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Barranquero AG, Pastor P, Ortega A, Corral S, Gómez Ramírez J, Luengo P, Porrero B, Cabañas LJ. 4D-CT as a second line preoperative localization test for the evaluation of primary hyperparathyroidism. Cir Esp 2023; 101:530-537. [PMID: 35905870 DOI: 10.1016/j.cireng.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Four-dimensional computerized tomography (4D-CT) offers a good sensitivity for the localization of the pathological gland responsible of primary hyperparathyroidism. The aim was to evaluate its results as a second line preoperative localization test after inconclusive or discordant results of usual preoperative studies. MATERIAL AND METHODS Observational retrospective study that included all patients intervened for primary hyperparathyroidism with 4D-CT scan as preoperative study, from 1st October 2016 to 1st October 2021, in a tertiary referral centre. The results of 4D-CT, cervical ultrasound, and Nuclear Medicine explorations (scintigraphy, SPECT and SPECT-CT) were compared with the gold standard of the surgical exploration and the pathological result. The correct lateralization and the approximate localization rates of the pathological gland were evaluated. RESULTS A total of 64 patients were analysed, with a 93,8% (60/64) remission rate. 4DCT showed a correct lateralization in 57,8% (37/64) of the cases and revealed the approximate localization of the gland in 48,4% (31/64) of the cases. The cervical ultrasound had a rate of 31,1% (19/61) and 18% (11/61) for the correct lateralization and approximate localization, respectively, compared to 34,9% (22/63) and 28,6% (18/63) in Nuclear Medicine explorations, and 32,7% (16/49) and 24,5% (12/49) in SPECT-CT. These differences were statistically significant. CONCLUSION 4D-CT demonstrated acceptable results for the localization of the lesions responsible of primary hyperparathyroidism, thus its use should be considered with the absence of localization in routinely studies.
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Affiliation(s)
- Alberto G Barranquero
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Arnau de Vilanova, Lleida, Spain.
| | - Paula Pastor
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Ana Ortega
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Sara Corral
- Sección de Cirugía Endocrina, Mama, Sarcoma y Melanoma - Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Joaquín Gómez Ramírez
- Unidad de Cirugía Endocrina y Cirugía de Mama - Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario La Paz, Madrid, Spain
| | - Patricia Luengo
- Sección de Cirugía Endocrina, Mama, Sarcoma y Melanoma - Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Belén Porrero
- Sección de Cirugía Endocrina, Mama, Sarcoma y Melanoma - Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Luis Jacobo Cabañas
- Sección de Cirugía Endocrina, Mama, Sarcoma y Melanoma - Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Martinez-Arroyo O, Ortega A, Flores-Chova A, Sanchez-Garcia B, Garcia-Garcia AB, Chaves FJ, Martin-Escudero JC, Forner MJ, Redon J, Cortes R. High miR-126-3p levels associated with cardiovascular events in a general population. Eur J Intern Med 2023; 113:49-56. [PMID: 37080818 PMCID: PMC10271715 DOI: 10.1016/j.ejim.2023.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/27/2023] [Accepted: 04/12/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Endothelial dysfunction is a forerunner of atherosclerosis, leading to cardiovascular disease, and albuminuria is a marker of endothelial dysfunction. Circulating levels of microRNAs are emerging as potential biomarkers for cardiovascular disease. Here we estimate the predictive value of a plasma microRNAs signature associated with albuminuria in the incidence of cardiovascular events. METHODS Plasma microRNAs quantified in hypertensive patients by next generation sequencing were validated in a cohort of patients and controls by real-time quantitative PCR. The microRNAs found to be associated with albuminuria were analysed for their prognostic value in predicting cardiovascular events incidence on a retrospective, population-based study (Hortega Study), using Cox proportional hazard models. RESULTS A plasma microRNA profile was identified in the discovery cohort (n = 48) associated with albuminuria and three microRNAs (miR-126-3p, miR-1260b and miR-374a-5p) were confirmed in the validation cohort (n = 98). The microRNA signature discriminates urinary albumin excretion at baseline (n = 1025), and predicts the incidence of cardiovascular events and coronary heart disease and stroke in a general population retrospective study within a 14-year follow-up (n = 926). High miR-126-3p levels were associated with a shorter time free of both cardiovascular events (HR=1.48, (1.36-1.62), p < 0.0001), as well as coronary artery disease and stroke combined (HR=2.49, (2.19-2.83), p < 0.0001). CONCLUSIONS An increased plasma microRNAs profile was identified in hypertensive patients with albuminuria. Increased miR-126-3p suggest it may serve as a prognostic marker for cardiovascular events in a long-term general population. Further studies will assess the potential role of miR-126-3p as a guide for the status of endothelial dysfunction.
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Affiliation(s)
- Olga Martinez-Arroyo
- Cardiometabolic and Renal Risk Research Group, Biomedical Research Institute of Hospital Clinico de Valencia INCLIVA, Valencia, Spain
| | - Ana Ortega
- Cardiometabolic and Renal Risk Research Group, Biomedical Research Institute of Hospital Clinico de Valencia INCLIVA, Valencia, Spain; CIBERCV (CIBER of Cardiovascular Diseases), Madrid, Spain.
| | - Ana Flores-Chova
- Cardiometabolic and Renal Risk Research Group, Biomedical Research Institute of Hospital Clinico de Valencia INCLIVA, Valencia, Spain
| | - Belen Sanchez-Garcia
- Cardiometabolic and Renal Risk Research Group, Biomedical Research Institute of Hospital Clinico de Valencia INCLIVA, Valencia, Spain
| | | | - Felipe J Chaves
- CIBERDEM (CIBER of Diabetes and Metabolic Diseases), Madrid, Spain; Unit of Genomics and Diabetes, Biomedical Research Institute of Hospital Clinico de Valencia INCLIVA, Valencia, Spain
| | - Juan C Martin-Escudero
- Department of Internal Medicine, Rio Hortega Universitary Hospital, Valladolid, Spain; Department of Medicine, Faculty of Medicine, University of Valladolid, Valladolid, Spain
| | - Maria Jose Forner
- Department of Internal Medicine, University Hospital Clinico, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - Josep Redon
- Cardiometabolic and Renal Risk Research Group, Biomedical Research Institute of Hospital Clinico de Valencia INCLIVA, Valencia, Spain; Department of Internal Medicine, University Hospital Clinico, Valencia, Spain; CIBEROBN (CIBER of Obesity and Nutrition Physiopathology), Madrid, Spain
| | - Raquel Cortes
- Cardiometabolic and Renal Risk Research Group, Biomedical Research Institute of Hospital Clinico de Valencia INCLIVA, Valencia, Spain.
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Martinez-Arroyo O, Flores-Chova A, Sanchez-Garcia B, Redon J, Cortes R, Ortega A. Rab3A/Rab27A System Silencing Ameliorates High Glucose-Induced Injury in Podocytes. Biology (Basel) 2023; 12:biology12050690. [PMID: 37237503 DOI: 10.3390/biology12050690] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/04/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023]
Abstract
Diabetic nephropathy is a major complication in diabetic patients. Podocytes undergo loss and detachment from the basal membrane. Intra- and intercellular communication through exosomes are key processes for maintaining function, and the Rab3A/Rab27A system is an important counterpart. Previously, we observed significant changes in the Rab3A/Rab27A system in podocytes under glucose overload, demonstrating its important role in podocyte injury. We investigated the implication of silencing the Rab3A/Rab27A system in high glucose-treated podocytes and analysed the effect on differentiation, apoptosis, cytoskeletal organisation, vesicle distribution, and microRNA expression in cells and exosomes. For this, we subjected podocytes to high glucose and transfection through siRNAs, and we isolated extracellular vesicles and performed western blotting, transmission electron microscopy, RT-qPCR, immunofluorescence and flow cytometry assays. We found that silencing RAB3A and RAB27A generally leads to a decrease in podocyte differentiation and cytoskeleton organization and an increase in apoptosis. Moreover, CD63-positive vesicles experienced a pattern distribution change. Under high glucose, Rab3A/Rab27A silencing ameliorates some of these detrimental processes, suggesting a differential influence depending on the presence or absence of cellular stress. We also observed substantial expression changes in miRNAs that were relevant in diabetic nephropathy upon silencing and glucose treatment. Our findings highlight the Rab3A/Rab27A system as a key participant in podocyte injury and vesicular traffic regulation in diabetic nephropathy.
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Affiliation(s)
- Olga Martinez-Arroyo
- Cardiometabolic and Renal Risk Research Group, Biomedical Research Institute of Hospital Clinico de Valencia INCLIVA, 46010 Valencia, Spain
| | - Ana Flores-Chova
- Cardiometabolic and Renal Risk Research Group, Biomedical Research Institute of Hospital Clinico de Valencia INCLIVA, 46010 Valencia, Spain
| | - Belen Sanchez-Garcia
- Cardiometabolic and Renal Risk Research Group, Biomedical Research Institute of Hospital Clinico de Valencia INCLIVA, 46010 Valencia, Spain
| | - Josep Redon
- Cardiometabolic and Renal Risk Research Group, Biomedical Research Institute of Hospital Clinico de Valencia INCLIVA, 46010 Valencia, Spain
- CIBEROBN (CIBER of Obesity and Nutrition Physiopathology), Institute of Health Carlos III, Minister of Health, 28029 Madrid, Spain
| | - Raquel Cortes
- Cardiometabolic and Renal Risk Research Group, Biomedical Research Institute of Hospital Clinico de Valencia INCLIVA, 46010 Valencia, Spain
| | - Ana Ortega
- Cardiometabolic and Renal Risk Research Group, Biomedical Research Institute of Hospital Clinico de Valencia INCLIVA, 46010 Valencia, Spain
- CIBERCV (CIBER of Cardiovascular Diseases), Institute of Health Carlos III, Minister of Health, 28029 Madrid, Spain
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Flores-Chova A, Martinez-Arroyo O, Riffo-Campos AL, Ortega A, Forner MJ, Cortes R. Plasma Exosomal Non-Coding RNA Profile Associated with Renal Damage Reveals Potential Therapeutic Targets in Lupus Nephritis. Int J Mol Sci 2023; 24:ijms24087088. [PMID: 37108249 PMCID: PMC10139178 DOI: 10.3390/ijms24087088] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
Despite considerable progress in our understanding of systemic lupus erythematosus (SLE) pathophysiology, patient diagnosis is often deficient and late, and this has an impact on disease progression. The aim of this study was to analyze non-coding RNA (ncRNA) packaged into exosomes by next-generation sequencing to assess the molecular profile associated with renal damage, one of the most serious complications of SLE, to identify new potential targets to improve disease diagnosis and management using Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. The plasma exosomes had a specific ncRNA profile associated with lupus nephritis (LN). The three ncRNA types with the highest number of differentially expressed transcripts were microRNAs (miRNAs), long non-coding RNAs (lncRNAs) and piwi-interacting RNAs (piRNAs). We identified an exosomal 29-ncRNA molecular signature, of which 15 were associated only with LN presence; piRNAs were the most representative, followed by lncRNAs and miRNAs. The transcriptional regulatory network showed a significant role for four lncRNAs (LINC01015, LINC01986, AC087257.1 and AC022596.1) and two miRNAs (miR-16-5p and miR-101-3p) in network organization, targeting critical pathways implicated in inflammation, fibrosis, epithelial-mesenchymal transition and actin cytoskeleton. From these, a handful of potential targets, such as transforming growth factor-β (TGF-β) superfamily binding proteins (activin-A, TGFB receptors, etc.), WNT/β-catenin and fibroblast growth factors (FGFs) have been identified for use as therapeutic targets of renal damage in SLE.
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Affiliation(s)
- Ana Flores-Chova
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
| | - Olga Martinez-Arroyo
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
| | - Angela L Riffo-Campos
- Millennium Nucleus on Sociomedicine (SocioMed) and Universidad de La Frontera, Doctorado en Ciencias Medicas, Temuco 4780000, Chile
- Department of Computer Science, ETSE, University of Valencia, 46010 Valencia, Spain
| | - Ana Ortega
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
- CIBERCV (CIBER of Cardiovascular Diseases), 28029 Madrid, Spain
| | - Maria J Forner
- Internal Medicine Unit, Hospital Clinico Universitario, 46010 Valencia, Spain
- Department of Medicine, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
| | - Raquel Cortes
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
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Brunelli MV, Estrada S, Celano C, Bandriwskyj C, Riquelme RJ, Ortega A, Gonzalez EG, Monserrat IE, Mesurado B. [Second victim experience and support from health professionals]. Medicina (B Aires) 2023; 83:918-926. [PMID: 38117711] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
INTRODUCTION The second victims are those professionals who, when faced with a mistake, are traumatized, questioning their professional and personal skills. Knowledge of their experience allows institutions to understand the consequences of error in professionals to carry out care actions for the professionals involved, improving care security. The objective of this study is to characterize the phenomenon of second victims and to know the perceived support measures. METHOD Cross-sectional descriptive observational quantitative study. Health professionals from five highly complex institutions participated through convenience sampling. The data collection instrument was the Second Victim Experience and Support Tool (SVEST) validated in Argentina, composed of impact dimensions (psychological, physical and professional skills) of support received (colleagues, supervisors, institutional and measures not related to the workplace) and two outcome dimensions (professional abandonment and absenteeism). RESULTS 1134 professionals participated and 56% said they had made a mistake. The mean STEVS was 2.5, with the psychological impact dimension predominating (x = 3.4). As part of the support measures, professionals perceived greater support from family and friends (not related to work) (x = 3.1). The greater the impact, the lower the perception of support measures (Rho: -0.8, p = 0.047). DISCUSSION More than half of the professionals refer to being second victim with a significant psychological impact, who, despite working in institutions that have patient safety protocols, received support from nonwork-related environments.
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Affiliation(s)
| | - Silvina Estrada
- Facultad de Ciencia Biomédicas, Universidad Austral, Buenos Aires, Argentina
| | - Constanza Celano
- Facultad de Ciencia Biomédicas, Universidad Austral, Buenos Aires, Argentina
| | | | - Reinaldo J Riquelme
- Hospital Universitario Austral, Universidad Austral, Buenos Aires, Argentina
| | - Ana Ortega
- Hospital Materno Infantil Florencio Escardó, Buenos Aires, Argentina
| | | | | | - Belén Mesurado
- Facultad de Ciencia Biomédicas, Universidad Austral, Buenos Aires, Argentina
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Luri M, Gastaminza G, Idoate A, Ortega A. Allergic Adverse Drug Events After Alert Overrides in Hospitalized Patients. J Patient Saf 2022; 18:630-636. [PMID: 35617638 DOI: 10.1097/pts.0000000000001034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aimed to assess how often overridden drug allergy alerts (ODAAs) lead to allergic adverse drug events (All-ADEs) and to evaluate the frequency with which drug allergy alerts (DAAs) were overridden and the reasons, as well as appropriateness of these overrides. METHODS A retrospective observational study of DAA generated between 2014 and 2016 was conducted. The corresponding DAA records were reviewed to determine the frequency of alert overrides. A chart review was performed on a subset of 194 ODAA (the first of every 3 chronologically ordered ODAA) to identify All-ADEs and to evaluate the override reasons and the appropriateness of these overrides. RESULTS A total of 2044 DAAs were overridden (override rate of 44.8%). Most were triggered by a nonexact match (93.81%), when ordering nervous system (21.1%) and cardiovascular system (19.6%) drugs and were generated by physicians (72.7%). The main override reason was that the patient was already taking the drug or had previously tolerated the drug. Only 9.28% of ODAAs were inappropriately overridden. Six All-ADEs (3.09%) were identified and were due to anti-infective (1), antineoplastic (1), and iodinated-contrast (4) drug administration. Most All-ADEs were cutaneous and were mild. None was life-threatening or fatal. The All-ADEs rate was higher among inappropriately ODAA (15.79%, P = 0.013). CONCLUSIONS Alert overrides are not exempt from clinical consequences, although few are associated with All-ADEs. It is necessary to identify the drugs involved in those reactions and to update allergy lists to generate only specific and important DAA and to avoid the negative consequences of overrides.
