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Medina-Herrera A, Vazquez I, Cuenca I, Rosa-Rosa JM, Ariceta B, Jimenez C, Fernandez-Mercado M, Larrayoz MJ, Gutierrez NC, Fernandez-Guijarro M, Gonzalez-Calle V, Rodriguez-Otero P, Oriol A, Rosiñol L, Alegre A, Escalante F, De La Rubia J, Teruel AI, De Arriba F, Hernandez MT, Lopez-Jimenez J, Ocio EM, Puig N, Paiva B, Lahuerta JJ, Bladé J, San Miguel JF, Mateos MV, Martinez-Lopez J, Calasanz MJ, Garcia-Sanz R. The genomic profiling of high-risk smoldering myeloma patients treated with an intensive strategy unveils potential markers of resistance and progression. Blood Cancer J 2024; 14:74. [PMID: 38684670 PMCID: PMC11059156 DOI: 10.1038/s41408-024-01053-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/09/2024] [Accepted: 04/12/2024] [Indexed: 05/02/2024] Open
Abstract
Smoldering multiple myeloma (SMM) precedes multiple myeloma (MM). The risk of progression of SMM patients is not uniform, thus different progression-risk models have been developed, although they are mainly based on clinical parameters. Recently, genomic predictors of progression have been defined for untreated SMM. However, the usefulness of such markers in the context of clinical trials evaluating upfront treatment in high-risk SMM (HR SMM) has not been explored yet, precluding the identification of baseline genomic alterations leading to drug resistance. For this reason, we carried out next-generation sequencing and fluorescent in-situ hybridization studies on 57 HR and ultra-high risk (UHR) SMM patients treated in the phase II GEM-CESAR clinical trial (NCT02415413). DIS3, FAM46C, and FGFR3 mutations, as well as t(4;14) and 1q alterations, were enriched in HR SMM. TRAF3 mutations were specifically associated with UHR SMM but identified cases with improved outcomes. Importantly, novel potential predictors of treatment resistance were identified: NRAS mutations and the co-occurrence of t(4;14) plus FGFR3 mutations were associated with an increased risk of biological progression. In conclusion, we have carried out for the first time a molecular characterization of HR SMM patients treated with an intensive regimen, identifying genomic predictors of poor outcomes in this setting.
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Affiliation(s)
- A Medina-Herrera
- Departamento de Hematología, Hospital Universitario de Salamanca, (HUSA/IBSAL), Centro de Investigación del Cáncer-IBMCC (CSIC/USAL), CIBERONC, Salamanca, Spain
| | - I Vazquez
- Cancer Center Clínica Universidad de Navarra (CCUN), Centro de Investigación Médica Aplicada (CIMA LAB Diagnostics), IDISNA, CIBERONC, Pamplona, Spain
| | - I Cuenca
- Hospital 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i + 12), Centro Nacional de Investigaciones Oncológicas (CNIO), Universidad Complutense, Madrid, Spain
| | - J M Rosa-Rosa
- Hospital 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i + 12), Centro Nacional de Investigaciones Oncológicas (CNIO), Universidad Complutense, Madrid, Spain
| | - B Ariceta
- Cancer Center Clínica Universidad de Navarra (CCUN), Centro de Investigación Médica Aplicada (CIMA LAB Diagnostics), IDISNA, CIBERONC, Pamplona, Spain
| | - C Jimenez
- Departamento de Hematología, Hospital Universitario de Salamanca, (HUSA/IBSAL), Centro de Investigación del Cáncer-IBMCC (CSIC/USAL), CIBERONC, Salamanca, Spain.
| | - M Fernandez-Mercado
- Cancer Center Clínica Universidad de Navarra (CCUN), Centro de Investigación Médica Aplicada (CIMA LAB Diagnostics), IDISNA, CIBERONC, Pamplona, Spain
| | - M J Larrayoz
- Cancer Center Clínica Universidad de Navarra (CCUN), Centro de Investigación Médica Aplicada (CIMA LAB Diagnostics), IDISNA, CIBERONC, Pamplona, Spain
| | - N C Gutierrez
- Departamento de Hematología, Hospital Universitario de Salamanca, (HUSA/IBSAL), Centro de Investigación del Cáncer-IBMCC (CSIC/USAL), CIBERONC, Salamanca, Spain
| | - M Fernandez-Guijarro
- Hospital 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i + 12), Centro Nacional de Investigaciones Oncológicas (CNIO), Universidad Complutense, Madrid, Spain
| | - V Gonzalez-Calle
- Departamento de Hematología, Hospital Universitario de Salamanca, (HUSA/IBSAL), Centro de Investigación del Cáncer-IBMCC (CSIC/USAL), CIBERONC, Salamanca, Spain
| | - P Rodriguez-Otero
- Cancer Center Clínica Universidad de Navarra (CCUN), Centro de Investigación Médica Aplicada (CIMA LAB Diagnostics), IDISNA, CIBERONC, Pamplona, Spain
| | - A Oriol
- Institut Català d'Oncologia (ICO), Institut d'Investigació Josep Carreras, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - L Rosiñol
- Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - A Alegre
- Hematology Department, Hospital Universitario Quirónsalud and Hospital Universitario de La Princesa, Madrid, Spain
| | - F Escalante
- Department of Hematology, Hospital Universitario de León, León, Spain
| | - J De La Rubia
- Hematology Department, University Hospital La Fe, Universidad Católica "San Vicente Mártir", CIBERONC, Valencia, Spain
| | - A I Teruel
- Hematology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - F De Arriba
- Hospital Morales Meseguer, IMIB-Pascual Parrilla, Universidad de Murcia, Murcia, Spain
| | - M T Hernandez
- Hospital Universitario de Canarias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - J Lopez-Jimenez
- Hematology and Hemotherapy Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - E M Ocio
- Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla (IDIVAL), Universidad de Cantabria, Santander, Spain
| | - N Puig
- Departamento de Hematología, Hospital Universitario de Salamanca, (HUSA/IBSAL), Centro de Investigación del Cáncer-IBMCC (CSIC/USAL), CIBERONC, Salamanca, Spain
| | - B Paiva
- Cancer Center Clínica Universidad de Navarra (CCUN), Centro de Investigación Médica Aplicada (CIMA LAB Diagnostics), IDISNA, CIBERONC, Pamplona, Spain
| | - J J Lahuerta
- Hospital 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i + 12), Centro Nacional de Investigaciones Oncológicas (CNIO), Universidad Complutense, Madrid, Spain
| | - J Bladé
- Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - J F San Miguel
- Cancer Center Clínica Universidad de Navarra (CCUN), Centro de Investigación Médica Aplicada (CIMA LAB Diagnostics), IDISNA, CIBERONC, Pamplona, Spain
| | - M V Mateos
- Departamento de Hematología, Hospital Universitario de Salamanca, (HUSA/IBSAL), Centro de Investigación del Cáncer-IBMCC (CSIC/USAL), CIBERONC, Salamanca, Spain
| | - J Martinez-Lopez
- Hospital 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i + 12), Centro Nacional de Investigaciones Oncológicas (CNIO), Universidad Complutense, Madrid, Spain
| | - M J Calasanz
- Cancer Center Clínica Universidad de Navarra (CCUN), Centro de Investigación Médica Aplicada (CIMA LAB Diagnostics), IDISNA, CIBERONC, Pamplona, Spain
| | - R Garcia-Sanz
- Departamento de Hematología, Hospital Universitario de Salamanca, (HUSA/IBSAL), Centro de Investigación del Cáncer-IBMCC (CSIC/USAL), CIBERONC, Salamanca, Spain
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Fernández-Sarmiento J, Lamprea S, Barrera S, Acevedo L, Duque C, Trujillo M, Aguirre V, Jimenez C. The association between prolonged capillary refill time and microcirculation changes in children with sepsis. BMC Pediatr 2024; 24:68. [PMID: 38245695 PMCID: PMC10799439 DOI: 10.1186/s12887-024-04524-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 01/01/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUNDS In children with sepsis, circulatory shock and multi-organ failure remain major contributors to mortality. Prolonged capillary refill time (PCRT) is a clinical tool associated with disease severity and tissue hypoperfusion. Microcirculation assessment with videomicroscopy represents a promising candidate for assessing and improving hemodynamic management strategies in children with sepsis. Particularly when there is loss of coherence between the macro and microcirculation (hemodynamic incoherence). We sought to evaluate the association between PCRT and microcirculation changes in sepsis. METHODS This was a prospective cohort study in children hospitalized with sepsis. Microcirculation was measured using sublingual video microscopy (capillary density and flow and perfused boundary region [PBR]-a parameter inversely proportional to vascular endothelial glycocalyx thickness), phalangeal tissue perfusion, and endothelial activation and glycocalyx injury biomarkers. The primary outcome was the association between PCRT and microcirculation changes. RESULTS A total of 132 children with sepsis were included, with a median age of two years (IQR 0.6-12.2). PCRT was associated with increased glycocalyx degradation (PBR 2.21 vs. 2.08 microns; aOR 2.65, 95% CI 1.09-6.34; p = 0.02) and fewer 4-6 micron capillaries recruited (p = 0.03), with no changes in the percentage of capillary blood volume (p = 0.13). Patients with hemodynamic incoherence had more PBR abnormalities (78.4% vs. 60.8%; aOR 2.58, 95% CI 1.06-6.29; p = 0.03) and the persistence of these abnormalities after six hours was associated with higher mortality (16.5% vs. 6.1%; p < 0.01). Children with an elevated arterio-venous CO2 difference (DCO2) had an abnormal PBR (aOR 1.13, 95% CI 1.01-1.26; p = 0.03) and a lower density of small capillaries (p < 0.05). Prolonged capillary refill time predicted an abnormal PBR (AUROC 0.81, 95% CI 0.64-0.98; p = 0.03) and relative percentage of blood in the capillaries (AUROC 0.82, 95% CI 0.58-1.00; p = 0.03) on admission. A normal CRT at 24 h predicted a shorter hospital stay (aOR 0.96, 95% CI 0.94-0.99; p < 0.05). CONCLUSIONS We found an association between PCRT and microcirculation changes in children with sepsis. These patients had fewer small capillaries recruited and more endothelial glycocalyx degradation. This leads to nonperfused capillaries, affecting oxygen delivery to the tissues. These disorders were associated with hemodynamic incoherence and worse clinical outcomes when the CRT continued to be abnormal 24 h after admission.
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Affiliation(s)
- Jaime Fernández-Sarmiento
- Department of Critical Care Medicine and Pediatrics, Universidad de La Sabana, Fundación Cardioinfantil-Institute of Cardiology, Bogotà, Colombia.
| | - Shirley Lamprea
- Department of Critical Care Medicine and Pediatrics, Universidad de La Sabana, Fundación Cardioinfantil-Institute of Cardiology, Bogotà, Colombia
| | - Sofia Barrera
- Department of Critical Care Medicine and Pediatrics, Universidad de La Sabana, Fundación Cardioinfantil-Institute of Cardiology, Bogotà, Colombia
| | - Lorena Acevedo
- Department of Critical Care Medicine and Pediatrics, Universidad de La Sabana, Fundación Cardioinfantil-Institute of Cardiology, Bogotà, Colombia
| | - Catalina Duque
- Department of Critical Care Medicine and Pediatrics, Universidad de La Sabana, Fundación Cardioinfantil-Institute of Cardiology, Bogotà, Colombia
| | - Manuela Trujillo
- Department of Critical Care Medicine and Pediatrics, Universidad de La Sabana, Fundación Cardioinfantil-Institute of Cardiology, Bogotà, Colombia
| | - Valeria Aguirre
- Department of Critical Care Medicine and Pediatrics, Universidad de La Sabana, Fundación Cardioinfantil-Institute of Cardiology, Bogotà, Colombia
| | - Carolina Jimenez
- Department of Critical Care Medicine and Pediatrics, Universidad de La Sabana, Fundación Cardioinfantil-Institute of Cardiology, Bogotà, Colombia
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Truppa C, Alonso B, Clezy K, Deglise C, Dromer C, Garelli S, Jimenez C, Kanapathipillai R, Khalife M, Repetto E. Antimicrobial stewardship in primary health care programs in humanitarian settings: the time to act is now. Antimicrob Resist Infect Control 2023; 12:89. [PMID: 37667372 PMCID: PMC10476422 DOI: 10.1186/s13756-023-01301-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 08/30/2023] [Indexed: 09/06/2023] Open
Abstract
Fragile and conflict-affected settings bear a disproportionate burden of antimicrobial resistance, due to the compounding effects of weak health policies, disrupted medical supply chains, and lack of knowledge and awareness about antibiotic stewardship both among health care providers and health service users. Until now, humanitarian organizations intervening in these contexts have confronted the threat of complex multidrug resistant infections mainly in their surgical projects at the secondary and tertiary levels of care, but there has been limited focus on ensuring the implementation of adequate antimicrobial stewardship in primary health care, which is known to be setting where the highest proportion of antibiotics are prescribed. In this paper, we present the experience of two humanitarian organizations, Médecins sans Frontières and the International Committee of the Red Cross, in responding to antimicrobial resistance in their medical interventions, and we draw from their experience to formulate practical recommendations to include antimicrobial stewardship among the standards of primary health care service delivery in conflict settings. We believe that expanding the focus of humanitarian interventions in unstable and fragile contexts to include antimicrobial stewardship in primary care will strengthen the global response to antimicrobial resistance and will decrease its burden where it is posing the highest toll in terms of mortality.
