCA: 129] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 06/14/2013] [Accepted: 07/10/2013] [Indexed: 11/09/2022]
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Rodríguez LA, Magén C, Snoeck E, Gatel C, Marín L, Serrano-Ramón L, Prieto JL, Muñoz M, Algarabel PA, Morellon L, De Teresa JM, Ibarra MR. Quantitative in situ magnetization reversal studies in Lorentz microscopy and electron holography. Ultramicroscopy 2013; 134:144-54. [PMID: 23831132 DOI: 10.1016/j.ultramic.2013.06.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 06/05/2013] [Accepted: 06/07/2013] [Indexed: 10/26/2022]
Abstract
A generalized procedure for the in situ application of magnetic fields by means of the excitation of the objective lens for magnetic imaging experiments in Lorentz microscopy and electron holography is quantitatively described. A protocol for applying magnetic fields with arbitrary in-plane magnitude and orientation is presented, and a freeware script for Digital Micrograph(™) is provided to assist the operation of the microscope. Moreover, a method to accurately reconstruct hysteresis loops is detailed. We show that the out-of-plane component of the magnetic field cannot be always neglected when performing quantitative measurements of the local magnetization. Several examples are shown to demonstrate the accuracy and functionality of the methods.
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Affiliation(s)
- L A Rodríguez
- Laboratorio de Microscopías Avanzadas (LMA), Instituto de Nanociencia de Aragón (INA), Universidad de Zaragoza, 50018 Zaragoza, Spain; Departamento de Física de la Materia Condensada, Universidad de Zaragoza, 50009 Zaragoza, Spain; Transpyrenean Associated Laboratory for Electron Microscopy (TALEM), CEMES-INA, CNRS-Universidad de Zaragoza, Toulouse, France; CEMES-CNRS 29, rue Jeanne Marvig, B.P. 94347, F-31055 Toulouse Cedex, France
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Marín L, Mañosa M, Garcia-Planella E, Gordillo J, Zabana Y, Cabré E, Domènech E. Sexual function and patients' perceptions in inflammatory bowel disease: a case-control survey. J Gastroenterol 2013; 48:713-20. [PMID: 23124604 DOI: 10.1007/s00535-012-0700-2] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2012] [Accepted: 10/05/2012] [Indexed: 02/04/2023]
Abstract
BACKGROUND Sexuality is important when assessing quality of life (QoL), which is often disturbed in inflammatory bowel disease (IBD). However, sexuality is not addressed in most QoL questionnaires. AIMS To evaluate the prevalence and predisposing factors of sexual dysfunction among IBD patients, and their own perception. METHODS A postal survey was conducted in IBD patients 25-65 years of age from two tertiary centres. Patients were asked to provide a control of the same gender and age without IBD. The questionnaire assessed patient perception of the impact of IBD on their sexuality, and also allowed calculation of the Erectile Function International Index or the Female Sexual Function Index. RESULTS A total of 355 patients and 200 controls were available for the final analysis. Both groups were comparable except for a higher proportion of individuals who had been treated for depression among patients. Half of the female and one-third of the male patients considered that both sexual desire and satisfaction worsened after IBD diagnosis. As compared to controls, both men and women with IBD showed significantly lower scores in sexual function indexes, but a higher prevalence of sexual dysfunction was only noticed among women. Independent predictors of sexual dysfunction among IBD patients were the use of corticosteroids in women, and the use of biological agents, depression and diabetes in men. CONCLUSIONS Sexuality is often disturbed in IBD patients, particularly among women. Many factors seem to contribute to worsened intimacy. Sexuality should be considered when QoL is assessed in these patients.