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Riffo-Campos AL, Perez-Hernandez J, Martinez-Arroyo O, Ortega A, Flores-Chova A, Redon J, Cortes R. Biofluid Specificity of Long Non-Coding RNA Profile in Hypertension: Relevance of Exosomal Fraction. Int J Mol Sci 2022; 23:ijms23095199. [PMID: 35563588 PMCID: PMC9101961 DOI: 10.3390/ijms23095199] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 11/16/2022] Open
Abstract
Non-coding RNA (ncRNA)-mediated targeting of various genes regulates the molecular mechanisms of the pathogenesis of hypertension (HTN). However, very few circulating long ncRNAs (lncRNAs) have been reported to be altered in essential HTN. The aim of our study was to identify a lncRNA profile in plasma and plasma exosomes associated with urinary albumin excretion in HTN by next-generation sequencing and to assess biological functions enriched in response to albuminuria using GO and KEGG analysis. Plasma exosomes showed higher diversity and fold change of lncRNAs than plasma, and low transcript overlapping was found between the two biofluids. Enrichment analysis identified different biological pathways regulated in plasma or exosome fraction, which were implicated in fatty acid metabolism, extracellular matrix, and mechanisms of sorting ncRNAs into exosomes, while plasma pathways were implicated in genome reorganization, interference with RNA polymerase, and as scaffolds for assembling transcriptional regulators. Our study found a biofluid specific lncRNA profile associated with albuminuria, with higher diversity in exosomal fraction, which identifies several potential targets that may be utilized to study mechanisms of albuminuria and cardiovascular damage.
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Affiliation(s)
- Angela L. Riffo-Campos
- Millennium Nucleus on Sociomedicine (SocioMed) and Vicerrectoría Académica, Universidad de La Frontera, Temuco 4780000, Chile;
- Department of Computer Science, ETSE, University of Valencia, 46010 Valencia, Spain
| | - Javier Perez-Hernandez
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (J.P.-H.); (O.M.-A.); (A.F.-C.); (J.R.)
- Department of Nutrition and Health, Valencian International University (VIU), 46002 Valencia, Spain
- T-Cell Tolerance, Biomarkers and Therapies in Type 1 Diabetes Team, Institut Cochin CNRS, INSERM, Université de Paris Cité, F-75014 Paris, France
| | - Olga Martinez-Arroyo
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (J.P.-H.); (O.M.-A.); (A.F.-C.); (J.R.)
| | - Ana Ortega
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (J.P.-H.); (O.M.-A.); (A.F.-C.); (J.R.)
- Correspondence: (A.O.); (R.C.); Tel.: +34-961973517 (R.C.)
| | - Ana Flores-Chova
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (J.P.-H.); (O.M.-A.); (A.F.-C.); (J.R.)
| | - Josep Redon
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (J.P.-H.); (O.M.-A.); (A.F.-C.); (J.R.)
- Internal Medicine Unit, Hospital Clinico Universitario, 46010 Valencia, Spain
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Minister of Health, 28029 Madrid, Spain
| | - Raquel Cortes
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (J.P.-H.); (O.M.-A.); (A.F.-C.); (J.R.)
- Correspondence: (A.O.); (R.C.); Tel.: +34-961973517 (R.C.)
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Pape S, Snijders RJALM, Gevers TJG, Chazouilleres O, Dalekos GN, Hirschfield GM, Lenzi M, Trauner M, Manns MP, Vierling JM, Montano-Loza AJ, Lohse AW, Schramm C, Drenth JPH, Heneghan MA, Alvarez F, Andrade R, Arikan C, Assis D, Bardou-Jacquet E, Biewenga M, Cancado E, Cazzagon N, Chazouillères O, Colloredo G, Cuarterolo M, Dalekos G, Debray D, Robles-Díaz M, Drenth J, Dyson J, Efe C, Engel B, Ferri S, Fontana R, Gatselis N, Gerussi A, Halilbasic E, Halliday N, Heneghan M, Hirschfield G, van Hoek B, Hørby Jørgensen M, Indolfini G, Iorio R, Jeong S, Jones D, Kelly D, Kerkar N, Lacaille F, Lammert C, Leggett B, Lenzi M, Levy C, Liberal R, Lleo A, Lohse A, Ines Lopez S, de Martin E, McLin V, Mieli-Vergani G, Milkiewicz P, Mohan N, Muratori L, Nebbia G, van Nieuwkerk C, Oo Y, Ortega A, Páres A, Pop T, Pratt D, Purnak T, Ranucci G, Rushbrook S, Schramm C, Stättermayer A, Swain M, Tanaka A, Taubert R, Terrabuio D, Terziroli B, Trauner M, Valentino P, van den Brand F, Villamil A, Wahlin S, Ytting H, Zachou K, Zeniya M. Systematic review of response criteria and endpoints in autoimmune hepatitis by the International Autoimmune Hepatitis Group. J Hepatol 2022; 76:841-849. [PMID: 35066089 DOI: 10.1016/j.jhep.2021.12.041] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [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: 04/09/2021] [Revised: 11/18/2021] [Accepted: 12/11/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Autoimmune hepatitis (AIH) has been well characterised and codified through the development of diagnostic criteria. These criteria have been adapted and simplified and are widely used in clinical practice. However, there is a need to update and precisely define the criteria for both treatment response and treatment. METHODS A systematic review was performed and a modified Delphi consensus process was used to identify and redefine the response criteria in autoimmune hepatitis. RESULTS The consensus process initiated by the International Autoimmune Hepatitis Group proposes that the term 'complete biochemical response' defined as 'normalization of serum transaminases and IgG below the upper limit of normal' be adopted to include a time point at 6 months after initiation of treatment. An insufficient response by 6 months was a failure to meet the above definition. Non-response was defined as '<50% decrease of serum transaminases within 4 weeks after initiation of treatment'. Remission is defined as liver histology with a Hepatitis Activity Index <4/18. Intolerance to treatment was agreed to stand for 'any adverse event possibly related to treatment leading to potential drug discontinuation'. CONCLUSIONS These definitions provide a simple and reproducible framework to define treatment response and non-response, irrespective of the therapeutic intervention. A consensus on endpoints is urgently required to set a global standard for the reporting of study results and to enable inter-study comparisons. Future prospective database studies are needed to validate these endpoints. LAY SUMMARY Consensus among international experts on response criteria and endpoints in autoimmune hepatitis is lacking. A consensus on endpoints is urgently required to set a global standard for the reporting of study results and to enable the comparison of results between clinical trials. Therefore, the International Autoimmune Hepatitis Group (IAIHG) herein presents a statement on 5 agreed response criteria and endpoints: complete biochemical response, insufficient response, non-response, remission, and intolerance to treatment, which can be used to guide future reporting.
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Affiliation(s)
- Simon Pape
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Romée J A L M Snijders
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Tom J G Gevers
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands; Division of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht 6229HX, The Netherlands; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Oliver Chazouilleres
- Hepatology Department, Reference Center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, Saint-Antoine Hospital Assistance Publique-Hôpitaux de Paris, Paris, France; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - George N Dalekos
- Department of Medicine and Research Laboratory of Internal Medicine, University of Thessaly Medical School, Larissa, Greece
| | - Gideon M Hirschfield
- Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada
| | - Marco Lenzi
- Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Michael Trauner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Michael P Manns
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - John M Vierling
- Departments of Medicine and Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Aldo J Montano-Loza
- Division of Gastroenterology and Hepatology, University of Alberta Hospital, Edmonton, Canada
| | - Ansgar W Lohse
- 1(st) Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Christoph Schramm
- 1(st) Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Martin Zeitz Centre for Rare Diseases, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Joost P H Drenth
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands; European Reference Network on Hepatological Diseases (ERN RARE-LIVER)
| | - Michael A Heneghan
- Institute of Liver Studies, King's College Hospital, London, United Kingdom; European Reference Network on Hepatological Diseases (ERN RARE-LIVER).
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9
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Martinez-Arroyo O, Ortega A, Forner MJ, Cortes R. Mesenchymal Stem Cell-Derived Extracellular Vesicles as Non-Coding RNA Therapeutic Vehicles in Autoimmune Diseases. Pharmaceutics 2022; 14:pharmaceutics14040733. [PMID: 35456567 PMCID: PMC9028692 DOI: 10.3390/pharmaceutics14040733] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 02/14/2022] [Revised: 03/17/2022] [Accepted: 03/26/2022] [Indexed: 02/07/2023] Open
Abstract
Autoimmune diseases (ADs) are characterized by the activation of the immune system against self-antigens. More common in women than in men and with an early onset, their incidence is increasing worldwide, and this, combined with their chronic nature, is contributing to an enlarged medical and economic burden. Conventional immunosuppressive agents are designed to alleviate symptoms but do not constitute an effective therapy, highlighting a need to develop new alternatives. In this regard, mesenchymal stem cells (MSCs) have demonstrated powerful immunosuppressive and regenerative effects. MSC-derived extracellular vesicles (MSC-EVs) have shown some advantages, such as less immunogenicity, and are proposed as novel therapies for ADs. In this review, we summarize current perspectives on therapeutic options for ADs based on MSCs and MSC-EVs, focusing particularly on their mechanism of action exerted through their non-coding RNA (ncRNA) cargo. A complete state-of-the-art review was performed, centralized on some of the most severe ADs (rheumatoid arthritis, autoimmune type 1 diabetes mellitus, and systemic lupus erythematosus), giving evidence that a promising field is evolving to overcome the current knowledge and provide new therapeutic possibilities centered on MSC-EVs and their role as ncRNA delivery vehicles for AD gene therapy.
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Affiliation(s)
- Olga Martinez-Arroyo
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (O.M.-A.); (M.J.F.)
| | - Ana Ortega
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (O.M.-A.); (M.J.F.)
- Correspondence: (A.O.); (R.C.); Tel.: +34-96398-3916 (R.C.); Fax: +34-96398-7860 (R.C.)
| | - Maria J. Forner
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (O.M.-A.); (M.J.F.)
- Internal Medicine Unit, Hospital Clinico Universitario, 46010 Valencia, Spain
| | - Raquel Cortes
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (O.M.-A.); (M.J.F.)
- Correspondence: (A.O.); (R.C.); Tel.: +34-96398-3916 (R.C.); Fax: +34-96398-7860 (R.C.)
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10
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Luri M, Leache L, Gastaminza G, Idoate A, Ortega A. A systematic review of drug allergy alert systems. Int J Med Inform 2022; 159:104673. [PMID: 34990941 DOI: 10.1016/j.ijmedinf.2021.104673] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 09/09/2021] [Revised: 11/12/2021] [Accepted: 12/20/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND OBJECTIVE Drug allergy alert systems (DAAS), have been considered an effective strategy to reduce preventable adverse drug events (ADEs), improving patient's safety. To date, no review has been conducted analyzing characteristics of DAAS in the hospital setting. Therefore, the aim of this study is to identify, describe and summarize the DAAS used in hospitals. The secondary objectives are to analyse drug allergy alerts (DAA) characteristics, the override rate (OvR) and the clinical consequences of alert overrides. METHODS Searches were conducted in Medline and Cochrane Library to identify studies describing DAAS. Systems characteristics, generated alerts, DAA, OvR, and its clinical consequences were extracted and analyzed. RESULTS Twenty-eight articles were included in the review. Seventeen different electronic DAAS were identified, of which 53% were commercially available. Systems differed in drug allergy information and rules for generating alerts. DAA were generally interruptive, triggered by non-exact match at drug prescribing and when ignored, an override reason was mandatory. The OvR ranged from 43.7% to 97%. The main override reason given by providers was that 'patient had previously tolerated or had taken the drug without allergic reaction'. Clinical consequences of overriding DAA were only analyzed in four studies, with an ADE incidence between 0% and 6%. CONCLUSIONS Different DAAS are used in hospitals with some degree of heterogeneity. Accurate and updated drug allergy information is important to generate only high value alerts. A regular review of DAAS and a standardization of alert rules, alert information and override reasons are necessary to optimize systems. Future studies should evaluate the impact of the DAAS aspects on preventing ADEs.
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Affiliation(s)
- Marta Luri
- Hospital Pharmacy Services, Clínica Universidad de Navarra, Pio XII Avenue 36, Zip code: 31008, Pamplona, Spain.
| | - Leire Leache
- Unit of Innovation and Organization, Navarre Health Service, Tudela Street 20, 1(st) floor, Zip code: 31003, Pamplona, Spain.
| | - Gabriel Gastaminza
- Allergology Department, Clínica Universidad de Navarra, Pio XII Avenue 36, Zip code: 31008, Pamplona, Spain.
| | - Antonio Idoate
- Hospital Pharmacy Services, Clínica Universidad de Navarra, Pio XII Avenue 36, Zip code: 31008, Pamplona, Spain.
| | - Ana Ortega
- Hospital Pharmacy Services, Clínica Universidad de Navarra, Pio XII Avenue 36, Zip code: 31008, Pamplona, Spain.
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11
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Riffo-Campos AL, Perez-Hernandez J, Ortega A, Martinez-Arroyo O, Flores-Chova A, Redon J, Cortes R. Exosomal and Plasma Non-Coding RNA Signature Associated with Urinary Albumin Excretion in Hypertension. Int J Mol Sci 2022; 23:ijms23020823. [PMID: 35055008 PMCID: PMC8775608 DOI: 10.3390/ijms23020823] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/03/2022] [Accepted: 01/11/2022] [Indexed: 12/13/2022] Open
Abstract
Non-coding RNA (ncRNA), released into circulation or packaged into exosomes, plays important roles in many biological processes in the kidney. The purpose of the present study is to identify a common ncRNA signature associated with early renal damage and its related molecular pathways. Three individual libraries (plasma and urinary exosomes, and total plasma) were prepared from each hypertensive patient (with or without albuminuria) for ncRNA sequencing analysis. Next, an RNA-based transcriptional regulatory network was constructed. The three RNA biotypes with the greatest number of differentially expressed transcripts were long-ncRNA (lncRNA), microRNA (miRNA) and piwi-interacting RNA (piRNAs). We identified a common 24 ncRNA molecular signature related to hypertension-associated urinary albumin excretion, of which lncRNAs were the most representative. In addition, the transcriptional regulatory network showed five lncRNAs (LINC02614, BAALC-AS1, FAM230B, LOC100505824 and LINC01484) and the miR-301a-3p to play a significant role in network organization and targeting critical pathways regulating filtration barrier integrity and tubule reabsorption. Our study found an ncRNA profile associated with albuminuria, independent of biofluid origin (urine or plasma, circulating or in exosomes) that identifies a handful of potential targets, which may be utilized to study mechanisms of albuminuria and cardiovascular damage.
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Affiliation(s)
- Angela L. Riffo-Campos
- Millennium Nucleus on Sociomedicine (SocioMed) and Vicerrectoría Académica, Universidad de La Frontera, Temuco 4780000, Chile;
- Department of Computer Science, ETSE, University of Valencia, 46010 Valencia, Spain
| | - Javier Perez-Hernandez
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (J.P.-H.); (A.O.); (O.M.-A.); (A.F.-C.); (J.R.)
- Departament of Nutrition and Health, Valencian International University (VIU), 46010 Valencia, Spain
- T-Cell Tolerance, Biomarkers and Therapies in Type 1 Diabetes Team, Institut Cochin, CNRS, INSERM, Université de Paris, 75014 Paris, France
| | - Ana Ortega
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (J.P.-H.); (A.O.); (O.M.-A.); (A.F.-C.); (J.R.)
| | - Olga Martinez-Arroyo
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (J.P.-H.); (A.O.); (O.M.-A.); (A.F.-C.); (J.R.)
| | - Ana Flores-Chova
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (J.P.-H.); (A.O.); (O.M.-A.); (A.F.-C.); (J.R.)
| | - Josep Redon
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (J.P.-H.); (A.O.); (O.M.-A.); (A.F.-C.); (J.R.)
- Internal Medicine Unit, Hospital Clinico Universitario, 46010 Valencia, Spain
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Minister of Health, 28029 Madrid, Spain
| | - Raquel Cortes
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (J.P.-H.); (A.O.); (O.M.-A.); (A.F.-C.); (J.R.)