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Affiliation(s)
- Claudia Truppa
- International Committee of the Red Cross, Geneva, Switzerland.
- CRIMEDIM Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, University of Eastern Piedmont, Novara, Italy.
| | | | - Kate Clezy
- Médecins Sans Frontières, Amsterdam, The Netherlands
| | | | - Carole Dromer
- International Committee of the Red Cross, Geneva, Switzerland
| | - Silvia Garelli
- International Committee of the Red Cross, Geneva, Switzerland
| | | | | | | | - Ernestina Repetto
- Médecins Sans Frontières, Geneva, Switzerland
- Service des Maladies Infectieuses, Clinique Hospitalière Universitaire Saint Pierre, Bruxelles, Belgium
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Lamrous A, Repetto E, Depp T, Jimenez C, Chua AC, Kanapathipillai R, Jensen TO. C-reactive protein and procalcitonin use in adults in low- and middle-income countries: a narrative review. JAC Antimicrob Resist 2023; 5:dlad057. [PMID: 37206308 PMCID: PMC10190046 DOI: 10.1093/jacamr/dlad057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023] Open
Abstract
Objectives C-reactive protein (CRP) and procalcitonin (PCT) are widely used biomarkers in high-income countries. However, evidence for their use in low- and middle-income countries (LMICs) is scant. Because many factors, including rates of endemic disease, comorbidities and genetics, may influence biomarkers' behaviour, we aimed to review available evidence generated in LMICs. Methods We searched the PubMed database for relevant studies within the last 20 years that originated in regions of interest (Africa, Latin America, Middle East, South Asia or South East Asia), and full-text articles involving diagnosis, prognostication and evaluation of therapeutic response with CRP and/or PCT in adults (n = 88) were reviewed and categorized in 12 predefined focus areas. Results Overall, results were highly heterogeneous, at times conflicting, and often lacking clinically useful cut-off values. However, most studies demonstrated higher levels of CRP/PCT in patients with bacterial versus other infections. HIV and TB patients had consistently higher levels of CRP/PCT versus controls. In addition, higher CRP/PCT levels at baseline and follow-up in HIV, TB, sepsis and respiratory tract infections were associated with poorer prognosis. Conclusions Evidence generated from LMIC cohorts suggests that CRP and PCT may have potential to become effective clinical guiding tools particularly in respiratory tract infections, sepsis and HIV/TB. However, more studies are needed to define potential scenarios for use and cost-effectiveness. Consensus across stakeholders regarding target conditions, laboratory standards and cut-off values would support the quality and applicability of future evidence.
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Affiliation(s)
- Amin Lamrous
- Médecins Sans Frontières, Operational Center Barcelona, Barcelona, Spain
| | - Ernestina Repetto
- Médecins Sans Frontières, Operational Center Geneva, Geneva, Switzerland
- Infectious Diseases Department, Université Libre de Bruxelles (ULB), CHU Saint-Pierre, Brussels, Belgium
| | - Tim Depp
- Emergency Medicine, University of South Carolina School of Medicine, Greenville, SC, USA
| | - Carolina Jimenez
- Médecins Sans Frontières, Operational Center Paris, Paris, France
| | - Arlene C Chua
- Medical Department, Médecins Sans Frontières—International, Geneva, Switzerland
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Laganà M, Cosentini D, Grisanti S, Remde H, Almeida M, Pusceddu S, Deutschbein T, Fagundes G, Pereira A, Grana C, Fazio N, Corssmit E, Bongiovanni A, Canu L, Kim E, Habra M, Jimenez C, Berruti A. 31P Bone metastases and skeletal related events in pheochromocytoma and paraganglioma patients: International, retrospective study. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101052] [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: 04/05/2023] Open
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Jimenez C, Stanton E, Kondra K, Nickels EM, Jacob L, Shah R, Hammoudeh JA. NUT carcinoma of the mandible in a child: case report and systematic review. Int J Oral Maxillofac Surg 2023; 52:304-312. [PMID: 35868909 DOI: 10.1016/j.ijom.2022.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 11/26/2022]
Abstract
Nuclear protein of the testis (NUT) carcinoma is a rare, undifferentiated carcinoma that is characterized by NUTM1 gene rearrangements. Patients with NUT carcinoma have an overall survival of approximately 5% at 5 years despite a multimodal treatment approach. This report illustrates the management of mandibular NUT carcinoma in a pediatric patient, complemented by a systematic review of head and neck NUT carcinoma. A 5-year-old female presented with an enlarging jaw mass that was diagnosed as BRD4-NUTM1 carcinoma and was treated with hemimandibulectomy and chemoradiation. She remains disease-free 21 months after completion of therapy. A total of 63 patient cases reported in 34 articles were identified in the review. Only 26.9% (14/52) of tumors were correctly diagnosed initially as NUT carcinoma, whereas 73.1% (38/52) were incorrectly diagnosed as another malignancy; the initial diagnosis was not reported for 11 patients. The mandibular tumor subtype was among the rarest reported (n = 1; 1.6%). Combination therapy, including surgery and chemoradiation, was the most common treatment (55.2%). The patient case presented here is a novel case of pediatric mandibular NUT carcinoma. Due to the poor overall survival of patients with NUT carcinoma, aggressive upfront resection with 2-cm margins followed by adjuvant chemoradiation is advocated.
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Affiliation(s)
- C Jimenez
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - E Stanton
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - K Kondra
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - E M Nickels
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Division of Hematology-Oncology, Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - L Jacob
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - R Shah
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Division of Hematology-Oncology, Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - J A Hammoudeh
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Division of Oral and Maxillofacial Surgery, University of Southern California, Los Angeles, CA, USA.
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Martens-Uzunova E, Dits N, Heleman J, Van Royen M, Bijnsdorp I, Verhaegh G, Jimenez C, Schalken J, Jenster G. Diagnostic performance evaluation of small RNA biomarkers in urinary EVs from prostate cancer patients. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01932-2] [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: 11/06/2022] Open
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Campbell M, Jimenez C, Long J, Varghese J, Shah A, Zhang M, Tamsen G, Habra M. 1MO An open-label, phase II trial of cabozantinib for advanced adrenocortical carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.022] [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: 11/01/2022] Open
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Baudin E, Grisanti S, Fassnacht M, Menke-van der Houven van Oordt C, Haak H, de la Fouchardiere C, Subbiah V, Jimenez C, Capdevila Castillon J, Granberg D, Daugaard K, Kroiss M, Cosentini D, Kimpel O, Lamartina L, Hadoux J, Paillarse JM, Chêne L, Fagerberg J, Berruti A. 2MO EO2401 (EO) therapeutic vaccine for patients (pts) with adrenocortical carcinoma (ACC) and malignant pheochromocytoma/paraganglioma (MPP): Phase I/II SPENCER study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.023] [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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van de Weerd S, Torang A, Smit M, van den Berg I, Roelands J, Mesker W, Bedognetti D, Kuppen P, Putter H, Tollenaar R, Hendrickx W, Jimenez C, Vink G, Koopman M, Roodhart J, Ijzermans J, van Krieken H, Medema JP. 339P Molecular subtyping for chemotherapy response prediction in early stage colon cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Chandna A, Mahajan R, Gautam P, Mwandigha L, Gunasekaran K, Bhusan D, Cheung ATL, Day N, Dittrich S, Dondorp A, Geevar T, Ghattamaneni SR, Hussain S, Jimenez C, Karthikeyan R, Kumar S, Kumar S, Kumar V, Kundu D, Lakshmanan A, Manesh A, Menggred C, Moorthy M, Osborn J, Richard-Greenblatt M, Sharma S, Singh VK, Singh VK, Suri J, Suzuki S, Tubprasert J, Turner P, Villanueva AMG, Waithira N, Kumar P, Varghese GM, Koshiaris C, Lubell Y, Burza S. Facilitating Safe Discharge Through Predicting Disease Progression in Moderate Coronavirus Disease 2019 (COVID-19): A Prospective Cohort Study to Develop and Validate a Clinical Prediction Model in Resource-Limited Settings. Clin Infect Dis 2022; 75:e368-e379. [PMID: 35323932 PMCID: PMC9129107 DOI: 10.1093/cid/ciac224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND In locations where few people have received coronavirus disease 2019 (COVID-19) vaccines, health systems remain vulnerable to surges in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. Tools to identify patients suitable for community-based management are urgently needed. METHODS We prospectively recruited adults presenting to 2 hospitals in India with moderate symptoms of laboratory-confirmed COVID-19 to develop and validate a clinical prediction model to rule out progression to supplemental oxygen requirement. The primary outcome was defined as any of the following: SpO2 < 94%; respiratory rate > 30 BPM; SpO2/FiO2 < 400; or death. We specified a priori that each model would contain three clinical parameters (age, sex, and SpO2) and 1 of 7 shortlisted biochemical biomarkers measurable using commercially available rapid tests (C-reactive protein [CRP], D-dimer, interleukin 6 [IL-6], neutrophil-to-lymphocyte ratio [NLR], procalcitonin [PCT], soluble triggering receptor expressed on myeloid cell-1 [sTREM-1], or soluble urokinase plasminogen activator receptor [suPAR]), to ensure the models would be suitable for resource-limited settings. We evaluated discrimination, calibration, and clinical utility of the models in a held-out temporal external validation cohort. RESULTS In total, 426 participants were recruited, of whom 89 (21.0%) met the primary outcome; 257 participants comprised the development cohort, and 166 comprised the validation cohort. The 3 models containing NLR, suPAR, or IL-6 demonstrated promising discrimination (c-statistics: 0.72-0.74) and calibration (calibration slopes: 1.01-1.05) in the validation cohort and provided greater utility than a model containing the clinical parameters alone. CONCLUSIONS We present 3 clinical prediction models that could help clinicians identify patients with moderate COVID-19 suitable for community-based management. The models are readily implementable and of particular relevance for locations with limited resources.