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Affiliation(s)
- Laura Marín
- Gastroenterology Unit, Hospital Universitari Germans Trias i Pujol, 5th planta, edificio general, Ctra. del Canyet s/n, 08916, Badalona, Catalonia, Spain
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Torrejón A, Oltra L, Hernández-Sampelayo P, Marín L, García-Sánchez V, Casellas F, Alfaro N, Lázaro P, Vera MI. Development of quality standards in inflammatory bowel disease management and design of an evaluation tool of nursing care. Rev esp enferm dig 2013; 105:262-71. [DOI: 10.4321/s1130-01082013000500004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mañosa M, Navarro-Llavat M, Marín L, Zabana Y, Cabré E, Domènech E. Fecundity, pregnancy outcomes, and breastfeeding in patients with inflammatory bowel disease: a large cohort survey. Scand J Gastroenterol 2013; 48:427-32. [PMID: 23477328 DOI: 10.3109/00365521.2013.772229] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIM The aim was to assess the impact of inflammatory bowel disease (IBD) and its treatment on fertility, pregnancy outcomes, and breastfeeding. IBD is a chronic inflammatory condition that is usually diagnosed in young adulthood. Patients are often concerned about fertility and pregnancy outcomes. METHODS A structured questionnaire was posted to 850 adults with IBD followed-up on in a single center. RESULTS A total of 503 patients (59%) with a median age of 40 years and equally distributed for gender and type of IBD returned the questionnaire. Overall, 71% of the patients had a total of 659 children, 36% of whom were born after the diagnosis. A total of 132 miscarriages were registered, 46% after the diagnosis of IBD. Most childless patients stated that having no children was a personal decision, and only 6% of them were evaluated and diagnosed with infertility. Pregnancies after diagnosis of IBD had a higher probability of caesarean section and preterm delivery. IBD-related drug therapy was discontinued in 16% of the pregnancies, mainly as a result of medical advice. Babies born after the diagnosis of IBD were less often breastfed. CONCLUSIONS The infertility rate among IBD patients seems to be similar to that seen in the general population. However, a large proportion of patients chose to remain childless. Vaginal delivery and breastfeeding are less likely to occur in babies born after the diagnosis. Suitable information for patients to avoid unwarranted concerns about adverse reproductive outcomes, as well as improved obstetrical and perinatal management, still seems to be necessary.
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Affiliation(s)
- Míriam Mañosa
- Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, IBD Unit, Badalona, Catalonia, Spain.
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Eiró N, González L, González LO, Fernandez-Garcia B, Lamelas ML, Marín L, González-Reyes S, del Casar JM, Vizoso FJ. Relationship between the inflammatory molecular profile of breast carcinomas and distant metastasis development. PLoS One 2012; 7:e49047. [PMID: 23145063 PMCID: PMC3493514 DOI: 10.1371/journal.pone.0049047] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 10/03/2012] [Indexed: 01/28/2023] Open
Abstract
Inflammatory conditions may promote tumor progression and aggressiveness. In previous reports, we found a group of breast cancer tumors characterized by metalloprotease-11 (MMP-11) expression by intratumoral mononuclear inflammatory cells (MICs), which was associated with distant metastasis development. Thus, in the present study we evaluated the relationship between MMP-11 expression by MICs, distant metastasis development, and a wide panel of inflammatory factors in breast carcinoma. In an initial approach, we analyzed 65 factors associated with tumor progression and inflammation, in a tumor population classified in good or bad prognosis, based on MMP-11 expression by intratumoral MICs. The most differentially expressed factors were then analyzed in a wider tumor population classified according to MMP-11 expression by MICs and also according to metastasis development. These analyses were carried out by Real-time PCR. The results showed that of the 65 starting factors analyzed, those related with MMP-11 expression by MICs were: IL-1, −5, −6, −8, −17, −18, MMP-1, TIMP-1, ADAM-8, −10, −15, −23, ADAMTS-1, −2, −15, Annexin A2, IFNβ, Claudin-3, CCL-3, MyD88, IRAK-4 and NFκB. Of them, factors more differentially expressed between both groups of tumors were IL-1, IL-5, IL-6, IL-17, IFNβ and NFκB. Thereafter, we confirmed in the wider tumor population, that there is a higher expression of those factors in tumors infiltrated by MMP-11 positive MICs. Altogether these results indicate that tumors developing worse prognosis and identified by MMP-11 expression by intratumoral MICs, shows an up-regulation of inflammatory-related genes.