- Correspondence: ; Tel.: +34-961973517
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12
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Orsolini MF, Verstraete MH, van Heule M, Orellana D, Ortega A, Meyers S, Dini P. 93 Zeta potential of equine sperm and its association with sperm quality. Reprod Fertil Dev 2021; 34:283-284. [PMID: 35231223 DOI: 10.1071/rdv34n2ab93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- M F Orsolini
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - M H Verstraete
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - M van Heule
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - D Orellana
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - A Ortega
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - S Meyers
- Department of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - P Dini
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
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13
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Martinez-Arroyo O, Selma-Soriano E, Ortega A, Cortes R, Redon J. Small Rab GTPases in Intracellular Vesicle Trafficking: The Case of Rab3A/Raphillin-3A Complex in the Kidney. Int J Mol Sci 2021; 22:7679. [PMID: 34299299 PMCID: PMC8303874 DOI: 10.3390/ijms22147679] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 12/12/2022] Open
Abstract
Small Rab GTPases, the largest group of small monomeric GTPases, regulate vesicle trafficking in cells, which are integral to many cellular processes. Their role in neurological diseases, such as cancer and inflammation have been extensively studied, but their implication in kidney disease has not been researched in depth. Rab3a and its effector Rabphillin-3A (Rph3A) expression have been demonstrated to be present in the podocytes of normal kidneys of mice rats and humans, around vesicles contained in the foot processes, and they are overexpressed in diseases with proteinuria. In addition, the Rab3A knockout mice model induced profound cytoskeletal changes in podocytes of high glucose fed animals. Likewise, RphA interference in the Drosophila model produced structural and functional damage in nephrocytes with reduction in filtration capacities and nephrocyte number. Changes in the structure of cardiac fiber in the same RphA-interference model, open the question if Rab3A dysfunction would produce simultaneous damage in the heart and kidney cells, an attractive field that will require attention in the future.
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Affiliation(s)
- Olga Martinez-Arroyo
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (O.M.-A.); (R.C.)
| | - Estela Selma-Soriano
- Physiopathology of Cellular and Organic Oxidative Stress Group, University of Valencia, 46100 Valencia, Spain;
| | - Ana Ortega
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (O.M.-A.); (R.C.)
| | - Raquel Cortes
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (O.M.-A.); (R.C.)
| | - Josep Redon
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (O.M.-A.); (R.C.)
- CIBERObn, Carlos III Institute, 28029 Madrid, Spain
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14
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Nagahara M, Krishnamachari B, Ogura M, Ortega A, Tanaka Y, Ushifusa Y, Valente TW. Control, intervention, and behavioral economics over human social networks against COVID-19. Adv Robot 2021. [DOI: 10.1080/01691864.2021.1928553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- M. Nagahara
- Institute of Environmental Science and Technology, The University of Kitakyushu, Kitakyushu, Japan
| | - B. Krishnamachari
- Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, USA
| | - M. Ogura
- Graduate School of Information Science and Technology, Osaka University, Osaka, Japan
| | - A. Ortega
- Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, USA
| | - Y. Tanaka
- Department of Electrical Engineering and Computer Science, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Y. Ushifusa
- Faculty of Economics and Business Administration, The University of Kitakyushu, Kitakyushu, Japan
| | - T. W. Valente
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
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15
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Ortega-Cortez A, Espinoza-Navarro O, Ortega A, Brito-Hernández L. Rendimiento Académico de Estudiantes Universitarios en Asignaturas de las Ciencias Morfológicas: Uso de Aprendizajes Activos Basados en Problemas (ABP). INT J MORPHOL 2021. [DOI: 10.4067/s0717-95022021000200401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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16
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Garrido I, Ortega A, Hernández M, Fernández-Pozo L, Cabezas J, Espinosa F. Effect of antimony in soils of an Sb mine on the photosynthetic pigments and antioxidant system of Dittrichia viscosa leaves. Environ Geochem Health 2021; 43:1367-1383. [PMID: 32562108 DOI: 10.1007/s10653-020-00616-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
Antimony is a toxic element whose concentration in soil and water has been rising due to anthropogenic activities. This study focuses on its accumulation in leaves of Dittrichia viscosa growing in soils of an abandoned Sb mine, and the effect on oxidant/antioxidant systems and photosynthetic efficiency. The results showed leaves to have a high Sb accumulation capacity. The amount of total chlorophyll decreased depending on Sb concentration and of carotenoids increased slightly, with a consequent increase in carotenoid/chlorophyll ratio. Photosynthetic efficiency was unaffected. The amount of O 2 .- rose, although there was no increase in cell membrane damage, with lipid peroxidation levels being similar to normal. This response may be due to considerable increases that were observed in total phenolics, PPO activity, and enzymatic antioxidant system. SOD, POX, and DHAR activities increased in response to increased Sb amounts in leaves. The ascorbate/glutathione cycle was also affected, with strong increases observed in all of its components, and consequent increases in total contents of the ascorbate and glutathione pools. However, the ratio between reduced and oxidized forms declined, reflecting an imbalance between the two, especially that between GSH and GSSG. Efficient detoxification of Sb may take place either through increases in phenolics, carotenoids, and components of the glutathione-ascorbate cycle or through the enzymatic antioxidant system. Since Dittrichia viscosa accumulates large amounts of Sb without suffering oxidative damage, it could be used for phytoremediation.
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Affiliation(s)
- I Garrido
- Research Group of Physiology, Cellular and Molecular Biology of Plants, UEx, Av. Elvas, s/n, 06071, Badajoz, Spain
| | - A Ortega
- Research Group of Physiology, Cellular and Molecular Biology of Plants, UEx, Av. Elvas, s/n, 06071, Badajoz, Spain
| | - M Hernández
- European University of the Atlantic, Scientific and Technological Park of Cantabria, 39011, Santander, Spain
| | - L Fernández-Pozo
- Research Group of Environmental Resources Analysis, UEx, Avenida de Elvas, s/n, 06071, Badajoz, Spain
| | - J Cabezas
- Research Group of Environmental Resources Analysis, UEx, Avenida de Elvas, s/n, 06071, Badajoz, Spain
| | - F Espinosa
- Research Group of Physiology, Cellular and Molecular Biology of Plants, UEx, Av. Elvas, s/n, 06071, Badajoz, Spain.
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17
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Aldaz A, Idoate Grijalba AI, Ortega A, Aquerreta I, Monedero P. Effectiveness of Pharmacokinetic/Pharmacodynamic-Guided Meropenem Treatment in Critically Ill Patients: A Comparative Cohort Study. Ther Drug Monit 2021; 43:256-263. [PMID: 33149053 DOI: 10.1097/ftd.0000000000000826] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/25/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The proper dosage of antibiotics is a key element in the effective treatment of infection, especially in critically ill patients. This study aimed to evaluate the efficacy of optimized meropenem regimens based on pharmacokinetic/pharmacodynamic criteria in patients admitted to the intensive care unit. METHODS This observational, naturalistic, retrospective, unicentric cohort study was performed between May 2011 and December 2017. The clinical and bacteriologic responses of 77 control intensive care unit patients receiving meropenem were compared with those of 77 propensity score-balanced patients who received meropenem dose adjusted by therapeutic drug monitoring. The primary end point of clinical response was a reduction at the end of treatment of at least 80% of the maximum procalcitonin (PCT) value recorded during the meropenem treatment. RESULTS The primary end point was met by 55 patients (71.4%) in the adjusted group compared with 41 (53.3%) patients in the control group (mean difference 18.1%, P = 0.02). Fifty-one patients (66.2%) in the adjusted group required a meropenem dose adjustment, being necessary in 46 of them (90.2%) to decrease the dose. The reduction of PCT was the greatest in the adjusted group compared with the unadjusted group (93% versus 85%, P = 0.004); a greater percentage of patients reached a PCT level < 0.5 ng/mL (63.6% versus 41.6%, P = 0.006), and there was a trend toward an improved bacteriologic response (relative risk = 1.27; 95% confidence interval: 0.92-1.56). There were no differences in early mortality or safety between groups. CONCLUSIONS Adjustment of meropenem therapy by monitoring is a useful strategy for improving meropenem effectiveness in the treatment of infection in critically ill patients, with no impact on safety.
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Affiliation(s)
- Azucena Aldaz
- Clínica Universidad de Navarra, Pharmacy Services; and
| | | | - Ana Ortega
- Clínica Universidad de Navarra, Pharmacy Services; and
| | | | - Pablo Monedero
- Clínica Universidad de Navarra, Anaesthesia and Intensive Care Department, Pamplona, Spain
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18
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Martínez-Arroyo O, Ortega A, Perez-Hernandez J, Chaves FJ, Redon J, Cortes R. EXOSOMAL MICRORNA-26A RESPONSE TO TGF-B1 STRESS IN HYPERTENSION. J Hypertens 2021. [DOI: 10.1097/01.hjh.0000747304.42426.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Perez-Hernandez J, Riffo-Campos AL, Ortega A, Martinez-Arroyo O, Perez-Gil D, Olivares D, Solaz E, Martinez F, Martínez-Hervás S, Chaves FJ, Redon J, Cortes R. Urinary- and Plasma-Derived Exosomes Reveal a Distinct MicroRNA Signature Associated With Albuminuria in Hypertension. Hypertension 2021; 77:960-971. [PMID: 33486986 DOI: 10.1161/hypertensionaha.120.16598] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Urinary albumin excretion (UAE) is a marker of cardiovascular risk and renal damage in hypertension. MicroRNAs (miRNAs) packaged into exosomes function as paracrine effectors in cell communication and the kidney is not exempt. This study aimed to state an exosomal miRNA profile/signature associated to hypertension with increased UAE and the impact of profibrotic TGF-β1 (transforming growth factor β1) on exosomes miRNA release. Therefore, exosomes samples from patients with hypertension with/without UAE were isolated and characterized. Three individual and unique small RNA libraries from each subject were prepared (total plasma, urinary, and plasma-derived exosomes) for next-generation sequencing profiling. Differentially expressed miRNAs were over-represented in Kyoto Encyclopedia of Genes and Genomes pathways, and selected miRNAs were validated by real-time quantitative polymerase chain reaction in a confirmation cohort. Thus, a signature of 29 dysregulated circulating miRNAs was identified in UAE hypertensive subjects, regulating 21 pathways. Moreover, changes in the levels of 4 exosomes-miRNAs were validated in a confirmation cohort and found associated with albuminuria. In particular miR-26a, major regulator of TGF-β signaling, was found downregulated in both type of exosomes when compared with healthy controls and to hypertension normoalbuminurics (P<0.01). Similarly, decreased miR-26a levels were found in podocyte-derived exosomes after TGF-β stress. Our results revealed an exosomes miRNA signature associated to albuminuria in hypertension. In particular, exosomes miR-26a seemed to play a key role in the regulation of TGF-β, a relevant effector in podocyte damage. These findings support the use of exosomes miRNAs as biomarkers of cardiovascular risk progression and therapeutic tools in early kidney damage.
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Affiliation(s)
- Javier Perez-Hernandez
- From the Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain (J.P.-H., A.O., O.M.-A., D.P.-G., D.O., E.S., F.M., J.R., R.C.)
| | - Angela L Riffo-Campos
- Departamento de Anatomía Patológica, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile (A.L.R.-C.)
| | - Ana Ortega
- From the Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain (J.P.-H., A.O., O.M.-A., D.P.-G., D.O., E.S., F.M., J.R., R.C.)
| | - Olga Martinez-Arroyo
- From the Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain (J.P.-H., A.O., O.M.-A., D.P.-G., D.O., E.S., F.M., J.R., R.C.)
| | - Daniel Perez-Gil
- From the Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain (J.P.-H., A.O., O.M.-A., D.P.-G., D.O., E.S., F.M., J.R., R.C.)
| | - Dolores Olivares
- From the Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain (J.P.-H., A.O., O.M.-A., D.P.-G., D.O., E.S., F.M., J.R., R.C.)
| | - Elena Solaz
- From the Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain (J.P.-H., A.O., O.M.-A., D.P.-G., D.O., E.S., F.M., J.R., R.C.).,Internal Medicine Unit, Hospital Clínico Universitario, Valencia, Spain (E.S., F.M., J.R.)
| | - Fernando Martinez
- From the Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain (J.P.-H., A.O., O.M.-A., D.P.-G., D.O., E.S., F.M., J.R., R.C.).,Internal Medicine Unit, Hospital Clínico Universitario, Valencia, Spain (E.S., F.M., J.R.)
| | - Sergio Martínez-Hervás
- Endocrinology and Nutrition Department Clinic Hospital, Spain (S.M.-H.).,CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Institute of Health Carlos III, Minister of Health, Barcelona, Spain (S.M.-H., F.J.C.).,Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Spain (S.M.-H.)
| | - Felipe J Chaves
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Institute of Health Carlos III, Minister of Health, Barcelona, Spain (S.M.-H., F.J.C.).,Genomics and Diabetes Unit, INCLIVA Biomedical Research Institute, Valencia, Spain (F.J.C.)
| | - Josep Redon
- From the Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain (J.P.-H., A.O., O.M.-A., D.P.-G., D.O., E.S., F.M., J.R., R.C.).,Internal Medicine Unit, Hospital Clínico Universitario, Valencia, Spain (E.S., F.M., J.R.).,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Minister of Health, Madrid, Spain (J.R.)
| | - Raquel Cortes
- From the Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain (J.P.-H., A.O., O.M.-A., D.P.-G., D.O., E.S., F.M., J.R., R.C.)
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Ortega A, Martinez-Arroyo O, Forner MJ, Cortes R. Exosomes as Drug Delivery Systems: Endogenous Nanovehicles for Treatment of Systemic Lupus Erythematosus. Pharmaceutics 2020; 13:pharmaceutics13010003. [PMID: 33374908 PMCID: PMC7821934 DOI: 10.3390/pharmaceutics13010003] [Citation(s) in RCA: 40] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 02/07/2023] Open
Abstract
Exosomes, nanometer-sized lipid-bilayer-enclosed extracellular vesicles (EVs), have attracted increasing attention due to their inherent ability to shuttle proteins, lipids and genes between cells and their natural affinity to target cells. Their intrinsic features such as stability, biocompatibility, low immunogenicity and ability to overcome biological barriers, have prompted interest in using exosomes as drug delivery vehicles, especially for gene therapy. Evidence indicates that exosomes play roles in both immune stimulation and tolerance, regulating immune signaling and inflammation. To date, exosome-based nanocarriers delivering small molecule drugs have been developed to treat many prevalent autoimmune diseases. This review highlights the key features of exosomes as drug delivery vehicles, such as therapeutic cargo, use of targeting peptide, loading method and administration route with a broad focus. In addition, we outline the current state of evidence in the field of exosome-based drug delivery systems in systemic lupus erythematosus (SLE), evaluating exosomes derived from various cell types and engineered exosomes.
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Affiliation(s)
- Ana Ortega
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (A.O.); (O.M.-A.); (M.J.F.)
| | - Olga Martinez-Arroyo
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (A.O.); (O.M.-A.); (M.J.F.)
| | - Maria J. Forner
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (A.O.); (O.M.-A.); (M.J.F.)
- Internal Medicine Unit, Hospital Clinico Universitario, 46010 Valencia, Spain
| | - Raquel Cortes
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (A.O.); (O.M.-A.); (M.J.F.)
- Correspondence: ; Tel.: +34-96398-3916; Fax: +34-96398-7860
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Abstract
Hypertension-mediated organ damage frequently includes renal function decline in which several mechanisms are involved. The present review outlines the state of the art on extracellular vesicles in hypertension and hypertension-related renal damage. Emerging evidence indicates that extracellular vesicles, small vesicles secreted by most cell types and body fluids, are involved in cell-to-cell communication and are key players mediating biological processes such as inflammation, endothelial dysfunction or fibrosis, mechanisms present the onset and progression of hypertension-associated kidney disease. We address the potential use of extracellular vesicles as markers of hypertension-mediated kidney damage severity and their application as therapeutic agents in hypertension-associated renal damage. The capacity of exosomes to deliver a wide variety of cargos to the target cell efficiently makes them a potential drug delivery system for treatment of renal diseases.
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Affiliation(s)
- Olga Martinez-Arroyo
- From the Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain (O.M.-A., A.O., J.R., R.C.)
| | - Ana Ortega
- From the Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain (O.M.-A., A.O., J.R., R.C.)
| | - Josep Redon
- From the Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain (O.M.-A., A.O., J.R., R.C.).,Internal Medicine, Clinic Universitary Hospital, Valencia, Spain (J.R.).,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Minister of Health, Madrid, Spain (J.R.)
| | - Raquel Cortes
- From the Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain (O.M.-A., A.O., J.R., R.C.)