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Affiliation(s)
- Arjun Chandna
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
- Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom
| | | | - Priyanka Gautam
- Department of Infectious Diseases, Christian Medical College, Vellore, India
| | - Lazaro Mwandigha
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Divendu Bhusan
- Department of Internal Medicine, All India Institute of Medical Sciences, Patna, India
| | - Arthur T L Cheung
- Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom
- Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Nicholas Day
- Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom
- Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Sabine Dittrich
- Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom
- Foundation for Innovative Diagnostics, Geneva, Switzerland
| | - Arjen Dondorp
- Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom
- Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Tulasi Geevar
- Department of Transfusion Medicine & Immunohaematology, Christian Medical College, Vellore, India
| | | | | | | | - Rohini Karthikeyan
- Department of Infectious Diseases, Christian Medical College, Vellore, India
| | - Sanjeev Kumar
- Department of Cardiothoracic & Vascular Surgery, All India Institute of Medical Sciences, Patna, India
| | - Shiril Kumar
- Department of Virology, Rajendra Memorial Research Institute of Medical Sciences, Patna, India
| | | | - Debasree Kundu
- Department of Infectious Diseases, Christian Medical College, Vellore, India
| | | | - Abi Manesh
- Department of Infectious Diseases, Christian Medical College, Vellore, India
| | - Chonticha Menggred
- Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Mahesh Moorthy
- Department of Clinical Virology, Christian Medical College, Vellore, India
| | | | | | - Sadhana Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, Patna, India
| | - Veena K Singh
- Department of Burns & Plastic Surgery, All India Institute of Medical Sciences, Patna, India
| | | | | | - Shuichi Suzuki
- School of Tropical Medicine & Global Health, Nagasaki University, Nagasaki, Japan
| | - Jaruwan Tubprasert
- Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Paul Turner
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
- Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom
| | | | - Naomi Waithira
- Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom
- Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Pragya Kumar
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Patna, Indiaand
| | - George M Varghese
- Department of Infectious Diseases, Christian Medical College, Vellore, India
| | - Constantinos Koshiaris
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Yoel Lubell
- Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom
- Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Sakib Burza
- Médecins Sans Frontières, New Delhi, India
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
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12
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Diaz AD, Mesa-Monsalve JG, Echavarria-Gil AM, Jimenez C. 1136. Effect of Weekly Antibiotic Rounds as a Core Strategy of the Antimicrobial Stewardship Program on Antibiotic Utilization in a Terciary-care Neonatal Intensive Care Unit, Medellin, Colombia. Open Forum Infect Dis 2021. [PMCID: PMC8643754 DOI: 10.1093/ofid/ofab466.1329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Antibiotics are among the most prescribed drugs in the neonatal intensive care unit (NICU), but frequently are used inappropriately exposing preterm neonates to additional harm. Antibiotic stewardship programs (ASP) have demonstrated impact on antibiotic use in the hospital setting, but implementation in neonatal units is challenging. We sought to determine the effects of weekly antibiotic rounds on overall antibiotic consumption in the NICU. Methods Single-center, retrospective observational study. In November 2014, we implemented weekly antibiotic rounds in a 60-bed tertiary-care NICU, led by a pediatric infectious disease physician. Antibiotic therapy decisions were made in collaboration with neonatologists. Data collected included the proportion of patients receiving antibiotics, irrespective of the indication. Multimodal ASP was implemented hospital-wide in 2015. Antibiotic consumption was measured with days of therapy (DOT). Data on costs and in-hospital mortality were obtained from pharmacy and hospital records. Results From November 2014 to December 2020, we evaluated 13609 neonates admitted to the NICU during rounds. Of those, 3607 (27%) were receiving at least one antibiotic. Overall, the proportion of patients with antibiotics decreased from 31% to 19% during the study period (p< 0.001). In 2017, an outbreak of neonatal necrotizing enterocolitis (NEC) occurred. Specific countermeasures as well as reinforcement of ASP were implemented. Despite Antibiotic usage by DOT increased in 2017 driven by empiric treatment with piperacillin tazobactam in patients with NEC, overall antibiotic consumption decreased from 254.4 DOT/1000 patient days (PD) to 162.4 DOT/1000 PD (Figure 1). Annual costs from antibiotic prescriptions were US&23,161 in 2015 and decreased to US&12.046 in 2020 saving over US&3,800/year (fig 2a). During the study period, we did not observe an increase in crude in-hospital mortality rate (Figure 2b). ![]()
Primary Y axis indicates the proportion of patients with at least one antibiotic prescription during rounds. Secondary Y axis indicates antibiotic consumption by days of therapy metrics. Antibiotic prescription costs and NICU mortality rates during study period ![]()
A. Annual antibiotic prescription costs; B. NICU mortality rate Conclusion Weekly antibiotic rounds led to a significant decrease in antibiotic utilization in our NICU. This strategy is relatively simple and low-cost, saves hospital resources and has a large impact on antibiotic use. Hence, its implementation is encouraged as part of successful antimicrobial stewardship programs. Disclosures All Authors: No reported disclosures
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13
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Wu J, Lakomy D, Fellman B, Salcedo M, Sood A, Jhingran A, Klopp A, Iyer R, Jimenez C, Colbert L, Schmeler K, Eifel P, Lin L. Bone Mineral Density Changes Within and Outside of RT Fields Used to Treat Cervical Cancer. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1662] [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: 11/29/2022]
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14
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Chandna A, Aderie EM, Ahmad R, Arguni E, Ashley EA, Cope T, Dat VQ, Day NPJ, Dondorp AM, Illanes V, De Jesus J, Jimenez C, Kain K, Suy K, Koshiaris C, Lasry E, Mayxay M, Mondal D, Perera R, Pongvongsa T, Rattanavong S, Rekart M, Richard-Greenblatt M, Shomik M, Souvannasing P, Tallo V, Turner C, Turner P, Waithira N, Watson JA, Yosia M, Burza S, Lubell Y. Prediction of disease severity in young children presenting with acute febrile illness in resource-limited settings: a protocol for a prospective observational study. BMJ Open 2021; 11:e045826. [PMID: 33495264 PMCID: PMC7839891 DOI: 10.1136/bmjopen-2020-045826] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/03/2020] [Accepted: 01/11/2021] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION In rural and difficult-to-access settings, early and accurate recognition of febrile children at risk of progressing to serious illness could contribute to improved patient outcomes and better resource allocation. This study aims to develop a prognostic clinical prediction tool to assist community healthcare providers identify febrile children who might benefit from referral or admission for facility-based medical care. METHODS AND ANALYSIS This prospective observational study will recruit at least 4900 paediatric inpatients and outpatients under the age of 5 years presenting with an acute febrile illness to seven hospitals in six countries across Asia. A venous blood sample and nasopharyngeal swab is collected from each participant and detailed clinical data recorded at presentation, and each day for the first 48 hours of admission for inpatients. Multianalyte assays are performed at reference laboratories to measure a panel of host biomarkers, as well as targeted aetiological investigations for common bacterial and viral pathogens. Clinical outcome is ascertained on day 2 and day 28.Presenting syndromes, clinical outcomes and aetiology of acute febrile illness will be described and compared across sites. Following the latest guidance in prediction model building, a prognostic clinical prediction model, combining simple clinical features and measurements of host biomarkers, will be derived and geographically externally validated. The performance of the model will be evaluated in specific presenting clinical syndromes and fever aetiologies. ETHICS AND DISSEMINATION The study has received approval from all relevant international, national and institutional ethics committees. Written informed consent is provided by the caretaker of all participants. Results will be shared with local and national stakeholders, and disseminated via peer-reviewed open-access journals and scientific meetings. TRIAL REGISTRATION NUMBER NCT04285021.
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Affiliation(s)
- Arjun Chandna
- Angkor Hospital for Children, Cambodia Oxford Medical Research Unit, Siem Reap, Cambodia
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, Oxfordshire, UK
| | - Endashaw M Aderie
- Médecins Sans Frontières Operational Centre Barcelona, Barcelona, Spain
| | - Riris Ahmad
- Centre for Tropical Medicine, Universitas Gadjah Mada, Yogyakarta, Daerah Istimewa Yogyakart, Indonesia
| | - Eggi Arguni
- Centre for Tropical Medicine, Universitas Gadjah Mada, Yogyakarta, Daerah Istimewa Yogyakart, Indonesia
| | - Elizabeth A Ashley
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, Oxfordshire, UK
- Microbiology Department, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Vientiane, Lao People's Democratic Republic
| | - Tanya Cope
- Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | | | - Nicholas P J Day
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, Oxfordshire, UK
- Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Arjen M Dondorp
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, Oxfordshire, UK
- Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Victor Illanes
- Médecins Sans Frontières Operational Centre Barcelona, Barcelona, Spain
| | - Joanne De Jesus
- Clinical Trials, Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Carolina Jimenez
- Médecins Sans Frontières Operational Centre Barcelona, Barcelona, Spain
| | - Kevin Kain
- Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Keang Suy
- Angkor Hospital for Children, Cambodia Oxford Medical Research Unit, Siem Reap, Cambodia
- Angkor Hospital for Children, Siem Reap, Siem Reap, Cambodia
| | | | - Estrella Lasry
- Médecins Sans Frontières Operational Centre Barcelona, Barcelona, Spain
| | - Mayfong Mayxay
- Microbiology Department, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Vientiane, Lao People's Democratic Republic
- Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Lao People's Democratic Republic
| | - Dinesh Mondal
- Centre for Nutrition and Food Security (CNFS), icddr,b, Dhaka, Dhaka, Bangladesh
| | - Rafael Perera
- Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Tiengkham Pongvongsa
- Microbiology Department, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Vientiane, Lao People's Democratic Republic
- Savannakhet Provincial Health Department, Savannakhet, Lao People's Democratic Republic
| | - Sayaphet Rattanavong
- Microbiology Department, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Vientiane, Lao People's Democratic Republic
| | - Michael Rekart
- Médecins Sans Frontières Operational Centre Barcelona, Barcelona, Spain
| | | | - Mohammad Shomik
- Centre for Nutrition and Food Security (CNFS), icddr,b, Dhaka, Dhaka, Bangladesh
| | | | - Veronica Tallo
- Clinical Trials, Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Claudia Turner
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, Oxfordshire, UK
- Angkor Hospital for Children, Siem Reap, Siem Reap, Cambodia
| | - Paul Turner
- Angkor Hospital for Children, Cambodia Oxford Medical Research Unit, Siem Reap, Cambodia
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, Oxfordshire, UK
| | - Naomi Waithira
- Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - James A Watson
- Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Mikhael Yosia
- Médecins Sans Frontières Operational Centre Barcelona, Barcelona, Spain
| | - Sakib Burza
- Médecins Sans Frontières Operational Centre Barcelona, Barcelona, Spain
| | - Yoel Lubell
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, Oxfordshire, UK
- Faculty of Tropical Medicine, Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
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15
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Lachmet-Thébaud L, Marchandot B, Matsushita K, Sato C, Dagrenat C, Greciano S, De Poli F, Leddet P, Carmona A, Jimenez C, Heger J, Reydel A, Ohlmann P, Jesel L, Morel O. Residual systemic inflammatory burden is a major determinant of myocardial recovery and late cardiovascular outcome in Takotsubo patients. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Eibs T, Koscalova A, Nair M, Grohma P, Kohler G, Bakhit RG, Thurashvili M, Lasry E, Bauer SW, Jimenez C. Qualitative study of antibiotic prescription patterns and associated drivers in Sudan, Guinea-Bissau, Central African Republic and Democratic Republic of Congo. BMJ Open 2020; 10:e036530. [PMID: 32973055 PMCID: PMC7517544 DOI: 10.1136/bmjopen-2019-036530] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES The objective of this study was to address the knowledge gap regarding antibiotic use in Medecins Sans Frontiéres (MSF) projects located in Africa by exploring antibiotic prescription and consumption habits and their drivers at different healthcare levels. DESIGN This study used an exploratory study design through thematic analysis of semistructured, in-depth interviews, focus group discussions (FGDs) and field observations in order to understand the main drivers influencing current antibiotics prescription habits and consumption habits of patients in different geographical settings. SETTING The study took place in MSF centres and towns across four countries: Guinea-Bissau, Central African Republic (CAR), Democratic Republic of Congo (DRC) and Sudan. PARTICIPANTS 384 respondents participated in the study, which includes project staff, prescribers, community members, patients, among other groups. RESULTS Treatment protocols were physically present in all countries except DRC, but compliance to protocols varied across contexts. A failing health system and barriers to accessing healthcare were perceived as major drivers of overuse and inconsistent prescription practices. Patient demands influenced prescription decisions, and self-medication was commonly reported in the context of failing health systems. Additionally, there was a strong demand for quick cures and communities preferred injections over pills. Patients tended to stop antibiotic treatment once symptoms abated and had major gaps in understanding antibiotic intake instructions and functions. CONCLUSIONS While there were specific findings in each context, the larger trend from these four MSF projects in Africa indicates widespread use of antibiotics based on unclear assumptions, which are often influenced by patient demands. There needs to be a broader focus on the balance between access and excess, especially in such fragile contexts where access to healthcare is a real challenge.