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Affiliation(s)
- Noemí Eiró
- Unidad de Investigación, Fundación Hospital de Jove, Gijón, Asturias, Spain
| | - Lucía González
- Unidad de Investigación, Fundación Hospital de Jove, Gijón, Asturias, Spain
| | - Luis O. González
- Unidad de Investigación, Fundación Hospital de Jove, Gijón, Asturias, Spain
- Servicio de Anatomía Patológica, Fundación Hospital de Jove, Gijón, Asturias, Spain
| | | | - Maria Luz Lamelas
- Unidad de Investigación, Fundación Hospital de Jove, Gijón, Asturias, Spain
- Servicio de Ginecología, Fundación Hospital de Jove, Gijón, Asturias, Spain
| | - Laura Marín
- Unidad de Investigación, Fundación Hospital de Jove, Gijón, Asturias, Spain
| | | | - José Manuel del Casar
- Unidad de Investigación, Fundación Hospital de Jove, Gijón, Asturias, Spain
- Servicio de Cirugía General, Fundación Hospital de Jove, Gijón, Asturias, Spain
| | - Francisco J. Vizoso
- Unidad de Investigación, Fundación Hospital de Jove, Gijón, Asturias, Spain
- Servicio de Cirugía General, Fundación Hospital de Jove, Gijón, Asturias, Spain
- * E-mail:
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Naves JE, Lorenzo-Zúñiga V, Marín L, Mañosa M, Oller B, Moreno V, Zabana Y, Boix J, Cabré E, Domènech E. Long-term outcome of patients with distal ulcerative colitis and inflammation of the appendiceal orifice. J Gastrointestin Liver Dis 2012. [PMID: 22187699 DOI: 10.1016/s0016-5085(98)80095-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Skip inflammation of the appendiceal orifice has been described in distal UC (UC-IAO) but long-term clinical outcomes are poorly established. Our aim was to evaluate the long-term clinical outcomes of UC-IAO as compared to classic distal UC. METHODS Patients with UC-IAO were identified from the local IBD database. Disease outcome and therapeutic requirements during follow-up were accurately collected, and compared with a control group of patients with distal UC without peri-appendiceal involvement matched by disease extent (proctitis/distal), smoking habit, and date and age at diagnosis. RESULTS Fourteen UC patients were found to have UC-IAO, most of them with initial extent of UC limited to the rectum. All patients were initially managed with mesalazine administered orally (28.5%), topically (28.5%), or in combination (43%). After a median follow-up of 78 months (interquartile range--IQR 45-123) most UC-IAO patients were successfully managed with oral and/or topical aminosalicylates. Only one of them developed proximal disease progression. As compared to controls, no differences in clinical outcomes or therapeutic requirements were found. CONCLUSIONS Patients with UC-IAO tend to present a mild course, with a low probability to develop proximal progression of disease extent or to require immunosuppressive therapy or colectomy.
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Affiliation(s)
- Juan E Naves
- Germans Trias i Pujol University Hospital, Centro de Investigación Biomédica en red en Enfermedades Hepatica y Digestivas, Badalona, Spain
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Alcoceba M, Marín L, Balanzategui A, Sarasquete ME, Chillón MC, Martín-Jiménez P, Puig N, Santamaría C, Corral R, García-Sanz R, San Miguel JF, González M. Frequency of HLA-A, -B and -DRB1 specificities and haplotypic associations in the population of Castilla y León (northwest-central Spain). ACTA ACUST UNITED AC 2012; 78:249-55. [PMID: 21929573 DOI: 10.1111/j.1399-0039.2011.01766.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The frequencies of human leukocyte antigen (HLA) class I and class II specificities and haplotypic associations were determined in 1940 unrelated donors from Castilla y León and compared with other Iberian, Mediterranean and European populations. Specificities were determined using polymerase chain reaction reverse sequence-specific oligonucleotide or polymerase chain reaction sequence-specific primer techniques. In the analysis, 19, 29 and 13 specificities were found for HLA-A, -B and -DRB1, respectively, with HLA-A*02 (26%), -A*01 (11%), -B*44 (16%), -B*35 (10%), -DRB1*07 (16%) and -DRB1*13 (14%) showing the highest frequencies. In addition, 10 common HLA-A-B-DRB1 haplotypic associations were observed, A*01-B*08-DRB1*03 (3%) and A*29-B*44-DRB1*07 (3%) being the most frequent ones. These findings indicate that the population of Castilla y León is genetically equidistant from the Portuguese and other Spanish populations and shares a common origin with other Iberian populations, in which European, Mediterranean and North African genetic components are present; this is in agreement with the historical and genetic background of the population. These data contribute to a better understanding of the genetic structure of the Iberian Peninsula and provide a healthy control population from our region that should be useful for the study of disease associations.