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García-Manzanares M, Tarazón E, Ortega A, Gil-Cayuela C, Martínez-Dolz L, González-Juanatey JR, Lago F, Portolés M, Roselló-Lletí E, Rivera M. XPO1 Gene Therapy Attenuates Cardiac Dysfunction in Rats with Chronic Induced Myocardial Infarction. J Cardiovasc Transl Res 2020; 13:593-600. [PMID: 31768947 PMCID: PMC7423868 DOI: 10.1007/s12265-019-09932-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022]
Abstract
Transcriptomic signature of XPO1 was highly expressed and inversely related to left ventricular function in ischemic cardiomyopathy patients. We hypothesized that treatment with AAV9-shXPO1 attenuates left ventricular dysfunction and remodeling in a myocardial infarction rat model. We induced myocardial infarction by coronary ligation in Sprague-Dawley rats (n = 10), which received AAV9-shXPO1 (n = 5) or placebo AAV9-scramble (n = 5) treatment. Serial echocardiographic assessment was performed throughout the study. After myocardial infarction, AAV9-shXPO1-treated rats showed partial recovery of left ventricular fractional shortening (16.8 ± 2.8 vs 24.6 ± 4.1%, P < 0.05) and a maintained left ventricular dimension (6.17 ± 0.95 vs 4.70 ± 0.93 mm, P < 0.05), which was not observed in non-treated rats. Furthermore, lower levels of EXP-1 (P < 0.05) and lower collagen fibers and fibrosis in cardiac tissue were observed. However, no differences were found in the IL-6 or TNFR1 plasma levels of the myocardium of AAV9-shXPO1 rats. AAV9-shXPO1 administration attenuates cardiac dysfunction and remodeling in rats after myocardial infarction, producing the gene silencing of XPO1.
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Affiliation(s)
- María García-Manzanares
- Department of Animal Medicine and Surgery, Veterinary Faculty, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
- Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Avd. Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Estefanía Tarazón
- Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Avd. Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Ana Ortega
- Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Avd. Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Carolina Gil-Cayuela
- Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Avd. Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Luis Martínez-Dolz
- Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Avd. Fernando Abril Martorell, 106, 46026, Valencia, Spain
- Heart Failure and Transplantation Unit, Cardiology Department, University Hospital La Fe, Valencia, Spain
| | - José Ramón González-Juanatey
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research, University Clinical Hospital, Santiago de Compostela, Spain
| | - Francisca Lago
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research, University Clinical Hospital, Santiago de Compostela, Spain
| | - Manuel Portolés
- Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Avd. Fernando Abril Martorell, 106, 46026, Valencia, Spain.
| | - Esther Roselló-Lletí
- Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Avd. Fernando Abril Martorell, 106, 46026, Valencia, Spain
- Department of Animal Production and Health, Veterinary Public Health and Food Science and Technology, Veterinary Faculty, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Miguel Rivera
- Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Avd. Fernando Abril Martorell, 106, 46026, Valencia, Spain
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23
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Martinez-Arroyo O, Ortega A, Perez-Hernandez J, Chaves FJ, Redon J, Cortes R. The Rab-Rabphilin system in injured human podocytes stressed by glucose overload and angiotensin II. Am J Physiol Renal Physiol 2020; 319:F178-F191. [PMID: 32567349 PMCID: PMC7473899 DOI: 10.1152/ajprenal.00077.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Kidney injury in hypertension and diabetes entails, among in other structures, damage in a key cell of the glomerular filtration barrier, the podocyte. Podocytes are polarized and highly differentiated cells in which vesicular transport, partly driven by Rab GTPases, is a relevant process. The aim of the present study was to analyze Rab GTPases of the Rab-Rabphilin system in human immortalized podocytes and the impact of high glucose and angiotensin II. Furthermore, alterations of the system in urine cell pellets from patients with hypertension and diabetes were studied. Apoptosis was analyzed in podocytes, and mRNA level quantification, Western blot analysis, and immunofluorescence were developed to quantify podocyte-specific molecules and Rab-Rabphilin components (Rab3A, Rab27A, and Rabphilin3A). Quantitative RT-PCR was performed on urinary cell pellet from patients. The results showed that differentiated cells had reduced protein levels of the Rab-rabphillin system compared with undifferentiated cells. After glucose overload and angiotensin II treatment, apoptosis was increased and podocyte-specific proteins were reduced. Rab3A and Rab27A protein levels were increased under glucose overload, and Rabphilin3A decreased. Furthermore, this system exhibited higher levels under stress conditions in a manner of angiotensin II dose and time treatment. Immunofluorescence imaging indicated different expression patterns of podocyte markers and Rab27A under treatments. Finally, Rab3A and Rab27A were increased in patient urine pellets and showed a direct relationship with albuminuria. Collectively, these results suggest that the Rab-Rabphilin system could be involved in the alterations observed in injured podocytes and that a mechanism may be activated to reduce damage through the vesicular transport enhancement directed by this system.
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Affiliation(s)
- Olga Martinez-Arroyo
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Ana Ortega
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Javier Perez-Hernandez
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Felipe J Chaves
- Genomics and Diabetes Unit, INCLIVA Biomedical Research Institute, Valencia, Spain.,CIBER of Diabetes and Associated Metabolic Diseases, Institute of Health Carlos III, Minister of Health, Barcelona, Spain
| | - Josep Redon
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain.,Internal Medicine Unit, Hospital Clínico Universitario, Valencia, Spain.,CIBER of Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Minister of Health, Madrid, Spain
| | - Raquel Cortes
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Valencia, Spain
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Martin-Fernandez M, Vaquero-Roncero LM, Almansa R, Gómez-Sánchez E, Martín S, Tamayo E, Esteban-Velasco MC, Ruiz-Granado P, Aragón M, Calvo D, Rico-Feijoo J, Ortega A, Gómez-Pesquera E, Lorenzo-López M, López J, Doncel C, González-Sanchez C, Álvarez D, Zarca E, Ríos-Llorente A, Diaz-Alvarez A, Sanchez-Barrado E, Andaluz-Ojeda D, Calvo-Vecino JM, Muñoz-Bellvís L, Gomez-Herreras JI, Abad-Molina C, Bermejo-Martin JF, Aldecoa C, Heredia-Rodríguez M. Endothelial dysfunction is an early indicator of sepsis and neutrophil degranulation of septic shock in surgical patients. BJS Open 2020; 4:524-534. [PMID: 32073224 PMCID: PMC7260414 DOI: 10.1002/bjs5.50265] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 11/20/2019] [Accepted: 01/14/2020] [Indexed: 01/01/2023] Open
Abstract
Background Stratification of the severity of infection is currently based on the Sequential Organ Failure Assessment (SOFA) score, which is difficult to calculate outside the ICU. Biomarkers could help to stratify the severity of infection in surgical patients. Methods Levels of ten biomarkers indicating endothelial dysfunction, 22 indicating emergency granulopoiesis, and six denoting neutrophil degranulation were compared in three groups of patients in the first 12 h after diagnosis at three Spanish hospitals. Results There were 100 patients with infection, 95 with sepsis and 57 with septic shock. Seven biomarkers indicating endothelial dysfunction (mid‐regional proadrenomedullin (MR‐ProADM), syndecan 1, thrombomodulin, angiopoietin 2, endothelial cell‐specific molecule 1, vascular cell adhesion molecule 1 and E‐selectin) had stronger associations with sepsis than infection alone. MR‐ProADM had the highest odds ratio (OR) in multivariable analysis (OR 11·53, 95 per cent c.i. 4·15 to 32·08; P = 0·006) and the best area under the curve (AUC) for detecting sepsis (0·86, 95 per cent c.i. 0·80 to 0·91; P < 0·001). In a comparison of sepsis with septic shock, two biomarkers of neutrophil degranulation, proteinase 3 (OR 8·09, 1·34 to 48·91; P = 0·028) and lipocalin 2 (OR 6·62, 2·47 to 17·77; P = 0·002), had the strongest association with septic shock, but lipocalin 2 exhibited the highest AUC (0·81, 0·73 to 0·90; P < 0·001). Conclusion MR‐ProADM and lipocalin 2 could be alternatives to the SOFA score in the detection of sepsis and septic shock respectively in surgical patients with infection.
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Affiliation(s)
- M Martin-Fernandez
- Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.,Research Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - L M Vaquero-Roncero
- Anaesthesiology and Reanimation Service, Hospital Universitario de Salamanca, Salamanca, Spain
| | - R Almansa
- Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.,Research Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - E Gómez-Sánchez
- Group for Biomedical Research in Critical Care (BioCritic), Anaesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - S Martín
- Anaesthesiology and Reanimation Service, Hospital Universitario Río Hortega, Valladolid, Spain
| | - E Tamayo
- Group for Biomedical Research in Critical Care (BioCritic), Anaesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - M C Esteban-Velasco
- Department of General and Gastrointestinal Surgery, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL) and Universidad de Salamanca, Salamanca, Spain
| | - P Ruiz-Granado
- Group for Biomedical Research in Critical Care (BioCritic), Anaesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - M Aragón
- Group for Biomedical Research in Critical Care (BioCritic), Anaesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - D Calvo
- Clinical Analysis Service, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - J Rico-Feijoo
- Anaesthesiology and Reanimation Service, Hospital Universitario Río Hortega, Valladolid, Spain
| | - A Ortega
- Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.,Research Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - E Gómez-Pesquera
- Group for Biomedical Research in Critical Care (BioCritic), Anaesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - M Lorenzo-López
- Group for Biomedical Research in Critical Care (BioCritic), Anaesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - J López
- Department of General and Gastrointestinal Surgery, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL) and Universidad de Salamanca, Salamanca, Spain
| | - C Doncel
- Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.,Research Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - C González-Sanchez
- Department of General and Gastrointestinal Surgery, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL) and Universidad de Salamanca, Salamanca, Spain
| | - D Álvarez
- Anaesthesiology and Reanimation Service, Hospital Universitario de Salamanca, Salamanca, Spain
| | - E Zarca
- Clinical Analysis Service, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - A Ríos-Llorente
- Anaesthesiology and Reanimation Service, Hospital Universitario de Salamanca, Salamanca, Spain
| | - A Diaz-Alvarez
- Anaesthesiology and Reanimation Service, Hospital Universitario de Salamanca, Salamanca, Spain
| | - E Sanchez-Barrado
- Anaesthesiology and Reanimation Service, Hospital Universitario de Salamanca, Salamanca, Spain
| | - D Andaluz-Ojeda
- Intensive Care Medicine Service, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - J M Calvo-Vecino
- Anaesthesiology and Reanimation Service, Hospital Universitario de Salamanca, Salamanca, Spain
| | - L Muñoz-Bellvís
- Department of General and Gastrointestinal Surgery, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL) and Universidad de Salamanca, Salamanca, Spain.,Biomedical Research Networking Centre on Cancer (CIBERONC), Madrid, Spain
| | - J I Gomez-Herreras
- Group for Biomedical Research in Critical Care (BioCritic), Anaesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - C Abad-Molina
- Microbiology and Immunology Service, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - J F Bermejo-Martin
- Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.,Research Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - C Aldecoa
- Anaesthesiology and Reanimation Service, Hospital Universitario Río Hortega, Valladolid, Spain
| | - M Heredia-Rodríguez
- Anaesthesiology and Reanimation Service, Hospital Universitario de Salamanca, Salamanca, Spain
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Amole C, Ardid M, Arnquist I, Asner D, Baxter D, Behnke E, Bressler M, Broerman B, Cao G, Chen C, Chowdhury U, Clark K, Collar J, Cooper P, Coutu C, Cowles C, Crisler M, Crowder G, Cruz-Venegas N, Dahl C, Das M, Fallows S, Farine J, Felis I, Filgas R, Girard F, Giroux G, Hall J, Hardy C, Harris O, Hillier T, Hoppe E, Jackson C, Jin M, Klopfenstein L, Kozynets T, Krauss C, Laurin M, Lawson I, Leblanc A, Levine I, Licciardi C, Lippincott W, Loer B, Mamedov F, Mitra P, Moore C, Nania T, Neilson R, Noble A, Oedekerk P, Ortega A, Piro MC, Plante A, Podviyanuk R, Priya S, Robinson A, Sahoo S, Scallon O, Seth S, Sonnenschein A, Starinski N, Štekl I, Sullivan T, Tardif F, Vázquez-Jáuregui E, Walkowski N, Weima E, Wichoski U, Wierman K, Yan Y, Zacek V, Zhang J. Dark matter search results from the complete exposure of the PICO-60
C3F8
bubble chamber. Int J Clin Exp Med 2019. [DOI: 10.1103/physrevd.100.022001] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Leache L, Aquerreta I, Aldaz A, Monedero P, Idoate A, Ortega A. Clinical and economic impact of clinical pharmacist interventions regarding antimicrobials on critically ill patients. Res Social Adm Pharm 2019; 16:1285-1289. [PMID: 31327737 DOI: 10.1016/j.sapharm.2019.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 07/07/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Incorporating in the Intensive Care Unit (ICU) a clinical pharmacist who performs interventions on antimicrobials may be cost-effective. OBJECTIVES To evaluate the clinical and economic impact of clinical pharmacist interventions on antimicrobials in an ICU. To identify drug related problems and medication errors detected by the pharmacist. METHODS A retrospective observational study was performed to analyze drug related problems, medication errors and clinical pharmacist interventions related to antimicrobials in adults admitted to an ICU in a 5-month period. The economic impact of pharmacist interventions was estimated considering difference in cost derived from antimicrobial treatment, adverse drug events and clinical pharmacist time. RESULTS A total of 212 drug related problems were detected in 114 patients, 18 being medication errors. Clinical pharmacist developed one intervention for each problem identified. 204 interventions (96.2%) were considered important with improved patient care and 7 (3.3%) very important. No negative impact of any intervention was identified. Physicians accepted 97.6% of the interventions. A potential saving of 10,905 € was estimated as a result of pharmacist interventions and 4.8 € were avoided per euro invested in a clinical pharmacist. CONCLUSIONS A clinical pharmacist performing interventions on antimicrobials in the ICU has a positive impact on patient care and decreases costs.
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Affiliation(s)
- Leire Leache
- Pharmacy Service, Clínica Universidad de Navarra, Avenida Pío XII 36, Pamplona, 31008, Spain.
| | - Irene Aquerreta
- Pharmacy Service, Clínica Universidad de Navarra, Avenida Pío XII 36, Pamplona, 31008, Spain.
| | - Azucena Aldaz
- Pharmacy Service, Clínica Universidad de Navarra, Avenida Pío XII 36, Pamplona, 31008, Spain.
| | - Pablo Monedero
- Department of Anaesthesia and Intensive Care, Clínica Universidad de Navarra, Avenida Pío XII 36, Pamplona, 31008, Spain.
| | - Antonio Idoate
- Pharmacy Service, Clínica Universidad de Navarra, Avenida Pío XII 36, Pamplona, 31008, Spain.
| | - Ana Ortega
- Pharmacy Service, Clínica Universidad de Navarra, Avenida Pío XII 36, Pamplona, 31008, Spain.
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Largo SC, Jarabo VG, Martinez D, Ramirez M, Boronat MG, De la Fuente C, Marquina G, Ortega A, Mendez R. EP-1487 Prognostic value of 18F-FDG PET/CT parameters in patients with locally advanced cervical carcinoma. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31907-3] [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: 10/26/2022]
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28
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Reglero P, Ortega A, Balbín R, Abascal FJ, Medina A, Blanco E, de la Gándara F, Alvarez-Berastegui D, Hidalgo M, Rasmuson L, Alemany F, Fiksen Ø. Atlantic bluefin tuna spawn at suboptimal temperatures for their offspring. Proc Biol Sci 2019; 285:rspb.2017.1405. [PMID: 29321292 DOI: 10.1098/rspb.2017.1405] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 12/04/2017] [Indexed: 11/12/2022] Open
Abstract
Life-history traits such as spawning migrations and timing of reproduction are adaptations to specific environmental constraints and seasonal cycles in many organisms' annual routines. In this study we analyse how offspring fitness constrains spawning phenology in a large migratory apex predator, the Atlantic bluefin tuna. The reproductive schedule of Atlantic bluefin tuna varies between spawning sites, suggesting plasticity to local environmental conditions. Generally, temperature is considered to be the main constraint on tuna spawning phenology. We combine evidence from long-term field data, temperature-controlled rearing experiments on eggs and larvae, and a model of egg fitness, and show that Atlantic bluefin tuna do not spawn to optimize egg and larval temperature exposure. The timing of spawning leads to temperature exposure considerably lower than optimal at all spawning grounds across the Atlantic Ocean. The early spawning is constrained by thermal inhibition of egg hatching and larval growth rates, but some other factors must prevent later spawning. Matching offspring with ocean productivity and the prey peak might be an important driver for bluefin tuna spawning phenology. This finding is important for predictions of reproductive timing in future climate warming scenarios for bluefin tuna.
