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Estrada-Lorenzo JM, Martín-Arriscado Arroba C, López-López C. Bibliometric analysis of original articles of journal Enfermería Intensiva in the period 2001-2020. Enferm Intensiva (Engl Ed) 2023:S2529-9840(23)00019-8. [PMID: 37230896 DOI: 10.1016/j.enfie.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Bibliometric analysis allow the quantitative evaluation of the characteristics of a scientific publication. OBJECTIVE To perform a bibliometric analysis of original articles in the journal Enfermería Intensiva from 2001 to 2020. RESULTS The journal Enfermería Intensiva has published, between 2001 and 2020, 438 works, of which 259 are original articles (59.1%). These original articles are mostly quantitative studies (76.1%), with an average of 30.5 bibliographic references (SD 13.9), 4.9 citations (SD 1.7) in the Web of Science and Scopus repertoires, and 15,489.5 visits/downloads (median 9090 and interquartile range 4567-15,260) according to information on the magazine's website. These originals have been signed by 1345 authors, which represents a collaboration index of 5.2. 78.0% of the authors are sporadic, having published only one work. Most of the articles come from authors who work in institutionally located in hospitals and university centers, and geographically in the Communities of Madrid, Cataluña, Navarra and Andalucía. CONCLUSIONS There is little international, regional and institutional collaboration, producing the highest level of collaboration between authors from the same center. The journal has established itself in the panorama of scientific nursing research in Spain and shows bibliometric indicators similar or even superior to other publications in its environment.
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Affiliation(s)
- J M Estrada-Lorenzo
- Biblioteca, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - C Martín-Arriscado Arroba
- Unidad de Investigación y Soporte Científico, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - C López-López
- Unidad de Cuidados Intensivos de Trauma y Emergencias. Hospital Universitario 12 de Octubre, Madrid, Spain. Grupo de Investigación en Cuidados (InveCuid). Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain.
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Ortueta-Olartecoechea A, Torres-Peña JL, Muñoz-Gallego A, López-López C, Vázquez Román S, Tejada-Palacios P. Prematurity: A medical history of obligatory consideration when assessing the retinal ganglion cell complex. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:S2173-5794(22)00123-2. [PMID: 36075825 DOI: 10.1016/j.oftale.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Premature children birth and survival is becoming more frequent due to the improvement in obstetric and neonatal care. This makes it increasingly common to find patients with history of preterm birth in ophthalmology clinics, both in pediatric and adult ages. Premature birth can lead to ocular structural changes, being possible to affect the ganglion cell complex (GCC), among other structures, which can be studied using optical coherence tomography. MATERIALS AND METHODS To carry out a bibliographic review of the studies that analyze GCC in patients with a history of prematurity compared with patients born at term. RESULTS Several studies that analyze GCC in patients with a history of prematurity are referenced and their results are studied. CONCLUSIONS In our clinical practice, knowing the history of prematurity is fundamental in the assessment of GCC measured by optical coherence tomography, since this layer is different in the patients with a history of prematurity compared to patients born at term.
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Affiliation(s)
- A Ortueta-Olartecoechea
- Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain.
| | - J L Torres-Peña
- Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - A Muñoz-Gallego
- Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - C López-López
- Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - S Vázquez Román
- Neonatología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - P Tejada-Palacios
- Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
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Calleja-García C, Muñoz-Gallego A, Dorado-López-Rosado A, López-López C, Tejada-Palacios P. Ophthalmological manifestations in 6 patients diagnosed with Williams-Beuren syndrome and literature review. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:276-280. [PMID: 35292219 DOI: 10.1016/j.oftale.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 04/06/2021] [Indexed: 06/14/2023]
Abstract
Medical history of 6 patients diagnosed with Williams-Beuren Syndrome (SWB) in pediatric age was revised. All the patients presented characteristic elf facies and cardiovascular abnormalities. All presented good visual acuity, except one case of unilateral amblyopia. The most frequent refractive error was hyperopia (n = 6; 100%) and astigmatism (n = 5; 83.3%). Ocular motility alterations were found in 2 patients (1 case of exophoria with hyperfunction of right inferior oblique and another of congenital endotropia with bilateral hyperfunction of inferior oblique). On the cognitive function, 66.7% (n = 4) had visoperceptive disorders. Other findings were epicanthus (n = 6; 100%) and congenital obstruction of the nasolacrimal duct with unilateral epiphora (n = 1; 16.7%). SWB is a rare disorder with complex ophthalmological and systemic manifestations. For this reason, ophthalmological follow-up of these children is recommended.
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Affiliation(s)
- C Calleja-García
- Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Muñoz-Gallego
- Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Madrid, Spain.
| | | | - C López-López
- Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P Tejada-Palacios
- Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain; Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
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Hernández-Almeida S, Dorado López-Rosado A, Muñoz-Gallego A, López-López C, Tejada-Palacios P. Septo-optic dysplasia: Ophthalmological abnormalities in a series of 5 cases. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:28-33. [PMID: 35027141 DOI: 10.1016/j.oftale.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/20/2021] [Indexed: 06/14/2023]
Abstract
Septo-optic dysplasia (SOD) is a rare congenital condition of unknown cause, with a characteristic triad that includes optic nerve hypoplasia, pituitary function abnormalities and midline brain defects, in addition to a broad spectrum of symptoms and associations. A total of five clinical cases are presented, four of which met the complete classic triad. All of them showed a wide variety of ophthalmological, endocrinological and neurological alterations. Within the ophthalmological spectrum of SOD, papillary hypoplasia and ocular motility alterations (nystagmus, strabismus) stand out. Other less frequent ones may also appear, such as pupillary alterations, microphthalmia and coloboma. Given the suspicion of SOD, brain MRI scan should be performed, as well as consultation with the paediatric department in order to complete the study and indicate, if necessary, systemic treatment.
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Affiliation(s)
- S Hernández-Almeida
- Hospital Universitario 12 de Octubre, Servicio de Oftalmología, Madrid, Spain
| | | | - A Muñoz-Gallego
- Hospital Universitario 12 de Octubre, Servicio de Oftalmología, Madrid, Spain
| | - C López-López
- Hospital Universitario 12 de Octubre, Servicio de Oftalmología, Madrid, Spain
| | - P Tejada-Palacios
- Hospital Universitario 12 de Octubre, Servicio de Oftalmología, Madrid, Spain; Instituto de investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain; Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Inmunología, Oftalmología y ORL, Madrid, Spain
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Martínez-Nogueras A, Sáez-Zea C, López-López C, de la Fuente-Gómez M, Fernández-Olmo MR, Andrade-Ortega JA. [Variability in the neuropsychological performance of patients with acute coronary syndrome]. Rev Neurol 2021; 73:299-306. [PMID: 34676527 DOI: 10.33588/rn.7309.2020552] [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: 11/24/2022]
Abstract
INTRODUCTION There is a growing interest in the study of the relationship between heart disease, including acute coronary syndrome (ACS) and cognitive impairment, and although the factors mediating ACS and cognitive impairment are not well understood, the debate revolves around the role of the left ventricular ejection fraction (LVEF). AIMS To determine the presence of cognitive impairment in patients with ACS and explore its association with various factors, including sociodemographic, medication use and performance on cardiac function tests (in particular LVEF). PATIENTS AND METHODS Sociodemographic, medical and neuropsychological variables were collected in 80 patients with ACS participating in a cardiac rehabilitation programme. Their scores on the neuropsychological battery were compared with normative population data to determine which subjects showed deficient performance. Regression analyses were conducted to determine which factors are associated with performance on neuropsychological tests. RESULTS Compared to their normative group, 37.5% of the subjects had low scores on three or more neuropsychological tests. Age, low educational level and low LVEF explained up to 51% of the variability in neuropsychological test results. CONCLUSIONS Patients with ACS are more likely to have impaired cognitive functions, such as attention, memory and executive functions, along with a slower information processing speed. An LVEF below 50% could be a major explanatory factor for such cognitive impairment.
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Tabernero J, Bekaii-Saab T, Safont Aguilera M, Cubillo A, Garcia-Carbonero R, Limon L, Rodríguez-Salas N, Tournigand C, Borg C, Raghav K, Finley G, Strickler J, Beier F, Salim S, Esser R, Liu E, Adrian S, López-López C. P-111 PERSPECTIVE: Tepotinib plus cetuximab in patients with RAS/BRAF wild-type left-sided metastatic colorectal cancer and acquired resistance to anti-EGFR antibody therapy due to MET amplification. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.166] [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: 11/27/2022] Open
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Via-Clavero G, Frade-Mera MJ, Alonso-Crespo D, Castanera-Duro A, Gil-Castillejos D, Vallés-Fructuoso O, Rodríguez-Mondéjar JJ, López-López C, Robleda G, Acevedo-Nuevo M. Future lines of research on pain care, sedation, restraints and delirium in the critically ill patient. Enferm Intensiva (Engl Ed) 2021; 32:57-61. [PMID: 34099265 DOI: 10.1016/j.enfie.2021.04.001] [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] [Received: 03/18/2021] [Accepted: 04/14/2021] [Indexed: 11/26/2022]
Affiliation(s)
- G Via-Clavero
- Enfermera Clínica, Área del Paciente Crítico, Hospital Universitari de Bellvitge, Profesora Asociada, Escuela de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona, Grup de Recerca Infermera (GRIN-IDIBELL), Spain.
