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Salinas-Roca B, Sánchez E, Bermúdez-López M, Valdivielso JM, Farràs-Sallés C, Pamplona R, Torres G, Mauricio D, Castro E, Fernández E, Hernández M, Rius F, Lecube A. Association between adherence to the mediterranean diet, physical activity, and sleep apnea-hypopnea syndrome (SAHS) in a middle-aged population with cardiovascular risk: Insights from the ILERVAS cohort. Sleep Med 2024; 116:19-26. [PMID: 38408422 DOI: 10.1016/j.sleep.2024.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/31/2024] [Accepted: 02/19/2024] [Indexed: 02/28/2024]
Abstract
INTRODUCTION Sleep Apnea-Hypopnea Syndrome (SAHS) is a common sleep disorder influenced by factors like age, gender, and obesity. The Mediterranean Diet (MedDiet) and physical activity have shown health benefits in lung diseases, but their effects on SAHS remain underexplored. METHODS In a cross-sectional analysis of 678 middle-aged individuals with low-to-moderate cardiovascular risk from the ILERVAS cohort, we assessed adherence to the MedDiet and physical activity levels using validated tools. Sleep parameters, SAHS severity, and excessive daytime sleepiness were evaluated through non-attended cardiorespiratory polygraphy and the Epworth Sleepiness Scale. Multinomial logistic regression models were employed to assess the relationship between MedDiet adherence, physical activity, and SAHS severity. RESULTS The prevalence of severe, moderate, and mild SAHS was 15.5%, 23.2% and 36.1%, respectively. We found no significant associations between adherence to the MedDiet, physical activity levels, and the presence or severity of SAHS. However, we noted a significant interaction between MedDiet and physical activity with minimum SpO2 values (p = 0.049). Notably, consuming more than one serving of red meat per day was independently associated with a higher risk of moderate SAHS [OR = 2.65 (1.29-5.44), p = 0.008]. CONCLUSION Individually, MedDiet adherence and physical activity did not show independent correlations with SAHS. However, when considered together, a minimal but significant effect on minimum SpO2 was observed. Additionally, red meat consumption was associated with a moderate risk of SAHS. Further research is necessary to comprehend the intricate connections between lifestyle factors and sleep-breathing disorders, with a focus on personalized approaches for high-risk populations.
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Affiliation(s)
- Blanca Salinas-Roca
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain; Facultat de Ciències de la Salut-Universitat Ramón Llull Blanquerna, Barcelona, Spain
| | - Enric Sánchez
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain
| | - Marcelino Bermúdez-López
- Vascular and Renal Translational Research Group, IRBLleida. Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), Lleida, Spain; Department of Experimental Medicine, IRBLleida, University of Lleida, Lleida, Spain
| | - José Manuel Valdivielso
- Vascular and Renal Translational Research Group, IRBLleida. Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), Lleida, Spain
| | - Cristina Farràs-Sallés
- Centre d'Atenció Primària Cappont. Gerència Territorial de Lleida, Institut Català de la Salut. Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gorina (IDIAPJGol), Barcelona, Spain
| | - Reinald Pamplona
- Department of Experimental Medicine, IRBLleida, University of Lleida, Lleida, Spain
| | - Gerard Torres
- Respiratory Medicine Department, University Hospital Arnau de Vilanova and Santa María. Group of Translational Research in Respiratory Medicine, IRBLleida. University of Lleida, Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Dídac Mauricio
- Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau. Sant Pau Biomedical Research Institute (IIB Sant Pau). Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII). Madrid, Spain
| | - Eva Castro
- Vascular and Renal Translational Research Group, IRBLleida. Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), Lleida, Spain
| | - Elvira Fernández
- Vascular and Renal Translational Research Group, IRBLleida. Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), Lleida, Spain
| | - Marta Hernández
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain
| | - Ferran Rius
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain
| | - Albert Lecube
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain.
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Bruguera A, Egea-Cortés L, Mesías-Gazmuri J, Palacio-Vieira J, Forero CG, Miranda C, Saumoy M, Fernández E, Navarro G, Orti A, Miró JM, Casabona J, Reyes-Urueña J. Predictors of poor health-related quality of life among people living with HIV aged ≥60 years in the PISCIS cohort: Findings from the Vive+ project. HIV Med 2024; 25:424-439. [PMID: 38092529 DOI: 10.1111/hiv.13590] [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: 09/13/2023] [Accepted: 11/11/2023] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Advancements in and accessibility to effective antiretroviral therapy has improved the life expectancy of people living with HIV, increasing the proportion of people living with HIV reaching older age (≥60 years), making this population's health-related quality of life (HRQoL) more relevant. Our aim was to identify the determinants of poor HRQoL in people living with HIV aged ≥60 years and compare them with those of their younger counterparts. METHODS We used data from the 'Vive+' study, a cross-sectional survey conducted between October 2019 and March 2020, nested within the PISCIS cohort of people living with HIV in Catalonia and the Balearic Islands, Spain. We used the 12-item short-form survey (SF-12), divided into a physical component summary (PCS) and a mental component summary (MCS), to evaluate HRQoL. We used the least absolute shrinkage and selection operator for variable selection and used multivariable regression models to identify predictors. RESULTS Of the 1060 people living with HIV (78.6% males) who participated in the study, 209 (19.7%) were aged ≥60 years. When comparing older people living with HIV (≥60 years) and their younger counterparts, older people exhibited a worse PCS (median 51.3 [interquartile range {IQR} 46.0-58.1] vs. 46.43 [IQR 42.5-52.7], p < 0.001) but a similar MCS (median 56.0 [IQR 49.34-64.7] vs. 57.0 [IQR 48.9-66.3], p = 0.476). In the multivariable analysis, cognitive function correlated with a PCS (β correlation factor [β] -0.18, p = 0.014), and depressive symptoms and satisfaction with social role correlated with an MCS (β 0.61 and β -0.97, respectively, p < 0.001) in people living with HIV aged ≥60 years. CONCLUSION Depressive symptoms, poor cognitive function, and lower satisfaction with social roles predict poorer HRQoL in older people living with HIV. These factors need to be considered when designing targeted interventions.
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Affiliation(s)
- Andreu Bruguera
- Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine, and Public Health, Univ Autonoma de Barcelona, Badalona, Spain
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - L Egea-Cortés
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
| | - J Mesías-Gazmuri
- Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine, and Public Health, Univ Autonoma de Barcelona, Badalona, Spain
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
| | - J Palacio-Vieira
- Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine, and Public Health, Univ Autonoma de Barcelona, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - C G Forero
- Department of Medicine. School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat, Spain
| | - C Miranda
- Infectious Diseases, University Hospital Germans Trias i Pujol, Badalona, Spain
| | - M Saumoy
- HIV and STD Unit, Department of Infectious Diseases, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Spain
| | - E Fernández
- Infectious Diseases Service. Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - G Navarro
- HIV/AIDS Unit, Parc Taulí Hospital Universitario, Institut d'Ivestigació i Innovació Parc Tauli (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - A Orti
- Verge de la Cinta Hospital, Tortosa, Spain
| | - J M Miró
- Infectious Diseases Service. Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - J Casabona
- Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine, and Public Health, Univ Autonoma de Barcelona, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine, Univ Autónoma de Barcelona, Badalona, Spain
| | - J Reyes-Urueña
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
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Vila-Farinas A, Pérez-Rios M, Montes-Martinez A, Ruano-Ravina A, Forray A, Rey-Brandariz J, Candal-Pedreira C, Fernández E, Casal-Acción B, Varela-Lema L. Effectiveness of smoking cessation interventions among pregnant women: An updated systematic review and meta-analysis. Addict Behav 2024; 148:107854. [PMID: 37683574 DOI: 10.1016/j.addbeh.2023.107854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/08/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE To carry out a systematic review of systematic reviews with an update of the existing evidence relating to a broad range of smoking cessation interventions, including psycho-social, digital and pharmacologic interventions, for pregnant women. DATA-SOURCES Search was conducted in March 2022 in PubMed, EMBASE, and Cochrane in two stages: 1) a search of systematic reviews and meta-analyses, published from January 2012 through January 2022; 2) an update of those that fulfilled eligibility criteria reproducing the primary search strategy. STUDY ELIGIBILITY CRITERIA We selected randomized clinical trials (RCTs) that evaluated the effectiveness of pharmacological, digital, and psychosocial interventions in aged 18 years and over who were daily smokers, and compared these with routine care, less intense interventions or placebo. STUDY APPRAISAL AND SYNTHESIS METHODS Data from eligible studies were manually extracted by two authors and reviewed by a third. The quality of the reviews was evaluated using the AMSTAR scale, and risk of bias was measured with the Rob-2 tool and GRADE level of evidence. RESULTS The meta-analysis included 63 RCTs (n = 19849 women). The interventions found to be effective were: financial incentives (RR:1.77; 95%CI:1.21-2.58), counseling (RR:1.27; 95%CI:1.13-1.43) and long-term nicotine replacement therapy (NRT) (RR:1.53; 95%CI:1.16-2.01). Short-term NRT, bupropion, digital interventions, feedback, social support, and exercise showed no effectiveness. The GRADE level of evidence was moderate-to-high for all interventions, with the exception of long-term NRT. CONCLUSIONS Non-pharmacological interventions for smoking cessation are the most effective for pregnant women. The moderator analysis suggests that pregnant women of low socioeconomic status might benefit less from smoking cessation interventions than women of a high socioeconomic status. These women are usually heavier smokers that live in pro-smoking environments and could require more intensive and targeted interventions.
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Affiliation(s)
- A Vila-Farinas
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - M Pérez-Rios
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain.
| | - A Montes-Martinez
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain
| | - A Ruano-Ravina
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain
| | - Ariadna Forray
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - J Rey-Brandariz
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - C Candal-Pedreira
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - E Fernández
- Tobacco Control Unit, WHO Collaborating Center for Tobacco Control, Institut Català d'Oncologia (ICO), Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain; School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - B Casal-Acción
- Galician Agency for Health Knowledge Management (avalia-t; ACIS), Santiago de Compsotela, Spain
| | - L Varela-Lema
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain
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Rojo-López MI, Bermúdez-López M, Castro E, Farràs C, Torres G, Pamplona R, Lecube A, Valdivielso JM, Fernández E, Julve J, Castelblanco E, Franch-Nadal J, Alonso N, Granado-Casas M, Mauricio D. Low adherence to the Mediterranean diet is associated with increased prevalence and number of atherosclerotic plaques in the ILERVAS cohort. Atherosclerosis 2023; 380:117191. [PMID: 37586219 DOI: 10.1016/j.atherosclerosis.2023.117191] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 07/12/2023] [Accepted: 07/26/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND AND AIMS Current research on the association between dietary patterns and subclinical atherosclerotic disease (SAD) is still limited, and published results are inconsistent and often consist of small population sizes. We aimed to evaluate the association between the Mediterranean diet (MDiet) and SAD in a large cohort of Mediterranean individuals. METHODS This was a cross-sectional study that included 8116 subjects from the ILERVAS cohort. The presence of atherosclerotic plaques (AP) was assessed by ultrasound examination. Adherence to the MDiet was assessed using the 14-item Mediterranean Diet Adherence Score (MEDAS). Inclusion criteria were subjects with at least one cardiovascular risk factor. Exclusion criteria were a clinical history of diabetes, chronic kidney disease, or a prior cardiovascular event. Bivariable and multivariable models were performed. RESULTS Compared with subjects without SAD, participants with SAD were older and had a higher frequency of smoking habit, hypertension, dyslipidemia, HbA1c and waist circumference. The adjusted multivariable analysis showed that a higher MEDAS was associated with a lower risk of AP (incidence rate ratios [IRR] 0.97, 95% CI [0.96-0.98]; p<0.001). Furthermore, moderate or high adherence to the MDiet was associated with a lower number of AP compared with a low MDiet adherence (IRR 0.90, 95% CI [0.87-0.94]; p<0.001). In both models, female sex was associated with a lower risk of AP. CONCLUSIONS Our findings point to a potentially protective role of MDiet for SAD in a Mediterranean population with low-to-moderate cardiovascular risk. Further research is needed to establish a causal relationship between both variables.
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Affiliation(s)
- Marina Idalia Rojo-López
- Research Group of Endocrinology, Diabetes and Nutrition, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Marcelino Bermúdez-López
- Vascular and Renal Translational Research Group, IRBLleida, Renal Research Network (RedInRen, ISCIII), Lleida, Spain
| | - Eva Castro
- Vascular and Renal Translational Research Group, IRBLleida, Renal Research Network (RedInRen, ISCIII), Lleida, Spain
| | - Cristina Farràs
- Cappont Primary Care Center. Territorial Management of Lleida, Catalan Institute of Health, Barcelona, Spain; Research Support Unit Lleida, Jordi Gol i Gorina Primary Health Care Research Institute Foundation (IDIAPJGol), Barcelona, Spain
| | - Gerard Torres
- Department of Respiratory Medicine, Arnau de Vilanova University Hospital, Translational Research Group Respiratory Medicine, IRBLleida, University of Lleida, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Reinald Pamplona
- Department of Experimental Medicine, IRBLleida, University of Lleida, Lleida, Spain
| | - Albert Lecube
- Department of Endocrinology and Nutrition, Arnau de Vilanova University Hospital, Obesity and Metabolism Research Group (ODIM), IRBLleida, University of Lleida, Lleida, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - José Manuel Valdivielso
- Vascular and Renal Translational Research Group, IRBLleida, Renal Research Network (RedInRen, ISCIII), Lleida, Spain
| | - Elvira Fernández
- Vascular and Renal Translational Research Group, IRBLleida, Renal Research Network (RedInRen, ISCIII), Lleida, Spain
| | - Josep Julve
- Research Group of Endocrinology, Diabetes and Nutrition, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - Esmeralda Castelblanco
- Department of Internal Medicine, Endocrinology, Metabolism and Lipid Research Division, Washington University School of Medicine, St Louis, MO, 63110, USA; DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Josep Franch-Nadal
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain; DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Núria Alonso
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain; Endocrinology and Nutrition Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Minerva Granado-Casas
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain; Department of Nursing and Physiotherapy, Health Sciences Faculty, University of Lleida, Health Care Research Group (GRECS), IRBLleida, Lleida, Spain.
| | - Dídac Mauricio
- Research Group of Endocrinology, Diabetes and Nutrition, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain; DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Faculty of Medicine, University of Vic (UVIC/UCC), Vic, Spain.