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Affiliation(s)
- M Alcoceba
- Laboratorio de Biología Molecular/HLA, Servicio de Hematología, Hospital Universitario de Salamanca, Salamanca, Spain
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Zaratiegui M, Castel SE, Irvine DV, Kloc A, Ren J, Li F, de Castro E, Marín L, Chang AY, Goto D, Cande WZ, Antequera F, Arcangioli B, Martienssen RA. RNAi promotes heterochromatic silencing through replication-coupled release of RNA Pol II. Nature 2011; 479:135-8. [PMID: 22002604 PMCID: PMC3391703 DOI: 10.1038/nature10501] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Accepted: 08/25/2011] [Indexed: 11/25/2022]
Abstract
Heterochromatin comprises tightly compacted repetitive regions of eukaryotic chromosomes. The inheritance of heterochromatin through mitosis requires RNA interference (RNAi), which guides histone modification 1 during the DNA replication phase of the cell cycle2. Here, we show that the alternating arrangement of origins of replication and non-coding RNA in pericentromeric heterochromatin results in competition between transcription and replication. Co-transcriptional RNAi releases RNA polymerase II (PolII), allowing completion of DNA replication by the leading strand DNA polymerase, and associated histone modifying enzymes3 which spread heterochromatin with the replication fork. In the absence of RNAi, stalled forks are repaired by homologous recombination without histone modification.
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Affiliation(s)
- Mikel Zaratiegui
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York 11724, USA
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Saavedra PV, Stingle N, Iazbik C, Marín L, McLoughlin MA, Xie Y, Couto G. Thromboelastographic changes after gonadectomy in retired racing greyhounds. Vet Rec 2011; 169:99. [PMID: 21724753 DOI: 10.1136/vr.d2671] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Twenty-one healthy greyhounds with no history or clinical signs of bleeding disorders, and no abnormalities on physical examination, complete blood count, serum biochemistry profiles (in dogs more than five years of age), and SNAP-4DX test for vector borne diseases underwent routine gonadectomies at the Ohio State University Veterinary Teaching Hospital. Blood samples were collected 24 hours before and after surgery by jugular venepuncture for thromboelastography and haemostasis assays (prothrombin time [PT], activated partial thromboplastin time [aPTT], fibrinogen concentration). The magnitude of the bleeding in each patient was estimated using a bleeding scoring system recently validated in greyhounds. Eight dogs were classified as bleeders and 13 as non-bleeders. Thromboelastograph (TEG) tracings in bleeders were different to that of non-bleeders. Neither sex (odds ratio [OR]: 0.148, P=0.05), haematocrit (OR: 0.907, P=0.39), platelet count (OR: 0.996, P=0.65) or age (OR: 0.949, P=0.83) were predictors of the outcome. None of the variables that evaluated clot kinetics, and fibrinolysis (that is, aPTT OR: 0.781, P=0.51; PT OR: 1.337, P=0.63; TEG(R) OR: 1.269, P=0.06; TEG(K) OR: 1.696, P=0.05; TEG(LY60) OR: 1.028, P=0.81) were able to predict the bleeding episodes. Only the TEG variables that represent the fibrin cross-linking of the clot (TEG(angle) OR: 0.903, P=0.03); and the strength of the clot (TEG(MA) OR: 0.833, P=0.03) were considered predictors of the outcome.
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Affiliation(s)
- P Vilar Saavedra
- Department of Veterinary Clinical Sciences and Veterinary Teaching Hospital, Ohio State University, Columbus, Ohio 43210, USA.