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Affiliation(s)
- P Reglero
- Instituto Español de Oceanografía, Centre Oceanogràfic de les Balears, Moll de Ponent s/n, 07015 Palma de Mallorca, Spain
| | - A Ortega
- Instituto Español de Oceanografía, Centro Oceanográfico de Murcia, 30860 Puerto de Mazarrón, Murcia, Spain
| | - R Balbín
- Instituto Español de Oceanografía, Centre Oceanogràfic de les Balears, Moll de Ponent s/n, 07015 Palma de Mallorca, Spain
| | - F J Abascal
- Instituto Español de Oceanografía, Centro Oceanográfico de Canarias, 38180 Santa Cruz de Tenerife, Spain
| | - A Medina
- Departamento de Biología, Facultad de Ciencias del Mar y Ambientales, Avda. República Saharaui, s/n, 11510 Puerto Real, Cádiz, Spain
| | - E Blanco
- Instituto Español de Oceanografía, Centre Oceanogràfic de les Balears, Moll de Ponent s/n, 07015 Palma de Mallorca, Spain
| | - F de la Gándara
- Instituto Español de Oceanografía, Centro Oceanográfico de Murcia, 30860 Puerto de Mazarrón, Murcia, Spain
| | - D Alvarez-Berastegui
- Balearic Islands Coastal Observing and Forecasting System, Parc Bit, Naorte, Bloc A 2°p. pta 3, Palma de Mallorca, Balearic Islands, Spain
| | - M Hidalgo
- Instituto Español de Oceanografía, Centre Oceanogràfic de les Balears, Moll de Ponent s/n, 07015 Palma de Mallorca, Spain
| | - L Rasmuson
- Marine Resources Program, Oregon Department of Fish and Wildlife, 2040 SE Marine Science Drive, Newport, OR, USA.,National Oceanic and Atmospheric Administration, Southeast Fisheries Science Center, Miami, FL 33149, USA
| | - F Alemany
- Instituto Español de Oceanografía, Centre Oceanogràfic de les Balears, Moll de Ponent s/n, 07015 Palma de Mallorca, Spain
| | - Ø Fiksen
- Department of Biology, University of Bergen, 5020 Bergen, Norway
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Domenech Viñolas M, Santos C, Pérez J, Varela M, Martinez Villacampa M, Teule A, Ruffinelli Rodriguez J, Mulet Margalef N, Soler G, Ortega A, Bergamino M, SanJuan X, Torras J, Ramos E, Salazar R. KRAS mutations as a prognostic factor after metastasectomy in colorectal cancer patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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30
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Perez-Hernandez J, Olivares D, Forner MJ, Ortega A, Solaz E, Martinez F, Chaves FJ, Redon J, Cortes R. Urinary exosome miR-146a is a potential marker of albuminuria in essential hypertension. J Transl Med 2018; 16:228. [PMID: 30107841 PMCID: PMC6092786 DOI: 10.1186/s12967-018-1604-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 08/10/2018] [Indexed: 01/21/2023] Open
Abstract
Background There is increasing interest in using extracellular vesicle-derived microRNAs (miRNAs) as biomarkers in renal dysfunction and injury. Preliminary evidence indicates that miRNAs regulate the progression of glomerular disease. Indeed, exosomes from the renal system have provided novel evidence in the clinical setting of albuminuria. Thus, the aim of this study was to quantify the urinary miRNAs present in exosome and microvesicles (MVs), and to assess their association with the presence of increased urinary albumin excretion in essential hypertension. Methods Exosomes were collected from urine specimens from a cohort of hypertensive patients with (n = 24) or without albuminuria (n = 28), and from 20 healthy volunteers as a control group. Urinary exosomes were phenotyped by Western blot, tunable resistive pulse sensing, and electronic microscopy. Expression of miR-146a and miR-335* was analysed by qRT-PCR and any associations between albuminuria and exosomal miRNAs were analysed. Results Urinary miRNAs are highly enriched in exosome subpopulations compared to MVs, both in patients with or without increased albuminuria (p < 0.001), but not in the control group. High albuminuria was associated with 2.5-fold less miR-146a in exosomes (p = 0.017), whereas miR-146a levels in MV did not change. In addition, exosome miR-146a levels were inversely associated with albuminuria (r = 0.65, p < 0.0001), and discriminated the presence of urinary albumin excretion presence [area under the curve = 0.80, 95% confidence interval: 0.66–0.95; p = 0.0013]. Conclusions Our results indicate that miRNAs were enriched in the urinary exosome subpopulation in hypertensive patients and that low miR-146a expression in exosomes was associated with the presence of albuminuria. Thus, urinary exosome miR-146a may be a potentially useful tool for studying early renal injury in hypertension.
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Affiliation(s)
- Javier Perez-Hernandez
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Avd. Menendez Pelayo, accesorio 4, 46010, Valencia, Spain.,Genomic and Genetic Diagnosis Unit, INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Dolores Olivares
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Avd. Menendez Pelayo, accesorio 4, 46010, Valencia, Spain.,Genomic and Genetic Diagnosis Unit, INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Maria J Forner
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Avd. Menendez Pelayo, accesorio 4, 46010, Valencia, Spain.,Internal Medicine Unit, Hospital Clínico Universitario, Valencia, Spain
| | - Ana Ortega
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Avd. Menendez Pelayo, accesorio 4, 46010, Valencia, Spain
| | - Elena Solaz
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Avd. Menendez Pelayo, accesorio 4, 46010, Valencia, Spain.,Internal Medicine Unit, Hospital Clínico Universitario, Valencia, Spain
| | - Fernando Martinez
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Avd. Menendez Pelayo, accesorio 4, 46010, Valencia, Spain.,Internal Medicine Unit, Hospital Clínico Universitario, Valencia, Spain
| | - Felipe J Chaves
- Genomic and Genetic Diagnosis Unit, INCLIVA Biomedical Research Institute, Valencia, Spain.,CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Institute of Health Carlos III, Minister of Health, Barcelona, Spain
| | - Josep Redon
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Avd. Menendez Pelayo, accesorio 4, 46010, Valencia, Spain.,Internal Medicine Unit, Hospital Clínico Universitario, Valencia, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Minister of Health, Madrid, Spain
| | - Raquel Cortes
- Cardiometabolic and Renal Risk Research Group, INCLIVA Biomedical Research Institute, Avd. Menendez Pelayo, accesorio 4, 46010, Valencia, Spain. .,Genomic and Genetic Diagnosis Unit, INCLIVA Biomedical Research Institute, Valencia, Spain.
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31
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Ortega A, Tarazón E, Gil-Cayuela C, Martínez-Dolz L, Lago F, González-Juanatey JR, Sandoval J, Portolés M, Roselló-Lletí E, Rivera M. ASB1 differential methylation in ischaemic cardiomyopathy: relationship with left ventricular performance in end-stage heart failure patients. ESC Heart Fail 2018; 5:732-737. [PMID: 29667349 PMCID: PMC6073036 DOI: 10.1002/ehf2.12289] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 01/11/2018] [Accepted: 03/10/2018] [Indexed: 12/15/2022] Open
Abstract
Aims Ischaemic cardiomyopathy (ICM) leads to impaired contraction and ventricular dysfunction, causing high rates of morbidity and mortality. Epigenomics allows the identification of epigenetic signatures in human diseases. We analyse the differential epigenetic patterns of the ASB gene family in ICM patients and relate these alterations to their haemodynamic and functional status. Methods and results Epigenomic analysis was carried out using 16 left ventricular (LV) tissue samples, eight from ICM patients undergoing heart transplantation and eight from control (CNT) subjects without cardiac disease. We increased the sample size up to 13 ICM and 10 CNT for RNA sequencing and to 14 ICM for pyrosequencing analyses. We found a hypermethylated profile (cg11189868) in the ASB1 gene that showed a differential methylation of 0.26Δβ (P = 0.016). This result was validated by a pyrosequencing technique (0.23Δβ, P = 0.048). Notably, the methylation pattern was strongly related to LV ejection fraction (r = −0.849, P = 0.008), stroke volume (r = −0.929, P = 0.001), and end‐systolic and diastolic LV diameters (r = −0.743, P = 0.035 for both). ASB1 showed a down‐regulation in messenger RNA levels (−1.2‐fold, P = 0.039). Conclusions Our findings link a specific ASB1 methylation pattern to LV structure and performance in end‐stage ICM, opening new therapeutic opportunities and providing new insights regarding which is the functionally relevant genome in the ischaemic failing myocardium.
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Affiliation(s)
- Ana Ortega
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Avd. Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Estefanía Tarazón
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Avd. Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Carolina Gil-Cayuela
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Avd. Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Luis Martínez-Dolz
- Heart Failure and Transplantation Unit, Cardiology Department, University and Polytechnic La Fe Hospital, Valencia, Spain
| | - Francisca Lago
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research, University Clinical Hospital, Santiago de Compostela, Spain
| | - José Ramón González-Juanatey
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research, University Clinical Hospital, Santiago de Compostela, Spain
| | - Juan Sandoval
- Epigenomic Unit, Health Research Institute La Fe, Valencia, Spain
| | - Manuel Portolés
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Avd. Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Esther Roselló-Lletí
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Avd. Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Miguel Rivera
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Avd. Fernando Abril Martorell, 106, 46026, Valencia, Spain
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32
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Rubio O, Arnau A, Cano S, Subirà C, Balerdi B, Perea ME, Fernández-Vivas M, Barber M, Llamas N, Altaba S, Prieto A, Gómez V, Martin M, Paz M, Quesada B, Español V, Montejo JC, Gomez JM, Miro G, Xirgú J, Ortega A, Rascado P, Sánchez JM, Marcos A, Tizon A, Monedero P, Zabala E, Murcia C, Torrejon I, Planas K, Añon JM, Hernandez G, Fernandez MDM, Guía C, Arauzo V, Perez JM, Catalan R, Gonzalez J, Poyo R, Tomas R, Saralegui I, Mancebo J, Sprung C, Fernández R. Limitation of life support techniques at admission to the intensive care unit: a multicenter prospective cohort study. J Intensive Care 2018; 6:24. [PMID: 29686878 PMCID: PMC5899386 DOI: 10.1186/s40560-018-0283-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 02/19/2018] [Indexed: 12/03/2022] Open
Abstract
Purpose To determine the frequency of limitations on life support techniques (LLSTs) on admission to intensive care units (ICU), factors associated, and 30-day survival in patients with LLST on ICU admission. Methods This prospective observational study included all patients admitted to 39 ICUs in a 45-day period in 2011. We recorded hospitals’ characteristics (availability of intermediate care units, usual availability of ICU beds, and financial model) and patients’ characteristics (demographics, reason for admission, functional status, risk of death, and LLST on ICU admission (withholding/withdrawing; specific techniques affected)). The primary outcome was 30-day survival for patients with LLST on ICU admission. Statistical analysis included multilevel logistic regression models. Results We recruited 3042 patients (age 62.5 ± 16.1 years). Most ICUs (94.8%) admitted patients with LLST, but only 238 (7.8% [95% CI 7.0–8.8]) patients had LLST on ICU admission; this group had higher ICU mortality (44.5 vs. 9.4% in patients without LLST; p < 0.001). Multilevel logistic regression showed a contextual effect of the hospital in LLST on ICU admission (median OR = 2.30 [95% CI 1.59–2.96]) and identified the following patient-related variables as independent factors associated with LLST on ICU admission: age, reason for admission, risk of death, and functional status. In patients with LLST on ICU admission, 30-day survival was 38% (95% CI 31.7–44.5). Factors associated with survival were age, reason for admission, risk of death, and number of reasons for LLST on ICU admission. Conclusions The frequency of ICU admission with LLST is low but probably increasing; nearly one third of these patients survive for ≥ 30 days. Electronic supplementary material The online version of this article (10.1186/s40560-018-0283-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Olga Rubio
- Hospital Sant Joan De Déu, Fundació Althaia Xarxa Universitaria de Manresa, C/ Dr. Joan Soler s. n., 08243 Manresa, Spain
| | - Anna Arnau
- Hospital Sant Joan De Déu, Fundació Althaia Xarxa Universitaria de Manresa, C/ Dr. Joan Soler s. n., 08243 Manresa, Spain
| | - Sílvia Cano
- Hospital Sant Joan De Déu, Fundació Althaia Xarxa Universitaria de Manresa, C/ Dr. Joan Soler s. n., 08243 Manresa, Spain
| | - Carles Subirà
- Hospital Sant Joan De Déu, Fundació Althaia Xarxa Universitaria de Manresa, C/ Dr. Joan Soler s. n., 08243 Manresa, Spain
| | | | | | | | | | | | - Susana Altaba
- Hospital Universitario de Castellon, Castellon de la Plana, Spain
| | - Ana Prieto
- 8Hospital Rio Hortega, Valladolid, Spain
| | | | - Mar Martin
- 10Hospital Candelaria de Tenerife, Santa Cruz de Tenerife, Spain
| | - Marta Paz
- 11Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | | | | | | | | | | | | | - Ana Ortega
- 18Hospital Montecelo Pontevedra, Pontevedra, Spain
| | - Pedro Rascado
- 19Centro Hospitalario Universitario Santiago Compostela, Santiago de Compostela, Spain
| | | | | | - Ana Tizon
- 22Hospital Xeral Cíes Vigo, Vigo, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Rosa Poyo
- 36Hospital Son Llátzer, Palma, Spain
| | - Roser Tomas
- 37Hospital General de Catalunya, Sant Cugat del Valles, Spain
| | | | - Jordi Mancebo
- 39Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Charles Sprung
- 40Hadassh Hebrew University Medical Center, Jerusalem, Israel
| | - Rafael Fernández
- 41Hospital Sant Joan de Deu, Fundació Althaia Xarxa Universitaria de Manresa, Manresa, Spain
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Leache L, Aquerreta I, Aldaz A, Idoate A, Ortega A. Evidence of clinical and economic impact of pharmacist interventions related to antimicrobials in the hospital setting. Eur J Clin Microbiol Infect Dis 2018; 37:799-822. [PMID: 29322274 DOI: 10.1007/s10096-017-3166-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 12/11/2017] [Indexed: 01/13/2023]
Abstract
The purpose of this paper was to review the literature regarding the clinical and economic impact of pharmacist interventions (PIs) related to antimicrobials in the hospital setting. A PubMed literature search from January 2003 to March 2016 was conducted using the terms pharmacist* or clinical pharmacist* combined with antimicrobial* or antibiotic* or anti-infective*. Comparative studies that assessed the clinical and/or economic impact of PIs on antimicrobials in the hospital setting were reviewed. Outcomes were classified as: treatment-related outcomes (TROs), clinical outcomes (COs), cost and microbiological outcomes (MOs). Acceptance of pharmacist recommendations by physicians was collected. PIs were grouped into patient-specific recommendations (PSRs), policy, and education. Studies' risk of bias was analyzed using Cochrane's tool. Twenty-three studies were evaluated. All of them had high risk of bias. The design in most cases was uncontrolled before and after. PSRs were included in every study; five also included policy and four education. Significant impact of PI was found in 14 of the 18 studies (77.8%) that evaluated costs, 15 of the 20 studies (75.0%) that assessed TROs, 12 of the 22 studies (54.5%) that analyzed COs, and one of the two studies (50.0%) that evaluated MOs. None of the studies found significant negative impact of PIs. It could not be concluded that adding other strategies to PSRs would improve results. Acceptance of recommendations varied from 70 to 97.5%. Pharmacists improve TROs and COs, and decrease costs. Additional research with a lower risk of bias is unlikely to change this conclusion. Future research should focus on identifying the most efficient interventions.