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de la Pinta C, Sevillano D, Colmenares R, Barrio S, Olavarria A, Palomera A, Romera R, Cobos J, Muriel A, Fernández E, Perna LC, Albillos A, Sancho S. Are liver contour and bone fusion comparable to fiducials for IGRT in liver SBRT? Tech Innov Patient Support Radiat Oncol 2023; 27:100215. [PMID: 37744524 PMCID: PMC10511841 DOI: 10.1016/j.tipsro.2023.100215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 05/28/2023] [Accepted: 06/19/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Liver stereotactic body radiotherapy (SBRT) is increasingly being used to treat tumours. The purpose of this study was to compare the differences in patient positioning when using implanted fiducials as surrogates compared to alternative methods based on liver contour or bone registration. Material and methods Eighteen patients treated with SBRT who underwent a fiducial placement procedure were included. Fiducial guidance was our gold standard to guide treatment in this study. After recording the displacements, when fusing the planning CT and CBCT performed in the treatment unit using fiducials, liver contour and bone reference, the differences between fiducials and liver contour and bone reference were calculated. Data from 88 CBCT were analyzed. The correlation between the displacements found with fiducials and those performed based on the liver contour and the nearest bone structure as references was determined. The mean, median, variance, range and standard deviation of the displacements with each of the fusion methods were obtained. μ, Ʃ, and σ values and margins were obtained. Results Lateral displacements of less than 3 mm with respect to the gold standard in 92% vs. 62.5% of cases using liver contour and bone references, respectively, with 93.2% vs. 65.9% in the AP axis and SI movement in 69.3% vs. 51.1%. The errors μ, σ and Ʃ of the fusions with hepatic contour and bone reference in SI were 0.26 mm, 4 mm and 3 mm, and 0.8 mm, 5 mm and 3 mm respectively. Conclusion Our study showed that displacements were smaller with the use of hepatic contour compared to bone reference and comparable to those obtained with the use of fiducials in the lateral, AP and SI motion axes. This would justify that hepatic contouring can be a guide in the treatment of patients in the absence of fiducials.
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Affiliation(s)
- C. de la Pinta
- Radiation Oncology Department. IRYCIS. Ramón y Cajal Hospital. Crta Colmenar Viejo Km 9,100. 28034, Madrid, Spain
| | - D. Sevillano
- Medical Physics Department. Ramón y Cajal Hospital. IRYCIS, Crta Colmenar Viejo Km 9,100 28034, Madrid, Spain
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
| | - R. Colmenares
- Medical Physics Department. Ramón y Cajal Hospital. IRYCIS, Crta Colmenar Viejo Km 9,100 28034, Madrid, Spain
| | - S. Barrio
- Radiation Therapist. Ramón y Cajal Hospital. Crta Colmenar Viejo Km 9,100. 28034, Madrid, Spain
| | - A. Olavarria
- Radiology Department. Ramón y Cajal Hospital. Crta Colmenar Viejo Km 9,100. 28034, Madrid, Spain
| | - A. Palomera
- Radiology Department. Ramón y Cajal Hospital. Crta Colmenar Viejo Km 9,100. 28034, Madrid, Spain
| | - R. Romera
- Radiology Department. Ramón y Cajal Hospital. Crta Colmenar Viejo Km 9,100. 28034, Madrid, Spain
| | - J. Cobos
- Radiology Department. Ramón y Cajal Hospital. Crta Colmenar Viejo Km 9,100. 28034, Madrid, Spain
| | - A. Muriel
- Clinical Biostatistics Unit, Ramón y Cajal University Hospital, IRYCIS, CIBERESP. Universidad de Alcalá, Madrid, Spain
| | - E. Fernández
- Radiation Oncology Department. IRYCIS. Ramón y Cajal Hospital. Crta Colmenar Viejo Km 9,100. 28034, Madrid, Spain
| | - LC. Perna
- Pathology Department. Ramón y Cajal Hospital. Crta Colmenar Viejo Km 9,100. 28034, Madrid, Spain
| | - A. Albillos
- Dept of Gastroenterology. Hospital Universitario Ramón y Cajal. Universidad de Alcalá. IRYCIS. CIBEREHD., Madrid, Spain
| | - S. Sancho
- Radiation Oncology Department. IRYCIS. Ramón y Cajal Hospital. Crta Colmenar Viejo Km 9,100. 28034, Madrid, Spain
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Bermúdez-López M, Martí-Antonio M, Castro-Boqué E, Bretones MDM, Farràs C, Gonzalez J, Pamplona R, Lecube A, Mauricio D, Cambray S, Valdivielso JM, Fernández E. Cumulative tobacco consumption has a dose-dependent effect on atheromatosis burden and improves severe atheromatosis prediction in asymptomatic middle-aged individuals: The ILERVAS study. Atherosclerosis 2023; 375:75-83. [PMID: 37276714 DOI: 10.1016/j.atherosclerosis.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 04/26/2023] [Accepted: 05/01/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND AIMS Sex-specific impact of cumulative tobacco consumption (CTC) on atheromatosis extension and total plaque area remains unknown. We aimed to determine the impact of CTC in atheromatosis localization and burden. METHODS We performed a cross-sectional analysis in 8330 asymptomatic middle-aged individuals. 12-territory vascular ultrasounds in carotid and femoral arteries were performed to detect atheromatous plaque presence and to measure total plaque area. Adjusted regressions and conditional predictions by smoking habit or CTC (stratified in terciles as low (≤13.53), medium (13.54-29.3), and high (>29.3 packs-year)) were calculated. Severe atheromatosis (SA, ≥3 territories with atheroma plaque) was predicted with the Systematic COronary Risk Evaluation 2 (SCORE2) model. The improvement of SA prediction after adding CTC was evaluated. RESULTS CTC was associated with an increased risk of atheromatosis, stronger in femoral than in carotid artery, but similar in both sexes. A dose-dependent effect of CTC on the number of territories with atheroma plaque and total plaque area was observed. Addition of CTC to the SCORE2 showed a higher sensitivity, accuracy, and negative predictive value in males, and a higher specificity and positive predictive value in females. In both sexes, the new SCORE2-CTC model showed a significant increase in AUC (males: 0.033, females: 0.038), and in the integrated discrimination index (males: 0.072; females: 0.058, p < 0.001). Age and CTC were the most important clinical predictors of SA in both sexes. CONCLUSIONS CTC shows a dose-dependent association with atheromatosis burden, impacts more strongly in femoral arteries, and improves SA prediction.
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Affiliation(s)
- Marcelino Bermúdez-López
- Grupo de Investigación Translacional vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen. ISCIII), Lleida, Spain.
| | - Manuel Martí-Antonio
- Grupo de Investigación Translacional vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen. ISCIII), Lleida, Spain
| | - Eva Castro-Boqué
- Grupo de Investigación Translacional vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen. ISCIII), Lleida, Spain
| | - María Del Mar Bretones
- Grupo de Investigación Translacional vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen. ISCIII), Lleida, Spain
| | - Cristina Farràs
- Centre d'Atenció Primària Cappont. Gerència Territorial de Lleida, Institut Català de la Salut, Barcelona, Spain; Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gorina (IDIAPJGol), Barcelona, Spain
| | - Jessica Gonzalez
- Departament de Medicina Respiratòria, Hospital Universitari Arnau de Vilanova, Grup Recerca Translational Medicina Respiratòria, IRBLleida, Universitat de Lleida, Lleida, Spain; CIBER de enfermedades respiratorias (CIBERES), Madrid, Spain
| | - Reinald Pamplona
- Departament de Medicina Experimental, IRBLleida, Universitat de Lleida, Lleida, Spain
| | - Albert Lecube
- Departament d'Endocrinologia i Nutrició, Hospital Universitari Arnau de Vilanova, Grup de Recerca Obesitat i Metabolisme (ODIM), IRBLleida, Universitat de Lleida, Lleida, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Dídac Mauricio
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Departament d'Endocrinologia i Nutrició, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain; Faculty of Medicine, University of Vic & Central University of Vic, Vic, Spain
| | - Serafi Cambray
- Grupo de Investigación Translacional vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen. ISCIII), Lleida, Spain
| | - José Manuel Valdivielso
- Grupo de Investigación Translacional vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen. ISCIII), Lleida, Spain.
| | - Elvira Fernández
- Grupo de Investigación Translacional vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen. ISCIII), Lleida, Spain
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Ríos MP, López-Medina DC, Tort CG, Brandariz JR, Lema LV, Santiago-Pérez MI, Candal C, Montes A, López MJ, Dalmau R, Provencio M, Fernández E, Blanco A, Ravina AR. Mortality attributable to environmental tobacco smoke exposure in Spain in 2020. Arch Bronconeumol 2023; 59:305-310. [PMID: 36967344 DOI: 10.1016/j.arbres.2023.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 03/11/2023]
Abstract
INTRODUCTION AND OBJECTIVES Exposure to environmental tobacco smoke (ETS) is associated with increased mortality and morbidity. The objective of this study was to estimate the impact of ETS exposure in Spain on mortality in 2020 in the population aged 35 years and over. METHODS A method of estimating attributable mortality (AM) based on the prevalence of ETS exposure was applied. Prevalence data were obtained from a representative study conducted in Spain and the relative risks were derived from a meta-analysis. AM point estimates are presented along with 95% confidence intervals (95% CI), calculated using a bootstrap naive procedure. AM, both overall and by smoking habit, was estimated for each combination of sex, age group, and cause of death (lung cancer and ischemic heart disease). A sensitivity analysis was performed. RESULTS A total of 747 (95% CI 676-825) deaths were attributable to ETS exposure, of which 279 (95% CI 256-306) were caused by lung cancer, and 468 (95% CI 417-523) by ischemic heart disease. Three-quarters (75.1%) of AM occurred in men and 60.9% in non-smokers. When chronic obstructive pulmonary disease and cerebrovascular disease are included, the burden of AM is estimated at 2242 deaths. CONCLUSIONS ETS exposure is associated with 1.5% of all deaths from lung cancer and ischemic heart disease in the population aged 35 and over. These data underline the need for health authorities to focus on reducing exposure to ETS in all settings and environments.
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Bover J, Trinidad P, Jara A, Soler-Majoral J, Martín-Malo A, Torres A, Frazão J, Ureña P, Dusso A, Arana C, Graterol F, Romero-González G, Troya M, Samaniego D, D'Marco L, Valdivielso JM, Fernández E, Arenas MD, Torregrosa V, Navarro-González JF, Lloret MJ, Ballarín JA, Bosch RJ, Górriz JL, de Francisco A, Gutiérrez O, Ara J, Felsenfeld A, Canalejo A, Almadén Y. Silver jubilee: 25 years of the first demonstration of the direct effect of phosphate on the parathyroid cell. Nefrologia 2022; 42:645-655. [PMID: 36925324 DOI: 10.1016/j.nefroe.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 12/30/2021] [Indexed: 06/18/2023] Open
Abstract
Although phosphorus is an essential element for life, it is not found in nature in its native state but rather combined in the form of inorganic phosphates (PO43-), with tightly regulated plasma levels that are associated with deleterious effects and mortality when these are out of bounds. The growing interest in the accumulation of PO43- in human pathophysiology originated in its attributed role in the pathogenesis of secondary hyperparathyroidism (SHPT) in chronic kidney disease. In this article, we review the mechanisms by which this effect was justified and we commemorate the important contribution of a Spanish group led by Dr. M. Rodríguez, just 25 years ago, when they first demonstrated the direct effect of PO43- on the regulation of the synthesis and secretion of parathyroid hormone by maintaining the structural integrity of the parathyroid glands in their original experimental model. In addition to demonstrating the importance of arachidonic acid (AA) and the phospholipase A2-AA pathway as a mediator of parathyroid gland response, these findings were predecessors of the recent description of the important role of PO43- on the activity of the calcium sensor-receptor, and also fueled various lines of research on the importance of PO43- overload not only for the pathophysiology of SHPT but also in its systemic pathogenic role.