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Marín L, Torrejón A, Oltra L, Seoane M, Hernández-Sampelayo P, Vera MI, Casellas F, Alfaro N, Lázaro P, García-Sánchez V. Nursing resources and responsibilities according to hospital organizational model for management of inflammatory bowel disease in Spain. J Crohns Colitis 2011; 5:211-7. [PMID: 21575883 DOI: 10.1016/j.crohns.2011.01.001] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 01/07/2011] [Accepted: 01/07/2011] [Indexed: 02/08/2023]
Abstract
BACKGROUND Nurses play an important role in the multidisciplinary management of inflammatory bowel disease (IBD), but little is known about this role and the associated resources. OBJECTIVE To improve knowledge of resource availability for health care activities and the different organizational models in managing IBD in Spain. METHODS Cross-sectional study with data obtained by questionnaire directed at Spanish Gastroenterology Services (GS). Five GS models were identified according to whether they have: no specific service for IBD management (Model A); IBD outpatient office for physician consultations (Model B); general outpatient office for nurse consultations (Model C); both, Model B and Model C (Model D); and IBD Unit (Model E) when the hospital has a Comprehensive Care Unit for IBD with telephone helpline, computer, including a Model B. Available resources and activities performed were compared according to GS model (chi-square test and test for linear trend). RESULTS Responses were received from 107 GS: 33 Model A (31%), 38 Model B (36%), 4 Model C (4%), 16 Model D (15%) and 16 Model E (15%). The model in which nurses have the most resources and responsibilities is the Model E. The more complete the organizational model, the more frequent the availability of nursing resources (educational material, databases, office, and specialized software) and responsibilities (management of walk-in appointments, provision of emotional support, health education, follow-up of drug treatment and treatment adherence) (p<0.05). CONCLUSIONS Nurses have more resources and responsibilities the more complete is the organizational model for IBD management. Development of these areas may improve patient outcomes.
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Affiliation(s)
- Laura Marín
- Digestive System Service, Germans Trias i Pujol University Hospital, Badalona, Barcelona, Spain.
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González LO, González-Reyes S, Marín L, González L, González JM, Lamelas ML, Merino AM, Rodríguez E, Pidal I, del Casar JM, Andicoechea A, Vizoso F. Comparative analysis and clinical value of the expression of metalloproteases and their inhibitors by intratumour stromal mononuclear inflammatory cells and those at the invasive front of breast carcinomas. Histopathology 2011; 57:862-76. [PMID: 21166700 DOI: 10.1111/j.1365-2559.2010.03723.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIMS Matrix metalloproteases (MMPs) and their inhibitors (TIMPs) play an essential role in the degradation of stromal connective tissue and basement membrane components. The aim of this study was to determine whether the dynamic analysis of these components can help to predict tumour aggressiveness. METHODS AND RESULTS An immunohistochemical study was performed using tissue arrays and specific antibodies against MMPs -1, -2, -7, -9, -11, -13 and -14 and TIMPs -1, -2 and -3. More than 5000 determinations on cancer specimens from 124 patients with invasive breast cancer were performed on the tumour centre core as well as on the invasive front. Immunostaining for MMPs/TIMPs on mononuclear inflammatory cells (MICs) was evaluated. To identify specific groups of tumours with distinct expression profiles, data obtained from both MICs populations were analysed by unsupervised hierarchical cluster analysis. When compared with MICs at the invasive front, intratumour MICs more frequently showed expression of MMP-7 and -1 and TIMP-3, but less frequently expression of MMP-9 and -11 and TIMP-2. CONCLUSIONS Our data led us to consider the need of further studies in order to identify subsets of MICs and other protein elements of the microenvironment as attractive targets for new therapeutic strategies against cancer.
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Affiliation(s)
- Luis O González
- Unidad de Investigación, Fundación Hospital de Jove, Gijón, Spain
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González-Reyes S, Marín L, González L, González LO, del Casar JM, Lamelas ML, González-Quintana JM, Vizoso FJ. Study of TLR3, TLR4 and TLR9 in breast carcinomas and their association with metastasis. BMC Cancer 2010; 10:665. [PMID: 21129170 PMCID: PMC3009680 DOI: 10.1186/1471-2407-10-665] [Citation(s) in RCA: 166] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Accepted: 12/03/2010] [Indexed: 02/07/2023] Open
Abstract
Background Toll-like receptors (TLRs) have garnered an extraordinary amount of interest in cancer research due to their role in tumor progression. By activating the production of several biological factors, TLRs induce type I interferons and other cytokines, which drive an inflammatory response and activate the adaptive immune system. The aim of this study was to investigate the expression and clinical relevance of TLR3, 4 and 9 in breast cancer. Methods The expression levels of TLR3, TLR4 and TLR9 were analyzed on tumors from 74 patients with breast cancer. The analysis was performed by immunohistochemistry. Results Samples of carcinomas with recurrence exhibited a significant increase in the mRNA levels of TLR3, TLR4 and TLR9. Tumors showed high expression of TLRs expression levels by cancer cells, especially TLR4 and 9. Nevertheless, a significant percentage of tumors also showed TLR4 expression by mononuclear inflammatory cells (21.6%) and TLR9 expression by fibroblast-like cells (57.5%). Tumors with high TLR3 expression by tumor cell or with high TLR4 expression by mononuclear inflammatory cells were significantly associated with higher probability of metastasis. However, tumours with high TLR9 expression by fibroblast-like cells were associated with low probability of metastasis. Conclusions The expression levels of TLR3, TLR4 and TLR9 have clinical interest as indicators of tumor aggressiveness in breast cancer. TLRs may represent therapeutic targets in breast cancer.