| | - M J Frade-Mera
- Enfermera Clínica, Área del Paciente Crítico, Hospital Universitario 12 de Octubre, Profesora Asociada, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Spain
| | - D Alonso-Crespo
- Enfermero, Unidad de Cuidados Intensivos, Área Sanitaria de Vigo, Hospital Álvaro Cunqueiro SERGAS-UVigo, Translational Neuroscience Group-CIBERSAM, Galicia Sur, Instituto de Investigación Sanitaria (IIS Galicia Sur), Spain
| | - A Castanera-Duro
- Enfermero Clínico, Área del paciente crítico, Hospital Universitario de Girona Dr. Josep Trueta, Profesor Asociado departamento de Enfermería Universitat de Girona (UdG), Spain
| | - D Gil-Castillejos
- Enfermera Clínica, Área de Críticos, Servicio de Medicina Intensiva, Hospital Universitari Joan XXIII, Tarragona, Spain
| | - O Vallés-Fructuoso
- Enfermera, Unidad de Cuidados Intensivos, Hospital Vall d'Hebrón, Barcelona, Spain
| | - J J Rodríguez-Mondéjar
- Enfermero en UME-2 Alcantarilla, Gerencia de Urgencias y Emergencias Sanitarias 061 Región de Murcia, Servicio Murciano de Salud, Profesor asociado en la Facultad de Enfermería de la Universidad de Murcia, Campus Mare Nostrum, Miembro del grupo de investigación ENFERAVAN en el IMIB-Arrixaca, Spain
| | - C López-López
- Enfermera, Departamento de Cuidados Intensivos, Hospital Universitario 12 de Octubre, Madrid, Investigadora, Grupo de Investigación en Cuidados (InveCuid), Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Profesora Asociada, Facultad de Enfermería Fisioterapia y Podología, Universidad Complutense de Madrid, Spain
| | - G Robleda
- Campus docente Fundación Privada Sant Joan de Déu, Escuela de Enfermería, Universidad de Barcelona, Centro Cochrane Iberoamericano, Spain
| | - M Acevedo-Nuevo
- Enfermera, Organización Nacional de Trasplantes, Grupo de Investigación en Enfermería y Cuidados de Salud - Instituto de Investigación Sanitaria Puerta de Hierro - Segovia de Arana (IDIPHISA), Spain
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Bekaii-Saab TS, Van Cutsem E, Cubillo A, Petorin-Lesens C, Rodriguez-Salas N, Raghav KPS, Dupuis O, López-López C, Tournigand C, Isambert N, Abubaker K, Schumacher KM, Berghoff K, Vlassak S, Otto G, Tabernero J. PERSPECTIVE: Tepotinib + cetuximab in patients (pts) with RAS/BRAF wild-type left-sided metastatic colorectal cancer (mCRC) and acquired resistance to anti-EGFR antibody therapy due to MET amplification ( METamp). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.tps3616] [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: 11/20/2022] Open
Abstract
TPS3616 Background: METamp is a secondary, or co-driving, genetic change in pts with mCRC and acquired resistance to anti-EGFR therapy, which can contribute to disease progression. In EGFR-resistant pts with mCRC and METamp, MET inhibition + an anti-EGFR agent may achieve disease control by targeting emerging MET pathway activation and maintaining EGFR pathway inhibition. Tepotinib is an oral, once-daily, highly selective, potent MET tyrosine kinase inhibitor (TKI), recently approved in the US for NSCLC harboring MET exon 14 skipping. Tepotinib + gefitinib demonstrated improved outcomes in pts with EGFR-mutant METamp NSCLC and acquired EGFR TKI resistance vs chemotherapy (INSIGHT: NCT01982955). In these pts, progression-free survival (PFS) was 16.6 vs 4.2 months (HR = 0.13; 90% CI: 0.04, 0.43) and overall survival (OS) was 37.3 vs 13.1 months (HR = 0.08; 90% CI: 0.01, 0.51). In pts with mCRC and acquired resistance to anti-EGFR antibody therapy due to METamp, tepotinib + anti-EGFR antibody cetuximab may be active and provide an effective therapeutic option. Methods: This Phase II, multicenter, single-arm, open-label study will assess preliminary safety and tolerability, antitumor activity, and explore pharmacokinetic (PK) profiles of tepotinib + cetuximab in pts with RAS/BRAF wild-type left-sided mCRC and acquired resistance to anti-EGFR antibody-targeted therapy due to METamp (NCT04515394). A safety run-in (6–12 pts) will evaluate the recommended Phase II dose of tepotinib to be used in combination with cetuximab (endpoint: dose-limiting toxicities). Enrollment is based on a confirmed advanced left-sided CRC diagnosis ( RAS/BRAF wild-type), documented previous anti-EGFR therapy and acquired resistance on most recent anti-EGFR antibody and METamp confirmed by liquid and/or tissue biopsy. Pts must be ≥18 years old, have ECOG PS of 0/1 and normal organ function. The study will screen sufficient pts to account for setting-specific heterogenecity in reported METamp incidence. Approximately 42 pts are planned to receive study treatment: ̃22 in Cohort A (second-line, outside US) and 20 in Cohort B (≥third-line, US only). Primary endpoint: investigator-assessed objective response (RECIST 1.1). Secondary endpoints are investigator-assessed duration of response (DoR), PFS (RECIST 1.1) and OS, tolerability and safety (NCI-CTCAE v5.0), and cetuximab immunogenicity (measured by antidrug antibody assays at the start and end of treatment). Additional endpoints include assessment of tepotinib and cetuximab PK profiles, and expression of biomarkers of resistance (from blood and/or tissue samples). Retrospective assessment of best overall response, DoR and PFS by an independent review committee may be conducted. No formal statistical hypothesis will be tested in this exploratory study. Clinical trial information: NCT04515394.
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Affiliation(s)
| | | | - Antonio Cubillo
- Hospital Universitario Sanchinarro (Madrid)-Claro Campo (HIOCC), Madrid, Spain
| | | | | | | | | | | | | | - Nicolas Isambert
- Service d'Oncologie médicale, CLCC Georges-François Leclerc, Dijon Cedex, France
| | - Khalid Abubaker
- Clinical Biomarkers and Companion Diagnostics, Merck KGaA, Darmstadt, Germany
| | | | | | | | - Gordon Otto
- Global Clinical Development, Merck KGaA, Darmstadt, Germany
| | - Josep Tabernero
- Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology (VHIO), UVic-UCC, Barcelona, Spain
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López-López C, Collados-Gómez L, García-Manzanares ME, Segura-Paz AM, López-Gutierrez AM, Pérez-García S. Prospective cohort study on the management and complications of peripheral venous catheter in patients hospitalised in Internal Medicine. Rev Clin Esp 2021; 221:151-156. [PMID: 32513436 DOI: 10.1016/j.rce.2020.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/09/2020] [Accepted: 05/11/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To analyse compliance with the recommendations on the insertion-maintenance of peripheral venous catheter (PVC) and the incidence of complications according to the healthcare department that inserted the PVCs. PATIENTS AND METHODS We conducted a prospective cohort follow-up study of PVCs, from their insertion in the emergency or internal medicine (IM) department until their withdrawal. RESULTS We monitored 590 PVCs, 274 from the emergency department and 316 from IM. In terms of compliance with the process indicators, there was a cannulation rate in the antecubital fossa of 3.5 and 1.6 per 100 catheters-day (P<.001) in the emergency and IM departments, respectively. The sterile placement rates were 1.6 and 12.4 (P<.001), and the rate for transparent dressing was 2.1 and 11.5 (P<.001) per 100 catheters-day in the emergency and IM departments, respectively. The complications rates showed no differences between the departments. The most common complication was phlebitis (95 cases, 16.1%). CONCLUSIONS Compliance with the insertion-maintenance recommendations for PVC showed differences between the departments; however, the incidence of complications was similar.
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Affiliation(s)
- C López-López
- Grupo de Investigación en Cuidados (InveCuid), Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, España; Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, España.
| | - L Collados-Gómez
- Grupo de Investigación en Cuidados (InveCuid), Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, España; Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, España
| | - M E García-Manzanares
- Grupo de Investigación en Cuidados (InveCuid), Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, España; Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, España
| | - A M Segura-Paz
- Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, España
| | - A M López-Gutierrez
- Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, España
| | - S Pérez-García
- Grupo de Investigación en Cuidados (InveCuid), Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, España; Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, España; Área Funcional de Investigación, Desarrollo, Innovación y Procesos, Hospital Universitario 12 de Octubre, Madrid, España
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López-López C, Collados-Gómez L, García-Manzanares ME, Segura-Paz AM, López-Gutierrez AM, Pérez-García S. Prospective cohort study on the management and complications of peripheral venous catheter in patients hospitalised in internal medicine. Rev Clin Esp 2021; 221:151-156. [PMID: 33998463 DOI: 10.1016/j.rceng.2020.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/11/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To analyse compliance with the recommendations on the insertion-maintenance of peripheral venous catheter (PVC) and the incidence of complications according to the healthcare department that inserted the PVCs. PATIENTS AND METHODS We conducted a prospective cohort follow-up study of PVCs, from their insertion in the emergency or internal medicine (IM) department until their withdrawal. RESULTS We monitored 590 PVCs, 274 from the emergency department and 316 from IM. In terms of compliance with the process indicators, there was a cannulation rate in the antecubital fossa of 3.5 and 1.6 per 100 catheters-day (p < .001) in the emergency and IM departments, respectively. The sterile placement rates were 1.6 and 12.4 (p < .001), and the rate for transparent dressing was 2.1 and 11.5 (p < .001) per 100 catheters-day in the emergency and IM departments, respectively. The complications rates showed no differences between the departments. The most common complication was phlebitis (95 cases, 16.1%). CONCLUSIONS Compliance with the insertion-maintenance recommendations for PVC showed differences between the departments; however, the incidence of complications was similar.
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Affiliation(s)
- C López-López
- Grupo de Investigación en Cuidados (InveCuid), Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain.
| | - L Collados-Gómez
- Grupo de Investigación en Cuidados (InveCuid), Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, Spain
| | - M E García-Manzanares
- Grupo de Investigación en Cuidados (InveCuid), Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | - A M Segura-Paz
- Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A M López-Gutierrez
- Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - S Pérez-García
- Grupo de Investigación en Cuidados (InveCuid), Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain; Área Funcional de Investigación, Desarrollo, Innovación y Procesos, Hospital Universitario 12 de Octubre, Madrid, Spain
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Garcia-Carbonero R, Benavent M, Jiménez Fonseca P, Castellano D, Alonso T, Teule A, Custodio A, Tafuto S, La Casta Munoa A, Spada F, López-López C, Ibrahim T, Villanueva Silva MJ, Iranzo V, Garcia-Alfonso P, González E, Grande E, Crespo G, Capdevila J. A phase II/III randomized double-blind study of octreotide acetate LAR with axitinib versus octreotide acetate LAR with placebo in patients with advanced G1-G2 NETs of non-pancreatic origin (AXINET trial-GETNE-1107). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.3_suppl.360] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
360 Background: Angiogenesis plays an important role in NET development and progression. Axitinib is a potent and selective VEGFR-1,2,3 inhibitor, with proven activity against several vascular-dependent solid tumors. The aim of this randomized, double-blind phase II/III study was to assess the efficacy of axitinib in patients with advanced G1-2 extra-pancreatic NETs. Methods: Eligible pts were randomized (1:1) to receive octreotide LAR (30 mg IM q4w) with axitinib (5 mg BID) or placebo BID until disease progression or unacceptable toxicity. Pteswere stratified by time from diagnosis to study entry ( > or < 12m), primary tumor site (GI tract vs non-GI) and Ki-67 index (< 5% vs > 5%). Prior therapy with SSA, IFN and up to 2 lines of systemic treatment was allowed, but not prior VEGF- or VEGFR-targeted drugs. Clinical and/or radiological disease progression within 12 months prior to study entry was required. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), time to progression, overall response rate (ORR), duration of response, biochemical response and safety. Results: 256 pts were randomized (106 in the Phase II part, and 150 additional pts in the Phase III part), 126 to axitinib and 130 to placebo. The main characteristics of the study population were: median age 61 years (range: 21-85), 52% male, PS 0-1 (64-35%), G1-2 (29%-71%), primary tumor site GI (40%)-Lung (17%)-Other (32%). Prior therapies included: SSA (46%), everolimus (13%), chemotherapy (13%), TACE (5%) and PRRT (2%). ORR was significantly higher in axitinib- vs placebo-treated patients (17.5% vs 3.8%, p = 0.0004). PFS per investigator assessment also favored axitinib vs placebo-treated patients, although the difference did not reach statistical significance (median PFS 17.2 vs 12.3 months, respectively, HR 0.816, p = 0.169). Grade 3-4 treatment-related AEs occurred more frequently in the axitinib vs placebo arm (52% vs 13.8%), and included hypertension (21% vs 6 %), cardiac disorders (3.2% vs 0.7%), diarrhoea (13% vs 1.5 %), asthenia (9% vs 3%) and nausea&vomiting (2% vs 0.7%). There were 3 treatment-related deaths, 1 in the axitinib arm (cardiac failure) and 2 in the placebo arm (myocardial infarction and hepatorenal syndrome). Conclusions: Although the study failed to demonstrate a significant PFS benefit per investigator assessment, axitinib in combination with octreotide LAR demonstrated activity and had a tolerable safety profile in patients with advanced G1-2 extra-pancreatic NETs. Data base cleaning and central blinded radiological PFS assessment are currently ongoing. Clinical trial information: NCT01744249.