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Affiliation(s)
- Jordi Bover
- Servicio de Nefrología, Hospital Universitario Germans Trias i Pujol, RICORS, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain.
| | - Pedro Trinidad
- Departamento de Nefrología, HECMN siglo XXI, IMSS, Ciudad de México, México
| | - Aquiles Jara
- Departamento de Nefrología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jordi Soler-Majoral
- Servicio de Nefrología, Hospital Universitario Germans Trias i Pujol, RICORS, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain
| | - Alejandro Martín-Malo
- Unidad de Gestión Clinica Nefrología, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, España. Red Nacional de Investigación en Nefrología (REDinREN), Instituto de Salud Carlos III, Spain
| | - Armando Torres
- Servicio de Nefrología, Hospital Universitario de Canarias, Instituto de Tecnologías Biomédicas, Universidad de La Laguna, Tenerife, Spain
| | - João Frazão
- Department of Nephrology, Centro Hospitalar Universitário São João, Institute for Innovation and Health Research (I3S), Institute of Biomedical Engineering (INEB), Nephrology and Infectious Diseases Research Group, University of Porto, Porto, Portugal
| | - Pablo Ureña
- AURA Nord Saint Ouen Dialysis Service. Saint Ouen, France and Service d'Explorations Fonctionnelles Rénales, Hôpital Necker, Université Paris V, René Descartes, Paris, France
| | - Adriana Dusso
- Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St Louis, MO, USA
| | - Carolt Arana
- Departamento de Nefrología y Trasplante Renal, Hospital Clínic, Barcelona, España
| | - Fredzzia Graterol
- Servicio de Nefrología, Hospital Universitario Germans Trias i Pujol, RICORS, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain
| | - Gregorio Romero-González
- Servicio de Nefrología, Hospital Universitario Germans Trias i Pujol, RICORS, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain
| | - Maribel Troya
- Servicio de Nefrología, Hospital Universitario Germans Trias i Pujol, RICORS, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain
| | - Diana Samaniego
- Servicio de Nefrología, Hospital Universitario Germans Trias i Pujol, RICORS, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain
| | - Luis D'Marco
- CEU Cardenal Herrera University, Valencia, Spain
| | - José Manuel Valdivielso
- Vascular and Renal Translational Research Group, Biomedical Research Institute, IRBLLEIDA, Lleida, España. Red Nacional de Investigación en Nefrología (REDinREN, RETIC), Instituto de Salud Carlos III, Spain
| | - Elvira Fernández
- Vascular and Renal Translational Research Group, Biomedical Research Institute, IRBLLEIDA, Lleida, España. Red Nacional de Investigación en Nefrología (REDinREN, RETIC), Instituto de Salud Carlos III, Spain; Grupo de Investigación Traslacional Vascular y Renal, Fundación Renal Jaume Arnó, Lleida, Spain
| | | | - Vicente Torregrosa
- Departamento de Nefrología y Trasplante Renal, Hospital Clínic, Barcelona, España
| | - Juan F Navarro-González
- Unidad de Investigación y Servicio de Nefrología, Hospital Universitario Nuestra Señora de la Candelaria, Instituto Universitario de Tecnologías Biomédicas, Universidad de la Laguna, Santa Cruz de Tenerife, España. Red Nacional de Investigación en Nefrología (REDinREN, RICORS), Instituto de Salud Carlos III, Spain
| | - María Jesús Lloret
- Servicio de Nefrología, Fundació Puigvert, IIB Sant Pau, Barcelona, Spain
| | - J A Ballarín
- Servicio de Nefrología, Fundació Puigvert, IIB Sant Pau, Barcelona, Spain
| | - Ricardo J Bosch
- Unidad de Fisiología, Departamento de Biología de Sistemas, Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - José L Górriz
- Servicio de Nefrología, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, Valencia, Spain
| | | | - Orlando Gutiérrez
- Division of Nephrology, Department of Medicine, Universidad de Alabama en Birmingham, Birmingham USA
| | - Jordi Ara
- Servicio de Nefrología, Hospital Universitario Germans Trias i Pujol, RICORS, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain
| | - Arnold Felsenfeld
- Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System and David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Antonio Canalejo
- Departamento de Ciencias Integradas/Centro de Investigación RENSMA, Facultad de Ciencias Experimentales, Universidad de Huelva. Huelva, Spain
| | - Yolanda Almadén
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain
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Bermúdez-López M, Martí-Antonio M, Castro-Boqué E, Bretones MDM, Farràs C, Torres G, Pamplona R, Lecube A, Mauricio D, Valdivielso JM, Fernández E. Development and Validation of a Personalized, Sex-Specific Prediction Algorithm of Severe Atheromatosis in Middle-Aged Asymptomatic Individuals: The ILERVAS Study. Front Cardiovasc Med 2022; 9:895917. [PMID: 35928938 PMCID: PMC9344070 DOI: 10.3389/fcvm.2022.895917] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 03/14/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAlthough European guidelines recommend vascular ultrasound for the assessment of cardiovascular risk in low-to-moderate risk individuals, no algorithm properly identifies patients who could benefit from it. The aim of this study is to develop a sex-specific algorithm to identify those patients, especially women who are usually underdiagnosed.MethodsClinical, anthropometrical, and biochemical data were combined with a 12-territory vascular ultrasound to predict severe atheromatosis (SA: ≥ 3 territories with plaque). A Personalized Algorithm for Severe Atheromatosis Prediction (PASAP-ILERVAS) was obtained by machine learning. Models were trained in the ILERVAS cohort (n = 8,330; 51% women) and validated in the control subpopulation of the NEFRONA cohort (n = 559; 47% women). Performance was compared to the Systematic COronary Risk Evaluation (SCORE) model.ResultsThe PASAP-ILERVAS is a sex-specific, easy-to-interpret predictive model that stratifies individuals according to their risk of SA in low, intermediate, or high risk. New clinical predictors beyond traditional factors were uncovered. In low- and high-risk (L&H-risk) men, the net reclassification index (NRI) was 0.044 (95% CI: 0.020–0.068), and the integrated discrimination index (IDI) was 0.038 (95% CI: 0.029–0.048) compared to the SCORE. In L&H-risk women, PASAP-ILERVAS showed a significant increase in the area under the curve (AUC, 0.074 (95% CI: 0.062–0.087), p-value: < 0.001), an NRI of 0.193 (95% CI: 0.162–0.224), and an IDI of 0.119 (95% CI: 0.109–0.129).ConclusionThe PASAP-ILERVAS improves SA prediction, especially in women. Thus, it could reduce the number of unnecessary complementary explorations selecting patients for a further imaging study within the intermediate risk group, increasing cost-effectiveness and optimizing health resources.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [NCT03228459].
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Affiliation(s)
- Marcelino Bermúdez-López
- Grupo de Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
| | - Manuel Martí-Antonio
- Grupo de Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
| | - Eva Castro-Boqué
- Grupo de Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
| | - María del Mar Bretones
- Grupo de Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
| | - Cristina Farràs
- Centre d’Atenció Primària Cappont, Gerència Territorial de Lleida, Institut Català de la Salut, Barcelona, Spain
- Research Support Unit Lleida, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gorina (IDIAPJGol), Barcelona, Spain
| | - Gerard Torres
- Departament de Medicina Respiratòria, Hospital Universitari Arnau de Vilanova, Grup Recerca Translational Medicina Respiratòria, IRBLleida, Universitat de Lleida, Lleida, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Reinald Pamplona
- Departament de Medicina Experimental, IRBLleida, Universitat de Lleida, Lleida, Spain
| | - Albert Lecube
- Departament d’Endocrinologia i Nutrició, Hospital Universitari Arnau de Vilanova, Grup de Recerca Obesitat i Metabolisme (ODIM), IRBLleida, Universitat de Lleida, Lleida, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Dídac Mauricio
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Departament d’Endocrinologia i Nutrició, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - José Manuel Valdivielso
- Grupo de Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
- *Correspondence: José Manuel Valdivielso,
| | - Elvira Fernández
- Grupo de Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
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Prieto-Peña D, Loricera J, Castañeda S, Moriano C, Bernabéu P, Vela-Casasempere P, Narváez J, Aldasoro V, Maíz O, Fernández-López C, Freire González M, Melero R, Villa-Blanco I, González-Alvarez B, Solans-Laqué R, Callejas-Rubio JL, Fernández-Díaz C, Rubio Romero E, García Morillo S, Minguez M, Fernández-Carballido C, De Miguel E, Sanchez-Martin J, Fernández E, Melchor S, Salgado-Pérez E, Bravo B, Romero-Yuste S, Galíndez-Agirregoikoa E, Sivera F, Ferraz-Amaro I, Hidalgo C, Romero-Gómez C, Galisteo C, Moya P, Alvarez-Rivas N, Mendizabal J, Nieto González JC, De Dios JR, Andreu JL, Pérez de Pedro I, Revenga M, Alonso Valdivieso JL, Rosa RM, De la Morena I, Fernández-Llanio N, Labrador E, Roman-Ivorra JA, Ortiz-Sanjuán F, García-Valle A, Gallego A, Iñiguez C, Garrido-Puñal N, De la Torre R, López-González R, Collado P, Raya E, Navarro F, Mas AJ, Ordás C, Boquet MD, Velloso Feijoo ML, Campos Fernández C, Rúa-Figueroa I, Conesa A, Manrique Arija S, González-Gay MA, Blanco R. POS0804 TOCILIZUMAB IN LARGE-VESSEL GIANT CELL ARTERITIS AND TAKAYASU ARTERITIS: MULTICENTRIC OBSERVATIONAL COMPARATIVE STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundTocilizumab (TCZ) has shown to be effective for large vessel vasculitis including giant cell arteritis (GCA) and Takayasu arteritis (TAK) (1-5). However, LVV-GCA and TAK show different demographic and clinical features that may influence on TCZ therapeutic response.ObjectivesTo compare the effectiveness of TCZ in patients with LVV-GCA and patients with TAK.MethodsObservational multicenter study of patients with LVV-GCA and TAK who received TCZ. Outcome variables were: a) proportion of patients who achieved complete clinical improvement along with normalization of laboratory markers (CRP ≤0.5mg/dL and/or ESR ≤ 20 mm/1st hour) at 12 months b) complete improvement in imaging techniques. A comparative study between patients with LVV-GCA and TAK was performed.ResultsWe evaluated 70 LVV-GCA and 57 TAK patients who received TCZ. Main clinical and demographic characteristic are described in Table 1. Patients with TAK were younger, had longer disease duration, had received more commonly previous biologic therapy and were receiving higher doses of prednisone at baseline. TCZ intravenous administration was more common in TAK patients (80.7% vs 48.6%; p<0.01). Follow-up time after TCZ onset was similar in both groups. At 12 months, about 75% of patients achieved complete clinical improvement and ESR/CRP normalization in both groups. A follow-up imaging technique was performed in 37 LVV-GCA patients after a mean time of 12.9±6.0 months and 38 TAK patients after 9.5±5.0 months. Complete improvement in imaging techniques was only observed in 18.9% and 21.1% of patients with LVV-GCA and TAK, respectively (Figure 1).Table 1.LVV-GCA (n=70)TAK (n=57)pGeneral featuresAge (years), mean ± SD67.2 ± 10.540.5 ± 16.3< 0.01Sex (female), n (%)51 (72.9)49 (86)0.07Disease evolution before TCZ onset (months), median [IQR]5 [2-15]12 [3-37]<0.01Baseline laboratory parametersESR (mm/1st hour), median [IQR]32 [12.5-54.7]31 [10-52]0.82CRP (mg/dL), median [IQR]1.4 [0.5-2.4]1.4 [0.5-3.5]0.41Baseline prednisone dose (mg/day), median [IQR]15 [10-20]30 [15-50]< 0.01Previous therapyConventional DMARDs, n(%)45 (64.3)44(77.2)0.51Biologic therapy, n (%)0(0)12 (21.1)<0.01TCZ therapyIntravenous, n (%)34 (48.6)46 (80.7)< 0.01Combined with MTX, n(%)24 (34.3)24 (42.1)0.37Follow-up time after TCZ onset, median [IQR]20 [10-36]18 [7-41]0.73Complete clinical improvement and ESR/CRP normalization at 12 months, n/N (%)35/47 (74.4)30/39 (76.9)0.79Complete improvement in imaging techniques, n/N(%)7/37 (18.9)8/38 (21.1)0.85CRP: C-reactive protein; DMARDs: Disease-modifying anti-rheumatic drugs ESR: erythrocyte sedimentation rate; GCA: giant cell arteritis; IQR: interquartile range; LVV: large vessel; MTX: methotrexate; n: Number of patients; N: total number of patients: TCZ: tocilizumab; TAK:takayasuFigure 1.ConclusionThe effectiveness of TCZ was similar in patients with LVV-GCA and TAK, despite a more refractory disease in TAK patients. A discordance between clinical and imaging activity improvement was observed in both LVV-GCA and TAK, as reported in previous studies (3).References[1]Calderón-Goercke M, et al. Semin Arthritis Rheum 2019; 49:126-35. https://doi.org/10.1016/j.semarthrit.2019.01.003[2]Prieto-Peña D et al. Ther Adv Musculoskelet Dis. 2021;13:175. PMID: 34211589.[3]Prieto Peña D et al. Clin Exp Rheumatol. 2021;39 Suppl 129:69-75. PMID: 33253103.[4]González-Gay MA, et al. Expert Opin Biol Ther. 2019;19:65-72. doi: 10.1080/14712598.2019.1556256.[5]Prieto-Peña D, et al. Semin Arthritis Rheum. 2019;48(4):720-727. doi: 10.1016/j.semarthrit.2018.05.007Disclosure of InterestsNone declared
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Sánchez E, Kerkeni M, Hernández M, Gavaldà R, Rius F, Sauret A, Torres G, Bermúdez-López M, Fernández E, Castro-Boqué E, Purroy F, Mauricio D, Farràs-Sallés C, Buti M, Godoy P, Pamplona R, Lecube A. Weak Association between Skin Autofluorescence Levels and Prediabetes with an ILERVAS Cross-Sectional Study. Nutrients 2022; 14:nu14051102. [PMID: 35268075 PMCID: PMC8912766 DOI: 10.3390/nu14051102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/27/2022] [Accepted: 03/03/2022] [Indexed: 02/04/2023] Open
Abstract
A large body of evidence demonstrates a relationship between hyperglycemia and increased concentrations of advanced glycation end-products (AGEs). However, there is little information about subcutaneous AGE accumulation in subjects with prediabetes, and whether or not this measurement could assist in the diagnosis of prediabetes is unclear. A cross-sectional study was conducted in 4181 middle-aged subjects without diabetes. Prediabetes (n = 1444) was defined as a glycosylated hemoglobin (HbA1c) level between 39 and 47 mmol/mol (5.7 to 6.4%), and skin autofluorescence (SAF) measurement was performed to assess AGEs. A multivariable logistic regression model and receiver operating characteristic curve were used. The cohort consisted of 50.1% women with an age of 57 [52;62] years, a BMI of 28.3 [25.4;31.6] kg/m2, and a prevalence of prediabetes of 34.5%. Participants with prediabetes showed higher SAF than control participants (2.0 [1.7;2.2] vs. 1.9 [1.7;2.2], p < 0.001). However, HbA1c was not significantly correlated with SAF levels (r = 0.026, p = 0.090). In addition, the SAF level was not independently associated with prediabetes (OR = 1.12 (0.96 to 1.30)). Finally, there was no good cutoff point for SAF to identify patients with prediabetes (AUC = 0.52 (0.50 to 0.54), sensitivity = 0.61, and 1-specificity = 0.56). Given all of this evidence, we can conclude that although there is an increase in SAF levels in participants with prediabetes, the applicability and clinical relevance of the results is low in this population.