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Affiliation(s)
- Tonka Eibs
- Vienna Evaluation Unit, Medecins Sans Frontieres, Vienna, Austria
| | - Alena Koscalova
- Vienna Evaluation Unit, Medecins Sans Frontieres, Vienna, Austria
| | - Mohit Nair
- Vienna Evaluation Unit, Medecins Sans Frontieres, Vienna, Austria
| | - Paul Grohma
- Infectious diseases departement, Slovak Medical University, Bratislava, Slovakia
| | - Gisa Kohler
- Vienna Evaluation Unit, Medecins Sans Frontieres, Vienna, Austria
| | | | - Mzia Thurashvili
- Vienna Evaluation Unit, Medecins Sans Frontieres, Vienna, Austria
| | - Estrella Lasry
- Medical departement, Medecins Sans Frontieres, Barcelona, Spain
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17
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Erozenci A, Feenstra F, Jenster G, Van Moorselaar R, Piersma S, Jimenez C, Bijnsdorp I. Identification of the prostate cancer exosome surface proteome and its application to detect prostate cancer in urine. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33715-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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18
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Nantais J, Skelhorne-Gross G, Jimenez C, Ahmed N, Gomez D. Bilioptysis due to a single transcavitary thoracoabdominal gunshot wound. Trauma Surg Acute Care Open 2020; 5:e000425. [PMID: 32072019 PMCID: PMC6996785 DOI: 10.1136/tsaco-2019-000425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 12/03/2022] Open
Affiliation(s)
- Jordan Nantais
- Division of Critical Care, University of Toronto, Toronto, Ontario, Canada
| | | | - Carolina Jimenez
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Najma Ahmed
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Surgery, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - David Gomez
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Surgery, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
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19
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Gamarra Lobato AL, Rojas AM, Cecconi A, Dominguez L, Benedicto A, Diego G, Nogales MT, Monguio E, Munoz D, Perich J, Montes A, De Rueda C, Jimenez C, Jimenez LJ, Alfonso F. 1640 Pulmonary valve in carcinoid disease: be suspicious of functional assessment. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1030] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Carcinoid heart disease occurs in 50% of patients with carcinoid syndrome, especially on serotonin-secreting neuroendocrine tumors (NET) [1, 2]. Carcinoid heart disease"s typical findings are carcinoid plaques, composed of smooth muscle, myofibroblasts and endothelium. These plaques, most frequently localized on the right side valvular cusps and leaflets, produce fixation and retraction, causing regurgitation and/or stenosis [3, 4, 5]. Left-sided heart disease is rare (<10%), as serotonin is purified in the pulmonary circulation [3, 6, 7].
We present the case of a 67 year old female patient with previous history of right ovarian NET. She presented with dyspnea (II-III NYHA functional class), and slight edema in lower limbs. She denied symptoms of carcinoid syndrome before or after the ovarian surgery.
Examination showed an increased jugular venous pulse.
Transthoracic echocardiography (TTE) showed severely dilated right cavities and a rigid, immobile tricuspid valve, with massive tricuspid regurgitation (Panel A, 1). Anatomy of
pulmonary valve was not properly visualized but jet area of pulmonary regurgitation was small (Panel A, 2). Left cavities and valves were intact.
As TTE was not anatomically conclusive, a cardiac magnetic resonance (CMR) and a cardiac computed tomography (CCT) were performed to assess the carcinoid involvement of pulmonary valve.
CMR showed severely dilated right ventricle with mild impairment of systolic function (Panel A, 3). Based on phase contrast imaging, pulmonary regurgitation fraction was 14%,
suggestive of a mild grade. However, CCT showed a diffuse thickening of the pulmonary valve, with complete opening during diastole (Panel A, 4, arrowhead). Finally, the patient underwent replacement of tricuspid valve and pulmonary valve for biological prosthesis without complications.
Our case is remarkable because it highlights the limitations of the functional assessment of pulmonary regurgitation in the presence of a concomitant massive tricuspid valve regurgitation, since the rapid equalization of pressure between pulmonary artery and right ventricle reduces the expression of pulmonary regurgitation. For these reason, the anatomic assessment of the pulmonary valve is mandatory to stage the involvement of pulmonary valve in carcinoid disease.
Abstract 1640 Figure. Panel A
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Affiliation(s)
| | - A M Rojas
- University Hospital De La Princesa, Madrid, Spain
| | - A Cecconi
- University Hospital De La Princesa, Madrid, Spain
| | - L Dominguez
- University Hospital De La Princesa, Madrid, Spain
| | - A Benedicto
- University Hospital De La Princesa, Madrid, Spain
| | - G Diego
- University Hospital De La Princesa, Madrid, Spain
| | - M T Nogales
- University Hospital De La Princesa, Madrid, Spain
| | - E Monguio
- University Hospital De La Princesa, Madrid, Spain
| | - D Munoz
- University Hospital De La Princesa, Madrid, Spain
| | - J Perich
- University Hospital De La Princesa, Madrid, Spain
| | - A Montes
- University Hospital De La Princesa, Madrid, Spain
| | - C De Rueda
- University Hospital De La Princesa, Madrid, Spain
| | - C Jimenez
- University Hospital De La Princesa, Madrid, Spain
| | - L J Jimenez
- University Hospital De La Princesa, Madrid, Spain
| | - F Alfonso
- University Hospital De La Princesa, Madrid, Spain
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20
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Jimenez C, Ohana M, Marchandot B, Kibler M, Carmona A, Peillex M, Heger J, Trimaille A, Matsushita K, Reydel A, Hess S, Jesel L, Ohlmann P, Morel O. Impact of anti-thrombotic regimen and platelet inhibition extent on leaflet thrombosis detected by cardiac MDCT after transcatheter aortic-valve replacement. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Vera Sainz A, Garcia Guimaraes M, Jimenez C, De La Cuerda F, Gonzalez E, Montes A, De Rueda C, Rojas A, Cecconi A, Diego G, Benedicto A, Dominguez L, Monguio E, Jimenez Borreguero LJ, Alfonso F. P845 Deep vein thrombosis, pulmonary embolism and patent foramen ovale: a lethal mix. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.494] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
A 50-year-old woman without remarkable medical history was admitted at the Emergency Department for acute dyspnoea. The patient had been recently submitted to C5-C6 microdiscectomy. She was tachypneic and oxygen saturation was 88%. CT angiography showed bilateral pulmonary embolism (PE) (Figure 1A, yellow arrowheads) with signs of right ventricle overload. Bilateral deep vein thrombosis was also confirmed. The patient was admitted at the Intensive Care Unit, clinically stable. Few hours later, she presented sudden hemodynamic and respiratory deterioration, requiring invasive mechanical ventilation and vasopressors. Due to recent cervical surgery, systemic fibrinolysis was ruled out. Decision for percutaneous thrombectomy and inferior vena cava filter placement was made. Nevertheless, percutaneous thrombectomy was unsuccessful due to the impossibility to catheterize pulmonary artery. Contrast injection demonstrated that the guiding catheter was located in the left atrium (Figure 1B), suggesting a patent foramen ovale (PFO). Transoesophageal echocardiogram confirmed the presence of a 5x6 mm PFO with right-to-left shunt (Figures 1C – yellow arrows, and 1D). In addition, a 4 cm mobile mass attached to the aortic valve and protruding throughout the left ventricle outflow tract was visualized, suggesting paradoxical embolism (Figure 1E – white arrows). Accordingly, open surgical approach with pulmonary thrombectomy, PFO closure and removal of the left-sided thrombus was decided. Unfortunately, despite careful cannulation, thrombus was not found when aortic valve was inspected. Worst suspicions were confirmed, when the patient presented non-reactive mydriatic pupils. A brain CT showed signs of an extensive bihemisferic ischemic stroke (Figure 1F) presumably related to cerebral embolization of aortic thrombus. The patient finally died. Autopsy study was not consented.
PFO has been associated with paradoxical embolisms and risk of stroke in PE. This case strikingly illustrates that treatment of these patients may be challenging in spite of an adequate diagnosis and management.
Abstract P845 Figure.
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Affiliation(s)
- A Vera Sainz
- University Hospital De La Princesa, Madrid, Spain
| | | | - C Jimenez
- University Hospital De La Princesa, Madrid, Spain
| | | | - E Gonzalez
- University Hospital De La Princesa, Madrid, Spain
| | - A Montes
- University Hospital De La Princesa, Madrid, Spain
| | - C De Rueda
- University Hospital De La Princesa, Madrid, Spain
| | - A Rojas
- University Hospital De La Princesa, Madrid, Spain
| | - A Cecconi
- University Hospital De La Princesa, Madrid, Spain
| | - G Diego
- University Hospital De La Princesa, Madrid, Spain
| | - A Benedicto
- University Hospital De La Princesa, Madrid, Spain
| | - L Dominguez
- University Hospital De La Princesa, Madrid, Spain
| | - E Monguio
- University Hospital De La Princesa, Madrid, Spain
| | | | - F Alfonso
- University Hospital De La Princesa, Madrid, Spain
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22
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Montes A, Cecconi A, Alvarado T, Vera A, Barrios A, Caballero P, Olivera MJ, De Rueda C, Gonzalez E, De La Cuerda F, Jimenez C, Perich J, Gamarra A, Jimenez Borreguero LJ, Alfonso F. 1095 Effective image-guided medical management in effusive constrictive pericarditis. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.646] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
A 59 year old man was admited to hospitalization for persistent chest pain related to acute pericarditis. Within the admision tests, a transthoracic echography was performed, showing a moderate pericardial effusion with ventricular septal bounce and significant respiratory variations in mitral and tricuspid inflows, all of it consistent with effusive-constrictive pericarditis (Panel A). Anti-inflammatory treatment with ibuprofen and colchicine was started.
During the first 48 hours of admission there was a clinical and hemodinamic worsening in the patient’s condition that forced the performance of a pericardial window, obtaining a very little quantity of dense pericardial fluid. Looking for a more accurate study of the pericardium, a cardiovascular magnetic resonance (CMR) was performed, revealing a thick heterogeneous pericardial effusion (Panel B) and a significant late gadolinium enhancement of both pericardial layers (Panel C). All these findings where consistent with an effusive constrictive pericarditis with persistent inflammatory activity despite high doses of conventional inflammatory treatment. Furthermore, the growth of Propionibacterium acnes in the pericardial fluid disclosed the etiology of this condition.
Medical treatment was enhanced with high doses of intravenous corticosteroid, ceftriaxone and doxycycline. During the following days, the patient showed an excellent response achieving the complete clinical and echocardiographic relief of constrictive signs (Panel D).
Effusive constrictive pericarditis is characterized by the presence of pericardial effusion and constriction secondary to an inflammatory process of the pericardium. Pericardiectomy might be necessary in case of failure of medical treatment, a very common scenario in this kind of .pericarditis.
Our case is remarkable because it demonstrates the value of CMR to detect persistent inflammation of pericardium despite high doses of conventional medical treatment for pericaricarditis guiding the successful escalation to intravenous corticosteroid and avoiding the risk of an unnecessary cardiac surgery.
Abstract 1095 Figure.