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Affiliation(s)
| | | | | | | | | | - Alex Teule
- Institut Català d’Oncologia, L’Hospitalet, Barcelona, Spain
| | | | | | | | | | | | - Toni Ibrahim
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | - Vega Iranzo
- Hospital General Universitario de Valencia, Valencia, Spain
| | | | | | | | | | - Jaume Capdevila
- Medical Oncology Department, Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
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12
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Salvador-Marín J, Izquierdo-Plazas L, Ausina-Gómez S, López-López C, Castro-Copete MC. [Hematuria as the first sign of pelvic chondrosarcoma]. Acta Ortop Mex 2020; 34:313-318. [PMID: 33634636] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Chondrosarcoma is a malignant tumor which often affects the pelvic ring and its symptomathology is non-specific and insidious. We display a case of a right iliopubic branch chondrosarcoma in a 62-year-old male whose first sing was a four-year history of sporadic macroscopic haematuria, related to efforts. After being studied by the Urology Department by cystoscopy and biopsy of bladder tumor, chondral cells were appreciated. Further study with imaging tests diagnosed low-grade chondrosarcoma with bladder infringement. The case is assessed by Musculoskeletal Tumors Committee and a multidisciplinary approach is carried out through en bloc resection and pelvic floor reconstruction. Currently the patient remains asymptomatic.
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Affiliation(s)
- J Salvador-Marín
- Servicio de Cirugía Ortopédica y Traumatología. Unidad de Tumores Musculoesqueléticos. Hospital Universitario Sant Joan d' Alacant. Alicante, España
| | - L Izquierdo-Plazas
- Servicio de Cirugía Ortopédica y Traumatología. Unidad de Tumores Musculoesqueléticos. Hospital Universitario Sant Joan d' Alacant. Alicante, España
| | - S Ausina-Gómez
- Servicio de Cirugía Ortopédica y Traumatología. Unidad de Tumores Musculoesqueléticos. Hospital Universitario Sant Joan d' Alacant. Alicante, España
| | - C López-López
- Servicio de Urología. Hospital Universitario Sant Joan d' Alacant. Alicante, España
| | - M C Castro-Copete
- Servicio de Radiodiagnóstico. Hospital Universitario Sant Joan d' Alacant. Alicante, España
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13
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López-López C, Alonso Gordoa T, Benavent M, Capdevila J, Teule A, Custodio A, Sevilla I, Santos M, Lanillos J, Rodríguez-Antona C, Garcia-Carbonero R, Grande E. Molecular correlation of the activity of evofosfamide (EVO) in combination with sunitinib (SUN) in pancreatic Neuroendocrine Tumors (pNETs) in the SUNEVO GETNE Trial. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e16706] [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: 11/20/2022] Open
Abstract
e16706 Background: MEN1, DAXX, ATRX, and PI3K/AKT/mTOR pathway genes are frequently mutated in pNETs. Sunitinib is approved and widely used in the metastatic setting but unfortunately, no validated predictive biomarker has been identified to guide therapy yet. The SUNEVO phase II trial of the Spanish Task Force Group for Neuroendocrine and Endocrine Tumours (GETNE) trial combined the pro-drug of EVO under SUN-induced hypoxic conditions. Methods: We performed an exploratory analysis aimed to identify somatic mutations associated with the clinical benefit of pNET patients treated with SUN+EVO combination. Seventeen treatment-naïve pts with pNETS were included in the SUNEVO trial, and 4 (23.5%) achieved a partial response (by RECIST 1.1). Tumor DNA from 10 FFPE tumor samples were successfully sequenced with an enrichment panel (Nimblegen, Roche) including 42 cancer-related genes and TERT promoter region. Median coverage was 793x. Coding non-synonymous and loss-of-function variants were considered for the analysis. Final analysis included tumor samples from the 10 patients with NGS results. Results: Somatic mutations were found in MEN1 (70%), DAXX (30%), ATRX (20%), SETD2 (20%) and PTEN (10%). Mutations in the telomere maintenance genes DAXX and ATRX were concordant with mutual exclusivity. The loss of MEN1 was associated with a greater number of mutations (p = 0.019). Patients with complete and partial response showed heterogeneous genetic profiles. Conclusions: The molecular alterations of the patients in the SUNEVO trial were consistent with those previously described for metastatic pNETs. No clear association between molecular defects and treatment response was found. Clinical trial information: NCT02402062 .
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Affiliation(s)
| | | | | | | | - Alex Teule
- Institut Català d’Oncologia, L’Hospitalet, Barcelona, Spain
| | | | - Isabel Sevilla
- Hospital Universitario Regional y Virgen de la Victoria, Málaga, Spain
| | - Maria Santos
- Spanish National Cancer Research Center, Madrid, Spain
| | - J. Lanillos
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain, Madrid, Spain
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Muñoz-Gallego A, Rodríguez-Salgado M, de la Cruz J, López-López C, Cañas-Zamarra I, Tejada-Palacios P. Paediatric optical coherence tomography normative databases: A real need. ACTA ACUST UNITED AC 2019; 94:591-597. [PMID: 31685301 DOI: 10.1016/j.oftal.2019.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 08/28/2019] [Accepted: 08/30/2019] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Optical coherence tomography (OCT) has become an essential tool in paediatric ophthalmology. However, none of the currently available OCT devices include any kind of normative database for the paediatric population, which can lead to important interpretation errors. OBJECTIVE To review the paediatric OCT normative databases. MATERIAL AND METHODS The applications and implications of the use of paediatric OCT normative databases are reviewed. RESULTS The paediatric normative databases that have been published so far in scientific literature with different OCT devices for Spanish and European population are presented. CONCLUSIONS The knowledge and interpretation of paediatric OCT normative databases in our daily clinical practice is crucial in order for the correct interpretation of OCT thickness maps.
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Affiliation(s)
- A Muñoz-Gallego
- Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, España.
| | | | - J de la Cruz
- Instituto de investigación i+12. ISCIII, SAMID, Hospital Universitario 12 de Octubre, Madrid, España
| | - C López-López
- Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, España
| | - I Cañas-Zamarra
- Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, España
| | - P Tejada-Palacios
- Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, España; Instituto de investigación i+12. ISCIII, SAMID, Hospital Universitario 12 de Octubre, Madrid, España
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15
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González Borja I, Viudez A, Goñi S, Pérez Sanz J, Santamaria E, López-López C, Pazo R, Fonseca PJ, Arévalo S, Feliu J, Fernández Irigoyen J. Search for new predictive/prognostic biomarkers in potentially resectable pancreatic ductal adenocarcinoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Aranda E, Garcia-Alfonso P, Vieitez JM, Ortiz MJ, López-López C, Reina-Zoilo JJ, Salud Salvia A, Quintero Aldana GA, Robles L, Safont MJ, La Casta Munoa A, Alés I, Polo Marques E, Gallego Plazas J, García de Paredes B, Lopez R, Mónica G, Valladares-Ayerbes M, Sastre J, Díaz-Rubio E. Randomized phase II study on the influence of BRAF and PIK3CA mutations on the efficacy of FOLFIRI plus bevacizumab (Bev) or cetuximab (Cet), as first line therapy of patients (pts) with RAS wild-type metastatic colorectal carcinoma (mCRC) and <3 baseline circulating tumor cells (bCTCs). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.3549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3549 Background: The outcome for mCRC has changed since the introduction of new chemotherapy schedules and targeted therapies, however new predictive biomarkers are needed. bCTCs and BRAF / PIK3CA mutations have been studied as a potential predictive biomarkers. The primary endpoint was progression-free survival (PFS) in pts WT KRAS and <3 bCTCs, according to BRAF/ PIK3CA status. Methods: This is an open, multicentric, randomized phase II trial and included wildtype KRAS mCRC pts (RAS after approval of protocol amendment), younger than ≤70 with <3 bCTCs, ECOG 0-1 and available tissue for molecular analyses. Pts were stratified per number of metastatic organs involved (1 vs >1) and mutation status of BRAF and/or PIK3CA (WT vs MUT) and randomized to group A (FOLFIRI+Bev) or group B (FOLFIRI+Cet). Results: 240 pts (196 WT and 44 MUT: 6 BRAF, 12 PIK3CA and 6 BRAF + PIK3CA) were included. General characteristics per mutation status (WT vs MUT): Mean age (59 vs 61 years), gender (Male/Female 68/32 vs 70/30%), ECOG 0/1 (57/43 vs 66/34%), primary tumor unresected (48 vs 64%), RAS MUT in 12 pts (11 and 1 pts, respectively), previous chemotherapy (12 vs 9%). Overall response rate (ORR) was 52 and 41% in the WT and MUT groups, respectively. PFS and overall survival (OS) are presented in the table. Conclusions: In the low risk mCRC pts according to bCTCs, BRAF and/or PIK3CA MUT have a negative impact in OS and a trend to worse PFS in the ITT population. The impact of treatment is under evaluation and will be provided during the meeting. Clinical trial information: 2012-000840-90. [Table: see text]