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Hernández-Sampelayo P, Seoane M, Oltra L, Marín L, Torrejón A, Vera MI, García V, Lázaro P, Parody E, Blasco AJ, Casellas F. Contribution of nurses to the quality of care in management of inflammatory bowel disease: a synthesis of the evidence. J Crohns Colitis 2010; 4:611-22. [PMID: 21122570 DOI: 10.1016/j.crohns.2010.08.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 07/13/2010] [Accepted: 08/27/2010] [Indexed: 02/08/2023]
Abstract
BACKGROUND The purpose of quality of care programs is to improve patient outcomes. In programs targeting patients with inflammatory bowel disease (IBD), nurses play a key role. AIM To know the available scientific evidence on the quality of care in IBD management, at the levels of structure, process and outcome, in relation to nurses. METHODS Systematic search in MEDLINE, EMBASE, Índice Médico Español, Cochrane Library, and grey literature. Inclusion criteria were: 1) documents referring IBD; 2) documents providing relevant information on nurses' involvement in the management of IBD; and 3) an original article. RESULTS A total of 284 documents were identified, 15 of which were included: 8 related with structure, 12 with process, and 6 with outcomes. Some documents treated more than one level. At the level of structure, services should incorporate specialist nurses as part of the multidisciplinary team, as well as resources to facilitate patient access to nursing care. Notable at the process level, organizational aspects and nurses' competencies and skills in the management of IBD have been described. Among the outcomes mentioned are clinical outcomes, quality of life, and patient satisfaction attributable to nursing staff. No evidence was found about the association between structure or process issues with patient outcomes. Most of the studies reviewed have methodological limitations. CONCLUSIONS The available evidence provide useful information for the design of standards of structure and process relating to nurses' management of IBD. The IBD nurses' challenge is to provide evidence that these standards help improve health outcomes in patients.
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Affiliation(s)
- Paloma Hernández-Sampelayo
- Digestive System Service, Gregorio Marañón University Hospital, C/ Doctor Esquerdo 46, 28007, Madrid, Spain.
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Gonzalez LO, Junquera S, del Casar JM, González L, Marín L, González-Reyes S, Andicoechea A, González-Fernández R, González JM, Pérez-Fernández R, Vizoso FJ. Immunohistochemical study of matrix metalloproteinases and their inhibitors in pure and mixed invasive and in situ ductal carcinomas of the breast. Hum Pathol 2010; 41:980-9. [PMID: 20236691 DOI: 10.1016/j.humpath.2009.08.027] [Citation(s) in RCA: 15] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Revised: 07/27/2009] [Accepted: 08/21/2009] [Indexed: 12/24/2022]
Abstract
We assessed differences in the patterns of expression of matrix metalloproteases and their inhibitors (tissue inhibitors of metalloproteases) in ductal carcinoma in situ alone and admixed with invasive ductal carcinomas (n = 40), as well as in pure invasive ductal carcinomas (n = 40), immunohistochemically and using tissue arrays. The invasive ductal carcinoma components showed higher expression of matrix metalloprotease-9 and -13 than did the admixed ductal carcinoma in situ, whereas stromal fibroblasts of the invasive components showed higher expression of matrix metalloprotease-2, -7, -9, -13, and -14 and tissue inhibitor of metalloprotease-1 and -3 than did fibroblasts around the neoplastic ducts of the admixed ductal carcinoma in situ. Expression of matrix metalloprotease-14 and tissue inhibitor of metalloprotease-3 was significantly higher in the mononuclear inflammatory cells of the invasive components. By contrast, matrix metalloprotease-1 expression was significantly higher in stromal cells of the ductal carcinoma in situ admixed with invasive ductal carcinoma. The pure invasive ductal carcinomas had significantly higher expression of matrix metalloprotease-1, -9, -11, and -14 and tissue inhibitor of metalloprotease-1 and -3 than the invasive ductal carcinomas admixed with ductal carcinoma in situ. Our findings indicate a significant association of matrix metalloprotease expression by the periductal stromal cells of the ductal carcinoma in situ component of mixed tumors and the occurrence of distant metastasis. Our data suggest that the molecular matrix metalloprotease/tissue inhibitor of metalloprotease profile can contribute to better characterization of early breast carcinomas.