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Affiliation(s)
- A Montes
- University Hospital De La Princesa, Madrid, Spain
| | - A Cecconi
- University Hospital De La Princesa, Madrid, Spain
| | - T Alvarado
- University Hospital De La Princesa, Madrid, Spain
| | - A Vera
- University Hospital De La Princesa, Madrid, Spain
| | - A Barrios
- University Hospital De La Princesa, Madrid, Spain
| | - P Caballero
- University Hospital De La Princesa, Madrid, Spain
| | - M J Olivera
- University Hospital De La Princesa, Madrid, Spain
| | - C De Rueda
- University Hospital De La Princesa, Madrid, Spain
| | - E Gonzalez
- University Hospital De La Princesa, Madrid, Spain
| | | | - C Jimenez
- University Hospital De La Princesa, Madrid, Spain
| | - J Perich
- University Hospital De La Princesa, Madrid, Spain
| | - A Gamarra
- University Hospital De La Princesa, Madrid, Spain
| | | | - F Alfonso
- University Hospital De La Princesa, Madrid, Spain
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Naing A, Meric-Bernstam F, Karp D, Rodon J, Piha-Paul S, Subbiah V, Hong D, Pant S, Fu S, Janku F, Yap T, Tsimberidou A, Dumbrava EEI, Colen R, Hess K, Campbell M, Tu SM, Jimenez C, Habra M, Varadhachary G. Pembrolizumab in advanced rare cancers. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.095] [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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Specht S, Scoto M, Childs A, Eglon G, Hastings L, Pysden K, Manning S, Jimenez C, Munot P, Brusa C, Turner M, Guglieri M, Manzur A, Muntoni F, Straub V, Marini-Bettolo C. P.212Mortality in patients with spinal muscular atrophy over the last 10 years: the UK experience. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Campbell M, Xie W, Shah A, Habra M, Jimenez C, Venkatesan A, Bubley G, McKay R, Choueiri T, McGregor B, Killbridge K, Mortazavi A, Bilen M. Initial results of a phase II study of nivolumab and ipilimumab in metastatic adrenal tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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26
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Cambra MJ, Moreno F, Sanz X, Anglada L, Mollà M, Reyes V, Arenas M, Pedro A, Ballester R, García V, Casals J, Cusidó M, Jimenez C, Escribà JM, Macià M, Solé JM, Arcusa A, Seguí MA, Gonzalez S, Farrús B, Biete A. Role of boost radiotherapy for local control of pure ductal carcinoma in situ after breast-conserving surgery: a multicenter, retrospective study of 622 patients. Clin Transl Oncol 2019; 22:670-680. [PMID: 31264148 DOI: 10.1007/s12094-019-02168-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/19/2019] [Indexed: 12/01/2022]
Abstract
PURPOSE To evaluate the effect of boost radiotherapy on ipsilateral breast tumor recurrence (IBTR) for ductal carcinoma in situ (DCIS) after breast-conserving surgery and whole breast radiotherapy (WBRT) with or without boost. METHODS AND MATERIALS Retrospective, multicentre study of 622 patients (624 tumors) diagnosed with pure DCIS from 1993-2011. RESULTS Most tumors (377/624; 60.4%) received a boost. At a median follow-up of 8.8 years, IBTR occurred in 64 cases (10.3%). A higher percentage of patients with risk factors for IBTR received a boost (p < 0.05). Boost was not associated with lower rates of IBTR than WBRT alone (HR 0.75, 95% CI 0.42-1.35). On the univariate analyses, IBTR was significantly associated with tumor size (11-20 mm, HR 2.32, 95% CI 1.27-4.24; and > 20 mm, HR 2.10, 95% CI 1.14-3.88), re-excision (HR 1.76, 95% CI 1.04-2.96), and tamoxifen (HR 2.03, 95% CI 1.12-3.70). Boost dose > 16 Gy had a protective effect (HR 0.39, 95% CI 0.187-0.824). Multivariate analyses confirmed the independent associations between IBTR and 11-20 mm (p = 0.02) and > 20 mm (p = 0.009) tumours, and re-excision (p = 0.006). On the margin-stratified multivariate analysis, tamoxifen was a poor prognostic factor in the close/positive margin subgroup (HR 4.28 95% CI 1.23-14.88), while the highest boost dose ( > 16 Gy) had a significant positive effect (HR 0.34, 95% CI 0.13-0.86) in the negative margin subgroup. CONCLUSIONS Radiotherapy boost did not improve the risk of IBTR. Boost radiotherapy was more common in patients with high-risk disease. Tumor size and re-excision were significant independent prognostic factors.
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Affiliation(s)
- M J Cambra
- Department of Radiation Oncology, Hospital Universitari General de Catalunya-Grupo Quirónsalud (IOV-HGC-Quironsalud), Carrer Pedro i Pons 1, 08195, Sant Cugat del Vallés, Barcelona, Spain.
| | - F Moreno
- Department of Radiation Oncology, Institut Català d'Oncologia L'Hospitalet, L'Hospitalet de Llobregat, Avda de la Granvia, 199, 08908, Barcelona, Spain
| | - X Sanz
- Department of Radiation Oncology, Parc de Salut MAR, Passeig Marítim 25-29, 08003, Barcelona, Spain
| | - L Anglada
- Department of Radiation Oncology, ICO Girona, Avda de França, s/n, 17007, Girona, Spain
| | - M Mollà
- Department of Radiation Oncology, Hospital Vall d'Hebrón, Pg Vall d'Hebron 119, 129, 08035, Barcelona, Spain.,Department of Radiation Oncology, Hospital Clìnic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - V Reyes
- Department of Radiation Oncology, Hospital Vall d'Hebrón, Pg Vall d'Hebron 119, 129, 08035, Barcelona, Spain
| | - M Arenas
- Department of Radiation Oncology, Hospital Universitari Sant Joan Reus, Avda del Dr. Josep Laporte, 2, 43204, Reus, Tarragona, Spain
| | - A Pedro
- Department of Radiation Oncology, Hospital Plató, c/Plató, 21, 08006, Barcelona, Spain
| | - R Ballester
- Department of Radiation Oncology, Institut Català D'Oncologia-Badalona, Carretera del Canyet, s/n, 08916, Badalona, Barcelona, Spain
| | - V García
- Department of Radiation Oncology, Hospital Arnau de Vilanova, Avda Alcalde Rovira Roure, 80, 25198, Lleida, Spain
| | - J Casals
- Department of Radiation Oncology, Hospital Quirón, Plaça Alfonso Comín, 5, 08023, Barcelona, Spain
| | - M Cusidó
- Department of Gynecology and Obstetrics, Hospital Universitari Dexeus-Grupo Quirónsalud, c/Sabino Arana, 5-19, 08028, Barcelona, Spain
| | - C Jimenez
- Biostatistics and Bioinformatic Expert, Olesa de Montserrat, c/Urgell 55 A, 08640, Barcelona, Spain
| | - J M Escribà
- Catalan Cancer Registry, Cancer Planning Directorate, L'Hospitalet de Llobregat, Avda de La Granvia, s/n, 08908, Barcelona, Spain.,Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - M Macià
- Department of Radiation Oncology, Institut Català d'Oncologia L'Hospitalet, L'Hospitalet de Llobregat, Avda de la Granvia, 199, 08908, Barcelona, Spain
| | - J M Solé
- Department of Radiation Oncology, Consorci Sanitari de Terrassa, Ctra. Torrebonica s/n, 08227, Terrassa, Barcelona, Spain
| | - A Arcusa
- Department of Medical Oncology, Ctra. Torrebonica s/n, Consorci Sanitari de Terrassa, 08227, Terrassa, Barcelona, Spain
| | - M A Seguí
- Department of Medical Oncology, Corporació Sanitaria Parc Taulí, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - S Gonzalez
- Department of Medical Oncology, Hospital Universitari Mútua de Terrassa, Plaça del Doctor Robert, 5, 08221, Terrassa, Barcelona, Spain
| | - B Farrús
- Department of Radiation Oncology, Hospital Clìnic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - A Biete
- Department of Radiation Oncology, Hospital Clìnic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain
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Nair M, Tripathi S, Mazumdar S, Mahajan R, Harshana A, Pereira A, Jimenez C, Halder D, Burza S. "Without antibiotics, I cannot treat": A qualitative study of antibiotic use in Paschim Bardhaman district of West Bengal, India. PLoS One 2019; 14:e0219002. [PMID: 31247028 PMCID: PMC6597109 DOI: 10.1371/journal.pone.0219002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 06/13/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Misuse of antibiotics is a well-known driver of antibiotic resistance. Given the decentralized model of the Indian health system and the shortage of allopathic doctors in rural areas, a wide variety of healthcare providers cater to the needs of patients in urban and rural settings. This qualitative study explores the drivers of antibiotic use among formal and informal healthcare providers as well as patients accessing care at primary health centers across Paschim Bardhaman district in West Bengal. MATERIALS AND METHODS We conducted 28 semi-structured, in-depth interviews with four groups of healthcare providers (allopathic doctors, informal health providers, nurses, and pharmacy shopkeepers) as well as patients accessing care at primary health centers and hospitals across Paschim Bardhaman district. Qualitative data was analyzed using the framework method in an inductive and deductive manner. RESULTS Our results indicate that patients demand antibiotics from healthcare providers and seek the fastest cure possible, which influences the prescription choices of healthcare providers, particularly informal health providers. Many allopathic doctors provide antibiotics without any clinical indication due to inconsistent follow up, lack of testing facilities, risk of secondary infections, and unhygienic living conditions. Pharmaceutical company representatives actively network with informal health providers and formal healthcare providers alike, and regularly visit providers even in remote areas to market newer antibiotics. Allopathic doctors and informal health providers frequently blame the other party for being responsible for antibiotic resistance, and yet both display interdependence in referring patients to one another. CONCLUSIONS A holistic approach to curbing antibiotic resistance in West Bengal and other parts of India should focus on strengthening the capacity of the existing public health system to deliver on its promises, improving patient education and counseling, and including informal providers and pharmaceutical company representatives in community-level antibiotic stewardship efforts.