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Affiliation(s)
- Enrique Aranda
- IMIBIC, Reina Sofía Hospital, University of Córdoba, CIBERONC, Instituto de Salud Carlos III/ Spain, Córdoba, Spain
| | - Pilar Garcia-Alfonso
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Maria Jose Ortiz
- IMIBIC, Reina Sofía Hospital, Univeristy of Córdoba, CIBERONC, Instituto de Salud Carlos III, Córdoba, Spain
| | | | | | | | | | | | | | | | - Inmaculada Alés
- Hospital Universitario Regional Virgen de la Victoria, Málaga, Spain
| | | | | | - Beatriz García de Paredes
- Hospital Clínico San Carlos, Instituto de Investigación Hospital Clinico San Carlos (IdISSC), CIBERONC, Madrid, Spain
| | - Rafael Lopez
- University Clinical Hospital and Health Research Institute (IDIS), CIBERONC, Santiago de Compostela University School of Medicine, Santiago De Compostela, Spain
| | | | - Manuel Valladares-Ayerbes
- Complejo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica (INIBIC), A Coruña, Spain
| | - Javier Sastre
- Hospital Clínico San Carlos, Instituto de Investigación Hospital Clinico San Carlos (IdISSC), Madrid/Spain, CIBERONC, Madrid, Spain
| | - Eduardo Díaz-Rubio
- Hospital Clínico San Carlos, Instituto de Investigación Hospital Clinico San Carlos (IdISSC), Madrid/Spain, CIBERONC, Madrid, Spain
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17
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Santos C, Azuara D, Viéitez JM, Páez D, Falcó E, Élez E, López-López C, Valladares M, Robles-Díaz L, García-Alfonso P, Bugés C, Durán G, Salud A, Navarro V, Capellá G, Aranda E, Salazar R. Phase II study of high-sensitivity genotyping of KRAS, NRAS, BRAF and PIK3CA to ultra-select metastatic colorectal cancer patients for panitumumab plus FOLFIRI: the ULTRA trial. Ann Oncol 2019; 30:796-803. [PMID: 30840064 DOI: 10.1093/annonc/mdz082] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Several studies show the importance of accurately quantifying not only KRAS and other low-abundant mutations because benefits of anti-EGFR therapies may depend on certain sensitivity thresholds. We assessed whether ultra-selection of patients using a high-sensitive digital PCR (dPCR) to determine KRAS, NRAS, BRAF and PIK3CA status can improve clinical outcomes of panitumumab plus FOLFIRI. PATIENTS AND METHODS This was a single-arm phase II trial that analysed 38 KRAS, NRAS, BRAF and PIK3CA hotspots in tumour tissues of irinotecan-resistant metastatic colorectal cancer patients who received panitumumab plus FOLFIRI until disease progression or early withdrawal. Mutation profiles were identified by nanofluidic dPCR and correlated with clinical outcomes (ORR, overall response rate; PFS, progression-free survival; OS, overall survival) using cut-offs from 0% to 5%. A quantitative PCR (qPCR) analysis was also performed. RESULTS Seventy-two evaluable patients were enrolled. RAS (KRAS/NRAS) mutations were detected in 23 (32%) patients and RAS/BRAF mutations in 25 (35%) by dPCR, while they were detected in 7 (10%) and 11 (15%) patients, respectively, by qPCR. PIK3CA mutations were not considered in the analyses as they were only detected in 2 (3%) patients by dPCR and in 1 (1%) patient by qPCR. The use of different dPCR cut-offs for RAS (KRAS/NRAS) and RAS/BRAF analyses translated into differential clinical outcomes. The highest ORR, PFS and OS in wild-type patients with their lowest values in patients with mutations were achieved with a 5% cut-off. We observed similar outcomes in RAS/BRAF wild-type and mutant patients defined by qPCR. CONCLUSIONS High-sensitive dPCR accurately identified patients with KRAS, NRAS, BRAF and PIK3CA mutations. The optimal RAS/BRAF mutational cut-off for outcome prediction is 5%, which explains that the predictive performance of qPCR was not improved by dPCR. The biological and clinical implications of low-frequent mutated alleles warrant further investigations. CLINICALTRIALS.GOV NUMBER NCT01704703. EUDRACT NUMBER 2012-001955-38.
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Affiliation(s)
- C Santos
- Translational Research Laboratory, Institut Català d'Oncologia Oncobell Program-IDIBELL, L'Hospitalet de Llobregat; Department of Medical Oncology, Institut Català d'Oncologia Oncobell Program-IDIBELL, CIBERONC, L'Hospitalet de Llobregat
| | - D Azuara
- Translational Research Laboratory, Institut Català d'Oncologia Oncobell Program-IDIBELL, L'Hospitalet de Llobregat
| | - J M Viéitez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo
| | - D Páez
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona
| | - E Falcó
- Department of Medical Oncology, Hospital Son Llàtzer, Palma de Mallorca
| | - E Élez
- Department of Medical Oncology, Hospital Vall d'Hebrón, Barcelona
| | - C López-López
- Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander
| | - M Valladares
- Department of Medical Oncology, Hospital Universitario de A Coruña, A Coruña
| | - L Robles-Díaz
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid
| | - P García-Alfonso
- Department of Medical Oncology, Hospital General Universitario Gregorio Marañón, Madrid
| | - C Bugés
- Department of Medical Oncology, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Badalona, Institut Català d'Oncologia-Hospital Germans Trias i Pujol
| | - G Durán
- Department of Medical Oncology, Hospital Universitario Virgen de la Victoria, Málaga
| | - A Salud
- Department of Medical Oncology, Hospital Universitari Arnau de Vilanova, Lleida
| | - V Navarro
- Clinical Research Unit, Institut Català d'Oncologia, L'Hospitalet de Llobregat
| | - G Capellá
- Translational Research Laboratory, Institut Català d'Oncologia Oncobell Program-IDIBELL, L'Hospitalet de Llobregat
| | - E Aranda
- Department of Medical Oncology, IMIBIC, Hospital Universitario Reina Sofía, Universidad de Córdoba, CIBERONC, Córdoba, Spain
| | - R Salazar
- Translational Research Laboratory, Institut Català d'Oncologia Oncobell Program-IDIBELL, L'Hospitalet de Llobregat; Department of Medical Oncology, Institut Català d'Oncologia Oncobell Program-IDIBELL, CIBERONC, L'Hospitalet de Llobregat.
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18
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Arias-Rivera S, López-López C, Frade-Mera MJ, Via-Clavero G, Rodríguez-Mondéjar JJ, Sánchez-Sánchez MM, Acevedo-Nuevo M, Gil-Castillejos D, Robleda G, Cachón-Pérez M, Latorre-Marco I. Assessment of analgesia, sedation, physical restraint and delirium in patients admitted to Spanish intensive care units. Proyecto ASCyD. Enferm Intensiva (Engl Ed) 2019; 31:3-18. [PMID: 31003871 DOI: 10.1016/j.enfi.2018.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 11/15/2018] [Accepted: 11/23/2018] [Indexed: 01/25/2023]
Abstract
AIMS Main aim: To determine the Spanish intensive care units (ICU) that assess and record pain levels, sedation/agitation, delirium and the use of physical restraint (PR) as standard practice. Secondary aims: To determine the use of validated assessment tools and to explore patients' levels of pain and sedation/agitation, the prevalence of delirium, and the use of PR. METHOD An observational, descriptive, cross-sectional, prospective and multicentre study using an ad hoc survey with online access that consisted of 2 blocks. Block I: with questions on the unit's characteristics and routine practice; Block II: aspects of direct care and direct assessments of patients admitted to participating units. RESULTS One hundred and fifty-eight units and 1574 patients participated. The pain of communicative patients (CP) was assessed and recorded as standard in 109 units (69%), the pain of non-communicative patients (NCP) in 84 (53%), sedation/agitation in 111 (70%), and delirium in 39 units (25%). There was recorded use of PR in 39 units (25%). Validated scales were used to assess the pain of CP in 139 units (88%), of NCP in 102 (65%), sedation/agitation in 145 (92%), delirium in 53 units (34%). In 33 units (21%) pain, sedation/agitation and delirium of PC and NPC was assessed, and in 8 of these units there was a specific PR protocol and register. Among the patients who could be assessed, an absence of pain was reported in 57%, moderate pain in 27%; 48% were calm and collaborative, and 10% agitated; 21% had PR, and 12.6% of the patients had delirium. CONCLUSIONS The assessment of pain, sedation and delirium is demonstrated, and low percentages of agitation and delirium achieved. We observed a high percentage of patients with pain, and moderate use of PC. We should generalise the use of protocols to assess, prevent and treat pain and delirium by appropriately managing analgesia, sedation, and individual and well-considered use of PC. (ClinicalTrials.gov Identifier: NCT03773874).
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Affiliation(s)
- S Arias-Rivera
- Hospital Universitario de Getafe, Getafe, Madrid, España; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, España; Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España.