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Affiliation(s)
- Enric Sánchez
- Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.H.); (F.R.); (A.S.)
| | - Mohsen Kerkeni
- Laboratory of Research on Biologically Compatible Compounds, Faculty of Dental Medicine, University of Monastir, Monastir 5000, Tunisia;
| | - Marta Hernández
- Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.H.); (F.R.); (A.S.)
| | - Ricard Gavaldà
- Amalfi Analytics, Polytechnic University of Catalonia, 08034 Barcelona, Spain;
| | - Ferran Rius
- Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.H.); (F.R.); (A.S.)
| | - Ariadna Sauret
- Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.H.); (F.R.); (A.S.)
| | - Gerard Torres
- Precision Medicine in Chronic Diseases Group, IRBLleida, 25198 Lleida, Spain;
| | - Marcelino Bermúdez-López
- Vascular and Renal Translational Research Group, IRBLleida, 25198 Lleida, Spain; (M.B.-L.); (E.F.); (E.C.-B.)
- Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), 28029 Madrid, Spain
| | - Elvira Fernández
- Vascular and Renal Translational Research Group, IRBLleida, 25198 Lleida, Spain; (M.B.-L.); (E.F.); (E.C.-B.)
- Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), 28029 Madrid, Spain
| | - Eva Castro-Boqué
- Vascular and Renal Translational Research Group, IRBLleida, 25198 Lleida, Spain; (M.B.-L.); (E.F.); (E.C.-B.)
- Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), 28029 Madrid, Spain
| | - Francisco Purroy
- Stroke Unit, Clinical Neurosciences Group, University Hospital Arnau de Vilanova, IRBLleida, University of Lleida, 25198 Lleida, Spain; (F.P.); (P.G.)
| | - Dídac Mauricio
- Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Biomèdica Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain;
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Cristina Farràs-Sallés
- Applied Epidemiology Research Group, IRBLleida. Unitat de Suport a la Recerca Lleida, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 25198 Lleida, Spain; (C.F.-S.); (M.B.)
| | - Miquel Buti
- Applied Epidemiology Research Group, IRBLleida. Unitat de Suport a la Recerca Lleida, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 25198 Lleida, Spain; (C.F.-S.); (M.B.)
| | - Pere Godoy
- Stroke Unit, Clinical Neurosciences Group, University Hospital Arnau de Vilanova, IRBLleida, University of Lleida, 25198 Lleida, Spain; (F.P.); (P.G.)
| | - Reinald Pamplona
- Department of Experimental Medicine, IRBLleida, University of Lleida, 25198 Lleida, Spain;
| | - Albert Lecube
- Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.H.); (F.R.); (A.S.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-973-70-51-83; Fax: +34-973-70-51-89
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Purroy F, Sánchez E, Lecube A, Arqué G, Vicente-Pascual M, Mauri-Capdevila G, Torreguitart N, Hernández M, Barbé F, Fernández E, Pamplona R, Farràs C, Mauricio D, Bermúdez-López M. Prevalence and Predictors of Cerebral Microangiopathy Determined by Pulsatility Index in an Asymptomatic Population From the ILERVAS Project. Front Neurol 2022; 12:785640. [PMID: 34970215 PMCID: PMC8712482 DOI: 10.3389/fneur.2021.785640] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Little is known about the prevalence of cerebral microangiopathy (CM), which is related to cognitive impairment, in an asymptomatic population. Pulsatility index (PI) is an easily measurable parameter of cerebral vascular resistance in transcranial duplex of the middle cerebral artery (MCA) study. We aimed to determine the prevalence of CM measured by PI of MCA in low to moderate vascular risk subjects. Methods: We included 3,721 subjects between 45 and 70 years without previous history of vascular disease or diabetes mellitus and with at least one other vascular risk factor from the cross-sectional study ILERVAS (Lleida, Spain). Patients underwent transcranial duplex to determine MCA-PI. Possible CM was defined by MCA-PI >1.1. Carotid and femoral arteries ultrasound registration was done to determine the presence, the number, and the area of atheromatous plaques. Body mass index (BMI), pulse pressure (PP) and laboratory data were also recorded. Results: 439 (11.8%) subjects were excluded due to the low quality of transcranial duplex images. Median age was 57 [IQR 52, 62] years. Possible CM was found in 424 (12.9%) subjects. CM patients had higher prevalence of plaques than non-CM (77.4 vs. 66.4%, p < 0.001). PI showed a positive linear correlation with the number of territories with plaques (r = 0.130, p < 0.001), and the total plaque area (r = 0.082, p < 0.001). The predictors of possible CM were the age, male gender, and PP. Conclusions: In low-to-moderate vascular risk asymptomatic population, the proportion of abnormal brain microvascular bed determined by MCA-PI is not negligible. The planned 10-year follow-up will describe the clinical relevance of these findings.
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Affiliation(s)
- Francisco Purroy
- Stroke Unit, University Hospital Arnau de Vilanova, Lleida, Spain.,Clinical Neurosciences Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Enric Sánchez
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain.,Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, Lleida, Spain.,University of Lleida, Lleida, Spain
| | - Albert Lecube
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain.,Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, Lleida, Spain.,University of Lleida, Lleida, Spain.,CIBER de Diabetes y Enfermedades Metabólicas Asociadas, CIBERDEM, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Gloria Arqué
- Clinical Neurosciences Group, IRBLleida, University of Lleida, Lleida, Spain
| | | | - Gerard Mauri-Capdevila
- Stroke Unit, University Hospital Arnau de Vilanova, Lleida, Spain.,Clinical Neurosciences Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Núria Torreguitart
- Clinical Neurosciences Group, IRBLleida, University of Lleida, Lleida, Spain.,Vascular Surgery Service, University Hospital Arnau de Vilanova, Lleida, Spain
| | - Marta Hernández
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Lleida, Spain.,Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, Lleida, Spain.,University of Lleida, Lleida, Spain
| | - Ferrán Barbé
- Pneumology Service, Translational Research in Respiratory Medicine Research Group, IRBLleida, University Hospital Arnau de Vilanova, University of Lleida, Lleida, Spain.,CIBER de Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III (ISCIII), Lleida, Spain
| | - Elvira Fernández
- Vascular and Renal Translational Research Group, IRBLleida, ReinRen-ISCIII, University of Lleida, Lleida, Spain
| | - Reinald Pamplona
- Department of Experimental Medicine, Metabolic Pathophysiology Research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Cristina Farràs
- DAP Lleida, Unitat de Suport a la Recerca - IDIAP Jordi Gol, Lleida, Spain
| | - Dídac Mauricio
- Department of Endocrinology and Nutrition, CIBER of Diabetes and Associated Metabolic Diseases, Hospital de la Sant Creu i Sant Pau, Barcelona, Spain
| | - Marcelino Bermúdez-López
- Vascular and Renal Translational Research Group, IRBLleida, ReinRen-ISCIII, University of Lleida, Lleida, Spain
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Leandrin TP, Fernández E, Lima RO, Besegato JF, Escalante-Otárola WG, Kuga MC. Customized Fiber Post Improves the Bond Strength and Dentinal Penetrability of Resin Cementation System to Root Dentin. Oper Dent 2021; 47:E22-E34. [PMID: 34969119 DOI: 10.2341/20-117-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effect of fiber post customization on the bond strength (24 hours and 6 months), resin cement thickness, and dentinal penetrability of Adper Scotchbond Multi-Purpose - RelyX ARC (AS-RA), RelyX U200 (R2), and Scotchbond Universal - RelyX Ultimate (SU-RU) cementation systems to root dentin from the cervical-, middle-, and apical-thirds of the post space. METHODS One hundred twenty bovine incisors were endodontically treated. After post space preparation, the roots were divided into six groups, according to the luting protocols (AS-RA, R2, SU- RU) and the type of fiber post [noncustomized post (NC) and customized post (C)]. Customization procedures were peformed using a resin composite (Z350 XT). 24 hours (n=60) or 6 months later (n=60), specimens from the cervical-, middle-, and apical-thirds of the post space were submitted to cementation system thickness measurement, bond strength evaluation, and dentinal penetrability analysis with Confocal Laser Scanning Microscopy (CLSM). Failure mode was classified as adhesive, cohesive, or mixed. Data were submitted to ANOVA and Tukey tests (α=0.05). RESULTS Cementation protocols with customized fiber posts presented the lowest cementation system thickness, regardless of the cementation system or post space-third (p<0.05), and the highest bond strength values (p<0.05), regardless of the third space (p>0.05), for both periods (24 hours or 6 months). The comparison of push-out bond strength values between 24 hours and 6 months showed a reduction in all groups for the cervical-third (p<0.05). For the middle-third, only noncustomized groups showed reduction (p<0.05). For the apical-third, no reduction was observed (p>0.05). CONCLUSIONS Anatomical customization favored both the bond strength of cements to dentin and the dentinal penetrability, but with lower cementation system thickness, regardless of cement composition and adhesive strategy.
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Affiliation(s)
- T P Leandrin
- Thais Piragine Leandrin, DDS, MSc, PhD, Restorative Dentistry Department, Araraquara Dental School, Univ Estadual Paulista, Araraquara, São Paulo, Brazil
| | - E Fernández
- *Eduardo Fernández, DDS, PhD, Professor Titular, Universidad de Chile Facultad de Odontologia, Santiago, Chile and Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Providencia, Santiago, Chile
| | - R O Lima
- Reinaldo Oliveira Lima, DDS, MSc, PhD, Restorative Dentistry Department, Araraquara Dental School, Univ Estadual Paulista, Araraquara, São Paulo, Brazil
| | - J F Besegato
- João Felipe Besegato, DDS, MSc, PhD, Restorative Dentistry Department, Araraquara Dental School, Univ Estadual Paulista, Araraquara, São Paulo, Brazil
| | - W G Escalante-Otárola
- Wilfredo Gustavo Escalante-Otárola, DDS, MSc, PhD, NCCL Research Group, School of Dentistry, Faculty of Health Sciences, Jorge Basadre Grohmann National University-UNJBG, Tacna, Perú
| | - M C Kuga
- Milton Carlos Kuga, DDS, MSc, PhD, Restorative Dentistry Department, Araraquara Dental School, Univ Estadual Paulista, Araraquara, São Paulo, Brazil
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14
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Bermúdez-López M, Martínez-Alonso M, Castro-Boqué E, Betriu À, Cambray S, Farràs C, Barbé F, Pamplona R, Lecube A, Mauricio D, Purroy F, Valdivielso JM, Fernández E. Localización y carga de ateromatosis subclínica en población con un riesgo cardiovascular bajo-moderado: estudio ILERVAS. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.09.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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15
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Esteve-Pardo G, Esteve-Colomina L, Fernández E. A new inertial navigation system for guiding implant placement. An in-vitro proof-of-concept study. PLoS One 2021; 16:e0255481. [PMID: 34673786 PMCID: PMC8530356 DOI: 10.1371/journal.pone.0255481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 07/18/2021] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to assess the potential use of a new advanced inertial navigation system for guiding dental implant placement and to compare this approach with standard stereolithographic template guiding. A movement processing unit with a 9-axis absolute orientation sensor was adapted to a surgical handpiece and wired to a computer navigation interface. Sixty implants were placed by 10 operators in 20 jaw models. The 30 implants of the test group were placed in 10 models guided by the new inertial navigation prototype. The 30 implants of the control group were placed in another 10 models using a CAD-CAM template. Both groups were subdivided into experienced and non-experienced operators. Pre- and postoperative computer tomography images were obtained and matched to compare the planned and final implant positions. Four deviation parameters (global, angular, depth, and lateral deviation) were defined and calculated. The primary outcome was the angular deviation between the standard stereolithographic approach and the new inertial navigation system. Results showed no significant differences between both groups, suggesting that surgical navigation based on inertial measurement units (IMUs) could potentially be useful for guiding dental implant placement. However, more studies are still needed to translate this new approach into clinical practice.