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Affiliation(s)
- Mohit Nair
- Medecins Sans Frontieres, New Delhi, India
| | | | - Sumit Mazumdar
- Centre for Health Economics, University of York, York, United Kingdom
| | | | | | | | | | | | - Sakib Burza
- Medecins Sans Frontieres, New Delhi, India
- * E-mail:
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Beder M, Cohen M, Hui K, Jimenez C. End immigration detention: an open letter. Lancet 2018; 392:381-382. [PMID: 30017547 DOI: 10.1016/s0140-6736(18)31567-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 07/02/2018] [Indexed: 11/18/2022]
Affiliation(s)
| | | | - Katrina Hui
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Najafi A, Schuldt M, Pham T, Michels M, Schlossarek S, Carrier L, Jimenez C, Zaccolo M, van der Velden J, Kuster D. PKA’s favorite son: prioritizing phosphorylation of phospholamban over cardiac troponin I contributes to diastolic dysfunction in hypertrophic cardiomyopathy. J Mol Cell Cardiol 2018. [DOI: 10.1016/j.yjmcc.2018.05.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Negro G, Aschenbrenner B, Skvortsov S, Jimenez C, Ganswindt U, Skvortsova I. PO-115 Radiation resistance mechanisms of breast cancer cells. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.640] [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: 11/04/2022] Open
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31
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Rolfs F, Gogola E, Piersma S, Pham T, Knol J, Rottenberg S, Jonkers J, Jimenez C. PO-019 Phosphoproteomics to characterise DNA damage response in mouse mammary tumours of different PARP inhibitor susceptibility. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.64] [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: 11/04/2022] Open
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32
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Masanas M, Soriano A, Boloix A, Masiá N, Jimenez C, Roma J, Sánchez de Toledo J, Santamaria A, Gallego S, Segura M. PO-353 Functional high-throughput screening reveals multiple tumour-suppressive microRNAs in neuroblastoma. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.865] [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: 11/03/2022] Open
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Portoles J, Perez-Saez MJ, Hernandez D, Espi J, Navarro D, Juega J, Mazuecos MA, Maruri-Kareaga N, Moreso F, Melilli E, de Sousa E, Ruiz JC, Llamas F, Guirado L, Gutierrez A, Martin Moreno P, Perez-Flores I, Serrano Salazar ML, Jimenez C, Gavela E, Ramos A, Pascual J. SP686DELAYED GRAFT FUNCTION AND DONOR SELECTION CRITERIA ASSOCIATE A LOWER BEST-EGFR AFTER KIDNEY TRANSPLANTATION WITH CONTROLLED CIRCULATORY DEATH DONOR (cDCD). Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.sp686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | - J Espi
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - D Navarro
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - J Juega
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - M A Mazuecos
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | | | - F Moreso
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - E Melilli
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - E de Sousa
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - J C Ruiz
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - F Llamas
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - L Guirado
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - A Gutierrez
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - P Martin Moreno
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - I Perez-Flores
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | | | - C Jimenez
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - E Gavela
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - Ana Ramos
- Nephrology, Spanish Multicentre Group GEODAS-III, Madrid, Spain
| | - J Pascual
- Nephrology, HU del Mar, Barcelona, Spain
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Custodio E, López‐Alcalde J, Herrero M, Bouza C, Jimenez C, Storcksdieck genannt Bonsmann S, Mouratidou T, López‐Cuadrado T, Benito A, Alvar J. Nutritional supplements for patients being treated for active visceral leishmaniasis. Cochrane Database Syst Rev 2018; 3:CD012261. [PMID: 29578237 PMCID: PMC6494195 DOI: 10.1002/14651858.cd012261.pub2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Visceral leishmaniasis (VL) is a disease caused by a parasite, which can lead to death if untreated. Poor nutritional status hastens the progression of VL infection, and VL worsens malnutrition status. Malnutrition is one of the poor prognostic factors identified for leishmaniasis. However, the effects of nutritional supplementation in people treated for VL are not known. OBJECTIVES To assess the effects of oral nutritional supplements in people being treated with anti-leishmanial drug therapy for VL. SEARCH METHODS We searched the Cochrane Infectious Diseases Group (CIDG) Specialized Register, CENTRAL, MEDLINE, Embase, LILACS, and two trial registers up to 12 September 2017. We checked conference proceedings and WHO consultative meeting reports, the reference lists of key documents and existing reviews, and contacted experts and nutritional supplement companies. SELECTION CRITERIA Randomized controlled trials (RCTs), quasi-randomized controlled trials (quasi-RCTs), and non-randomized controlled trials (NRCTs) of any oral nutritional supplement, compared to no nutritional intervention, placebo, or dietary advice alone, in people being treated for VL. DATA COLLECTION AND ANALYSIS Two review authors independently screened the literature search results for studies that met the inclusion criteria. We had planned for two review authors to independently extract data and assess the risk of bias of the included studies. We planned to follow the Cochrane standard methodological procedures for assessing risk of bias and analysing the data. MAIN RESULTS We identified no eligible studies for this review, either completed or ongoing. AUTHORS' CONCLUSIONS We found no studies, either completed or ongoing, that assessed the effects of oral nutritional supplements in people with VL who were being treated with anti-leishmanial drug therapy. Thus, we could not draw any conclusions on the impact of these interventions on primary cure of VL, definitive cure of VL, treatment completion, self-reported recovery from illness or resolution of symptoms, weight gain, increased skinfold thickness, other measures of lean or total mass, or growth in children.This absence of evidence should not be interpreted as evidence of no effect for nutritional supplements in people under VL treatment. It means that we did not identify research that fulfilled our review inclusion criteria.The effects of oral nutritional supplements in people with VL who are being treated with anti-leishmanial drug therapy have yet to be determined by rigorous experimental studies, such as cluster-randomized trials, that focus on outcomes relevant for patients.
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Affiliation(s)
- Estefanía Custodio
- European Commission, Joint Research Centre (JRC)IspraItaly
- Instituto de Salud Carlos III (ISCIII)National Centre of Tropical MedicineAvda. Monforte de Lemos, 3Pabellón 13MadridSpain28029
| | - Jesús López‐Alcalde
- Universidad Francisco de Vitoria (UFV) MadridFaculty of MedicineCtra. Pozuelo‐Majadahonda km. 1,800MadridSpain
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS)Clinical Biostatistics UnitCtra. Colmenar, km. 9.100MadridSpain28034
| | - Mercè Herrero
- World Health Organization (WHO)Department of Neglected Tropical DiseasesGenevaSwitzerland
| | - Carmen Bouza
- Instituto de Salud Carlos III (ISCIII)Healthcare Technology Assessment AgencyAvda. Monforte de Lemos, 3Pabellón 13MadridSpain28029
| | | | | | | | - Teresa López‐Cuadrado
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII)Av Monforte de Lemos 5, Pab 12MadridSpain
| | - Agustin Benito
- Instituto de Salud Carlos III (ISCIII)National Centre of Tropical MedicineAvda. Monforte de Lemos, 3Pabellón 13MadridSpain28029
| | - Jorge Alvar
- Drugs for Neglected Diseases initiative (DNDi)GenevaSwitzerland
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Chansel-Debordeaux L, Bourdenx M, Dovero S, Grouthier V, Dutheil N, Espana A, Groc L, Jimenez C, Bezard E, Dehay B. In utero delivery of rAAV2/9 induces neuronal expression of the transgene in the brain: towards new models of Parkinson’s disease. Gene Ther 2017; 24:801-809. [DOI: 10.1038/gt.2017.84] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 06/26/2017] [Accepted: 08/23/2017] [Indexed: 12/21/2022]
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Velazquez Martin M, Albarran A, Hernandez I, Mayordomo S, Revilla Y, Roldan A, Lopez Gude M, Cortina J, Alonso G, Quezada A, Pilkington P, Perez Vela J, Jimenez C, Alonso S, Escribano P. P2598Is pressure wire useful to predict reperfusion pulmonary edema after balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Velazquez Martin M, Albarran A, Hernandez I, Alonso S, Perez M, Mayordomo S, Jimenez C, Quezada A, Lopez Gude M, Cortina J, Roldan A, Coto B, Tovar N, Perez Vela J, Escribano P. P2602Predictors of reperfusion pulmonary edema and hemodynamic improvement at follow-up after balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Portolés J, Perez-Saez MJ, Sanchez-Sobrino B, Hernandez D, Rodriguez-Ferrero ML, Moreso F, Lafuente O, Valero R, Mazuecos MA, Juega J, Alonso A, Jimenez C, Ramos A, Melilli E, Pascual J. SP776EXPANDED CRITERIA DONORS AFTER CARDIAC DEATH: AN INCREASING AND USEFUL SOURCE FOR KIDNEY TRANSPLANTATION. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx158.sp776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Martinez-Lopez J, Sanchez-Vega B, Barrio S, Cuenca I, Ruiz-Heredia Y, Alonso R, Rapado I, Marin C, Cedena MT, Paiva B, Puig N, Mateos MV, Ayala R, Hernández MT, Jimenez C, Rosiñol L, Martínez R, Teruel AI, Gutiérrez N, Martin-Ramos ML, Oriol A, Bargay J, Bladé J, San-Miguel J, Garcia-Sanz R, Lahuerta JJ. Analytical and clinical validation of a novel in-house deep-sequencing method for minimal residual disease monitoring in a phase II trial for multiple myeloma. Leukemia 2017; 31:1446-1449. [PMID: 28210002 PMCID: PMC5467041 DOI: 10.1038/leu.2017.58] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- J Martinez-Lopez
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - B Sanchez-Vega
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - S Barrio
- Department of Hematology, University Hospital Würzburg, Wurzburg, Germany
| | - I Cuenca
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Y Ruiz-Heredia
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - R Alonso
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - I Rapado
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - C Marin
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M-T Cedena
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - B Paiva
- Department of Hematology, Clinica Universidad de Navarra, Centro de Investigación Médica Aplicada (CIMA), IDISNA, Pamplona, Spain
| | - N Puig
- Department of Hematology, Hospital Universitario, Salamanca, Spain
| | - M-V Mateos
- Department of Hematology, Hospital Universitario, Salamanca, Spain
| | - R Ayala
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M-T Hernández
- Department of Hematology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - C Jimenez
- Department of Hematology, Hospital Universitario, Salamanca, Spain
| | - L Rosiñol
- Department of Hematology, Hospital Clinic, Barcelona, Spain
| | - R Martínez
- Department of Hematology, Hospital Clinico San Carlos, Madrid, Spain
| | - A-I Teruel
- Department of Hematology, Hospital Clinico Universitario de Valencia, Valencia, Spain
| | - N Gutiérrez
- Department of Hematology, Hospital Universitario, Salamanca, Spain
| | - M-L Martin-Ramos
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Oriol
- Department of Hematology, Hospital Germans Trias I Pujol, Badalona, Spain
| | - J Bargay
- Department of Hematology, Hospital Sont Llatzer,Palma de Mallorca, Spain
| | - J Bladé
- Department of Hematology, Hospital Clinic, Barcelona, Spain
| | - J San-Miguel
- Department of Hematology, Clinica Universidad de Navarra, Centro de Investigación Médica Aplicada (CIMA), IDISNA, Pamplona, Spain
| | - R Garcia-Sanz
- Department of Hematology, Hospital Universitario, Salamanca, Spain
| | - J-J Lahuerta
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
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Flores-Montero J, Sanoja-Flores L, Paiva B, Puig N, García-Sánchez O, Böttcher S, van der Velden VHJ, Pérez-Morán JJ, Vidriales MB, García-Sanz R, Jimenez C, González M, Martínez-López J, Corral-Mateos A, Grigore GE, Fluxá R, Pontes R, Caetano J, Sedek L, Del Cañizo MC, Bladé J, Lahuerta JJ, Aguilar C, Bárez A, García-Mateo A, Labrador J, Leoz P, Aguilera-Sanz C, San-Miguel J, Mateos MV, Durie B, van Dongen JJM, Orfao A. Next Generation Flow for highly sensitive and standardized detection of minimal residual disease in multiple myeloma. Leukemia 2017; 31:2094-2103. [PMID: 28104919 PMCID: PMC5629369 DOI: 10.1038/leu.2017.29] [Citation(s) in RCA: 406] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 12/24/2016] [Accepted: 01/03/2017] [Indexed: 12/20/2022]
Abstract
Flow cytometry has become a highly valuable method to monitor minimal residual disease (MRD) and evaluate the depth of complete response (CR) in bone marrow (BM) of multiple myeloma (MM) after therapy. However, current flow-MRD has lower sensitivity than molecular methods and lacks standardization. Here we report on a novel next generation flow (NGF) approach for highly sensitive and standardized MRD detection in MM. An optimized 2-tube 8-color antibody panel was constructed in five cycles of design-evaluation-redesign. In addition, a bulk-lysis procedure was established for acquisition of ⩾107 cells/sample, and novel software tools were constructed for automatic plasma cell gating. Multicenter evaluation of 110 follow-up BM from MM patients in very good partial response (VGPR) or CR showed a higher sensitivity for NGF-MRD vs conventional 8-color flow-MRD -MRD-positive rate of 47 vs 34% (P=0.003)-. Thus, 25% of patients classified as MRD-negative by conventional 8-color flow were MRD-positive by NGF, translating into a significantly longer progression-free survival for MRD-negative vs MRD-positive CR patients by NGF (75% progression-free survival not reached vs 7 months; P=0.02). This study establishes EuroFlow-based NGF as a highly sensitive, fully standardized approach for MRD detection in MM which overcomes the major limitations of conventional flow-MRD methods and is ready for implementation in routine diagnostics.