| | - C López-López
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Hospital Universitario 12 de Octubre, Madrid, España; Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), Madrid, España; Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense, Madrid, España
| | - M J Frade-Mera
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Hospital Universitario 12 de Octubre, Madrid, España; Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense, Madrid, España
| | - G Via-Clavero
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Hospital Universitari de Bellvitge (GRIN-IDIBELL), Hospitalet de Llobregat, Barcelona, España
| | - J J Rodríguez-Mondéjar
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Gerencia de Urgencias y Emergencias 061, Servicio Murciano de Salud, Murcia, España; Universidad de Murcia, Instituto Murciano de Investigación Biomédica del HCU Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, España
| | - M M Sánchez-Sánchez
- Hospital Universitario de Getafe, Getafe, Madrid, España; Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España
| | - M Acevedo-Nuevo
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, España; Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Majadahonda, Madrid, España; Facultad de Ciencias de la Salud, Universidad Autónoma de Madrid, Madrid, España
| | - D Gil-Castillejos
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Hospital Universitario Juan XXIII, Tarragona, España
| | - G Robleda
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Escuela Superior de Enfermería Mar (ESIMar), Universidad Pompeu Fabra, Barcelona, España; Centro Cochrane Iberoamericano, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - M Cachón-Pérez
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, España
| | - I Latorre-Marco
- Grupo de Trabajo de Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (GT-ASCyD-SEEIUC), España; Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, España; Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Majadahonda, Madrid, España
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Capdevila J, Fazio N, López-López C, Teule A, Valle JW, Tafuto S, Custodio AB, Reed N, Raderer M, Grande E, Garcia-Carbonero R, Jiménez-Fonseca P, Alonso V, Antonuzzo L, Spallanzani A, Berruti A, Sevilla I, La Casta Munoa A, Hernando J, Ibrahim T. Progression-free survival (PFS) and subgroups analyses of lenvatinib in patients (pts) with G1/G2 advanced pancreatic (panNETs) and gastrointestinal (giNETs) neuroendocrine tumors (NETs): Updated results from the phase II TALENT trial (GETNE 1509). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.4_suppl.332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
332 Background: Pts with advanced G1/G2 NETs have limited treatment options with overall response rates (ORR) with targeted agents (TA) < 10%. Benefit on PFS after TA therapy has not been demonstrated. The mechanism of action of lenvatinib (VEGFR1-3 & FGFR1-4 inhibitor) may increase efficacy and revert primary and acquired resistance to TA. We report the updated results on PFS, safety and subgroups. Methods: This prospective phase II study had two cohorts: G1/G2 panNETs and giNETs. All pts had baseline documented disease progression (PD) by RECIST. For panNETs, PD to TA was mandatory, regardless prior therapy with somatostatin analogs (SSAs) or chemotherapy (CHT), and for giNETs, PD on SSAs. Pts were treated with lenvatinib at 24 mg qd until PD or intolerable toxicity. The primary endpoint was ORR by central radiology review. PFS was calculated by investigator assessment. Biochemical responses were defined as reduction from baseline > 50%. With 55 pts per arm our study was powered to identify an ORR ≥ 25% (90% power, 5% α-error). Results: We recruited 111 pts (55 panNETs/56 giNETs). Prior therapies were CHT 32%, SSAs 87%, everolimus (E) 70% and sunitinib (S) 30% for panNETs. ORR was 29%, 40% for panNETs and 18.5% for giNETs. With a median follow-up of 17 months (m), PFS for panNETs was 15.8 m (95% CI 11.4-NR) and 15.4 m (95% CI 11.5-19.5) for giNETs. Dose reductions/interruptions were needed in 91.8% with a median dose of 20 mg qd. In the subgroups analyses, all pts obtained the same benefit in PFS and ORR, including grade and prior therapy with S (PFS: 16.4 m, ORR: 43.7%) or E (PFS: 15 m, ORR: 37.1%) (p = ns). A significant correlation of chromogranin A decrease and prolonged PFS in giNETs (17.6 m vs NR, p = 0.032) was observed. The most frequent G3-4 adverse events were hypertension (20.7%), asthenia (13.5%), diarrhea (7.2%) and abdominal pain (5.4%). Conclusions: Lenvatinib showed the highest reported ORR with a TA by central radiology assessment in panNETs and giNETs with promising PFS in a pretreated population. The benefit was observed across subgroups analyses, including pretreated pts with TA. Clinical trial information: NCT02678780.
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Affiliation(s)
- Jaume Capdevila
- Medical Oncology Department, Vall d’Hebron University Hospital; Vall d’Hebron Institute of Oncology (VHIO)., Barcelona, Spain
| | | | | | - Alexandre Teule
- Hereditary Cancer Program, Catalan Institute of Oncology, Barcelona, Spain
| | - Juan W. Valle
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | | | | | | | | | | | | | - Vicente Alonso
- Medical Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Andrea Spallanzani
- Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Alfredo Berruti
- Medical Oncology, University of Brescia, Spedali Civili Hospital, Brescia, Italy
| | - Isabel Sevilla
- Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | | | - Jorge Hernando
- Vall Hebron University Hospital, Vall Hebron Institute of Oncology (VHIO), Bracelona, Spain
| | - Toni Ibrahim
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
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Alsina A, Kudo M, Vogel A, Cheng AL, Tak WY, Ryoo BY, Evans TJ, López-López C, Daniele B, Misir S, Ren M, Izumi N, Qin S, Finn RS. Subsequent anticancer medication following first-line lenvatinib: A posthoc responder analysis from the phase 3 REFLECT study in unresectable hepatocellular carcinoma. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.4_suppl.371] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
371 Background: Lenvatinib (LEN) was shown to be noninferior to sorafenib (SOR) for overall survival (OS) in REFLECT (median OS [mOS], 13.6 vs 12.3 months [mo]; HR 0.92; 95% CI 0.79–1.06). LEN was superior vs SOR for secondary endpoints including objective response rate (ORR) per mRECIST: 24.1% vs 9.2% by investigator and 40.6% vs 12.4% by independent review (Kudo M et al. Lancet 2018). We report a posthoc responder analysis of patients (pts) who received first-line LEN in REFLECT and subsequent anticancer medication during survival follow up. Methods: In REFLECT, pts with unresectable hepatocellular carcinoma were randomized 1:1 to receive first-line LEN or SOR. Objective response was defined as complete or partial response by mRECIST per investigator. Pts with disease progression and who discontinued treatment were followed for survival every 12 weeks; subsequent anticancer medication during survival follow up were recorded until time of death. Data cutoff: Nov 13, 2016. mOS was calculated using Kaplan-Meier estimates with 2-sided 95% CIs. Results: In REFLECT, one third of the overall study population (156/478 pts randomized to LEN and 184/476 to SOR) received subsequent anticancer medication, most commonly SOR (25% in LEN arm). ECOG performance status and laboratory assessments, including liver function tests, were comparable between arms prior to subsequent treatments. Among these pts, mOS was 21 vs 17 mo and ORR was 27.6% vs 8.7% for LEN vs SOR arms, respectively. In a subset analysis of LEN responders who received any subsequent anticancer medication (n = 43), mOS was 26 mo (95% CI 18.5–34.6). For SOR responders who received any subsequent anticancer medication (n = 16), mOS was 22 mo (95% CI, 14.6–NE). For LEN responders who subsequently received SOR (n = 35), mOS was 26 mo (95% CI 18.2–34.6). Conclusions: In REFLECT, one third of pts randomized to first-line LEN received subsequent anticancer medication, including SOR, with a mOS of 21 mo. In this exploratory, posthoc analysis of pts who responded to LEN and received any subsequent anticancer medication or SOR, mOS was 26 mo. Clinical trial information: NCT01761266.
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Affiliation(s)
| | - Masatoshi Kudo
- Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | | | - Ann-Lii Cheng
- National Taiwan University Hospital and National Taiwan University Cancer Center, Taipei, Taiwan
| | - Won Young Tak
- School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Baek-Yeol Ryoo
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, Republic of (South)
| | - T.R. Jeffry Evans
- University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | | | | | | | - Min Ren
- Eisai Inc., Woodcliff Lake, NJ
| | | | - Shukui Qin
- Nanjing Bayi Hospital, Nanjing, Jiangsu, China
| | - Richard S. Finn
- Geffen School of Medicine, UCLA Medical Center, Santa Monica, CA
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Feliu J, Garcia-Carbonero R, Capdevila J, Guasch I, Alonso V, López-López C, Garcia Alfonso P, Castañon Lopez C, Sevilla I, Maurel J. Phase II study of panitumumab, 5-fluorouracil, mitomycin-c and radiotherapy treatment in patients with non-metastatic squamous cell carcinoma of the anal canal: safety and efficacy results (VITAL study)—GEMCAD 09-02. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.3566] [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: 11/20/2022] Open
Affiliation(s)
- Jaime Feliu
- Hospital Universitario La Paz, Madrid, Spain
| | | | - Jaume Capdevila
- Medical Oncology Department, Vall d’Hebron University Hospital; Vall d’Hebron Institute of Oncology (VHIO)., Barcelona, Spain
| | | | | | | | | | | | - Isabel Sevilla
- Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Joan Maurel
- Hospital Clinic de Barcelona, Barcelona, Spain
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Mielgo X, Diaz Beveridge R, Pineda E, Sepúlveda JM, López Castro R, Lecumberri-Biurrun MJ, Vaz Salgado MÁ, De Las Penas R, López-López C, Rodriguez Salas N, virizuela JA, Lopez R, Medina J, Valverde C, Beato C, Lainez N, Rodríguez-Antona C, Berraondo P, Herrador A, GarcÃa-Donas J. A multicenter phase 2 study of nivolumab combined with ipilimumab in patients with pediatric solid tumors in adulthood (GETHI021). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.tps3123] [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: 11/20/2022] Open
Affiliation(s)
- Xabier Mielgo
- Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | | | | | | | | | | | | | | | | | | | | | - Rafael Lopez
- Hospital Clinico Santiago, Santiago De Compostela, Spain
| | - Javier Medina
- Virgen de la Salud Hospital, Medical Oncology Department, Toledo, Spain
| | | | | | - Nuria Lainez
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | - Pedro Berraondo
- Center for Applied Medical Research (CIMA), Universidad de Navarra, Pamplona, Spain