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Affiliation(s)
- G. Esteve-Pardo
- Bioengineering Institute, Miguel Hernández University of Elche, Group Aula Dental Avanzada, Alicante, Spain
| | - L. Esteve-Colomina
- Bioengineering Institute, Miguel Hernández University of Elche, Group Aula Dental Avanzada, Alicante, Spain
| | - E. Fernández
- Bioengineering Institute, Miguel Hernández University of Elche and CIBER-BBN, Elche, Spain
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Díaz Y, Tabio D, Rondón M, Piloto-Rodríguez R, Fernández E. Phenomenological model for the prediction of Moringa oleifera extracted oil using a laboratory Soxhlet apparatus. grasasaceites 2021. [DOI: 10.3989/gya.0664201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Moringa oleifera is an oilseed crop with potential for biodiesel production. The second step in this process is the extraction of oil. Extraction in hot water, with a Soxhlet apparatus and the ultrasound technique are the most commonly used methods. The aim of the present work was to obtain a phenomenological model for the Moringa oleifera oil extraction process using Soxhlet. Effective diffusivity for Moringa oil through the kernels is obtained, using the kinetics of the extraction process (experimentally determined) and the Fick’s diffusion second law for non-steady state. The value of 0.685·10-12 m2/s fully matched reports on effective diffusion coefficient for other solids. It was also verified from the statistical analysis and a linear fit for experimental data that the model can be used to describe the oil extraction process of Moringa oleifera in the Soxhlet extractor, responding to the diffusive phenomenon (process controlled by internal resistance).
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Moran BM, Ziegelmann PK, Berger SB, Burey A, de Paris Matos T, Fernández E, Loguercio AD, Reis A. Evaluation of Tooth Sensitivity of In-office Bleaching with Different Light Activation Sources: A Systematic Review and a Network Meta-analysis. Oper Dent 2021; 46:E199-E223. [PMID: 35486507 DOI: 10.2341/20-127-l] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES A systematic review and network meta-analysis were performed to answer the following research question: Are there differences in the risk and the intensity of tooth sensitivity (TS) among eight light activation systems for in-office bleaching in adults? METHODS Randomized controlled trials (RCTs) that compared at least two different in-office bleaching light activations were included. The risk of bias (RoB) was evaluated with the RoB tool version 1.0 from the Cochrane Collaboration tool. A random-effects Bayesian mixed treatment comparison (MTC) model was used independently for high- and low-concentration hydrogen peroxide. The certainty of the evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach. A comprehensive search was performed in PubMed, Bridge Base Online (BBO), Latin American and Caribbean Health Sciences Literature database (LILACS), Cochrane Library, Scopus, Web of Science, and grey literature without date and language restrictions on April 23, 2017 (updated on September 26, 2019). Dissertations and theses, unpublished and ongoing trials registries, and IADR (International Association for Dental Research) abstracts (2001-2019) were also searched. RESULTS After title and abstract screening and the removal of duplicates, 32 studies remained. Six were considered to be at low RoB, three had high RoB, and the remaining had an unclear RoB. The MTC analysis showed no significant differences among the treatments in each network. In general, the certainty of the evidence was graded as low due to unclear RoB and imprecision. CONCLUSION There is no evidence that the risk and intensity of TS are affected by light activation during in-office bleaching.
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Affiliation(s)
- B M Moran
- *Bianca M Maran, DDS, MS, PhD, professor, Department of Restorative Dentistry, School of Dentistry, State University of Western Paraná, Cascavel, Paraná, Brazil; Postgraduate Program in Dentistry, School of Dentistry, University of North Paraná, Londrina, Paraná, Brazil
| | - P K Ziegelmann
- Patrícia K Ziegelmann, DDS, MS, PhD, associate professor, Statistics Department and Post-Graduation Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - S B Berger
- Sandrine Bittencourt Berger DDS, MS, PhD, professor, Department of Restorative Dentistry, School of Dentistry, University of North Paraná, Londrina, Paraná
| | - A Burey
- Adrieli Burey, DDS, MS, PhD student, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - T de Paris Matos
- Thalita de Paris Matos, DDS, MS, PhD student, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - E Fernández
- Eduardo Fernández, DDS, MS, PhD, professor, Department Restorative Dentistry, University of Chile, Santiago de Chile, Chile; Professor, Universidad Autónoma de Chile, Instituto de Investigaciones Biomédicas, Santiago de Chile Chile
| | - A D Loguercio
- Alessandro D Loguercio, DDS, MS, PhD, adjunct professor, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - A Reis
- Alessandra Reis, DDS, MS, PhD, adjunctive professor, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
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Pérez-Montero H, Godino O, Lozano A, Asiáin L, Martínez I, Sánchez JJ, de BlasFernández R, Fernández E, Stefanovic M, García N, Martínez J, Guedea F, Navarro-Martin A. Long-term outcomes of spinal SBRT. Is it important to select the treatment time? Clin Transl Oncol 2021; 24:276-287. [PMID: 34342817 DOI: 10.1007/s12094-021-02684-9] [Citation(s) in RCA: 3] [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: 03/10/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE SBRT (stereotactic body radiation therapy) is widely used as a curative treatment in tumoral lesions and has become a fundamental tool for the treatment of spine metastasis. In this study, we present survival and toxicity outcomes of spine SBRT after a 2-year follow-up. METHODS/PATIENTS Data from spine SBRT treatments performed at our institution between March 2012 and February 2020 was collected. Medical records, including demographic, primary tumor, and treatment characteristics were reviewed. Patient follow-up included clinical evaluation, imaging, and blood tests. Toxicity was recorded according to CTCAE v4.0. RESULTS We analyzed 73 consecutive spine SBRT treatments in 60 patients. 39.7% of the cases had primary breast cancer and 23.3% had prostate cancer. Most cases (87.7%) were treated with a single SBRT fraction of 16 Gy. Median follow-up was 26.1 months (range 1.7-78.6), and 1- and 2-year overall survival (OS) rates were 96.9% and 84.2%, respectively. Local control (LC) rates at 1- and 2-years were 76.3% and 70.6%, respectively. Multivariate analysis identified histology as a prognostic factor for both OS and LC. Patients who underwent spine SBRT 6 months after the spinal lesion diagnosis had LC at 2 years of 88%, vs 61.7% for those who underwent SBRT before this period. No grade III or higher toxicity was reported. The vertebral compression fracture (VCF) rate was 4.1%. CONCLUSION Spine SBRT at our institution showed a 2-year LC of 70.6%, without G3 toxicities. Delaying SBRT at least 6 months to administer systemic treatment was related to an improvement in local control.
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Affiliation(s)
- H Pérez-Montero
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - O Godino
- Neurosurgery Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - A Lozano
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - L Asiáin
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - I Martínez
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - J J Sánchez
- Radiodiagnostic Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - R de BlasFernández
- Medical Physics and Radiation Protection Department, Institut Català D'Oncologia, Barcelona, Spain
| | - E Fernández
- Physical Medicine and Rehabilitation Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - M Stefanovic
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - N García
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - J Martínez
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - F Guedea
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - A Navarro-Martin
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain.
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Martínez Fernández L, Sánchez-Alvarez JE, Morís de la Tassa C, Bande Fernández JJ, María V, Fernández E, Valdivielso JM, Betriu A. Risk factors associated with valvular calcification in patients with chronic kidney disease. Analysis of NEFRONA study. Nefrologia 2021; 41:337-346. [PMID: 36166249 DOI: 10.1016/j.nefroe.2021.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 08/14/2020] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Patients with chronic kidney disease (CKD) are at high risk of cardiovascular morbidity and mortality. Subclinical cardiac structural alterations have prognostic value in these patients. The aim was to analyse the prevalence of valvular calcification, the evolution and the relationship with different risk factors. MATERIAL AND METHODS Part of the sample of the NEFRONA study was randomly selected. Aortic and mitral valve calcification were analysed in echocardiograms performed at the baseline visit and at 24 months. RESULTS We included 397 patients, the estimated basal glomerular filtrate (eGFR) was 33 ml/min with significant decrease to 30.9 ml/min. There was an increase in the area of carotid and femoral plaque, as well as an increase in patients with aortic and mitral calcification at 24 months. A positive association of mitral calcification at 24 months with age, ankle-brachial index (ABI) and calcium-phosphorus product (CaxP) at baseline visit was observed, without association with eGFR. Aortic calcification at 24 months was positively associated with age, phosphorous and total carotid plaque area at baseline, with no relationship to eGFR. CONCLUSIONS A significant prevalence of valvular calcification was observed in patients with CKD without known cardiovascular disease.Two-year progression was observed independently of the eGFR. Patients with higher risk of mitral valve calcification were those with older age, higher ABI and CaxP product. Patients with a higher risk of aortic calcification were those with older age, higher phosphorous levels and larger area of carotid plaque. Identifying these higher risk patients would help to avoid future cardiovascular events intensifying follow-ups.
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Affiliation(s)
| | - J Emilio Sánchez-Alvarez
- Hospital Universitario de Cabueñes, Gijón, Asturias, Spain; Red de Investigación Renal (REDINREN), Spain
| | | | | | - Virtudes María
- Vascular and Renal Translational, Research Group, Institut de Recerca Biomèdica, Lleida, Spain
| | - Elvira Fernández
- Vascular and Renal Translational, Research Group, Institut de Recerca Biomèdica, Lleida, Spain
| | - Jose M Valdivielso
- Vascular and Renal Translational, Research Group, Institut de Recerca Biomèdica, Lleida, Spain
| | - Angels Betriu
- Vascular and Renal Translational, Research Group, Institut de Recerca Biomèdica, Lleida, Spain
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Dòria M, Betriu À, Belart M, Rosado V, Hernández M, Sarro F, Real J, Castelblanco E, Pacheco LR, Fernández E, Franch-Nadal J, Gratacòs M, Mauricio D. High Incidence of Adverse Outcomes in Haemodialysis Patients with Diabetes with or without Diabetic Foot Syndrome: A 5-Year Observational Study in Lleida, Spain. J Clin Med 2021; 10:jcm10071368. [PMID: 33810545 PMCID: PMC8037880 DOI: 10.3390/jcm10071368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/21/2021] [Accepted: 03/23/2021] [Indexed: 11/24/2022] Open
Abstract
Background: We evaluated whether, in subjects receiving haemodialysis (HD), the presence of diabetic foot syndrome (DFS) was associated with increased mortality compared with subjects with diabetes mellitus (DM) without DFS and with non-diabetic subjects. Methods: Retrospective, observational study in 220 subjects followed for six years. We calculated and compared the frequency and 5-year cumulative incidence of all-cause mortality, cardiovascular (CV) mortality, CV events, major adverse CV events (MACE), and new foot ulcer (FU) or amputation. We also examined prognostic factors of all-cause and CV mortality based on baseline characteristics. Results: DM patients had a 1.98 times higher probability of all-cause mortality than those without DM (p = 0.001) and 2.42 times higher likelihood of CV mortality and new FU or amputation (p = 0.002 and p = 0.008, respectively). In the DM cohort, only the risk of a new FU or amputation was 2.69 times higher among those with previous DFS (p = 0.021). In patients with DM, older age was the only predictor of all-cause and CV mortality (p = 0.001 and p = 0.014, respectively). Conclusions: Although all-cause and CV mortality were increased on HD subjects with DM, the presence of DFS did not modify the excess risk. Additional studies are warranted to further explore the impact of DFS in subjects with DM undergoing HD.
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Affiliation(s)
- Montserrat Dòria
- Department of Endocrinology & Nutrition, University Hospital Arnau de Vilanova and Santa Maria, 25198 Lleida, Spain; (M.D.); (V.R.); (M.H.); (L.R.P.)
- Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, 08041 Barcelona, Spain
| | | | | | - Verónica Rosado
- Department of Endocrinology & Nutrition, University Hospital Arnau de Vilanova and Santa Maria, 25198 Lleida, Spain; (M.D.); (V.R.); (M.H.); (L.R.P.)
| | - Marta Hernández
- Department of Endocrinology & Nutrition, University Hospital Arnau de Vilanova and Santa Maria, 25198 Lleida, Spain; (M.D.); (V.R.); (M.H.); (L.R.P.)
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation IRBLleida, University of Lleida, 25198 Lleida, Spain;
| | - Felipe Sarro
- Department of Nephrology, University Hospital Arnau de Vilanova and Santa Maria, 25198 Lleida, Spain;
| | - Jordi Real
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08006 Barcelona, Spain; (J.R.); (E.C.); (J.F.-N.); (M.G.)
- Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 08041 Barcelona, Spain
| | - Esmeralda Castelblanco
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08006 Barcelona, Spain; (J.R.); (E.C.); (J.F.-N.); (M.G.)
- Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 08041 Barcelona, Spain
| | - Linda Roxana Pacheco
- Department of Endocrinology & Nutrition, University Hospital Arnau de Vilanova and Santa Maria, 25198 Lleida, Spain; (M.D.); (V.R.); (M.H.); (L.R.P.)
| | - Elvira Fernández
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation IRBLleida, University of Lleida, 25198 Lleida, Spain;
| | - Josep Franch-Nadal
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08006 Barcelona, Spain; (J.R.); (E.C.); (J.F.-N.); (M.G.)
- Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 08041 Barcelona, Spain
- Primary Health Care Center Raval Sud, Gerència d’Atenció Primaria, Institut Català de la Salut, 08001 Barcelona, Spain
| | - Mònica Gratacòs
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08006 Barcelona, Spain; (J.R.); (E.C.); (J.F.-N.); (M.G.)
| | - Dídac Mauricio
- Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, 08041 Barcelona, Spain
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08006 Barcelona, Spain; (J.R.); (E.C.); (J.F.-N.); (M.G.)
- Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 08041 Barcelona, Spain
- Faculty of Medicine, University of Vic (UVIC/UCC), 08500 Vic, Spain
- Correspondence: ; Tel.: +34-935-565-661
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Sapiña-Beltrán E, Gracia-Lavedan E, Torres G, Gaeta AM, Paredes J, Mayoral A, Fernández E, Bermúdez-López M, Valdivielso JM, Farràs-Salles C, Pamplona R, Lecube A, de Batlle J, Barbé F, Dalmases M. Prevalence of Obstructive Sleep Apnoea and Its Association With Atherosclerotic Plaques in a Cohort of Subjects With Mild-Moderate Cardiovascular Risk. Arch Bronconeumol 2021; 58:490-497. [PMID: 33741145 DOI: 10.1016/j.arbres.2021.01.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Classic cardiovascular risk factors do not explain all the cardiovascular events. Obstructive sleep apnoea (OSA) has been proposed as a potential and prevalent cardiovascular risk factor. Our study aimed to describe the prevalence of OSA in a middle-aged cohort with mild-moderate cardiovascular risk and evaluate its association with atherosclerotic disease. METHODS This is an observational cross-sectional ancillary study of the ILERVAS project which was aimed to study subclinical arterial disease in a cohort with mild-moderate cardiovascular risk. In a sample of consecutive subjects, we performed a sleep study and evaluate OSA prevalence and its association with carotid and femoral atheroma plaques and atherosclerotic burden. RESULTS Overall, 966 subjects with a median age of 57 years (25-75th percentile; 52-62) and a body mass index (BMI) of 28.5kg/m2 (25.6-31.6) were included. Of these, 72.6% (69.7%-75.3%) had OSA (apnoea-hypopnoea index (AHI)≥5/h); 35.7% (32.8%-38.8%) had mild OSA (AHI 5-14.9/h) and 36.9% (33.9%-39.9%) had moderate/severe OSA (AHI≥15/h). Mean oxygen saturation and the percentage of time with oxygen saturation<90% (CT90) were associated with atherosclerotic burden (eβ (95%CI) 0.932 (0.892, 0.974); 1.005 (1.002, 1.009), respectively) and total plaque (OR (95%CI) 0.88 (0.797,0.971); 1.013 (1.004,1.021), respectively). No association with the AHI or oxygen desaturation index was found. CONCLUSIONS This study confirms a high prevalence of OSA in patients with mild-moderate cardiovascular risk and shows an association between atherosclerotic burden, total and femoral plaque with CT90 and mean oxygen saturation, suggesting the importance of OSA-related hypoxaemia in the induction of atherosclerotic disease.
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Affiliation(s)
- Esther Sapiña-Beltrán
- Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Universitat de Lleida, Av. Rovira Roure 80, 25198 Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, 28029 Madrid, Spain
| | - Esther Gracia-Lavedan
- Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Universitat de Lleida, Av. Rovira Roure 80, 25198 Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, 28029 Madrid, Spain
| | - Gerard Torres
- Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Universitat de Lleida, Av. Rovira Roure 80, 25198 Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, 28029 Madrid, Spain
| | - Anna M Gaeta
- Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Universitat de Lleida, Av. Rovira Roure 80, 25198 Lleida, Spain
| | - Judith Paredes
- Oxigen Salud, Homecare Provider, C/ Pere IV, 453, 08020 Barcelona, Spain
| | - Ana Mayoral
- Oxigen Salud, Homecare Provider, C/ Pere IV, 453, 08020 Barcelona, Spain
| | - Elvira Fernández
- Vascular and Renal Translational Research Group, IRBLleida, RedinRen-ISCIII, Av. Rovira Roure 80, 25198 Lleida, Spain
| | - Marcelino Bermúdez-López
- Vascular and Renal Translational Research Group, IRBLleida, RedinRen-ISCIII, Av. Rovira Roure 80, 25198 Lleida, Spain
| | - José Manuel Valdivielso
- Vascular and Renal Translational Research Group, IRBLleida, RedinRen-ISCIII, Av. Rovira Roure 80, 25198 Lleida, Spain
| | - Cristina Farràs-Salles
- Primary Care ABS Balàfia - Pardinyes - Secà de Sant pere, Av. Alcalde Recasens s/n, 25005 Lleida, Spain
| | - Reinald Pamplona
- Department of Experimental Medicine, University of Lleida-Lleida Biomedical Research Institute (UdL-IRBLleida), Av. Rovira Roure 80, 25198 Lleida, Spain
| | - Albert Lecube
- Endocrinology and Nutrition Department, Hospital Universitari Arnau de Vilanova, Obesity, Diabetes and Metabolism Research Group (ODIM), Institut de Recerca Biomèdica de Lleida (IRBLleida), Universitat de Lleida, Av. Rovira Roure 80, Lleida, Spain
| | - Jordi de Batlle
- Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Universitat de Lleida, Av. Rovira Roure 80, 25198 Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, 28029 Madrid, Spain
| | - Ferran Barbé
- Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Universitat de Lleida, Av. Rovira Roure 80, 25198 Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, 28029 Madrid, Spain
| | - Mireia Dalmases
- Hospital Universitari Arnau de Vilanova and Santa Maria, Group of Translational Research in Respiratory Medicine, IRB Lleida, Universitat de Lleida, Av. Rovira Roure 80, 25198 Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, 28029 Madrid, Spain.
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Martínez Fernández L, Sánchez-Alvarez JE, Morís de la Tassa C, Bande Fernández JJ, María V, Fernández E, Valdivielso JM, Betriu A. [Risk factors associated with valvular calcification in patients with chronic kidney disease. Analysis of NEFRONA Study]. Nefrologia 2020; 41:337-346. [PMID: 33358625 DOI: 10.1016/j.nefro.2020.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 08/04/2020] [Accepted: 08/14/2020] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Patients with chronic kidney disease (CKD) are at high risk of cardiovascular morbidity and mortality. Subclinical cardiac structural alterations have prognostic value in these patients. The aim was to analyse the prevalence of valvular calcification, the evolution and the relationship with different risk factors. MATERIAL AND METHODS Part of the sample of the NEFRONA study was randomly selected. Aortic and mitral valve calcification were analysed in echocardiograms performed at the baseline visit and at 24 months. RESULTS We included 397 patients, the estimated basal glomerular filtrate (eGFR) was 33ml/min with significant decrease to 30.9ml/min. There was an increase in the area of carotid and femoral plaque, as well as an increase in patients with aortic and mitral calcification at 24 months. A positive association of mitral calcification at 24 months with age, ankle-brachial index (ABI) and calcium-phosphorus product (CaxP) at baseline visit was observed, without association with eGFR. Aortic calcification at 24 months was positively associated with age, phosphorous and total carotid plaque area at baseline, with no relationship to eGFR. CONCLUSIONS A significant prevalence of valvular calcification was observed in patients with CKD without known cardiovascular disease.Two-year progression was observed independently of the eGFR. Patients with higher risk of mitral valve calcification were those with older age, higher ABI and CaxP product. Patients with a higher risk of aortic calcification were those with older age, higher phosphorous levels and larger area of carotid plaque. Identifying these higher risk patients would help to avoid future cardiovascular events intensifying follow-ups.
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Affiliation(s)
| | - J Emilio Sánchez-Alvarez
- Hospital Universitario de Cabueñes, Gijón, Asturias, España; Red de Investigación Renal (REDINREN), España
| | | | | | - Virtudes María
- Vascular and Renal Translational, Research Group, Institut de Recerca Biomèdica, Lleida, España
| | - Elvira Fernández
- Vascular and Renal Translational, Research Group, Institut de Recerca Biomèdica, Lleida, España
| | - José M Valdivielso
- Vascular and Renal Translational, Research Group, Institut de Recerca Biomèdica, Lleida, España
| | - Angels Betriu
- Vascular and Renal Translational, Research Group, Institut de Recerca Biomèdica, Lleida, España
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Fernández E, Morillo V, Salvador M, Santafé A, Beato I, Rodríguez M, Ferrer C. Hyperbaric oxygen and radiation therapy: a review. Clin Transl Oncol 2020; 23:1047-1053. [PMID: 33206332 DOI: 10.1007/s12094-020-02513-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 06/17/2020] [Accepted: 10/10/2020] [Indexed: 11/26/2022]
Abstract
About 5% of cancer patients treated with radiotherapy will have severe late-onset toxicity. Hyperbaric oxygen therapy (HBOT) has been used as a treatment for radiation injuries for decades, with many publications presenting data from small series or individual cases. Moreover, we know that the hypoxic areas of tumours are more resistant to radiation. HBOT increases the oxygen tension in tissues and, theoretically, it should enhance the efficiency of radiotherapy. To better understand how HBOT works, we carried out this bibliographic review. We found Grade B and C evidence that at pressures exceeding 2 absolute atmospheres (ata), HBOT reduced late-onset radiation injuries to the head and neck, bone, prostate and bladder. It also appeared to prevent osteoradionecrosis after exodontia in irradiated areas. Finally, HBOT at 2 ata increased the effectiveness of radiation in head and neck tumours and achieved promising results in the local control of high-grade gliomas.
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Affiliation(s)
- E Fernández
- Radiation Oncology Service, Provincial Hospital of Castellón, Avda. Dr. Clara 19, 12002, Castellón de la Plana, Spain.
| | - V Morillo
- Radiation Oncology Service, Provincial Hospital of Castellón, Avda. Dr. Clara 19, 12002, Castellón de la Plana, Spain
| | - M Salvador
- Hyperbaric Therapy Unit, General Hospital of Castellón, Castellón de la Plana, Spain
| | - A Santafé
- Radiation Oncology Service, Provincial Hospital of Castellón, Avda. Dr. Clara 19, 12002, Castellón de la Plana, Spain
| | - I Beato
- Radiation Oncology Service, Provincial Hospital of Castellón, Avda. Dr. Clara 19, 12002, Castellón de la Plana, Spain
| | - M Rodríguez
- Radiation Oncology Service, Provincial Hospital of Castellón, Avda. Dr. Clara 19, 12002, Castellón de la Plana, Spain
| | - C Ferrer
- Radiation Oncology Service, Provincial Hospital of Castellón, Avda. Dr. Clara 19, 12002, Castellón de la Plana, Spain
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Bermúdez-López M, Martínez-Alonso M, Castro-Boqué E, Betriu À, Cambray S, Farràs C, Barbé F, Pamplona R, Lecube A, Mauricio D, Purroy F, Valdivielso JM, Fernández E. Subclinical atheromatosis localization and burden in a low-to-moderate cardiovascular risk population: the ILERVAS study. ACTA ACUST UNITED AC 2020; 74:1042-1053. [PMID: 33162389 DOI: 10.1016/j.rec.2020.09.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 09/10/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION AND OBJECTIVES There is a discrepancy between risk assessment based on cardiovascular risk factors (CVRF) and atheromatosis burden. The objective was to identify the prevalence of subclinical diseases with common risk factors, such as atheromatosis, occult kidney disease, prediabetes, and diabetes in a middle-aged population with low-to-moderate cardiovascular risk; to assess the vascular distribution, and severity of subclinical atheromatosis. METHODS Randomized, interventional, longitudinal clinical trial. The intervention consisted of vascular ultrasound examination in the carotid and femoral arteries assessing 12 territories, combined with clinical, anthropometric, lifestyle, and biochemical parameters. Inclusion criteria consisted of women (aged 50-70 years) and men (aged 45-65 years) with at least 1 CVRF. Exclusion criteria consisted of a clinical history of diabetes, chronic kidney disease, or a prior CV event. Here, baseline characteristics of the ILERVAS cohort are shown. RESULTS A total of 8330 middle-aged asymptomatic participants, 50.7% women, were enrolled. The presence of 1-2 CVRF was found in 74.8% and adherence to the Mediterranean diet was low in 52.8%. Several previously unknown chronic diseases were diagnosed, such as dyslipidemia (21.1%), hypertension (15.3%), kidney disease (15.4%), obesity (10.6%), and diabetes (2.3%). Subclinical atheromatosis was found in 71.4% of participants, localized in common femoral (54.5%), carotid bifurcation (41.1%) and internal carotid (22%). Intermediate atheromatosis (2-3 territories with atheroma plaque) was found in 32.6%, and generalized atheromatosis (>3 territories) in 19.7. Total plaque area was higher in men (0.97 cm2 vs 0.58 cm2, P<.001). Total plaque area was also higher in the femoral artery, and increased with the number of CVRF. CONCLUSIONS Subclinical atheromatosis was highly prevalent in a middle-aged population with low-to moderate cardiovascular risk, with 1 in 5 participants having generalized atheromatosis. ClinicalTrials.gov Identifier: NCT03228459.