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Affiliation(s)
- J Flores-Montero
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL); Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain (USAL)
| | - L Sanoja-Flores
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL); Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain (USAL)
| | - B Paiva
- Clinica Universidad de Navarra; Applied Medical Research Center (CIMA), IDISNA, Pamplona, Spain (UNAV)
| | - N Puig
- Department of Hematology, University Hospital of Salamanca, IBSAL; IBMCC (USAL-CSIC), Salamanca, Spain (HUSAL)
| | - O García-Sánchez
- Department of Hematology, University Hospital of Salamanca, IBSAL; IBMCC (USAL-CSIC), Salamanca, Spain (HUSAL)
| | - S Böttcher
- Second Department of Medicine, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany (UNIKIEL)
| | - V H J van der Velden
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands (EMC)
| | - J-J Pérez-Morán
- Department of Hematology, University Hospital of Salamanca, IBSAL; IBMCC (USAL-CSIC), Salamanca, Spain (HUSAL)
| | - M-B Vidriales
- Department of Hematology, University Hospital of Salamanca, IBSAL; IBMCC (USAL-CSIC), Salamanca, Spain (HUSAL)
| | - R García-Sanz
- Department of Hematology, University Hospital of Salamanca, IBSAL; IBMCC (USAL-CSIC), Salamanca, Spain (HUSAL)
| | - C Jimenez
- Department of Hematology, University Hospital of Salamanca, IBSAL; IBMCC (USAL-CSIC), Salamanca, Spain (HUSAL)
| | - M González
- Department of Hematology, University Hospital of Salamanca, IBSAL; IBMCC (USAL-CSIC), Salamanca, Spain (HUSAL)
| | | | - A Corral-Mateos
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL); Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain (USAL)
| | | | - R Fluxá
- Cytognos SL, Salamanca, Spain
| | - R Pontes
- Faculty of Medicine, Federal University of Rio de Janeiro and Institute of Pediatrics and Childhood Care, Rio de Janeiro, Brazil
| | - J Caetano
- Department of Hematology, Portuguese Institute of Oncology, Lisbon, Portugal (IPOLFG)
| | - L Sedek
- Department of Pediatric Hematology and Oncology, Medical University of Silesia in Katowice, Zabrze, Poland (SUM)
| | - M-C Del Cañizo
- Department of Hematology, University Hospital of Salamanca, IBSAL; IBMCC (USAL-CSIC), Salamanca, Spain (HUSAL)
| | - J Bladé
- Department of Hematology, Hospital Clinic I Provincial, Barcelona, Spain
| | - J-J Lahuerta
- Department of Hematology, Hospital 12 de Octubre, Madrid, Spain
| | - C Aguilar
- Department of Hematology, Hospital General de Santa Bárbara, Soria, Spain
| | - A Bárez
- Department of Hematology, Complejo Asistencial de Ávila, Ávila, Spain
| | - A García-Mateo
- Department of Hematology, Complejo Asistencial de Segovia, Segovia, Spain
| | - J Labrador
- Hematology Department, Hospital Universitario de Burgos, Burgos, Spain
| | - P Leoz
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL); Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain (USAL)
| | - C Aguilera-Sanz
- Department of Hematology, Hospital El Bierzo, Ponferrada, Spain
| | - J San-Miguel
- Clinica Universidad de Navarra; Applied Medical Research Center (CIMA), IDISNA, Pamplona, Spain (UNAV)
| | - M-V Mateos
- Department of Hematology, University Hospital of Salamanca, IBSAL; IBMCC (USAL-CSIC), Salamanca, Spain (HUSAL)
| | - B Durie
- Cedars-Sinai Samuel Oschin Cancer Center, Los Angeles, CA, USA
| | - J J M van Dongen
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands (EMC).,Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
| | - A Orfao
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL); Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain (USAL)
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Hutter S, Baldi M, Firth C, León B, Käsbohrer A, Jimenez C. Seroprevalence and risk factors for equine arboviral infections (Eastern Equine Encephalomyelitis, Western Equine Encephalomyelitis, Venezuelan Equine Encephalomyelitis and West Nile Fever) in Costa Rica. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.11.151] [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: 11/29/2022] Open
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Lambert M, Hocké C, Jimenez C, Frantz S, Papaxanthos A, Creux H. Échecs répétés de fécondation in vitro : anomalies retrouvées sur le bilan diagnostique. ACTA ACUST UNITED AC 2016; 44:565-571. [DOI: 10.1016/j.gyobfe.2016.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/22/2016] [Indexed: 11/25/2022]
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Cambra MJ, Moreno F, Sanz X, Anglada L, Moià M, Reyes V, Arenas M, Pedro A, Ballester R, García V, Sanjosé S, Cusidó M, Jimenez C, Macià M, Solé JM, Farrus B. Abstract P5-17-08: Study of boost radiotherapy's influence on local control in 646 pure ductal carcinoma in situ breast cancer with long-term follow-up. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-17-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: Boost radiotherapy (B-RT) improves outcome in patients (pts) with invasive breast cancer. It's use in patients with pure ductal carcinoma in situ (DCIS) is unclear. There are two ongoing randomize trials, results are expected in ten years. Twelve retrospective observational studies have been published since 2006, the recent meta-analysis, support boost in the presence of positive margins.
PATIENTS and METHODS: We analyse a retrospective women's cohort of 646 pure DCIS patients (pts) treated mainly in two Hospitals (n=518) from 1993 to 2014. The other ten Hospitals included 128 pts all 2005 long. Proportions were compared by boost status, using the chi-square tests. The impact of boost radiation on the development of local recurrence (LR) was determined using survival analyses. In the comparison of Kaplan-Meier (K-M) was used log-rank test.
RESULTS: B-RT subgroup is 394 pts (61%), noB-RT 252 (39%). Median follow-up (FU) is 8.8 years. High risk factors: young age, size, margin status and tamoxifen (TMX) show differences among B-RT (p<0.05). 46% were Estrogen Receptor positive (ER+), 30% B-RT and 16% noB-RT. 22% RE+ in B-RT take TMX vs 9.4 % RE+ noB-RT. Total LR 65 (10%). In situ LR 30 pts (4,6%) and Invasive (Inv) 35 (5,4%). By subgroup, LR in B-RT 47 (12%) vs. 18 (7%) in noB-RT. By subtype, In situ LR in B-RT 20 (5.1%) vs. noB-RT 10 (4%). Inv LR in B-RT 27 (6.9%) vs. noB-RT 8 (3.2%). In uni & multivariate analysis, tumour size, Re-Excision, and TMX, are significant LR risk factors (p<0.05). Boost total doses >16 Gy in the B-RT subgroup is a LR significant risk factor related to 10-16 Gy (p∼0.05). TMX and Dose Boost are related (p<0.001). When Dose is introduced in multivariate analysis model, TMX lost signification. Contralateral local recurrence (CLR) in 29 pts (7%). Second tumours 9 pts (NSD between subgroups). Global disease free survival (DFS) is 80.5%, 77% in B-RT vs. 85% in noB-RT. Four pts have a LR combined with CLR; 2 pts have a LR and a second tumor; 1 pt with CLR and second tumour; 1 pt a Inv regional recurrence; 1 pt mixosarcoma in ipsilateral breast and lung metastases. Deaths: 3 pts (0.5%) after an Inv LR; 3 pts (0.5%) after Inv CR; 20 pts other causes; 10 pts lost their FU. Median FU in B-RT subgroup was 9y vs. 8.3y in noB-RT. The maximum FU according LR in B-RT is 20.6y vs. 17.4y in noB-RT. RL is not significant according to Boost (K-M p=0.398). Median LR in situ or inv depending of B-RT vs. noB-RT shows NSD (p=0.663).
CONCLUSIONS: In this large cohort retrospective study with long-term follow-up B-RT was associated with similar LR as noB-RT despite being used more frequently with higher risk disease. Dose boost >16 Gy has a protective effect. Tamoxifen and boost dose are related variables. Further evidence, based on ongoing randomized trials results is essential.
Citation Format: Cambra MJ, Moreno F, Sanz X, Anglada L, Moià M, Reyes V, Arenas M, Pedro A, Ballester R, García V, Sanjosé S, Cusidó M, Jimenez C, Macià M, Solé JM, Farrus B. Study of boost radiotherapy's influence on local control in 646 pure ductal carcinoma in situ breast cancer with long-term follow-up. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-17-08.
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Affiliation(s)
- MJ Cambra
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - F Moreno
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - X Sanz
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - L Anglada
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - M Moià
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - V Reyes
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - M Arenas
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - A Pedro
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - R Ballester
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - V García
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - S Sanjosé
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - M Cusidó
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - C Jimenez
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - M Macià
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - JM Solé
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - B Farrus
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
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Escudero J, Notario B, Jimenez C, Rodriguez-Perez MA. Characterization of nanoclay intercalation during foaming within situenergy-dispersive X-ray diffraction. J Appl Polym Sci 2016. [DOI: 10.1002/app.43432] [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: 11/11/2022]
Affiliation(s)
- J. Escudero
- Cellular Materials Laboratory, Condensed Matter Physics Department; University of Valladolid; Valladolid Spain
| | - B. Notario
- Cellular Materials Laboratory, Condensed Matter Physics Department; University of Valladolid; Valladolid Spain
| | - C. Jimenez
- Helmhotz-Zentrum Berlin; Hahn Meitner Platz 1 14109 Berlin Germany
| | - M. A. Rodriguez-Perez
- Cellular Materials Laboratory, Condensed Matter Physics Department; University of Valladolid; Valladolid Spain
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Harlaar J, Deerenberg EB, Dwarkasing RS, Kamperman AM, Jeekel J, Lange JF, Samartsev VA, Gavrilov VA, Kuchumov AG, Nyashin YI, Vildeman VE, Slovikov SV, Rubtsova EA, Parshakov AA, Morawski J, Miller A, Kallenberger G, Hannen C, Strey CW, Robin A, López-Monclús J, Melero D, Blazquez L, Moreno A, Palencia N, Cruz A, López-Quindós P, Aguilera A, Jimenez C, Becerra R, García M, Galván A, Gonzalez E, García-Ureña MA, Costa T, Abdalla R, Garcia R, Costa R, Williams Z, Kotwall C, Tenzel P, Alam N, Narang S, Pathak S, Daniels I, Smart N, Guérin G, Ordrenneau C, Bouré L, Turquier F, Abbonante F. Abdominal Wall "Closure". Hernia 2015; 19 Suppl 1:S123-6. [PMID: 26518787 DOI: 10.1007/bf03355338] [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: 11/28/2022]
Affiliation(s)
- J Harlaar
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - E B Deerenberg
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - R S Dwarkasing
- Department of Radiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - A M Kamperman
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - J Jeekel
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - J F Lange
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - V A Samartsev
- Perm State Medical University named after ac. E.A Wagner, Perm, Russia
| | - V A Gavrilov
- Perm State Medical University named after ac. E.A Wagner, Perm, Russia
| | - A G Kuchumov
- Perm National Research Polytechnical University, Perm, Russia
| | - Y I Nyashin
- Perm National Research Polytechnical University, Perm, Russia
| | - V E Vildeman
- Perm National Research Polytechnical University, Perm, Russia
| | - S V Slovikov
- Perm National Research Polytechnical University, Perm, Russia
| | - E A Rubtsova
- Perm State National Research University, Perm, Russia
| | - A A Parshakov
- Perm State Medical University named after ac. E.A Wagner, Perm, Russia
| | - J Morawski
- Diakoniekrankenhaus Friederikenstift, Hannover, Germany
| | - A Miller
- Diakoniekrankenhaus Friederikenstift, Hannover, Germany
| | | | - C Hannen
- Diakoniekrankenhaus Friederikenstift, Hannover, Germany
| | - C W Strey
- Diakoniekrankenhaus Friederikenstift, Hannover, Germany
| | - A Robin
- Hospital del Henares, Coslada (Madrid), Spain
| | | | - D Melero
- Hospital del Henares, Coslada (Madrid), Spain
| | - L Blazquez
- Hospital del Henares, Coslada (Madrid), Spain
| | - A Moreno
- Hospital del Henares, Coslada (Madrid), Spain
| | - N Palencia
- Hospital del Henares, Coslada (Madrid), Spain
| | - A Cruz
- Hospital del Henares, Coslada (Madrid), Spain
| | | | - A Aguilera
- Hospital del Henares, Coslada (Madrid), Spain
| | - C Jimenez
- Hospital del Henares, Coslada (Madrid), Spain
| | - R Becerra
- Hospital del Henares, Coslada (Madrid), Spain
| | - M García
- Hospital del Henares, Coslada (Madrid), Spain
| | - A Galván