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Affiliation(s)
- Luis O Gonzalez
- Unidad de Investigación, Fundación Hospital de Jove, Gijón, Spain
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Del Casar JM, González LO, Alvarez E, Junquera S, Marín L, González L, Bongera M, Vázquez J, Vizoso FJ. Comparative analysis and clinical value of the expression of metalloproteases and their inhibitors by intratumor stromal fibroblasts and those at the invasive front of breast carcinomas. Breast Cancer Res Treat 2009; 116:39-52. [PMID: 19241156 DOI: 10.1007/s10549-009-0351-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2008] [Accepted: 02/12/2009] [Indexed: 11/26/2022]
Abstract
An immunohistochemical study was performed using tissue arrays and specific antibodies against MMPs -1, -2, -7, -9, -11, -13, -14, and TIMPs -1, -2 and -3. More than 5,000 determinations on cancer specimens from 124 patients with invasive breast cancer were performed at the center of the tumor and the invasive front. Immunostaining for MMPs/TIMPs by fibroblasts was evaluated. To identify specific groups of tumors with distinct expression profiles, the data obtained from both fibroblast populations were analyzed by unsupervised hierarchical cluster analysis. Intratumor stromal fibroblasts more frequently showed expression of MMP-2, -7, and -14, and TIMP-3, but less frequently of MMP-9 than fibroblasts at the invasive front. Multivariate analysis showed that a high profile of MMPs and TIMPs staining in both fibroblast populations was the most potent predictor factor of distant metastases, whereas a low staining profile in fibroblasts was associated with a low risk of metastases.
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Affiliation(s)
- J M Del Casar
- Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
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Alcoceba M, Marín L, Balanzategui A, Sarasquete ME, Martín-Jiménez P, Chillón MC, Corral R, Pérez-Persona E, Fernández-Calvo FJ, Hernández JM, Bladé J, Lahuerta JJ, González M, San Miguel JF, García-Sanz R. The presence of DRB1*01 allele in multiple myeloma patients is associated with an indolent disease. ACTA ACUST UNITED AC 2008; 71:548-51. [DOI: 10.1111/j.1399-0039.2008.01048.x] [Citation(s) in RCA: 3] [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: 11/28/2022]
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Sanabria M, Muñoz J, Trillos C, Hernández G, Latorre C, Díaz CS, Murad S, Rodríguez K, Rivera A, Amador A, Ardila F, Caicedo A, Camargo D, Díaz A, González J, Leguizamón H, Lopera P, Marín L, Nieto I, Vargas E. Dialysis outcomes in Colombia (DOC) study: a comparison of patient survival on peritoneal dialysis vs hemodialysis in Colombia. Kidney Int 2008:S165-72. [PMID: 18379541 DOI: 10.1038/sj.ki.5002619] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The goal of the Dialysis Outcomes in Colombia (DOC) study was to compare the survival of patients on hemodialysis (HD) vs peritoneal dialysis (PD) in a network of renal units in Colombia. The DOC study examined a historical cohort of incident patients starting dialysis therapy between 1 January 2001 and 1 December 2003 and followed until 1 December 2005, measuring demographic, socioeconomic, and clinical variables. Only patients older than 18 years were included. As-treated and intention-to-treat statistical analyses were performed using the Kaplan-Meier method and Cox proportional hazard model. There were 1094 eligible patients in total and 923 were actually enrolled: 47.3% started HD therapy and 52.7% started PD therapy. Of the patients studied, 751 (81.3%) remained in their initial therapy until the end of the follow-up period, death, or censorship. Age, sex, weight, height, body mass index, creatinine, calcium, and Subjective Global Assessment (SGA) variables did not show statistically significant differences between the two treatment groups. Diabetes, socioeconomic level, educational level, phosphorus, Charlson Co-morbidity Index, and cardiovascular history did show a difference, and were less favorable for patients on PD. Residual renal function was greater for PD patients. Also, there were differences in the median survival time between groups: 27.2 months for PD vs 23.1 