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Affiliation(s)
- Marcelino Bermúdez-López
- Grupo Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain.
| | - Montse Martínez-Alonso
- Unitat de Bioestadística, IRBLleida, Departament de Ciències Mèdiques Bàsiques, Universitat de Lleida, Lleida, Spain
| | - Eva Castro-Boqué
- Grupo Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
| | - Àngels Betriu
- Grupo Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
| | - Serafí Cambray
- Grupo Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
| | - Cristina Farràs
- Centre d'Atenció Primària Cappont, Gerència Territorial de Lleida; Institut Català de la Salut, Unitat de Suport a la Recerca Lleida, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Ferran Barbé
- Departament de Medicina Respiratòria, Hospital Universitari Arnau de Vilanova, Grup Recerca Translacional Medicina Respiratòria, IRBLleida, Universitat de Lleida, Lleida, Spain
| | - Reinald Pamplona
- Departament de Medicina Experimental, IRBLleida, Universitat de Lleida, Lleida, Spain
| | - Albert Lecube
- Departament d'Endocrinologia i Nutrició, Hospital Universitari Arnau de Vilanova, Grup de Recerca Obesitat i Metabolisme (ODIM), IRBLleida, Universitat de Lleida, Lleida, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - Dídac Mauricio
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Departament d'Endocrinologia i Nutrició, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Francisco Purroy
- Unitat Ictus, Hospital Universitari Arnau de Vilanova, Grup Neurosciències Clíniques, IRBLleida, Universitat de Lleida, Lleida, Spain
| | - José Manuel Valdivielso
- Grupo Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain.
| | - Elvira Fernández
- Grupo Investigación Translacional Vascular y Renal, IRBLleida, Red de Investigación Renal (RedInRen-ISCIII), Lleida, Spain
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Estay J, Angel P, Bersezio C, Tonetto M, Jorquera G, Peña M, Fernández E. The change of teeth color, whiteness variations and its psychosocial and self-perception effects when using low vs. high concentration bleaching gels: a one-year follow-up. BMC Oral Health 2020; 20:255. [PMID: 32917192 PMCID: PMC7488418 DOI: 10.1186/s12903-020-01244-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 09/02/2020] [Indexed: 11/29/2022] Open
Abstract
Background Dental bleaching in traditional concentrations generates greater sensitivity. In this respect, new systems of lower concentration of hydrogen peroxide for tooth bleaching appeared, with color stability unknown over time. The aim of this study was to compare the change and stability of color with low-concentration (6%) hydrogen peroxide gel in an in-office bleaching setting relative to conventional 37.5% gel, including their effects on psychosocial and esthetic self-perception, after 1 year. Methods Patients (n = 25) were assessed at 12 months post bleaching treatment (whitening with 6% chemo-activated alkaline formula gel versus 37.5% traditional concentration gel). Color changes were measured objectively using total variation in color (ΔE), and subjectively using Vita Classical and Vita Bleached scale (ΔSGU) by calibrated evaluators (Kappa = 0.85). The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and Oral Health Impact Profile (OHIP-14) aesthetic questionnaires were used to measure the self-perception and the psychosocial impact of the bleaching protocols. Results The effect (ΔE) of 37.5% HP (8.37 ± 2.73) was significantly better than that of 6% HP (5.27 ± 2.53) in terms of color rebound after 1 year of follow-up. There were significant differences in psychosocial impact and esthetic self-perception measurements prior to bleaching versus one-year post-whitening time points; positive effects were maintained. Conclusions Low concentration (6%) achieved effective bleaching with good stability after 1 year, accompanied by a positive psychosocial impact and enhanced self-perception at follow-up. Trial registration NCT03217994 (before enrollment of the first participant). Data register: July 14, 2017.
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Affiliation(s)
- J Estay
- Department of Restorative Dentistry - Faculty of Dentistry, University of Chile, Sergio Livingstone Pohlhammer 943, Independencia, Santiago, Chile
| | - P Angel
- Department of Restorative Dentistry - Faculty of Dentistry, University of Chile, Sergio Livingstone Pohlhammer 943, Independencia, Santiago, Chile
| | - C Bersezio
- Department of Restorative Dentistry - Faculty of Dentistry, University of Chile, Sergio Livingstone Pohlhammer 943, Independencia, Santiago, Chile
| | - M Tonetto
- Postgraduate Program in Integrated Dental Sciences, University of Cuiabá, Cuiabá, Brazil
| | - G Jorquera
- Department of Prosthodontics, College of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - M Peña
- Department of Restorative Dentistry - Faculty of Dentistry, University of Chile, Sergio Livingstone Pohlhammer 943, Independencia, Santiago, Chile
| | - E Fernández
- Department of Restorative Dentistry - Faculty of Dentistry, University of Chile, Sergio Livingstone Pohlhammer 943, Independencia, Santiago, Chile. .,Instituto de Ciencias Biomédicas - Universidad Autónoma de Chile, Av. Pedro de Valdivia 425, Providencia, Santiago, Chile.
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Bielsa-Gracia S, Lou LM, Gimeno JA, Gracia-García O, López-Alejaldre I, Fernández E. Fenotipo de Cintura Hipertrigliceridémica en la población con Enfermedad Renal Crónica. Cohorte NEFRONA. Nefrologia 2020; 40:514-521. [DOI: 10.1016/j.nefro.2019.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 11/20/2019] [Accepted: 12/10/2019] [Indexed: 10/24/2022] Open
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Palau V, Riera M, Duran X, Valdivielso JM, Betriu A, Fernández E, Pascual J, Soler MJ. Correction Details. Nephrol Dial Transplant 2020; 35:1642. [PMID: 31106367 DOI: 10.1093/ndt/gfz110] [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: 11/13/2022] Open
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Palau V, Riera M, Duran X, Valdivielso JM, Betriu A, Fernández E, Pascual J, Soler MJ. Circulating ADAMs are associated with renal and cardiovascular outcomes in chronic kidney disease patients. Nephrol Dial Transplant 2020; 35:130-138. [PMID: 30102333 DOI: 10.1093/ndt/gfy240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 06/11/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND A disintegrin and metalloproteinase (ADAM) 17, also known as tumour necrosis factor α-converting enzyme (TACE), is a metalloproteinase that releases the ectodomains of most growth factors, cytokines, receptors and enzymes and has been associated with the presence of chronic kidney disease (CKD) and cardiovascular (CV) disease. The role of circulating ADAMs in the progression of renal function and CV events in CKD patients is unknown. METHODS A total of 2570 subjects from an observational and multicentre study with CKD Stages 3-5, CKD Stage 5D and controls without any history of CV disease were studied. Circulating ADAM activity was assessed using a fluorometric technique. Progression of renal disease was defined as a 30% increase in serum creatinine or dialysis requirement after 24 months of follow-up. CV outcomes were assessed after 48 months of follow-up. RESULTS Patients with advanced CKD had higher ADAM activity as compared with patients with moderate CKD or controls. Male patients with progression of CKD had higher ADAM levels at baseline compared with patients with stable renal function {22.19 relative fluorescence units/μL/h [95% confidence interval (CI) 11.22-37.32] versus 12.15 (7.02-21.50)}. After multivariate adjustment, higher ADAM activity was identified as a risk factor for progression of CKD in male patients [30% increase in the creatinine odds ratio (OR) 2.72 (95% CI 1.58-4.68), P < 0.001; dialysis requirement OR 3.00 (95% CI 1.65-5.46), P < 0.001; dialysis requirement or 30% increase in the creatinine OR 3.15 (95% CI 2.06-4.81), P < 0.001]. ADAM activity was also identified as an independent risk factor for CV events [hazard ratio (HR) 1.68 (95% CI 1.20-2.36), P = 0.003]. CONCLUSIONS High ADAMs activity levels are independently associated with CKD progression in males and with CV events in CKD patients.
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Affiliation(s)
- Vanesa Palau
- Department of Nephrology, Hospital del Mar-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Marta Riera
- Department of Nephrology, Hospital del Mar-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Xavier Duran
- Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - José Manuel Valdivielso
- Unit for Detection and Treatment of Atherothrombotic Diseases, Experimental Nephrology Laboratory, Arnau de Vilanova University Hospital, Biomedical Research Institute of Lleida, Lleida, Spain
| | - Angels Betriu
- Unit for Detection and Treatment of Atherothrombotic Diseases, Experimental Nephrology Laboratory, Arnau de Vilanova University Hospital, Biomedical Research Institute of Lleida, Lleida, Spain
| | - Elvira Fernández
- Unit for Detection and Treatment of Atherothrombotic Diseases, Experimental Nephrology Laboratory, Arnau de Vilanova University Hospital, Biomedical Research Institute of Lleida, Lleida, Spain
| | - Julio Pascual
- Department of Nephrology, Hospital del Mar-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Maria José Soler
- Department of Nephrology, Hospital del Mar-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
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Fernández E, Tornero C, Navarro-Compán V, Bonilla G, Plasencia C, Balsa A, Aguado P. AB0925 MULTIPLE FRACTURES DUE TO IRON-INDUCED AND FGF23-MEDIATED HYPOPHOSPHATAEMIC OSTEOMALACIA: AN UNKNOWN ADVERSE EFFECT. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The use of a specific and widely used type of intravenous ferrotherapy, ferric carboxymaltose (FCM), has been linked to the development of an asymptomatic and transient hypophosphataemia. However, in recent years it has been published that it can generate a severe hypophosphataemic osteomalacia (HPO) mediated by fibroblast growth factor 23 (FGF23) that is associated with high morbidity1. It is a potentially serious adverse effect whose prevalence is unknown and that clinicians may know little about.Objectives:To know the clinical and biochemical characteristics of this adverse effect and make it visible in the medical community.Methods:Observational descriptive study of three cases of patients assessed in the Rheumatology department of our hospital who were referred for study of recurrent fractures and diagnosed of FGF23-mediated HPO due to FCM. Demographic, clinical and laboratory data of the patients are described.Results:The clinical and laboratory characteristics of the patients are shown in table 1. All patients presented clinical and biochemical features compatible with FGF23-mediated HPO (mean of FGF levels 240 kRU/L, NR 0-145). All had multiple insufficiency fractures (Fx) and/or avascular necrosis (AN), with hip involvement in all 3 cases. Other causes of HPO were ruled out in all of them using PET18F-FDG, octreotide scintigraphy, abdominal magnetic resonance and PET68Ga-DOTATOC, and a genetic study of hypophosphataemic rickets was also performed in case 1. In all patients FCM was discontinued and phosphate levels were progressively normalized allowing the withdrawal of oral phosphate and calcitriol replacement therapy. After metabolic normalization, none presented new Fx or AN.Table 1.Clinical and biochemical characteristics of the patientsCase 1Case 2Case 3Age (years)a367543Medical historyCrohn’s disease (CD), right hemicolectomy. CD-associated spondyloarthritisSmall bowel angiodysplasiasAntisintetase syndrome. Uterine fibroids.Cause of anemiaGastrointestinal bleeding and malabsorptionGastrointestinal bleedingGynecological bleedingFe-CBX start date10/201008/201302/2018Fe-CBX discontinuation date10/201811/201806/2018Total time Fe-CBX (months)96634FracturesAN: left calcaneus posterior tuberosity, astragaline dome, right femoral headFx: left talus, tibial pylon, tibia-astragaline and ischiopubial branch; right 2nd metatarsal, distal tibia, posterior tuberosity of calcaneusFx both femoral necks and right sacral wingAN both femoral headsBone densitometryLS: Z-score-2.4FN: Z-score -2.4LS: Z-score -0.5FN: Z-score -1.3Phosphate, mg/dL (NR 2.5-4.5)a1.81.61.3Calcium, mg/dL (NR 8.6-10.2)a9.18.39.01,25(OH)zD3, ng/ml (NR 30-100)a54127PTH, pg/ml (NR 12-65)a71223104AP, UI/L (NR 46-116)a11314086Ph-exc, mg/24h (NR 400-1300)a16091630489TPR, % (NR 73-87)a58.350.270.7FGF-23, kRU/L (NR 0-145)a183335201Time to normalizationb1048aDuring treatment with FCM.bOf serum phosphate levels since FCM discontinuation in months. LS: Lumbar spine. FN: Femoral neck. NR: Normality range..PTH: Parathyroid hormone. AP: Alkaline phosphatase. Ph-exc: 24-hour urine phosphate excretion. Ph-cl: phosphate clearance. TPR: Tubular phosphate reabsorption. Data highlighted in bold indicate altered values.Conclusion:Treatment with FCM can cause severe FGF23-mediated HPO, multiple fractures and a great decrease in the quality of life. Since it can be potentially serious and easily reversible, it is important to favor the dissemination of these new cases and the knowledge of this disease. The need to monitor phosphate and/or FGF23 levels in patients receiving this intravenous iron therapy should be evaluated.References:[1]Bishay RH, Ganda K, Seibel MJ. Long-term iron polymaltose infusions associated with hypophosphataemic osteomalacia: a report of two cases and review of the literature. Ther Adv Endocrinol Metab. 2017;8(1-2):14–19. doi:10.1177/2042018816678363Disclosure of Interests:Elisa Fernández: None declared, Carolina Tornero: None declared, Victoria Navarro-Compán Consultant of: Abbvie, Lilly, Novartis, Pfizer, UCB, Speakers bureau: AbbVie, MSD, Lilly, Novartis, Pfizer, UCB, Gemma Bonilla: None declared, Chamaida Plasencia: None declared, Alejandro Balsa Grant/research support from: BMS, Roche, Consultant of: AbbVie, Gilead, Lilly, Pfizer, UCB, Sanofi, Sandoz, Speakers bureau: AbbVie, Lilly, Sanofi, Novartis, Pfizer, UCB, Roche, Nordic, Sandoz, Pilar Aguado: None declared