- Hospital del Henares, Coslada (Madrid), Spain
| | - E Gonzalez
- Hospital del Henares, Coslada (Madrid), Spain
| | | | - T Costa
- University of Sao Paulo, Sao Paulo, Brazil
| | - R Abdalla
- University of Sao Paulo, Sao Paulo, Brazil
| | - R Garcia
- Hospital Sirio Libanes, Sao Paulo, Brazil
| | - R Costa
- Hospital Sirio Libanes, Sao Paulo, Brazil
| | - Z Williams
- New Hanover Regional Medical Center, Wilmington, USA
| | - C Kotwall
- New Hanover Regional Medical Center, Wilmington, USA
| | - P Tenzel
- New Hanover Regional Medical Center, Wilmington, USA
| | - N Alam
- HeSRU, Royal Devon and Exeter Hospital, Exeter, UK
| | - S Narang
- HeSRU, Royal Devon and Exeter Hospital, Exeter, UK
| | - S Pathak
- HeSRU, Royal Devon and Exeter Hospital, Exeter, UK
| | - I Daniels
- HeSRU, Royal Devon and Exeter Hospital, Exeter, UK
| | - N Smart
- HeSRU, Royal Devon and Exeter Hospital, Exeter, UK
| | | | | | | | | | - F Abbonante
- Department of Surgery-Plastic Surgery, Catanzaro City Hospital, Catanzaro, Italy
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Chansel-Debordeaux L, Dandieu S, Bechoua S, Jimenez C. Reproductive outcome in globozoospermic men: update and prospects. Andrology 2015; 3:1022-34. [DOI: 10.1111/andr.12081] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 06/24/2015] [Accepted: 06/26/2015] [Indexed: 01/24/2023]
Affiliation(s)
- L. Chansel-Debordeaux
- Service de Biologie de la Reproduction-CECOS; CHU de Bordeaux; Centre Aliénor d'Aquitaine; Bordeaux France
| | | | - S. Bechoua
- Service de Biologie de la Reproduction-CECOS; CHU de Dijon; Maternité du Bocage; Dijon France
| | - C. Jimenez
- Service de Biologie de la Reproduction-CECOS; CHU de Bordeaux; Centre Aliénor d'Aquitaine; Bordeaux France
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Jimenez C, Moreno, Eagle M, Mayhew A, James M, Straub V, Bushby K. Impact of three decades of improvement in standards of care for Duchenne muscular dystrophy. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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48
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San-Juan R, Navarro D, García-Reyne A, Montejo M, Muñoz P, Carratala J, Len O, Fortun J, Muñoz-Cobo B, Gimenez E, Eworo A, Sabe N, Meije Y, Martín-Davila P, Andres A, Delgado J, Jimenez C, Amat P, Fernández-Ruiz M, López-Medrano F, Lumbreras C, Aguado JM. Effect of long-term prophylaxis in the development of cytomegalovirus-specific T-cell immunity in D+/R- solid organ transplant recipients. Transpl Infect Dis 2015; 17:637-46. [PMID: 26134282 DOI: 10.1111/tid.12417] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 04/04/2015] [Accepted: 06/17/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND This study aimed to characterize the dynamics of acquisition of cytomegalovirus (CMV)-specific cell-mediated immunity (CMI) in CMV donor positive/recipient negative solid organ transplant (SOT) patients receiving long-term antiviral prophylaxis, and to determine whether development of CMI confers protection against CMV disease. METHODS A prospective multicenter study was conducted in Spain from September 2009 to September 2012. Whole blood specimens were prospectively collected at 30, 90, 120, 200, and 365 days after SOT, and CMI was determined by enumeration of CMV pp65 and IE-1-specific CD69(+) /interferon-γ-producing CD8(+) and CD4(+) T cells by flow cytometry for intracellular cytokine staining. As part of a simultaneous clinical trial, patients received either early prophylaxis (in the first 3 days after transplantation) in the first period of the study or delayed prophylaxis (initiated at day 14) during the second period of the study. The impact of the dynamics of acquisition of CMV-specific CMI on the incidence of CMV disease was evaluated by Kaplan-Meier survival analysis. RESULTS A total of 95 SOT recipients were recruited. CMV infection and disease occurred in 38 (40%) and 26 (27.4%) patients, respectively. The proportion of patients achieving any detectable CMV-specific CMI response at each of the different monitoring points was higher in liver transplant recipients, as compared to kidney or heart transplant recipients. The presence of any detectable response at day 120 or 200 was protective against the development of CMV disease (positive predictive values 92% and 93%, respectively). CONCLUSIONS The rate of acquisition of CMV-specific CMI in SOT recipients undergoing antiviral prophylaxis differed significantly between different SOT populations. Patients developing any detectable CMI response were protected against the occurrence of CMV disease.
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Affiliation(s)
- R San-Juan
- Unit of Infectious Diseases, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense, Madrid, Spain
| | - D Navarro
- Department of Microbiology, Hospital Clínico Universitario, Instituto de Investigación Sanitaria INCLIVA, Universidad de Valencia, Valencia, Spain
| | - A García-Reyne
- Unit of Infectious Diseases, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense, Madrid, Spain
| | - M Montejo
- Unit of Infectious Diseases, Hospital Universitario de Cruces, Bilbao, Spain
| | - P Muñoz
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - J Carratala
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - O Len
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Fortun
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - B Muñoz-Cobo
- Department of Microbiology, Hospital Clínico Universitario, Instituto de Investigación Sanitaria INCLIVA, Universidad de Valencia, Valencia, Spain
| | - E Gimenez
- Department of Microbiology, Hospital Clínico Universitario, Instituto de Investigación Sanitaria INCLIVA, Universidad de Valencia, Valencia, Spain
| | - A Eworo
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - N Sabe
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Y Meije
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - P Martín-Davila
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - A Andres
- Department of Nephrology, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense, Madrid, Spain
| | - J Delgado
- Unit of Heart Transplantation, Department of Cardiology, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense, Madrid, Spain
| | - C Jimenez
- Department of Abdominal Organ Transplantation and General and Digestive Surgery, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense, Madrid, Spain
| | - P Amat
- Department of Hematology and Medical Oncology, Hospital Clínico Universitario, Instituto de Investigación Sanitaria INCLIVA, Universidad de Valencia, Valencia, Spain
| | - M Fernández-Ruiz
- Unit of Infectious Diseases, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense, Madrid, Spain
| | - F López-Medrano
- Unit of Infectious Diseases, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense, Madrid, Spain
| | - C Lumbreras
- Unit of Infectious Diseases, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense, Madrid, Spain
| | - J M Aguado
- Unit of Infectious Diseases, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense, Madrid, Spain
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San-Juan R, Navarro D, García-Reyne A, Montejo M, Muñoz P, Carratala J, Len O, Fortun J, Muñoz-Cobo B, Gimenez E, Eworo A, Sabe N, Meije Y, Martin-Davila P, Andres A, Delgado J, Jimenez C, Amat P, Fernández-Ruiz M, López-Medrano F, Lumbreras C, Aguado JM. Effect of delaying prophylaxis against CMV in D+/R- solid organ transplant recipients in the development of CMV-specific cellular immunity and occurrence of late CMV disease. J Infect 2015; 71:561-70. [PMID: 26183297 DOI: 10.1016/j.jinf.2015.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Revised: 04/12/2015] [Accepted: 06/11/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Evaluate the protective effect against late CMV disease of delaying antiviral prophylaxis initiation in D+/R- patients receiving solid organ transplant (SOT). METHODS Prospective multicenter study in D+/R- SOT recipients in Spain (Sept/09-Sept/12). Whole blood specimens were prospectively collected after Tx for CMV-specific cell-mediated immunity (CMI) determination. Two prophylaxis strategies were compared: early prophylaxis (EP; starting within the first 3 days after Tx) and delayed prophylaxis (DP; starting 14 days after Tx). Risk factors for the occurrence of CMV disease were determined by survival analysis and proportional risk Cox regression models. RESULTS We included 95 patients (50 EP V 45 DP). Twenty six patients (27.4%) developed CMV disease: 32.7% EP vs. 20% DP; (p = 0.2). No cases of CMV disease were reported previously to beginning delayed prophylaxis. The percentage of individuals with detectable CMI response was higher in patients with DP although differences did not reach statistic significance (42% vs 29.6% at day 200 after Tx; p = 0.4). There was a clear trend towards less end-organ CMV disease in patients receiving DP (18.2% EP vs 5% DP; p = 0.09) and DP was the only protective factor in the multivariate analysis (HR: 0.26; CI: 0.05-1.2; p = 0.09). CONCLUSIONS A 14-day delay in CMV prophylaxis in D+/R- SOT recipients is safe and may reduce the incidence of late CMV end-organ disease although correlation of this effect with CMI responses was not complete.
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Affiliation(s)
- R San-Juan
- Unit of Infectious Diseases, Instituto de Investigación Hospital 12 de Octubre (i+12), University Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain.
| | - D Navarro
- Microbiology Service, Hospital Clínico Universitario, Fundación INCLIVA, Valencia, Spain
| | - A García-Reyne
- Unit of Infectious Diseases, Instituto de Investigación Hospital 12 de Octubre (i+12), University Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain
| | - M Montejo
- Unit of Infectious Diseases, University Hospital de Cruces, Bilbao, Spain
| | - P Muñoz
- Department of Clinical Microbiology and Infectious Diseases, University Hospital Gregorio Marañon, Madrid, Spain
| | - J Carratala
- Department of Infectious Diseases, Department of Infectious Diseases, University Hospital Bellvitge-IDIBELL, Universidad de Barcelona, Barcelona, Spain
| | - O Len
- Department of Infectious Diseases, University Hospital Vall d'Hebron, Barcelona, Spain
| | - J Fortun
- Infectious Diseases Unit, University Hospital Ramon y Cajal, Madrid, Spain
| | - B Muñoz-Cobo
- Microbiology Service, Hospital Clínico Universitario, Fundación INCLIVA, Valencia, Spain
| | - E Gimenez
- Microbiology Service, Hospital Clínico Universitario, Fundación INCLIVA, Valencia, Spain
| | - A Eworo
- Department of Clinical Microbiology and Infectious Diseases, University Hospital Gregorio Marañon, Madrid, Spain
| | - N Sabe
- Department of Infectious Diseases, Department of Infectious Diseases, University Hospital Bellvitge-IDIBELL, Universidad de Barcelona, Barcelona, Spain
| | - Y Meije
- Department of Infectious Diseases, University Hospital Vall d'Hebron, Barcelona, Spain
| | - P Martin-Davila
- Infectious Diseases Unit, University Hospital Ramon y Cajal, Madrid, Spain
| | - A Andres
- Nephrology Service, Kidney Transplant Unit, Instituto de Investigación Hospital 12 de Octubre (i+12), University Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain
| | - J Delgado
- Cardiology Service, Heart Transplant Unit, Instituto de Investigación Hospital 12 de Octubre (i+12), University Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain
| | - C Jimenez
- General Abdominal Surgery Service, Intra-abdominal Transplant Unit, Instituto de Investigación Hospital 12 de Octubre (i+12), University Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain
| | - P Amat
- Haematology Service, Hospital Clínico Universitario, Fundación INCLIVA, Valencia, Spain
| | - M Fernández-Ruiz
- Unit of Infectious Diseases, Instituto de Investigación Hospital 12 de Octubre (i+12), University Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain
| | - F López-Medrano
- Unit of Infectious Diseases, Instituto de Investigación Hospital 12 de Octubre (i+12), University Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain
| | - C Lumbreras
- Unit of Infectious Diseases, Instituto de Investigación Hospital 12 de Octubre (i+12), University Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain
| | - J M Aguado
- Unit of Infectious Diseases, Instituto de Investigación Hospital 12 de Octubre (i+12), University Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain
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Hughes N, Boss S, Longe R, Sohal P, Jimenez C, Maksymowych W, Marotta A. AB0079 Independent Validation of 14-3-3ETA Assay Reproducibility, Consistent with Omeract Soluble Biomarker Criteria. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2383] [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: 11/03/2022]
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