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Affiliation(s)
- L Leache
- Pharmacy Services, Clínica Universidad de Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain.
| | - I Aquerreta
- Pharmacy Services, Clínica Universidad de Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain
| | - A Aldaz
- Pharmacy Services, Clínica Universidad de Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain
| | - A Idoate
- Pharmacy Services, Clínica Universidad de Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain
| | - A Ortega
- Pharmacy Services, Clínica Universidad de Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain
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Gil-Cayuela C, Ortega A, Tarazón E, Martínez-Dolz L, Cinca J, González-Juanatey JR, Lago F, Roselló-Lletí E, Rivera M, Portolés M. Myocardium of patients with dilated cardiomyopathy presents altered expression of genes involved in thyroid hormone biosynthesis. PLoS One 2018; 13:e0190987. [PMID: 29320567 PMCID: PMC5761948 DOI: 10.1371/journal.pone.0190987] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 12/22/2017] [Indexed: 11/18/2022] Open
Abstract
Background The association between dilated cardiomyopathy (DCM) and low thyroid hormone (TH) levels has been previously described. In these patients abnormal thyroid function is significantly related to impaired left ventricular (LV) function and increased risk of death. Although TH was originally thought to be produced exclusively by the thyroid gland, we recently reported TH biosynthesis in the human ischemic heart. Objectives Based on these findings, we evaluated whether the genes required for TH production are also altered in patients with DCM. Methods Twenty-three LV tissue samples were obtained from patients with DCM (n = 13) undergoing heart transplantation and control donors (n = 10), and used for RNA sequencing analysis. The number of LV DCM samples was increased to 23 to determine total T4 and T3 tissue levels by ELISA. Results We found that all components of TH biosynthesis are expressed in human dilated heart tissue. Expression of genes encoding thyroperoxidase (–2.57-fold, P < 0.05) and dual oxidase 2 (2.64-fold, P < 0.01), the main enzymatic system of TH production, was significantly altered in patients with DCM and significantly associated with LV remodeling parameters. Thyroxine (T4) cardiac tissue levels were significantly increased (P < 0.01), whilst triiodothyronine (T3) levels were significantly diminished (P < 0.05) in the patients. Conclusions Expression of TH biosynthesis machinery in the heart and total tissue levels of T4 and T3, are altered in patients with DCM. Given the relevance of TH in cardiac pathology, our results provide a basis for new gene-based therapeutic strategies for treating DCM.
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Affiliation(s)
- Carolina Gil-Cayuela
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Valencia, Spain
- Members of the Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Ana Ortega
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Valencia, Spain
- Members of the Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Estefanía Tarazón
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Valencia, Spain
- Members of the Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Luis Martínez-Dolz
- Members of the Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Heart Failure and Transplantation Unit, Cardiology Department, La Fe University Hospital, Valencia, Spain
| | - Juan Cinca
- Members of the Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Cardiology Service of Santa Creu i Sant Pau Hospital, Barcelona, Spain
| | - José Ramón González-Juanatey
- Members of the Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research, University Clinical Hospital, Santiago de Compostela, Spain
| | - Francisca Lago
- Members of the Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research, University Clinical Hospital, Santiago de Compostela, Spain
| | - Esther Roselló-Lletí
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Valencia, Spain
- Members of the Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
- * E-mail: (MR); (MP); (ERL)
| | - Miguel Rivera
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Valencia, Spain
- Members of the Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
- * E-mail: (MR); (MP); (ERL)
| | - Manuel Portolés
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Valencia, Spain
- Members of the Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
- * E-mail: (MR); (MP); (ERL)
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Ortega A, Tarazón E, Gil-Cayuela C, García-Manzanares M, Martínez-Dolz L, Lago F, González-Juanatey JR, Cinca J, Jorge E, Portolés M, Roselló-Lletí E, Rivera M. Intercalated disc in failing hearts from patients with dilated cardiomyopathy: Its role in the depressed left ventricular function. PLoS One 2017; 12:e0185062. [PMID: 28934278 PMCID: PMC5608295 DOI: 10.1371/journal.pone.0185062] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 04/25/2017] [Accepted: 09/06/2017] [Indexed: 11/19/2022] Open
Abstract
Alterations in myocardial structure and reduced cardiomyocyte adhesions have been previously described in dilated cardiomyopathy (DCM). We studied the transcriptome of cell adhesion molecules in these patients and their relationships with left ventricular (LV) function decay. We also visualized the intercalated disc (ID) structure and organization. The transcriptomic profile of 23 explanted LV samples was analyzed using RNA-sequencing (13 DCM, 10 control [CNT]), focusing on cell adhesion genes. Electron microscopy analysis to visualize ID structural differences and immunohistochemistry experiments of ID proteins was also performed. RT-qPCR and western blot experiments were carried out on ID components. We found 29 differentially expressed genes, most of all, constituents of the ID structure. We found that the expression of GJA3, DSP and CTNNA3 was directly associated with LV ejection fraction (r = 0.741, P = 0.004; r = 0.674, P = 0.011 and r = 0.565, P = 0.044, respectively), LV systolic (P = 0.003, P = 0.003, P = 0.028, respectively) and diastolic dimensions (P = 0.006, P = 0.001, P = 0.025, respectively). Electron microscopy micrographs showed a reduced ID convolution index and immunogold labeling of connexin 46 (GJA gene), desmoplakin (DSP gene) and catenin α-3 (CTNNA3 gene) proteins in DCM patients. Moreover, we observed that protein and mRNA levels analyzed by RT-qPCR of these ID components were diminished in DCM group. In conclusion, we report significant gene and protein expression changes and found that the ID components GJA3, DSP and CTNNA3 were highly related to LV function. Microscopic observations indicated that ID is structurally compromised in these patients. These findings give new data for understanding the ventricular depression that characterizes DCM, opening new therapeutic perspectives for these critically diseased patients.
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Affiliation(s)
- Ana Ortega
- Cardiocirculatory Unit, Health Research Institute La Fe, Valencia, Spain
- Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Estefanía Tarazón
- Cardiocirculatory Unit, Health Research Institute La Fe, Valencia, Spain
- Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Carolina Gil-Cayuela
- Cardiocirculatory Unit, Health Research Institute La Fe, Valencia, Spain
- Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - María García-Manzanares
- Cardiocirculatory Unit, Health Research Institute La Fe, Valencia, Spain
- Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Luis Martínez-Dolz
- Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Heart Failure and Transplantation Unit, Cardiology Department, University and Polytechnic La Fe Hospital, Valencia, Spain
| | - Francisca Lago
- Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research, University Clinical Hospital, Santiago de Compostela, Spain
| | - José Ramón González-Juanatey
- Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research, University Clinical Hospital, Santiago de Compostela, Spain
| | - Juan Cinca
- Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Cardiology Service of Santa Creu i Sant Pau Hospital, Barcelona, Spain
| | - Esther Jorge
- Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Cardiology Service of Santa Creu i Sant Pau Hospital, Barcelona, Spain
| | - Manuel Portolés
- Cardiocirculatory Unit, Health Research Institute La Fe, Valencia, Spain
- Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Esther Roselló-Lletí
- Cardiocirculatory Unit, Health Research Institute La Fe, Valencia, Spain
- Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Miguel Rivera
- Cardiocirculatory Unit, Health Research Institute La Fe, Valencia, Spain
- Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Madrid, Spain
- * E-mail:
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36
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Amole C, Ardid M, Arnquist IJ, Asner DM, Baxter D, Behnke E, Bhattacharjee P, Borsodi H, Bou-Cabo M, Campion P, Cao G, Chen CJ, Chowdhury U, Clark K, Collar JI, Cooper PS, Crisler M, Crowder G, Dahl CE, Das M, Fallows S, Farine J, Felis I, Filgas R, Girard F, Giroux G, Hall J, Harris O, Hoppe EW, Jin M, Krauss CB, Laurin M, Lawson I, Leblanc A, Levine I, Lippincott WH, Mamedov F, Maurya D, Mitra P, Nania T, Neilson R, Noble AJ, Olson S, Ortega A, Plante A, Podviyanuk R, Priya S, Robinson AE, Roeder A, Rucinski R, Scallon O, Seth S, Sonnenschein A, Starinski N, Štekl I, Tardif F, Vázquez-Jáuregui E, Wells J, Wichoski U, Yan Y, Zacek V, Zhang J. Dark Matter Search Results from the PICO-60 C_{3}F_{8} Bubble Chamber. Phys Rev Lett 2017; 118:251301. [PMID: 28696731 DOI: 10.1103/physrevlett.118.251301] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Indexed: 06/07/2023]
Abstract
New results are reported from the operation of the PICO-60 dark matter detector, a bubble chamber filled with 52 kg of C_{3}F_{8} located in the SNOLAB underground laboratory. As in previous PICO bubble chambers, PICO-60 C_{3}F_{8} exhibits excellent electron recoil and alpha decay rejection, and the observed multiple-scattering neutron rate indicates a single-scatter neutron background of less than one event per month. A blind analysis of an efficiency-corrected 1167-kg day exposure at a 3.3-keV thermodynamic threshold reveals no single-scattering nuclear recoil candidates, consistent with the predicted background. These results set the most stringent direct-detection constraint to date on the weakly interacting massive particle (WIMP)-proton spin-dependent cross section at 3.4×10^{-41} cm^{2} for a 30-GeV c^{-2} WIMP, more than 1 order of magnitude improvement from previous PICO results.
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Affiliation(s)
- C Amole
- Department of Physics, Queen's University, Kingston K7L 3N6, Canada
| | - M Ardid
- Departament de Física Aplicada, IGIC-Universitat Politècnica de València, Gandia 46730 Spain
| | - I J Arnquist
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
| | - D M Asner
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
| | - D Baxter
- Department of Physics and Astronomy, Northwestern University, Evanston, Illinois 60208, USA
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - E Behnke
- Department of Physics, Indiana University South Bend, South Bend, Indiana 46634, USA
| | - P Bhattacharjee
- Astroparticle Physics and Cosmology Division, Saha Institute of Nuclear Physics, Kolkata 700064, India
| | - H Borsodi
- Department of Physics, Indiana University South Bend, South Bend, Indiana 46634, USA
| | - M Bou-Cabo
- Departament de Física Aplicada, IGIC-Universitat Politècnica de València, Gandia 46730 Spain
| | - P Campion
- Department of Physics, Drexel University, Philadelphia, Pennsylvania 19104, USA
| | - G Cao
- Department of Physics, Queen's University, Kingston K7L 3N6, Canada
| | - C J Chen
- Department of Physics and Astronomy, Northwestern University, Evanston, Illinois 60208, USA
| | - U Chowdhury
- Department of Physics, Queen's University, Kingston K7L 3N6, Canada
| | - K Clark
- Department of Physics, Laurentian University, Sudbury P3E 2C6, Canada
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - J I Collar
- Enrico Fermi Institute, KICP and Department of Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - P S Cooper
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Crisler
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G Crowder
- Department of Physics, Queen's University, Kingston K7L 3N6, Canada
| | - C E Dahl
- Department of Physics and Astronomy, Northwestern University, Evanston, Illinois 60208, USA
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Das
- Astroparticle Physics and Cosmology Division, Saha Institute of Nuclear Physics, Kolkata 700064, India
| | - S Fallows
- Department of Physics, University of Alberta, Edmonton T6G 2E1, Canada
| | - J Farine
- Department of Physics, Laurentian University, Sudbury P3E 2C6, Canada
| | - I Felis
- Departament de Física Aplicada, IGIC-Universitat Politècnica de València, Gandia 46730 Spain
| | - R Filgas
- Institute of Experimental and Applied Physics, Czech Technical University in Prague, Prague, Cz-12800, Czech Republic
| | - F Girard
- Department of Physics, Laurentian University, Sudbury P3E 2C6, Canada
- Département de Physique, Université de Montréal, Montréal H3C 3J7, Canada
| | - G Giroux
- Department of Physics, Queen's University, Kingston K7L 3N6, Canada
| | - J Hall
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
| | - O Harris
- Department of Physics, Indiana University South Bend, South Bend, Indiana 46634, USA
- Northeastern Illinois University, Chicago, Illinois 60625, USA
| | - E W Hoppe
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
| | - M Jin
- Department of Physics and Astronomy, Northwestern University, Evanston, Illinois 60208, USA
| | - C B Krauss
- Department of Physics, University of Alberta, Edmonton T6G 2E1, Canada
| | - M Laurin
- Département de Physique, Université de Montréal, Montréal H3C 3J7, Canada
| | - I Lawson
- Department of Physics, Laurentian University, Sudbury P3E 2C6, Canada
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - A Leblanc
- Department of Physics, Laurentian University, Sudbury P3E 2C6, Canada
| | - I Levine
- Department of Physics, Indiana University South Bend, South Bend, Indiana 46634, USA
| | - W H Lippincott
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - F Mamedov
- Institute of Experimental and Applied Physics, Czech Technical University in Prague, Prague, Cz-12800, Czech Republic
| | - D Maurya
- Bio-Inspired Materials and Devices Laboratory (BMDL), Center for Energy Harvesting Material and Systems (CEHMS), Virginia Tech, Blacksburg, Virginia 24061, USA
| | - P Mitra
- Department of Physics, University of Alberta, Edmonton T6G 2E1, Canada
| | - T Nania
- Department of Physics, Indiana University South Bend, South Bend, Indiana 46634, USA
| | - R Neilson
- Department of Physics, Drexel University, Philadelphia, Pennsylvania 19104, USA
| | - A J Noble
- Department of Physics, Queen's University, Kingston K7L 3N6, Canada
| | - S Olson
- Department of Physics, Queen's University, Kingston K7L 3N6, Canada
| | - A Ortega
- Enrico Fermi Institute, KICP and Department of Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - A Plante
- Département de Physique, Université de Montréal, Montréal H3C 3J7, Canada
| | - R Podviyanuk
- Department of Physics, Laurentian University, Sudbury P3E 2C6, Canada
| | - S Priya
- Bio-Inspired Materials and Devices Laboratory (BMDL), Center for Energy Harvesting Material and Systems (CEHMS), Virginia Tech, Blacksburg, Virginia 24061, USA
| | - A E Robinson
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Roeder
- Department of Physics, Indiana University South Bend, South Bend, Indiana 46634, USA
| | - R Rucinski
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - O Scallon
- Department of Physics, Laurentian University, Sudbury P3E 2C6, Canada
| | - S Seth
- Astroparticle Physics and Cosmology Division, Saha Institute of Nuclear Physics, Kolkata 700064, India
| | - A Sonnenschein
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - N Starinski
- Département de Physique, Université de Montréal, Montréal H3C 3J7, Canada
| | - I Štekl
- Institute of Experimental and Applied Physics, Czech Technical University in Prague, Prague, Cz-12800, Czech Republic
| | - F Tardif
- Département de Physique, Université de Montréal, Montréal H3C 3J7, Canada
| | - E Vázquez-Jáuregui
- Department of Physics, Laurentian University, Sudbury P3E 2C6, Canada
- Instituto de Física, Universidad Nacional Autónoma de México, México D. F. 01000, Mexico
| | - J Wells
- Department of Physics, Indiana University South Bend, South Bend, Indiana 46634, USA
| | - U Wichoski
- Department of Physics, Laurentian University, Sudbury P3E 2C6, Canada
| | - Y Yan
- Bio-Inspired Materials and Devices Laboratory (BMDL), Center for Energy Harvesting Material and Systems (CEHMS), Virginia Tech, Blacksburg, Virginia 24061, USA
| | - V Zacek
- Département de Physique, Université de Montréal, Montréal H3C 3J7, Canada
| | - J Zhang
- Department of Physics and Astronomy, Northwestern University, Evanston, Illinois 60208, USA
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Ortega A, Domenech M, Falo C, Gil M, Stradella A, Fernandez A, Morilla I, Villanueva R, Castany R, Vazquez S, Molina K, Bergamino M, Navarro V, Pernas S. Abstract P4-21-32: Treatment of early HER2-positive breast cancer in trastuzumab era in everyday clinical practice: An overview after 10 years of its approval. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-21-32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: The addition of Trastuzumab(T) to chemotherapy (CT) revolutionized HER2-positive breast cancer(BC) and changed its natural history. We reviewed the efficacy of T outside clinical trials in a cancer comprehensive center.