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Fernandez-Martos C, Pericay C, Losa F, Garcia-Carbonero R, Layos L, Rodriguez Salas N, Martin M, Alonso V, Vera R, Gallego J, Capdevila J, Salud A, Nogue M, Maurel J, Guasch I, Montagut Viladot C, López-López C, Cañas MÁ, Macias Declara I, García-Albéniz X. RIA: Randomized phase II study comparing induction (I) mFOLFOX6 with or without aflibercept followed by chemoradiation (CRT) and total mesorectal excision (TME) in high risk-rectal cancer. GEMCAD 14-02 trial. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.3518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Ferran Losa
- Barcelona, Consorci Sanitari Integral. Hospital Sant Joan Despí – Moises Broggi. Institut Català d’Oncologia, Barcelona, Spain
| | | | - Laura Layos
- Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | - Marta Martin
- Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Vicente Alonso
- Medical Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Javier Gallego
- Servicio de Oncología Médica, Hospital General Universitario de Elche, Elche, Spain
| | - Jaume Capdevila
- Medical Oncology Department, Vall d’Hebron University Hospital; Vall d’Hebron Institute of Oncology (VHIO)., Barcelona, Spain
| | | | - Miquel Nogue
- Hospital de Granollers, Granollers (Barcelona), Spain
| | - Juan Maurel
- Medical Oncology, Hospital Clínic Barcelona, Barcelona, Spain
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López-López C, Arranz-Esteban A, Martinez-Ureta M, Sánchez-Rascón M, Morales-Sánchez C, Chico-Fernández M. ¿Influyen los antecedentes de consumo de sustancias psicótropas en el nivel de dolor del paciente con traumatismo grave? Enfermería Intensiva 2018; 29:64-71. [DOI: 10.1016/j.enfi.2017.08.002] [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] [Received: 03/29/2017] [Revised: 07/20/2017] [Accepted: 08/07/2017] [Indexed: 10/18/2022]
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25
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Leyva-Díaz J, Calero-Díaz G, López-López C, Martín-Pascual J, Torres J, Poyatos J. Kinetic study of the effect of bisphenol A on the rates of organic matter removal, decay and biomass generation in a membrane bioreactor. Biochem Eng J 2017. [DOI: 10.1016/j.bej.2017.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Cheng AL, Finn RS, Qin S, Han KH, Ikeda K, Piscaglia F, Baron AD, Park JW, Han G, Jassem J, Blanc JF, Vogel A, Komov D, Evans TJ, López-López C, Dutcus CE, Ren M, Kraljevic S, Tamai T, Kudo M. Phase III trial of lenvatinib (LEN) vs sorafenib (SOR) in first-line treatment of patients (pts) with unresectable hepatocellular carcinoma (uHCC). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.4001] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
4001 Background: SOR is the only approved agent in uHCC and new options are needed. LEN, an inhibitor of vascular endothelial growth factor receptors 1‒3, fibroblast growth factor receptors 1‒4, platelet derived growth factor receptor α, RET, and KIT, showed activity in uHCC in a phase II trial. We report a phase III trial of LEN vs SOR as first-line therapy for uHCC. Methods: In this randomized, open-label, noninferiority (NI) study, pts had uHCC, ≥ 1 measurable target lesion, Barcelona Clinic Liver Cancer stage B or C, Child-Pugh class A, ECOG PS ≤ 1, and no prior systemic therapy. Pts were randomized 1:1 to LEN (body weight ≥ 60 kg: 12 mg/day; < 60 kg: 8 mg/day) or SOR 400 mg twice daily. The primary endpoint was overall survival (OS). The OS hazard ratio (HR) and its 95% CI were estimated with a stratified Cox proportional hazard model. The predefined NI margin was 1.08. Secondary efficacy endpoints were progression-free survival (PFS), time to progression (TTP) and objective response rate (ORR) by modified RECIST. Type I error rates for secondary efficacy endpoints were controlled with a fixed sequence procedure at 2-sided α = 0.05 after OS NI was claimed. Results: 954 Pts enrolled (LEN: 478; SOR: 476). Efficacy outcomes are shown in the table. A similar number of pts in both arms had treatment-emergent adverse events (TEAEs). Most common LEN TEAEs were hypertension (42%), diarrhea (39%), decreased appetite (34%), decreased weight (31%), and fatigue (30%). Median (range) treatment duration was 5.7 mos (0−35.0) for LEN and 3.7 mos (0.1−38.7) for SOR. 13% Of LEN-treated and 9% of SOR-treated pts discontinued due to adverse events. 33% Of LEN-treated and 39% of SOR-treated pts received second-line therapy. Conclusions: LEN is noninferior in OS, and achieves statistically significant and clinically meaningful improvements in PFS, TTP, and ORR, as first line therapy for uHCC. TEAEs were consistent with the known LEN safety profile. Clinical trial information: NCT01761266. [Table: see text]
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Affiliation(s)
| | - Richard S. Finn
- David Geffen School of Medicine at University of California Los Angeles, Santa Monica, CA
| | | | - Kwang-Hyub Han
- Severance Hospital, Yonsei University, Seoul, South Korea
| | | | | | - Ari David Baron
- California Pacific Medical Center Research Institute, San Francisco, CA
| | | | - Guohong Han
- Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China
| | - Jacek Jassem
- Medical University of Gdańsk, Department of Oncology and Radiotherapy, Gdańsk, Poland
| | - Jean-Frédéric Blanc
- Service d’Hépato-Gastroentérologie et d’Oncologie Digestive, Groupe Hospitalier Saint André, Bordeaux, France
| | | | - Dmitry Komov
- N. N. Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia
| | - T.R. Jeffry Evans
- University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | | | | | - Min Ren
- Eisai Co., Ltd., Woodcliff Lake, NJ
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Bendell JC, Sauri T, Cubillo A, López-López C, Garcia Alfonso P, Hussein MA, Limon ML, Cervantes A, Montagut C, Santos C, Bessudo A, Modiano MR, Moons V, Andel J, Bennouna J, Van Der Westhuizen A, Samuel LM, Krieter O, Rossomanno S, Hurwitz H. Final results of the McCAVE trial: A double-blind, randomized phase 2 study of vanucizumab (VAN) plus FOLFOX vs. bevacizumab (BEV) plus FOLFOX in patients (pts) with previously untreated metastatic colorectal carcinoma (mCRC). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.3539] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3539 Background: VEGF-A and ANG-2 have complementary roles in regulation of tumor angiogenesis. Targeting VEGF-A with BEV in combination chemotherapy (CT) in mCRC has proven to increase PFS and OS. ANG-2 is overexpressed and associated with poor outcome of mCRC pts receiving BEVcontaining treatment. Hence, dual blockade of VEGF-A and ANG-2 by the bispecific mAb VAN with standard CT may improve clinical activity in mCRC. Methods: All pts received mFOLFOX-6 and were randomized 1:1 to also receive intravenous VAN 2000 mg every other week (Q2W) (Arm A) or BEV 5 mg/kg Q2W (Arm B). The primary end point was investigator assessed progression-free survival (PFS). Key eligibility criteria included pts with non-resectable mCRC, no prior therapy for advanced disease, PS 0-1, adequate organ functions, and no history of GI fistula/perforation or intraabdominal abscess within the last 6 months. Results: 192 pts were randomized (Arms A/B, n = 95/97) by 39 sites in 7 countries, between Oct 2014 and May 2016. Median follow-up was 17.6 months (range 2.8 – 20.7). In the ITT population (n = 189; Arms A/B, n = 94/95), median PFS in Arms A and B was 11.3 and 11.0 months (stratified hazard ratio (HR) 1.00 (95%CI 0.64-1.58; p = 0.985)), respectively. Objective response rate was 52.1% vs 57.9%. Relevant prognostic factors incl. RAS/BRAF status and tumor sidedness were balanced between arms and did not significantly influence outcome. Baseline plasma ANG-2 levels were prognostic in both arms but not predictive for response to VAN. The overall incidence of adverse events (AEs) grade ≥ 3 was similar (Arms A/B, 83.9%/82.1%); AEs grade ≥ 3 attributed to the mode of action of VAN/BEV included hypertension (37.6%/18.9%), hemorrhage (2.2%/1.1%), thromboembolic events (venous 6.5%/2.1%; arterial 1.1%/3.2%) and GI perforations incl. GI fistula & abdominal abscess (10.6%/8.4%). Conclusions: The combination of VAN and FOLFOX did not improve PFS and was associated with a marked increase in hypertension compared with BEV plus FOLFOX. Our results strongly suggest that ANG-2 is not a relevant therapeutic target in the setting of first line mCRC. Clinical trial information: NCT02141295.
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Affiliation(s)
- Johanna C. Bendell
- Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN
| | - Tamara Sauri
- Vall d’Hebron University Hospital, Barcelona, Spain
| | | | | | | | - Maen A. Hussein
- Florida Cancer Specialists and Research Institute, Leesburg, FL
| | | | - Andres Cervantes
- Department of Medical Oncology, Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Clara Montagut
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Cristina Santos
- Translational Research Laboratory and Department of Medical Oncology, Institut Català d'Oncologia-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Alberto Bessudo
- Research, California Cancer Associates for Research and Excellence, San Diego, CA
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Latorre-Marco I, Acevedo-Nuevo M, Solís-Muñoz M, Hernández-Sánchez L, López-López C, Sánchez-Sánchez MM, Wojtysiak-Wojcicka M, de Las Pozas-Abril J, Robleda-Font G, Frade-Mera MJ, De Blas-García R, Górgolas-Ortiz C, De la Figuera-Bayón J, Cavia-García C. Psychometric validation of the behavioral indicators of pain scale for the assessment of pain in mechanically ventilated and unable to self-report critical care patients. Med Intensiva 2016; 40:463-473. [PMID: 27590592 DOI: 10.1016/j.medin.2016.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 06/01/2016] [Accepted: 06/03/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the psychometric properties of the behavioral indicators of pain scale (ESCID) when applied to a wide range of medical and surgical critical patients. DESIGN A multicentre, prospective observational study was designed to validate a scale measuring instrument. SETTING Twenty Intensive Care Units of 14 hospitals belonging to the Spanish National Health System. PARTICIPANTS A total of 286 mechanically ventilated, unable to self-report critically ill medical and surgical adult patients. PROCEDURE Pain levels were measured by two independent evaluators simultaneously, using two scales: ESCID and the behavioral pain scale (BPS). Pain was observed before, during, and after two painful procedures (turning, tracheal suctioning) and one non-painful procedure. MAIN VARIABLES ESCID reliability was measured on the basis of internal consistency using the Cronbach-α coefficient. Inter-rater and intra-rater agreement were measured. The Spearman correlation coefficient was used to assess the correlation between ESCID and BPS. RESULTS A total of 4386 observations were made in 286 patients (62% medical and 38% surgical). High correlation was found between ESCID and BPS (r=0.94-0.99; p<0.001), together with high intra-rater and inter-rater concordance. ESCID was internally reliable, with a Cronbach-α value of 0.85 (95%CI 0.81-0.88). Cronbach-α coefficients for ESCID domains were high: facial expression 0.87 (95%CI 0.84-0.89), calmness 0.84 (95%CI 0.81-0.87), muscle tone 0.80 (95%CI 0.75-0.84), compliance with mechanical ventilation 0.70 (95%CI 0.63-0.75) and consolability 0.85 (95%CI 0.81-0.88). CONCLUSION ESCID is valid and reliable for measuring pain in mechanically ventilated unable to self-report medical and surgical critical care patients. CLINICALTRIALS.GOV: NCT01744717.