months for HD (P=0.001) by the intention-to-treat approach; and 24.5 months for PD vs 16.7 months for HD (P<0.001) by the as-treated approach. When performing univariate Cox analyses using the intention-to-treat approach, associations were with age > or =65 years (hazard ratio (HR)=2.21; confidence interval (CI) 95% (1.77-2.755); P<0.001); history of cardiovascular disease (HR=1.96; CI 95% (1.58-2.90); P<0.001); diabetes (HR=2.34; CI 95% (1.88-2.90); P<0.001); and SGA (mild or moderate-severe malnutrition) (HR=1.47; CI 95% (1.17-1.79); P=0.001); but no association was found with gender (HR=1.03, CI 95% 0.83-1.27; P=0.786). Similar results were found with the as-treated approach, with additional associations found with Charlson Index (0-2) (HR=0.29; Cl 95% (0.22-0.38); P<0.001); Charlson Index (3-4) (HR=0.61; Cl 95% (0.48-0.79); P<0.001); and SGA (mild-severe malnutrition) (HR=1.43; Cl 95% (1.15-1.77); P<0.001). Similarly, the multivariate Cox model was run with the variables that had shown association in previous analyses, and it was found that the variables explaining the survival of patients with end-stage renal disease in our study were age, SGA, Charlson Comorbidity Index 5 and above, diabetes, healthcare regimes I and II, and socioeconomic level 2. The results of Cox proportional risk model in both the as-treated and intention-to-treat analyses showed that there were no statistically significant differences in survival of PD and HD patients: intention-to-treat HD/PD (HR 1.127; CI 95%: 0.855-1.484) and as-treated HD/PD (HR 1.231; CI 95%: 0.976-1.553). In this historical cohort of incident patients, there was a trend, although not statistically significant, for a higher (12.7%) adjusted mortality risk associated with HD when compared to PD, even though the PD patients were poorer, were more likely to be diabetic, and had higher co-morbidity scores than the HD patients. The variables that most influenced survival were age, diabetes, comorbidity, healthcare regime, socioeconomic level, nutrition, and education.
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Affiliation(s)
- M Sanabria
- Baxter - RTS Colombia, Bogotá, Colombia.
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Muro M, Marín L, Torio A, Pagan JA, Alvarez-López MR. CCL5/RANTES chemokine gene promoter polymorphisms are not associated with atopic and nonatopic asthma in a Spanish population. Int J Immunogenet 2008; 35:19-23. [PMID: 18186796 DOI: 10.1111/j.1744-313x.2007.00724.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CCL5/RANTES, a member of the C-C chemokine family, is a potent eosinophil, monocyte, basophile and lymphocyte chemo-attractant at the site of inflammation. Recent studies revealed that a functional mutation at the -403 position in the promoter may have significance for atopic dermatitis, bronchial asthma, sarcoidosis, rheumatoid arthritis and HIV infection, and others. Another polymorphism in the -28 position has been reported. Our objective was to investigate the possible influence of the CCL5/RANTES promoter polymorphisms in the different types of bronchial asthma. CCL5/RANTES genotyping was performed by polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP) in 306 asthmatic patients with non-atopic (n = 145) and atopic (n = 161) asthma and 242 controls. The 81.9% of the atopic asthma patients for -403G/A had the G allele and the A allele frequency was 18%. Of the non-atopic asthma patients, the G allele frequency was 79.7% and the A allele was 20.3%. Concerning the -28C/G polymorphism, the frequency of the CCL5/RANTES -28G allele in our patients is 2.8%, which is similar to Spanish adult population. After comparing patients with asthma, atopic patients, non-atopic patients and control population, we found no significant deviation in the distribution of the alleles or genotypes of CCL5/RANTES promoter polymorphisms in any tested comparison. Therefore, human CCL5/RANTES gene promoter polymorphisms are not associated with the different types of bronchial asthma in Spanish population.
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Affiliation(s)
- M Muro
- Department of Immunology, University Hospital Virgen Arrixaca, Murcia, Spain.
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