Methods: Ambiespective and descriptive study was conducted in Catalan Institute of Oncology (ICO-Barcelona). Estimates of progression-free survival (PFS) and overall survival (OS) were obtained with the Kaplan-Meier method and compared with LogRank test. The association of clinic-pathological variables and outcome was studied by χ2and Cox proportional hazard analysis.
Results: 430 consecutive early HER2-positive BC patients (pts) were treated with adjuvant/neoadjuvant T and CT from Jan 2005 to Dec 2012. Pt basal characteristics are reported in Table 1. Neoadjuvant treatment was administrated in 230pts (54%) and in 200 (46%) in adjuvancy. Pathological complete response (pCR) in breast and nodes (ypT0/isypN0) was achieved in 48% of pts, with higher rates in hormone receptor (HR)-negative pts (62 vs 37% p=0.0005). Median duration of T: 10.6 months (m). 28%pts treated with neoadjuvant T+CT who achieved a pCR did not receive adjuvant T. Treatment discontinuation: 38pts (8.8%): 27pts due to cardiac toxicity and 4 relapsed during adjuvant T. In 87%pts, neoadjuvant CT was based on anthracyclines(A) and taxanes. Adjuvant CT: A and taxanes in 57.4%; 14%pts FAC, 15.4% A-CMF and 12% TCH. At a median follow-up of 70m (3-135), 44pts (10.4%) had relapsed: 33pts with distant M1, 9pts with only loco-regional disease and 2pts contralateral HER2-positive BC. M1 location: 46% visceral, 34% bone/lymph nodes and 20% in central nervous system (CNS). PFS was 23.4m(0-88); median OS was not reached; estimated 10 years-OS was 86.5%. Pts treated with A and taxanes had a significantly better OS compared to those treated with other CT (113 vs 98m, p= 0.009). Kaplan-Meier curve showed numerically higher relapses at 10 years in HR-positive pts (83 vs 90% p=0.8). Pts with pCR had significantly better OS (113 vs 104m, p=0.006). Pts with CNS-metastases had a significantly worse OS (13 vs 26m,p=0,02) and those with HR-negative (49 vs 24m, p= 0.033).
Conclusion: In everyday clinical practice, recurrences after adjuvant/neoadjuvant trastuzumab in HER2-positive BC were less than described in the T-pivotals trials, with 10% of recurrences at a median of FU of 70m. In our series, estimated 10 years-OS was 86.5%. Pts treated with A and taxanes had a significantly better OS as well as those pts who achieved a pCR. On the contrary, pts with CNS M1 and those with HR-negative had worse prognosis.
Table 1Median age51.9y (27-83)Stage I/II/III106 (25%)/ 226 (52%)/ 97 (23%)HR Positive/ Negative249 (58%)/181 (42%)
Citation Format: Ortega A, Domenech M, Falo C, Gil M, Stradella A, Fernandez A, Morilla I, Villanueva R, Castany R, Vazquez S, Molina K, Bergamino M, Navarro V, Pernas S. Treatment of early HER2-positive breast cancer in trastuzumab era in everyday clinical practice: An overview after 10 years of its approval [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-21-32.
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Affiliation(s)
- A Ortega
- Catalan Institute of Oncology, Hospitalet del Llobregat, Catalonia/Barcelona, Spain
| | - M Domenech
- Catalan Institute of Oncology, Hospitalet del Llobregat, Catalonia/Barcelona, Spain
| | - C Falo
- Catalan Institute of Oncology, Hospitalet del Llobregat, Catalonia/Barcelona, Spain
| | - M Gil
- Catalan Institute of Oncology, Hospitalet del Llobregat, Catalonia/Barcelona, Spain
| | - A Stradella
- Catalan Institute of Oncology, Hospitalet del Llobregat, Catalonia/Barcelona, Spain
| | - A Fernandez
- Catalan Institute of Oncology, Hospitalet del Llobregat, Catalonia/Barcelona, Spain
| | - I Morilla
- Catalan Institute of Oncology, Hospitalet del Llobregat, Catalonia/Barcelona, Spain
| | - R Villanueva
- Catalan Institute of Oncology, Hospitalet del Llobregat, Catalonia/Barcelona, Spain
| | - R Castany
- Catalan Institute of Oncology, Hospitalet del Llobregat, Catalonia/Barcelona, Spain
| | - S Vazquez
- Catalan Institute of Oncology, Hospitalet del Llobregat, Catalonia/Barcelona, Spain
| | - K Molina
- Catalan Institute of Oncology, Hospitalet del Llobregat, Catalonia/Barcelona, Spain
| | - M Bergamino
- Catalan Institute of Oncology, Hospitalet del Llobregat, Catalonia/Barcelona, Spain
| | - V Navarro
- Catalan Institute of Oncology, Hospitalet del Llobregat, Catalonia/Barcelona, Spain
| | - S Pernas
- Catalan Institute of Oncology, Hospitalet del Llobregat, Catalonia/Barcelona, Spain
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Abstract
PURPOSE A case of severe bilateral sensorineural hearing loss associated with oral morphine is reported. SUMMARY A 52-year-old Spanish man was admitted to the intensive care unit with a Glasgow Coma Scale score of 3, a fever, and sudden hearing loss with tinnitus in both ears. His medical history included type 2 diabetes mellitus, depression, sleep disorder, and hypertension. The patient also had pyelonephritis in 2011 and pulmonary embolism in 2014, requiring the placement of an inferior vena cava filter and chronic anticoagulation. His hearing loss appeared after the initiation of oral morphine, specifically on the eighth day of treatment, with increasing dosages of up to 120 mg daily. We did not find any other possible causes of the hearing loss. Ototoxicity is an adverse reaction of ibuprofen and acetaminophen, but the patient received only three doses of ibuprofen 600 mg and did not require acetaminophen. The patient's other medications did not have ototoxicity as an adverse reaction, and the patient confirmed not to have received any salicylate product. Brain magnetic resonance imaging discarded other possible causes of hearing loss. Our patient's hearing loss did not resolve after opioid discontinuation, and the use of hearing aids was necessary. According to the Naranjo et al. adverse drug reaction probability scale, this event would be classified as "probable." CONCLUSION A 52-year-old man developed tinnitus and hearing loss after receiving high doses of oral morphine sulfate. His hearing loss did not fully resolve after the discontinuation of morphine, and he required the use of hearing aids.
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Affiliation(s)
- Leire Leache
- Pharmacy Services, Clínica Universidad de Navarra, Pamplona, Spain
| | - Irene Aquerreta
- Pharmacy Services, Clínica Universidad de Navarra, Pamplona, Spain.
| | - Libe Moraza
- Pharmacy Services, Clínica Universidad de Navarra, Pamplona, Spain
| | - Ana Ortega
- Pharmacy Services, Clínica Universidad de Navarra, Pamplona, Spain
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Tarazón E, Roselló-Lletí E, Ortega A, Gil-Cayuela C, González-Juanatey JR, Lago F, Martínez-Dolz L, Portolés M, Rivera M. Changes in human Golgi apparatus reflect new left ventricular dimensions and function in dilated cardiomyopathy patients. Eur J Heart Fail 2016; 19:280-282. [PMID: 27785873 DOI: 10.1002/ejhf.671] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 09/01/2016] [Indexed: 11/11/2022] Open
Affiliation(s)
- Estefanía Tarazón
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Valencia, Spain
| | - Esther Roselló-Lletí
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Valencia, Spain
| | - Ana Ortega
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Valencia, Spain
| | - Carolina Gil-Cayuela
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Valencia, Spain
| | - José Ramón González-Juanatey
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research, University Clinical Hospital, Santiago de Compostela, Spain
| | - Francisca Lago
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research, University Clinical Hospital, Santiago de Compostela, Spain
| | - Luis Martínez-Dolz
- Heart Failure and Transplantation Unit, Cardiology Department, La Fe University Hospital, Valencia, Spain
| | - Manuel Portolés
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Valencia, Spain
| | - Miguel Rivera
- Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital (IIS La Fe), Valencia, Spain
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Suárez-Pozos E, De Vizcaya-Ruiz A, Ortega A. Particulate matter disrupts the glutamate uptake in cerebellar glia cells: Implications for glutamatergic transmission. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.07.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Linares J, Stradella A, Pernas S, Ortega A, Galdeano M, Lucas A, Macia M, Vidal N, Morilla I, Sabela R, Falo C, Velasco R, Gil-Gil M. Breast-GPA and type of treatment predictors of survival in brain metastasis patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ortega A, García-Hernández VM, Ruiz-García E, Meneses-García A, Herrera-Gómez A, Aguilar-Ponce JL, Montes-Servín E, Prospero-García O, Del Angel SA. Comparing the effects of endogenous and synthetic cannabinoid receptor agonists on survival of gastric cancer cells. Life Sci 2016; 165:56-62. [PMID: 27640887 DOI: 10.1016/j.lfs.2016.09.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 09/09/2016] [Accepted: 09/14/2016] [Indexed: 01/28/2023]
Abstract
AIMS Anti-neoplastic activity induced by cannabinoids has been extensively documented for a number of cancer cell types; however, this topic has been explored in gastric cancer cells only in a limited number of approaches. Thus, the need of integrative and comparative studies still persists. MATERIALS AND METHODS In this study we tested and compared the effects of three different cannabinoid receptor agonists-anandamide (AEA), (R)-(+)-methanandamide (Meth-AEA) and CP 55,940 (CP)- on gastric cancer cell morphology, viability and death events in order to provide new insights to the use of these agents for therapeutic purposes. KEY FINDINGS The three agents tested exhibited similar concentration-dependent effects in the induction of changes in cell morphology and cell loss, as well as in the decrease of cell viability and DNA laddering in the human gastric adenocarcinoma cell line (AGS). Differences among the cannabinoids tested were mostly observed in the density of cells found in early and late apoptosis and necrosis, favoring AEA and CP as the more effective inducers of apoptotic mechanisms, and Meth-AEA as a more effective inducer of necrosis through transient and rapid apoptosis. SIGNIFICANCE Through a comparative approach, our results support and confirm the therapeutic potential that cannabinoid receptor agonists exert in gastric cancer cells and open possibilities to use cannabinoids as part of a new gastric cancer therapy.
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Affiliation(s)
- A Ortega
- Laboratorio de Medicina Translacional, Instituto Nacional de Cancerología, SSA. Mexico City 14080, Mexico
| | - V M García-Hernández
- Laboratorio de Medicina Translacional, Instituto Nacional de Cancerología, SSA. Mexico City 14080, Mexico
| | - E Ruiz-García
- Laboratorio de Medicina Translacional, Instituto Nacional de Cancerología, SSA. Mexico City 14080, Mexico
| | - A Meneses-García
- Laboratorio de Medicina Translacional, Instituto Nacional de Cancerología, SSA. Mexico City 14080, Mexico
| | - A Herrera-Gómez
- Laboratorio de Medicina Translacional, Instituto Nacional de Cancerología, SSA. Mexico City 14080, Mexico
| | - J L Aguilar-Ponce
- Laboratorio de Medicina Translacional, Instituto Nacional de Cancerología, SSA. Mexico City 14080, Mexico
| | - E Montes-Servín
- Unidad de Oncología Torácica, Instituto Nacional de Cancerología, SSA. Mexico City 14080, Mexico
| | - O Prospero-García
- Laboratorio de Cannabinoides, Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de Mexico City, 04510, Mexico
| | - S A Del Angel
- Laboratorio de Aminoácidos Excitadores, Instituto Nacional de Neurología y Neurocirugía, SSA. Mexico City 14269, Mexico.
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Capp K, Ethridge K, Santos A, Ortega A, Myott M, Modesto M, Curiel R, Raffo A, Melo J, Crocco E, Wright C, Penate A, Lowenstein D. A-24Evaluating the Association of Early Alzheimer's Disease with Proactive Interference Ability and Magnetic Resonance Imaging (MRI) Scans. Arch Clin Neuropsychol 2016. [DOI: 10.1093/arclin/acw043.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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44
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Roselló-Lletí E, Tarazón E, Ortega A, Gil-Cayuela C, Carnicer R, Lago F, González-Juanatey JR, Portolés M, Rivera M. Protein Inhibitor of NOS1 Plays a Central Role in the Regulation of NOS1 Activity in Human Dilated Hearts. Sci Rep 2016; 6:30902. [PMID: 27481317 PMCID: PMC4969592 DOI: 10.1038/srep30902] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 07/08/2016] [Indexed: 12/22/2022] Open
Abstract
An essential factor for the production of nitric oxide by nitric oxide synthase 1 (NOS1), major modulator of cardiac function, is the cofactor tetrahydrobiopterin (BH4). BH4 is regulated by GTP cyclohydrolase 1, the rate-limiting enzyme in BH4 biosynthesis which catalyses the formation of dihydroneopterin 3'triphosfate from GTP, producing BH4 after two further steps catalyzed by 6-pyruvoyltetrahydropterin synthase and sepiapterin reductase. However, there are other essential factors involved in the regulation of NOS1 activity, such as protein inhibitor of NOS1 (PIN), calmodulin, heat shock protein 90, and NOS interacting protein. All these molecules have never been analysed in human non-ischemic dilated hearts (DCM). In this study we demonstrated that the upregulation of cardiac NOS1 is not accompanied by increased NOS1 activity in DCM, partly due to the elevated PIN levels and not because of alterations in biopterin biosynthesis. Notably, the PIN concentration was significantly associated with impaired ventricular function, highlighting the importance of this NOS1 activity inhibitor in Ca(2+) homeostasis. These results take a central role in the current list of targets for future studies focused on the complex cardiac dysfunction processes through more efficient harnessing of NOS1 signalling.
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Affiliation(s)
- Esther Roselló-Lletí
- Cardiocirculatory Unit, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
| | - Estefanía Tarazón
- Cardiocirculatory Unit, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
| | - Ana Ortega
- Cardiocirculatory Unit, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
| | - Carolina Gil-Cayuela
- Cardiocirculatory Unit, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
| | - Ricardo Carnicer
- Department of Cardiovascular Medicine, University of Oxford, United Kingdom
| | - Francisca Lago
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research, University Clinical Hospital, Santiago de Compostela, Spain
| | - Jose Ramón González-Juanatey
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research, University Clinical Hospital, Santiago de Compostela, Spain
| | - Manuel Portolés
- Cardiocirculatory Unit, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
| | - Miguel Rivera
- Cardiocirculatory Unit, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
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Ortega A, Gil-Cayuela C, Tarazón E, García-Manzanares M, Montero JA, Cinca J, Portolés M, Rivera M, Roselló-Lletí E. New Cell Adhesion Molecules in Human Ischemic Cardiomyopathy. PCDHGA3 Implications in Decreased Stroke Volume and Ventricular Dysfunction. PLoS One 2016; 11:e0160168. [PMID: 27472518 PMCID: PMC4966940 DOI: 10.1371/journal.pone.0160168] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 07/14/2016] [Indexed: 11/25/2022] Open
Abstract
Background Intercalated disks are unique structures in cardiac tissue, in which adherens junctions, desmosomes, and GAP junctions co-localize, thereby facilitating cardiac muscle contraction and function. Protocadherins are involved in these junctions; however, their role in heart physiology is poorly understood. We aimed to analyze the transcriptomic profile of adhesion molecules in patients with ischemic cardiomyopathy (ICM) and relate the changes uncovered with the hemodynamic alterations and functional depression observed in these patients. Methods and Results Twenty-three left ventricular tissue samples from patients diagnosed with ICM (n = 13) undergoing heart transplantation and control donors (CNT, n = 10) were analyzed using RNA sequencing. Forty-two cell adhesion genes involved in cellular junctions were differentially expressed in ICM myocardium. Notably, the levels of protocadherin PCDHGA3 were related with the stroke volume (r = –0.826, P = 0.003), ejection fraction (r = –0.793, P = 0.004) and left ventricular end systolic and diastolic diameters (r = 0.867, P = 0.001; r = 0.781, P = 0.005, respectively). Conclusions Our results support the importance of intercalated disks molecular alterations, closely involved in the contractile function, highlighting its crucial significance and showing gene expression changes not previously described. Specifically, altered PCDHGA3 gene expression was strongly associated with reduced stroke volume and ventricular dysfunction in ICM, suggesting a relevant role in hemodynamic perturbations and cardiac performance for this unexplored protocadherin.