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Affiliation(s)
- I Latorre-Marco
- Medical Intensive Care Unit, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain.
| | - M Acevedo-Nuevo
- Medical Intensive Care Unit, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
| | - M Solís-Muñoz
- Nursing and Healthcare, Research Area, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
| | - L Hernández-Sánchez
- Medical Intensive Care Unit, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
| | - C López-López
- Emergency and Trauma Intensive Care Unit, Hospital Universitario Doce de Octubre, Madrid, Spain
| | | | - M Wojtysiak-Wojcicka
- Intensive Care Unit, Hospital Universitario Quirón Madrid, Pozuelo de Alarcón, Spain
| | - J de Las Pozas-Abril
- Intensive Care Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - G Robleda-Font
- Intensive Care Unit, Hospital Universitario de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M J Frade-Mera
- Intensive Care Unit, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - R De Blas-García
- Postsurgical Intensive Care Unit, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
| | - C Górgolas-Ortiz
- Postsurgical Intensive Care Unit, Hospital Universitario de Basurto, Bilbao, Spain
| | | | - C Cavia-García
- Intensive Care Unit, Hospital Universitario de Cruces, Barakaldo, Spain
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Grande E, Castellano DE, Custodio AB, Garcia-Carbonero R, González E, López-López C, Munarriz J, Sevilla I, Teule A, Benavent Viñuales M, Alonso T, Gajate Borau P, Palacios J, Capdevila J. A phase II trial to assess the activity and safety of the hypoxia-activated prodrug evofosfamide (TH-302) in combination with sunitinib in patients with disseminated grade 1 and 2 pancreatic neuroendocrine tumors (pNET) as a first-line approach: The GETNE-1408 trial. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.4_suppl.tps479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS479 Background: Pancreatic-NETs are highly vascular tumors. The anti-angiogenetic sunitinib was approved in advanced pNETs based on prolongation of progression-free survival. Upregulation of several proangiogenic factors that reflects intratumor hypoxia conditions might drive resistance to sunitinib in pNETs. Evofosfamide is a prodrug that under hypoxic conditions preferentially releases a brominated version of isophosphoramide mustard and has shown activity in cell lines from neural crest derived tumors such as melanoma and glioblastoma/astrocytoma. We hypothesize that evofosfamide may have activity in the pathologic hypoxic conditions present in the tumor environment of neuroendocrine tumors inducing responses that may be consolidated and prolonged with sunitinib in patients with advanced pNETs that are naïve for systemic treatment. Methods: This is a prospective, non randomized, open-label, phase II study that is being conducted in 10 university sites belonging to the Spanish Task Force Group for NETs (GETNE) in Spain. Patients with histologically proven diagnosis of progressive unresectable or metastatic pNET with Ki67 < 20% and grade 1 or 2 will receive sunitinib orally at 37.5 mg PO daily on days 1 to 28 of a 28-day cycle (4 weeks) plus evofosfamide administered at 340 mg/m2 by IV infusion over 30-60 minutes on Days 8, 15 and 22 of a 28-day cycle (4 weeks). Hypoxia-related tumor markers, single nucleotide polymorphisms related to activity and metabolism of antiangiogenic agents (VEGFR2, VEGFR3, PDGFR-α, VEGF-A, IL8, CYP3A4, CYP3A5, ABCB1-2) will be correlated with clinical outcome. In this study it is planned to include 43 patientsbased on a two-stage Simon’s phase II design (α = 0.05, β = 80%). If the trial shows 8 responses or more among 43 patients, the treatment will be considered for further investigation. EudraCT number: 2014-004072-30 Clinical trial information: NCT02402062.
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Affiliation(s)
- Enrique Grande
- Medical Oncology Department, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | | | - Ana B. Custodio
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | | | - Isabel Sevilla
- Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | | | | | | | | | - José Palacios
- Pathology Department, Hospital Universitario Ramon y Cajal, Madrid, Spain
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González-Badillo JJ, Rodríguez-Rosell D, Sánchez-Medina L, Ribas J, López-López C, Mora-Custodio R, Yañez-García JM, Pareja-Blanco F. Short-term Recovery Following Resistance Exercise Leading or not to Failure. Int J Sports Med 2015; 37:295-304. [PMID: 26667923 DOI: 10.1055/s-0035-1564254] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study analyzed the time course of recovery following 2 resistance exercise protocols differing in level of effort: maximum (to failure) vs. half-maximum number of repetitions per set. 9 males performed 3 sets of 4 vs. 8 repetitions with their 80% 1RM load, 3×4(8) vs. 3×8(8), in the bench press and squat. Several time-points from 24 h pre- to 48 h post-exercise were established to assess the mechanical (countermovement jump height, CMJ; velocity against the 1 m·s(-1) load, V1-load), biochemical (testosterone, cortisol, GH, prolactin, IGF-1, CK) and heart rate variability (HRV) and complexity (HRC) response to exercise. 3×8(8) resulted in greater neuromuscular fatigue (higher reductions in repetition velocity and velocity against V1-load) than 3×4(8). CMJ remained reduced up to 48 h post-exercise following 3×8(8), whereas it was recovered after 6 h for 3×4(8). Significantly greater prolactin and IGF-1 levels were found for 3×8(8) vs. 3×4(8). Significant reductions in HRV and HRC were observed for 3×8(8) vs. 3×4(8) in the immediate recovery. Performing a half-maximum number of repetitions per set resulted in: 1) a stimulus of faster mean repetition velocities; 2) lower impairment of neuromuscular performance and faster recovery; 3) reduced hormonal response and muscle damage; and 4) lower reduction in HRV and HRC following exercise.
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Affiliation(s)
- J J González-Badillo
- Sports and Athletic Performance Research Centre. Faculty of Sport. Pablo de Olavide University, Seville, Spain
| | - D Rodríguez-Rosell
- Sports and Athletic Performance Research Centre. Faculty of Sport. Pablo de Olavide University, Seville, Spain
| | - L Sánchez-Medina
- Instituto Navarro de Deporte y Juventud (INDJ), Studies, Research and Sports Medicine Centre, Pamplona, Spain
| | - J Ribas
- Medical Physiology and Biophysics Department. University of Seville, Spain
| | - C López-López
- Junta de Andalucía, Centro Andaluz de Medicina del Deporte, Seville, Spain
| | - R Mora-Custodio
- Sports and Athletic Performance Research Centre. Faculty of Sport. Pablo de Olavide University, Seville, Spain
| | - J M Yañez-García
- Sports and Athletic Performance Research Centre. Faculty of Sport. Pablo de Olavide University, Seville, Spain
| | - F Pareja-Blanco
- Sports and Athletic Performance Research Centre. Faculty of Sport. Pablo de Olavide University, Seville, Spain
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31
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Aigner R, Debus F, Karaman Y, López-López C, Ruchholtz S, Kühne CA. [Outcomes after operative treatment of distal radius fractures - an analysis of 721 patients]. Z Orthop Unfall 2014; 152:375-80. [PMID: 25144848 DOI: 10.1055/s-0034-1368633] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM OF THE STUDY Treatment strategies in distal radius fractures differ nationally and internationally. Conservative and operative treatment options compete as well as implants, postoperative therapy regimens and the necessity of implant removal. In our institution operative treatment is favoured. In the following the results of 721 surgically treated patients are presented. PATIENTS PATIENTS who underwent operative treatment of their distal radius fractures in our institution between 2008 and 2011 were retrospectively analysed. Following patient characteristics have been surveyed regarding age, sex, location of plate osteosynthesis, operation time, time of cast immobilisation and complications like infections, tendon ruptures, need of revision surgery. RESULTS 721 patients (mean age: 59.03 years) were retrospectively analysed. 514 of them (71.29 %) were female. Time of operation was after a mean duration of 5.48 days. In 558 (77.39 %) patients we performed palmar plate osteosynthesis. 89 (12.34 %) had dorsal plate osteosynthesis and 74 (10.3 %) cases were treated with either K-wires or screws. 18 (2.5 %) patients had concomitant traumatic carpal tunnel syndrome and a concomitant SL rupture was seen in 38 (5.27 %) patients. 40 (5.55 %) patients underwent operative revision because of posttraumatic carpal tunnel syndrome (n = 15), tendon ruptures (n = 7), malposition of screws (n = 6), loss of reduction (n = 6) and infection (n = 3). Mean duration of in-hospital stay after operation was 6.6 days. Implant removal was performed in 77 (10.7) patients; 59 (8.2 %) patients had palmar plate osteosynthesis and 18 (2.5 %) patients had dorsal plating. CONCLUSION Because of the low complication rate after operative treatment of distal radius fractures, osteosynthesis of this fracture seems to be warranted. Regarding the patients' higher age we have seen an unexpectedly long in-hospital stay with a mean time of 6.6 days. Herein attempts should be made to reduce time of in-hospital stay. In our opinion implant removal should not be recommended routinely.
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Affiliation(s)
- R Aigner
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - F Debus
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - Y Karaman
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - C López-López
- Klinik für Viszeral-, Thorax und Gefäßchirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - S Ruchholtz
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - C A Kühne
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
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Abad A, Massutí B, Grávalos C, Escudero P, Guillén-Ponce C, Layos L, Gomez M, Safont M, Gallego J, Sastre J, Pericay C, Dueñas R, López-López C, Losa F, Valladares M, González-Flores E, Yuste A, Robles L, Sáenz A, Cano T, Carrato A, Aranda E. Panitumumab Plus FOLFOX4 or Panitumumab Plus Folfiri in Subjects with Wild-Type KRAS (EXON 2) Colorectal Cancer and Multiple or Unresectable Liver-Limited Metastases: Data from the Randomized, Phase II Planet Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu164.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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33
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Abad A, Massuti B, Gravalos C, Escudero P, Guillen C, Manzano JL, Gomez M, Safont MJ, Gallego Plazas J, Sastre J, Pericay C, Dueñas R, López-López C, Losa F, Valladares Ayerbes M, González E, Yuste A, Carrato A, Aranda E. Phase II trial of panitumumab plus FOLFOX4 or FOLFIRI in subjects with KRAS wild-type colorectal cancer and liver-limited disease: The PLANET study. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.3560] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Albert Abad
- University Hospital Germans Trias i Pujol-ICO, Barcelona, Spain
| | | | | | - Pilar Escudero
- Hospital Clínico, Universitario Lozano Blesa, Zaragoza, Spain
| | - Carmen Guillen
- Hospital Universitario Ramon y Cajal, Medical Oncology Department, Madrid, Spain
| | - Jose Luis Manzano
- Institut Català d'Oncologia, Hospital Universitario German Trias i Pujol, Badalona, Spain
| | - M.Auxiliadora Gomez
- Medical Oncology Department, University Reina Sofia Hospital, Biomedical Research Institute Maimonidas, Cordoba, Spain
| | | | | | - Javier Sastre
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Carles Pericay
- Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | | | | | | | | | | | - Ana Yuste
- Hospital General Universitario, Alicante, Spain
| | - Alfredo Carrato
- Hospital Universitario Ramon y Cajal, Medical Oncology Department, Madrid, Spain
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López-López C, Murillo-Pérez MA, Morales-Sánchez C, Torrente-Vela S, Orejana-Martín M, García-Iglesias M, Cuenca-Solanas M, Alted-López E. [Pain assessment of tracheal suctioning on brain injury patients by pain behavioral indicator scale (ESCID)]. Enferm Intensiva 2014; 25:114-21. [PMID: 24814281 DOI: 10.1016/j.enfi.2014.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Revised: 02/13/2014] [Accepted: 03/09/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess pain response on patients with moderate to severe head injury before a common nursing procedure: tracheal suctioning. MATERIAL AND METHOD An observational longitudinal pilot study with consecutive sampling performed from September to December of 2012. Pain was assessed by a pain behavioral indicator scale 5 minutes before, meanwhile and 15 minutes after tracheal suctioning the days 1, 3 and 6 of their intensive care unit (ICU) stay, as well as a non-painful procedure: rubbing with gauze the forearm of the patient. Pseudo-analgesia and hemodynamic variables were also recorded. Descriptive analysis of the variables, inferential statistics with t-student and Anova with SPSS 17.0; statistical tests were considered significant if the critical level observed was less than 5% (P<.05). RESULTS Pain was assessed on 27 patients. 82% suffered from severe head trauma and 18% moderate. The average pain value during nursing procedure day 1 was 3, 18±2.6, day 3: 2, 59±2 and day 6: 3, 94±2.3. There was a significant increase in mean pain while performing suctioning during the three days of assessment (P<.05); however no significant differences between the average pain value on the three days of the assessment (P>.05) were shown. Data for the painless procedure were significantly different on day 6 (P<.05) CONCLUSION: During tracheal suctioning in patients with head injury in the first 6 days in the ICU, objective mild-moderate pain according to ESCID scale has been detected.
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Affiliation(s)
- C López-López
- UCI de Trauma y Emergencias, Hospital Universitario 12 de Octubre, Madrid, España.
| | - M A Murillo-Pérez
- UCI de Trauma y Emergencias, Hospital Universitario 12 de Octubre, Madrid, España
| | - C Morales-Sánchez
- UCI de Trauma y Emergencias, Hospital Universitario 12 de Octubre, Madrid, España
| | - S Torrente-Vela
- UCI de Trauma y Emergencias, Hospital Universitario 12 de Octubre, Madrid, España
| | - M Orejana-Martín
- UCI de Trauma y Emergencias, Hospital Universitario 12 de Octubre, Madrid, España
| | - M García-Iglesias
- UCI de Trauma y Emergencias, Hospital Universitario 12 de Octubre, Madrid, España
| | - M Cuenca-Solanas
- UCI de Trauma y Emergencias, Hospital Universitario 12 de Octubre, Madrid, España
| | - E Alted-López
- UCI de Trauma y Emergencias, Hospital Universitario 12 de Octubre, Madrid, España
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35
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López-López C, Jiménez P, Crespo G, Grande E, Custodio AB, Mangas-Izquierdo M, Pérez Arnillas Q, Barrio-Alonso MJ, Soria Rivas A, Barriuso J. Temozolamide plus capecitabine as salvage treatment for patients with advanced neuroendocrine tumors (NETs) in the community setting. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e15169] [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: 11/20/2022] Open
Abstract
e15169 Background: Streptozotocin and doxorubicin-based chemotherapy schemes have been widely used in the treatment of advanced NETs. Unfortunately, balance between efficacy and toxicity is clearly improvable. Novel combinations of cytotoxic agents like temozolamide and capecitabine have shown promising antitumoral activity in retrospective series.We aimed toevaluate the efficacy and safety of this combination in patients with advanced NETs derived from the daily clinical practice. Methods: We analyzed the clinical outcome of 34 patients (pts) treated with temozolamide (150 mg/m2 qo, days 10-14) plus capecitabine (1.000 mg/m2 bid, days 1-14) every 28 days, between June-2008 and December-2012 in five referenced centers in Spain. Results: 21 pts (61%), were pancreatic primary NETs (pNETs). 8 pts (24%) were treated as first-line. 26 pts (76,5%) had ECOG 0 or 1. One (2,9%), 18 (52,9%), and 11 (32,4%) pts had low (G1), intermediate (G2) or high-grade (G3) respectively. Grade was not available in 4 pts (11,8%). Median administered cycles were 8 (range 1-26). At the time of the data cut-off (Dec-2012) 5 pts (14,7%) were still on treatment after a median follow up of 6,4 months. 13 pts (38,2%) had partial response (PR) and 12 (32,4%) stable disease (SD) according to RECIST 1.1 criteria. Estimated median time to progression (TTP) was 9,4 months IC95% (4,2-14,6) in the intention to treat population. Thrombocytopenia was the most frequent toxicity found in grade 3 or more (9%). Other grade 3 toxicities according to CTCAE v4.0 were observed in less than 5% of pts. Conclusions: These encouraging results show a promising activity and a favorable safety profile of the combination of temozolamide and capecitabine in patients with advanced NETs and deserves for further clinical research in the future.
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Affiliation(s)
| | - Paula Jiménez
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | | | | | | | | | | | - Jorge Barriuso
- Department of Medical Oncology, La Paz University Hospital, Madrid, Spain
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Martinez Villacampa M, Capdevila J, Manzano JL, Pericay C, Salazar R, López-López C, Losa F, Safont MJ, Gomez A, Alonso V, Escudero MP, Gallego Plazas J, Sastre J, Gravalos Castro C, Biondo S, Palacios A, Aranda E. A randomized phase II study of capecitabine-based chemoradiation with or without bevacizumab in resectable locally advanced rectal cancer. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.3571] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3571 Background: The addition of bevacizumab (BEV) to capecitabine (CAP)-based chemoradiation (CRT) has shown encouraging efficacy in locally advanced rectal cancer (LARC), in nonrandomized studies. This randomized phase II study investigated the effect of adding BEV to preoperative CAP-based CRT in patients (pts), with LARC. Methods: The primary end point was pathologic complete response (pCR). A two-stage design was used. Assuming a minimum pCR rate of at least 15% in one of the arms, a difference between the two arms of 10%, and accepting a probability of correct selection of 87%, 41 pts per arm were needed. Patients with LARC (Stages II-III assessed by MRI) and ECOG PS <2 were randomized to concurrent radiotherapy 45Gy/25f/5 weeks + CAP (825mg/m²/bid) + BEV every 2 weeks (5 mg/kg for 3 doses) (arm A) or the same schedule without BEV (arm B). Surgery was scheduled 6-8 weeks after completing CRT. Results: 90 pts were randomized (arm A/B: 44/46). Patient’s characteristics were well balanced between both arms: male 61%, median age 62 years, median distance from anal verge 7 cm, T3 79%, N+ 87%. 40 (91%)/43 (93%) of pts (arm A/B) finalized the planned CRT + surgery treatment. Overall grade 3-4 toxicity rates were 18 % and 13% (arm A/B, p=0.50); no grade 3-4 hematological toxicity was reported. Postoperative complications were 19(43%)/17(37%)(arm A/B). Efficacy data on patients who actually underwent surgery are reported in the table. Conclusions: The addition of BEV to CAP-based preoperative CRT has shown to be feasible and safe in the local control of LARC. No differences in pCR were observed and longer follow-up is needed to assess the impact on survival endpoints. [Table: see text]
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Affiliation(s)
| | - Jaume Capdevila
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | - Carles Pericay
- Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Ramon Salazar
- Instituto Catalán de Oncología, Hospital Durans i Reynals, Barcelona, Spain
| | | | - Ferran Losa
- Hospital General de L'Hospitalet, Barcelona, Spain
| | | | | | | | | | | | - Javier Sastre
- Hospital Clínico San Carlos Madrid, Spain; Center Affiliate to the Red Temática de Investigación Cooperativa (RD06/0020/0021), Instituto Carlos III, Spanish Ministry of Science and Innovation, Madrid, Spain
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37
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Rivera F, Calera L, Gutierrez-Sanz L, Hernandez-Garcia I, López-López C, Vega-Gil N, Salcedo M, Blanco Y, Mayordomo JI, Sanz-Ortiz J. Central nervous system metastases (CNSm) in patients with colorectal cancer (CRC): A retrospective review. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14105] [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: 11/20/2022] Open
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Comalada M, Xaus J, Valledor AF, López-López C, Pennington DJ, Celada A. PKC epsilon is involved in JNK activation that mediates LPS-induced TNF-alpha, which induces apoptosis in macrophages. Am J Physiol Cell Physiol 2003; 285:C1235-45. [PMID: 12867362 DOI: 10.1152/ajpcell.00228.2003] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.6] [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: 01/13/2023]
Abstract
Lipopolysaccharide (LPS) is a powerful stimulator of macrophages and induces apoptosis in these cells. Using primary cultures of bone marrow-derived macrophages, we found that the autocrine production of tumor necrosis factor-alpha (TNF-alpha) has a major function in LPS-induced apoptosis. LPS activates PKC and regulates the different mitogen-activated protein kinases (MAPK). We aimed to determine its involvement either in the secretion of TNF-alpha or in the induction of apoptosis. Using specific inhibitors and mice with the gene for PKCepsilon disrupted, we found that LPS-induced TNF-alpha-dependent apoptosis is mostly mediated by PKCepsilon, which is not directly involved in the signaling mechanism of apoptosis but rather in the process of TNF-alpha secretion. In our cell model, all three MAPKs were involved in the regulation of TNF-alpha secretion, but at different levels. JNK mainly regulates TNF-alpha transcription and apoptosis, whereas ERK and p38 contribute to the regulation of TNF-alpha production, probably through posttranscriptional mechanisms. Only JNK activity is mediated by PKCepsilon in response to LPS and so plays a major role in TNF-alpha secretion and LPS-induced apoptosis. We demonstrated in macrophages that LPS involving PKCepsilon regulates JNK activity and produces TNF-alpha, which induces apoptosis.
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Affiliation(s)
- Mònica Comalada
- Macrophage Biology Group, Biomedical Research Institute of Barcelona-Science Park, University of Barcelona, Josep Samitier 1-5, 08028 Barcelona, Spain
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Cullell-Young M, Barrachina M, López-López C, Goñalons E, Lloberas J, Soler C, Celada A. From transcription to cell surface expression, the induction of MHC class II I-A alpha by interferon-gamma in macrophages is regulated at different levels. Immunogenetics 2001; 53:136-44. [PMID: 11345590 DOI: 10.1007/s002510100312] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [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: 10/27/2022]
Abstract
Using mouse bone marrow-derived macrophages we determined the role of interferon (IFN)-gamma at the different steps in expression of the I-A alpha chain of MHC class II molecules, from transcription to the cell surface. Levels of transcription, RNA, and protein were low in cells not stimulated with IFN-gamma. Treatment with IFN-gamma for 24 or 48 h induced an increase in mRNA levels (7- and 12-fold) that did not correlate with the increase in transcription (2.5- and 2.7-fold). The half-life of mRNA was not modified by IFN-gamma. These data suggest a block at the level of translation. In fact, IFN-gamma increased ribosome loading, which confirms regulation at the translational level. Treatment with IFN-gamma increased protein synthesis (6-fold after 48 h) and level of expression at the cell surface (3- and 9-fold after 24 and 48 h, respectively). Interestingly, treatment with IFN-gamma also increased the I-A alpha protein half-life from 2 to 6-7 h. This is the first attempt to determine qualitatively and quantitatively the regulation of an inducible gene at all the putative levels of control. The data indicate that IFN-gamma plays a critical role in MHC class II protein expression in macrophages through the regulation of different steps, from transcription to surface expression.
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Affiliation(s)
- M Cullell-Young
- Departament de Fisiologia (Biologia del macròfag), Facultat de Biologia and Fundació August Pi i Sunyer, Campus de Bellvitge, Universitat de Barcelona, Av. Diagonal 645, 08028 Barcelona, Spain
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