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Affiliation(s)
- Ana Ortega
- Cardiocirculatory Unit, The Health Research Institute La Fe, Valencia, Spain
| | | | - Estefanía Tarazón
- Cardiocirculatory Unit, The Health Research Institute La Fe, Valencia, Spain
| | | | - José Anastasio Montero
- Cardiovascular Surgery Service, University and Polytechnic La Fe Hospital, Valencia, Spain
| | - Juan Cinca
- Cardiology Service of Santa Creu i Sant Pau Hospital, Barcelona, Spain
| | - Manuel Portolés
- Cardiocirculatory Unit, The Health Research Institute La Fe, Valencia, Spain
| | - Miguel Rivera
- Cardiocirculatory Unit, The Health Research Institute La Fe, Valencia, Spain
| | - Esther Roselló-Lletí
- Cardiocirculatory Unit, The Health Research Institute La Fe, Valencia, Spain
- * E-mail:
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Alonso M, Builes L, Morán P, Ortega A, Fernández E, Reinoso-Barbero F. Clinical experience with desflurane for paediatric anaesthesia outside the operating room. ACTA ACUST UNITED AC 2016; 64:6-12. [PMID: 27381256 DOI: 10.1016/j.redar.2016.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/19/2016] [Accepted: 04/21/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Desflurane has been used in paediatric patients for several surgical indications. This article analyses the efficacy and safety of desflurane for diagnostic-therapeutic procedures in remote areas far from operating room in a group of selected patients with no known associated respiratory disease. MATERIAL AND METHODS A retrospective analysis was performed on 2,072 general anaesthesia procedures stored in a computer database, in which desflurane was used in a Paediatric Pain Unit during the years 2013 and 2014. An analysis was also performed using the patient demographics, type of procedure, anaesthetic technique, type of airway management, patient cooperation, and incidence of anaesthetic complications. RESULTS The study included 876 patients, with a mean age of 8.8 years. The main procedures were bone marrow aspirates (23%), lumbar punctures (20%), panendoscopies (15%), and colonoscopies (5%). Induction was intravenous with propofol (26%) or inhalation with sevoflurane in the remaining 74%. Maintenance consisted of remifentanil and desflurane at mean end tidal concentrations of 6.2±2.1%. The airway was managed through a nasal cannula or face mask in spontaneous ventilation. The effectiveness was 98%, and the incidence of side effects was 15%, which included agitation (6%), headache (4%), nausea-vomiting (3%), and laryngospasm (2%). CONCLUSION The maintenance with desflurane (at concentrations close to the hypnotic-MAC in spontaneous ventilation) was effective, with a rapid recovery, and with a low incidence of adverse effects.
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Affiliation(s)
- M Alonso
- Servicio de Anestesiología, Reanimación, Tratamiento del Dolor Infantil, Hospital Universitario La Paz, Madrid, España.
| | - L Builes
- Servicio de Anestesiología, Reanimación, Tratamiento del Dolor Infantil, Hospital Universitario La Paz, Madrid, España
| | - P Morán
- Servicio de Anestesiología, Reanimación, Tratamiento del Dolor Infantil, Hospital Universitario La Paz, Madrid, España
| | - A Ortega
- Servicio de Anestesiología, Reanimación, Tratamiento del Dolor Infantil, Hospital Universitario La Paz, Madrid, España
| | - E Fernández
- Servicio de Anestesiología, Reanimación, Tratamiento del Dolor Infantil, Hospital Universitario La Paz, Madrid, España
| | - F Reinoso-Barbero
- Servicio de Anestesiología, Reanimación, Tratamiento del Dolor Infantil, Hospital Universitario La Paz, Madrid, España
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Ortega A, Pozza D, Rodrigues L, Guimarães A. Relationship Between Orthodontics and Temporomandibular Disorders: A Prospective Study. J Oral Facial Pain Headache 2016; 30:134-8. [DOI: 10.11607/ofph.1574] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Ortega A, Roselló-Lletí E, Tarazón E, Gil-Cayuela C, Lago F, González-Juanatey JR, Martinez-Dolz L, Portolés M, Rivera M. TRPM7 is down-regulated in both left atria and left ventricle of ischaemic cardiomyopathy patients and highly related to changes in ventricular function. ESC Heart Fail 2016; 3:220-224. [PMID: 27818786 PMCID: PMC5071679 DOI: 10.1002/ehf2.12085] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/12/2016] [Accepted: 01/17/2016] [Indexed: 01/17/2023] Open
Abstract
Aims The kinase ion channel transient receptor potential melastatin 7 (TRPM7) is considered a modulator of cardiac fibrosis progression; nevertheless, we lack of studies analysing its role in human ischaemic cardiomyopathy (ICM). Our objective was to analyse the expression of genes encoding cardiac ion channels in human ICM, focusing on the alterations in mRNA levels of TRPM7 and its relationship with changes in the ventricular function. Methods and results RNA‐sequencing was carried out in 13 left ventricular (LV) samples of patients with ICM compared with a control group (n = 10). The analysis revealed a total of 25 ion channel genes differentially expressed. We performed an RTqPCR analysis of the TRPM7 mRNA in LV and left atrial samples and found that it was down‐regulated in both cavities (−1.43‐fold and −1.52‐fold, respectively). Atrial TRPM7 mRNA levels showed an excellent and inverse relationships with the depressed ejection fraction (r = −0.724, P = 0.042) and with the mitral A wave (r = −0.938, P = 0.006). Conclusions We report the down‐regulation of TRPM7 in tissue samples from both left atria and left ventricle in patients with ICM. We found an inverse relationship between both cardiac chambers mRNA levels with LV dysfunction, suggesting an important role of TRPM7 in the left atrial and LV functional depression found in this cardiomyopathy.
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Affiliation(s)
- Ana Ortega
- Cardiocirculatory Unit Health Research Institute of La Fe University Hospital Valencia Spain
| | - Esther Roselló-Lletí
- Cardiocirculatory Unit Health Research Institute of La Fe University Hospital Valencia Spain
| | - Estefanía Tarazón
- Cardiocirculatory Unit Health Research Institute of La Fe University Hospital Valencia Spain
| | - Carolina Gil-Cayuela
- Cardiocirculatory Unit Health Research Institute of La Fe University Hospital Valencia Spain
| | - Francisca Lago
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research University Clinical Hospital Santiago de Compostela Spain
| | - Jose-Ramón González-Juanatey
- Cellular and Molecular Cardiology Research Unit, Department of Cardiology and Institute of Biomedical Research University Clinical Hospital Santiago de Compostela Spain
| | - Luis Martinez-Dolz
- Heart Failure and Transplantation Unit, Cardiology Department La Fe University Hospital Valencia Spain
| | - Manuel Portolés
- Cardiocirculatory Unit Health Research Institute of La Fe University Hospital Valencia Spain
| | - Miguel Rivera
- Cardiocirculatory Unit Health Research Institute of La Fe University Hospital Valencia Spain
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Rodríguez AH, Avilés-Jurado FX, Díaz E, Schuetz P, Trefler SI, Solé-Violán J, Cordero L, Vidaur L, Estella Á, Pozo Laderas JC, Socias L, Vergara JC, Zaragoza R, Bonastre J, Guerrero JE, Suberviola B, Cilloniz C, Restrepo MI, Martín-Loeches I, Cobo P, Martins J, Carbayo C, Robles-Musso E, Cárdenas A, Fierro J, Fernández DO, Sierra R, Huertos MJ, Carmona Pérez ML, Pozo Laderas JC, Guerrero R, Robles JC, León ME, Gómez AB, Márquez E, Rodríguez-Carvajal M, Estella Á, Pomares J, Ballesteros JL, Romero OM, Fernández Y, Lobato F, Prieto JF, Albofedo-Sánchez J, Martínez P, de la Torre MV, Nieto M, Sola EC, Díaz Castellanos MA, Soler GS, Leyba CO, Garnacho-Montero J, Hinojosa R, Fernández E, Loza A, León C, López SG, Arenzana A, Ocaña D, Navarrete I, Beryanaki MZ, Sánchez I, Pérez Alé M, Poullet Brea AM, Machado Casas JF, Serón C, Avellanas ML, Lander A, de Arellano SGR, Lacueva MM, Luque P, Serrano EP, Martín Lázaro JF, Polo CS, Cia IG, Bartolomé BJ, Nuñez CL, González I, Tomás Marsilla JI, Andrés CJ, Ibañes PG, Aguilar PA, Montón JM, Regil PD, Iglesias L, González CP, Fernández BQ, Iglesias LM, Soria LV, Escudero RY, Revuelta MDRM, Quiroga, García-Rodríguez Á, Cuadrado MM, Balán Mariño AL, Socias L, Ibánez P, Borges-Sa M, Socias A, Del Castillo A, Marcos RJ, Muñoz C, Bonell JM, Amestarán I, López MAG, Pàmies CV, Bonell Goytisolo JM, Morales Carbonero JA, Bonell Goytisolo JM, Morales Carbonero JA, Senoff RP, López de Medrano MG, Ruiz-Santana S, Díaz JJ, Ramírez CS, Sisón M, Hernández D, Trujillo A, Regalado L, Fndez SR, Lorente L, Rivero JC, Mora Quintero ML, Martín M, Martínez S, Cáceres J, Sanchez Palacio M, Marcos, García Rodríguez D, Leria MR, Suberviola B, Ugarte P, García-López F, Iniesta RS, Alonso AÁ, Padilla A, Palacios BM, Grande MLG, Martín Rodríguez MC, Adbel-Hadi Álvarez H, Ambros Checa A, Hernández HM, Albaya A, Obregón AS, Crespo CM, Estrella CA, Benito Puncel C, Oyargue EQ, Canabal A, Marina L, López de Toro I, Simón A, Añón JM, López Messa JB, López Pueyo MJ, del valle Sergio Ossa Echeverri OM, Ferreras Z, Ballesteros Herraez JC, Macias S, Berezo JÁ, Varela JB, Schweizer PB, Salamanca AG, Lomas LT, Anzález AO, Cicuéndez Avila R, Francisco Javier PG, Terrero AÁ, Ezpeleta FT, Sala C, López O, Paez Z, García Á, Carriedo Ule D, Crespo MR, Rebolledo JP, Andrés NH, Zirena ACC, García BR, López Messa JB, del Valle Ortiz M, Echeverri SO, Catalán RM, Ferrer M, Torres A, Cilloniz C, Ansorregui SB, Cabré L, Baeza I, Rovira A, Álvarez-Lerma F, Vázquez A, Nolla J, Fernández F, Cervelló JR, Iglesia R, Mañéz R, Ballús J, Granada RM, Vallés J, Díaz E, Ortíz M, Guía C, Martín-Loeches I, Páez J, Almirall J, Balanzo X, Güell E, Yebenes JC, Rello J, Arnau E, Pérez M, Laborda C, Souto J, Lagunes L, Catalán I, Sirvent JM, de Arbina NL, Serra AB, Sánchez A, Cuenca; SM, Badía M, Baseda-Garrido B, Valverdú-Vidal M, Barcenilla F, Palomar M, Nuvials X, Benedicto PG, Campo FR, Esteban M, Luna J, Eixarch GM, Diago AP, Nava JM, González de Molina J, Trenado J, Ferrer R, Josic Z, Casanovas M, Gurri F, Rodríguez P, Rodríguez A, Claverias L, Trefler S, Bodí M, Magret M, Ferri C, Díaz RM, Mesalles E, Arméstar F, de Mendoza D, Fernández CL, Berrade JJ, Saris AB, Pechkova M, Jiménez CM, Gil SP, Juliá-Narváez J, Marcos MR, Mallqui VF, Santiago Triviño MA, García PM, Fernández-Zapata A, Recio T, Arrascaeta A, García-Ramos MJ, Gallego E, Rodrigo ES, Bueno F, Díaz M, Pérez NG, Hormigo DL, Delgado JDJ, Frutos P, Rivera Pinna M, Cordero ML, Pastor JA, Álvarez-Rocha L, Ceniceros Barros A, Pedreira AV, Vila D, González CF, Pérez JB, Piquer MO, Merayo E, López-Ciudad VJ, Cañones JC, Vilaboy E, Chao JV, Cid López FS, Cortés PV, Pérez Veloso MA, Saborido EM, Pardavila EA, Montes AO, González RJ, Freita S, Alemparte E, Ortega A, López AM, Canabal J, Ferres E, Pérez JB, Piquer MO, Ramos SF, Cendón LL, Casal VG, Adrio SV, Fernández EM, Prado SG, Franco AV, Monzón JL, Goñi F, Del Nogal Sáez F, Navalpotro MB, Abad RD, Lasierra JLF, García-Torrejón MC, Pérez–Calvo C, López D, Arnaiz L, Sánchez-Alonso S, Velayos C, del Río F, González MÁ, Nieto M, Cesteros CS, Martín MC, Molina JM, Montejo JC, Catalán M, Albert P, de Pablo A, Guerrero JE, Zurita; M, Peyrat JB, Cámara MD, Cerdá E, Alvarez M, Pey C, Riestra EM, Martinez-Fidalgo C, Rodríguez M, Palencia E, Caballero R, Vaquero C, Mariscal F, García S, Cepeda R, Carrasco N, Prieto I, Liétor A, Ramos R, Casas RC, Cuesta CS, Sánchez Alonso S, Galván B, Figueira JC, Soriano MC, Martín BC, Caballero AR, Galdós P, Moreno BB, Alcántara Carmona S, del Cabo F, Hermosa C, Gordo F, Algora A, Paredes A, Carmona TG, Cambroner J, Ramos EL, de Zárate YO, Gómez-Rosado S, Lodo MM, Garrobo NF, Hernández SÁ, Honrubia T, Prado López LM, Esteban A, Lorente J, Nin N, Sotomayor CJ, Arnaiz L, Silvero EM, de la Reguera EMF, de la Casa Monje RM, Serrano FM, Trasmonte Martínez MV, Martín Delgado MC, Martínez S, Abad FF, Navalon IC, Velis MV, Martínez M, Martínez Baño D, Andreu E, Butí SM, Rueda BG, García F, Fernández NL, Para LH, Freire AO, Nvarro Ruiz MR, Romero CH, Maraví-Poma E, Urra IJ, Redin LM, Tellería A, Insansti J, Garcia NA, Macaya L, Palanco JL, González N, Marco P, Vidaur L, Salas E, Udabe RS, Santamaría B, Rodríguez T, Vergara JC, Amiano JRI, Santos IG, Manzano A, Arenal CC, Olaechea PM, Hernández HM, López AM, San Miguel FF, Blanquer J, Carbonell N, Franco JF, Valero RR, Belenger A, Altaba S, Álvarez–Sánchez B, Robles JC, Francisco JS, Sánchez MR, Picos SA, Llanes AA, Gutiérrez EH, Zapata AF, Sánchez-Miralles Á, Antón Pascual JL, Bonastre J, Palamo M, Cebrian J, Cuñat J, Sahuquillo MG, Romero B, Pallé SB, de León Belmar J, Zaragoza R, Tormo C, Chinesta SS, Paricio V, Marques A, Sánchez-Morcillo S, Tormo S, Latour J, García MÁ, Palomo M, Royo FT, Hinojosa PM, Sánchez Pino MS, Ribes CM, Luis RG, Ribas A. Procalcitonin (PCT) levels for ruling-out bacterial coinfection in ICU patients with influenza: A CHAID decision-tree analysis. J Infect 2016; 72:143-51. [DOI: 10.1016/j.jinf.2015.11.007] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 11/12/2015] [Accepted: 11/28/2015] [Indexed: 01/22/2023]
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Pérez-Calixto M, Ortega A, Garcia-Uriostegui L, Burillo G. Synthesis and characterization of N-vinylcaprolactam/N,N-dimethylacrylamide grafted onto chitosan networks by gamma radiation. Radiat Phys Chem Oxf Engl 1993 2016. [DOI: 10.1016/j.radphyschem.2015.10.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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