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Monjo I, Fernández E, Peiteado D, Balsa A, De Miguel E. OP0180 DIAGNOSTIC VALIDITY OF ULTRASOUND INCLUDING EXTRA-CRANIAL ARTERIES IN GIANT CELL ARTERITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Giant cell arteritis (GCA) is a chronic vasculitis of the medium and large arteries. The involvement of large vessel (LV) either isolated or associated with cranial artery is frequent, so it is necessary to use imaging techniques for diagnosis, because the biopsy in these cases is not useful. European League Against Rheumatism (EULAR) recommends an early imaging test in patients with suspected GCA, and ultrasound of temporal±axillary arteries is recommended as the first imaging modality in patients with suspected predominantly cranial GCA (1).Objectives:To assess the validity of Colour Doppler ultrasound (CDUS) of temporal superficial arteries (TA) and LV (axillary, subclavian and carotid) in the diagnosis of GCA, using as gold standard the patient’s definitive clinical diagnosis. Analyse if routine ultrasound examination of LV improves the diagnostic accuracy.Methods:This was an observational, descriptive and analytical study of 198 consecutive patients with GCA suspicion. A baseline CDUS of the TA and LV was performed. Ultrasound diagnosis was made according to the OMERACT (Outcome Measures in Rheumatology) definitions of halo sign and was established as a limit of average intimal thickness ≥ 0.34 mm for superficial temporal arteries and ≥ 1 mm for axillary, subclavian and carotid arteries. Statistical analysis was performed using SPSS version 25.Results:Eighty-seven patients (43.9%) were CDUS compatible with GCA, and 111 patients (56.1%) had a negative CDUS. Among the patients with positive CDUS three different patterns were detected: 45 patients (51.7%) had an exclusive cranial involvement, 31 (35.6%) had a mixed pattern with involvement of both TA and LV and 11 (12.6%) had an exclusive LV involvement. The validity (sensitivity and specificity) and security (positive predictive value and negative predictive value) of diagnostic are shown in table.When we analyse patients with LV involvement, 87.8% have axillary artery involvement, 77.4% subclavian involvement and 34.4% carotids involvement. If we only explored the axillary arteries, 12.2% of patients with LV involvement would not be diagnosed. However, if we explored axillary and subclavian arteries, 100% of patients with LV involvement would be diagnosed.Conclusion:Half of the patients with GCA have LV involvement and up to 12.8% exclusively LV affectation in our series. Adding CDUS exploration of LV arteries to TA increases both sensitivity and diagnostic specificity. The minimum ultrasound examination of LV should include both axillary and subclavian arteries.References:[1]Dejaco C, Ramiro S, Duftner C, et al. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice. Ann Rheum Dis. 2018;77(5):636–3SensitivitySpecificityPositive predictive valueNegative predictive valueCDUS TA and LV97,7%97,3%96,6%98,2%CDUS TA83,9%97,3%96,1%88,5%Disclosure of Interests:Irene Monjo: None declared, Elisa Fernández: None declared, Diana Peiteado: None declared, Alejandro Balsa Grant/research support from: BMS, Roche, Consultant of: AbbVie, Gilead, Lilly, Pfizer, UCB, Sanofi, Sandoz, Speakers bureau: AbbVie, Lilly, Sanofi, Novartis, Pfizer, UCB, Roche, Nordic, Sandoz, Eugenio de Miguel Grant/research support from: Yes (Abbvie, Novartis, Pfizer), Consultant of: Yes (Abbvie, Novartis, Pfizer), Paid instructor for: yes (AbbVie, Novartis, Pfizer, MSD, BMS, UCB, Roche, Grunental, Janssen, Sanofi), Speakers bureau: yes (AbbVie, Novartis, Pfizer, MSD, BMS, UCB, Roche, Grunental, Janssen, Sanofi)
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Fernández E, Monjo I, Bonilla G, Peiteado D, Plasencia C, Balsa A, De Miguel E. AB0476 GIANT CELL ARTERITIS: A DISEASE WITH DIFFERENT SUBSETS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Giant cell arteritis (GCA) is the most common form of autoimmune vasculitis in the elderly. Some evidence indicates that GCA is a heterogeneous disease in terms of symptoms, immune pathology and response to treatment1.Objectives:To analyze whether the identification by image of cranial vessels (VC) or large vessels (VG) involvement allows to characterize different clinical subsets of the disease.Methods:Descriptive observational study of the last 87 consecutive patients with a new diagnosis of GCA in our hospital. All patients had a CV and LV CDUS exam that included axillary, subclavian, vertebral and carotid arteries or a Positron Emission Tomography (PET-CT). The OMERACT (Outcome Measures in Rheumatology) definitions of halo sign were used for ultrasound diagnosis and IMT limits were established as ≥ 0.34 mm for superficial temporal arteries and ≥ 1 mm for axillary, subclavian and carotid arteries; a clear halo sign was used in the vertebral arteries. The radiologist’s report and the liver/vascular wall index were used for the definition of positive PET-CT. The medical records of these patients were reviewed and their demographic, clinical and laboratory data were compared between the different patterns of GCA. The statistical significance limit was set at P < 0.05. Statistical analyses were performed by using SPSS version 25.Results:Out of 198 patients with suspected GCA who underwent a CDUS or PET-CT between November 2016 and November 2019, 87 were diagnosed of GCA. Three different patterns were detected: 44 patients (50.6%) had an exclusive cranial pattern, 31 (35.6%) had a mixed pattern with involvement of both CV and LV and 12 (13.8%) had an exclusive large vessel pattern. The differences between these 3 subsets are shown in table 1. Patients with a LV pattern had more fever and polymyalgia rheumatica than patients with CV involvement and fewer ischemic visual disturbances than those with mixed pattern, reaching statistical significance. In addition, they tended to have fewer other ischemic symptoms (headache, jaw claudication) and more general symptoms than patterns with CV involvement. Regarding laboratory values, the erythrocyte sedimentation rate was significantly higher in the exclusive CV involvement group and lower in those with only LV involvement.Table 1.Characteristics of the patients with the different patternsCranial pattern (n = 44; 50.6%)Mixed pattern(n = 31; 35.6%)Large vessel pattern(n = 12; 13.8%)p-valueAge, years (mean, SD)78 ± 776 ± 774 ± 110.291Male sex12 (27.3%)14 (45.2%)5 (41.6%)0.252ESR, mm/h (mean, SD)78.7 ± 33.763.9 ± 33.052.1 ± 33.50.031*CRP, mg/L (mean, SD)55.8 ± 46.668.3 ± 63.685.9 ± 89.30.801Headache36 (81.8%)25 (80.6%)8 (66.6%)0.704Jaw claudication12 (27.3%)5 (16.1%)1 (8.3%)0.249Ischemic visual disturbances9 (20.4%)11 (35.5%)0 (0%)0.041#PMR18 (40.9%)13 (41.9%)8 (66.6%)0,018*0,029#General symptoms17 (38.6%)13 (41.9%)8 (66.6%)0.132Fever5 (11.4%)3 (9.7%)6 (50%)0.005*#SD: standard deviation. ESR: erythrocyte sedimentation rate. CRP: C reactive protein. PMR: polymyalgia rheumatica.*Statistically significant difference between cranial pattern and large vessel pattern.#Statistically significant difference between mixed pattern and large vessel pattern.Conclusion:Imaging in GCA allow us to establish different patterns of involvement (cranial, mixed, large vessel) that correspond to different clinical subsets. The patients with LV subset debut with a lower ESR and have more fever and polymyalgia rheumatica and less ischemic symptoms.References:[1]van der Geest KSM, Sandovici M, van Sleen Y, et al. Review: What Is the Current Evidence for Disease Subsets in Giant Cell Arteritis?. Arthritis Rheumatol. 2018;70(9):1366–1376. doi:10.1002/art.40520Disclosure of Interests: :Elisa Fernández: None declared, Irene Monjo: None declared, Gemma Bonilla: None declared, Diana Peiteado: None declared, Chamaida Plasencia: None declared, Alejandro Balsa Grant/research support from: BMS, Roche, Consultant of: AbbVie, Gilead, Lilly, Pfizer, UCB, Sanofi, Sandoz, Speakers bureau: AbbVie, Lilly, Sanofi, Novartis, Pfizer, UCB, Roche, Nordic, Sandoz, Eugenio de Miguel Grant/research support from: Yes (Abbvie, Novartis, Pfizer), Consultant of: Yes (Abbvie, Novartis, Pfizer), Paid instructor for: yes (AbbVie, Novartis, Pfizer, MSD, BMS, UCB, Roche, Grunental, Janssen, Sanofi), Speakers bureau: yes (AbbVie, Novartis, Pfizer, MSD, BMS, UCB, Roche, Grunental, Janssen, Sanofi)
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Blanco I, Diego I, Bueno P, Fernández E, Casas-Maldonado F, Esquinas C, Soriano JB, Miravitlles M. Geographic distribution of chronic obstructive pulmonary disease prevalence in Africa, Asia and Australasia. Int J Tuberc Lung Dis 2020; 23:1100-1106. [PMID: 31627775 DOI: 10.5588/ijtld.19.0015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE: To visualise spatial data on chronic obstructive pulmonary disease (COPD) prevalence in Africa, Asia and Australasia using a Geographic Information System (GIS) inverse distance weighted (IDW) interpolation technique.DESIGN: Prevalence rates from population surveys on individuals aged ≥40, with spirometry-confirmed COPD, were searched systematically. The prevalence observed in 59 selected surveys and the geographic coordinates of the places where they were conducted informed a GIS computer programme. The prevalence was represented by an ascending chromatic scale (blue-green-yellow-orange-brown-red) in the GIS maps.RESULTS: IDW-interpolation GIS maps were obtained of all the geographic areas investigated, and even from regions lacking data. Areas of high/very high prevalence were found in: Southern Africa and in most of the Central and Eastern Africa regions; in practically all of Central Asia; in the western regions of Southern Asia; in the southern regions of the East European Plain and the West Siberian Plain of Northern Asia; and in the Malay Archipelago. Intermediate prevalence predominated in Oceania and in most of the other regions of Africa and Asia.CONCLUSION: Despite some biases inherent to the interpolation method used in the present study, our approach provided an understandable visual perspective of the COPD prevalence distribution in these geographic regions.
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Affiliation(s)
- I Blanco
- Alpha1-Antitrypsin Deficiency Spanish Registry (REDAAT), Fundación Respira, Spanish Society of Pneumology and Thoracic Surgery (SEPAR). Barcelona
| | - I Diego
- Materials and Energy Department, School of Mining Engineering, Oviedo University, Oviedo
| | - P Bueno
- Internal Medicine Department, County Hospital of Jarrio, Principality of Asturias
| | - E Fernández
- Clinical Analysis Laboratory, University Hospital of Cabueñes, Gijón
| | | | - C Esquinas
- Pneumology Department, Hospital Universitari Vall d'Hebron/Vall d'Hebron Research Institute (VHIR), Barcelona
| | - J B Soriano
- Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid
| | - M Miravitlles
- Pneumology Department, Hospital Universitari Vall d'Hebron/Vall d'Hebron Research Institute (VHIR), Barcelona, CIBER de Enfermedades Respiratorias (CIBERES). Barcelona, Spain
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Gascó C, Suárez-Navarro JA, Escareño-Juárez E, Fernández E, García L, Puertas F, Alonso MM, Pérez C. Characteristic limits of 230Th in alpha spectrometry with 229Th as tracer, calculated by simulating interfering tails and overlapping peaks. Appl Radiat Isot 2020; 160:109097. [PMID: 32351213 DOI: 10.1016/j.apradiso.2020.109097] [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] [Received: 09/27/2019] [Revised: 01/17/2020] [Accepted: 02/23/2020] [Indexed: 10/24/2022]
Abstract
This study explores the effect of 229Th tracer tail interference on the determination of the sensitivity of 230Th alpha spectrometry of samples with environmental levels of radioactivity. Tracer peak tail interference was calculated with Suma-Alpha, whilst Visual Basic for Applications (VBA in Excel©) software was used to study the variation in sensitivity in terms of the amount of tracer added. Unnecessary increases in the amount of tracer or extended sample measuring times were observed to have adverse effects on method sensitivity (Detection Limit- Ld).
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Affiliation(s)
- C Gascó
- Unidad de Radiactividad Ambiental y Vigilancia Radiológica, CIEMAT, Avenida de la Complutense 40, Madrid, 28040, Spain.
| | - J A Suárez-Navarro
- Unidad de Radiactividad Ambiental y Vigilancia Radiológica, CIEMAT, Avenida de la Complutense 40, Madrid, 28040, Spain
| | - E Escareño-Juárez
- Universidad Autónoma de Zacatecas, Unidad Académica de Estudios Nucleares, Mexico
| | - E Fernández
- Unidad de Radiactividad Ambiental y Vigilancia Radiológica, CIEMAT, Avenida de la Complutense 40, Madrid, 28040, Spain
| | - L García
- Unidad de Radiactividad Ambiental y Vigilancia Radiológica, CIEMAT, Avenida de la Complutense 40, Madrid, 28040, Spain
| | - F Puertas
- Eduardo Torroja Institute for Construction Sciences (IETcc-CSIC), Spain
| | - M M Alonso
- Eduardo Torroja Institute for Construction Sciences (IETcc-CSIC), Spain
| | - C Pérez
- TECNASA, Calle Primera (Chamartín), 27 BAJO, Madrid, Spain
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Bozic M, Caus M, Rodrigues-Diez RR, Pedraza N, Ruiz-Ortega M, Garí E, Gallel P, Panadés MJ, Martinez A, Fernández E, Valdivielso JM. Protective role of renal proximal tubular alpha-synuclein in the pathogenesis of kidney fibrosis. Nat Commun 2020; 11:1943. [PMID: 32327648 PMCID: PMC7181766 DOI: 10.1038/s41467-020-15732-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 03/24/2020] [Indexed: 12/26/2022] Open
Abstract
Kidney fibrosis is a highly deleterious process and a final manifestation of chronic kidney disease. Alpha-(α)-synuclein (SNCA) is an actin-binding neuronal protein with various functions within the brain; however, its role in other tissues is unknown. Here, we describe the expression of SNCA in renal epithelial cells and demonstrate its decrease in renal tubules of murine and human fibrotic kidneys, as well as its downregulation in renal proximal tubular epithelial cells (RPTECs) after TGF-β1 treatment. shRNA-mediated knockdown of SNCA in RPTECs results in de novo expression of vimentin and α-SMA, while SNCA overexpression represses TGF-β1-induced mesenchymal markers. Conditional gene silencing of SNCA in RPTECs leads to an exacerbated tubulointerstitial fibrosis (TIF) in two unrelated in vivo fibrotic models, which is associated with an increased activation of MAPK-p38 and PI3K-Akt pathways. Our study provides an evidence that disruption of SNCA signaling in RPTECs contributes to the pathogenesis of renal TIF by facilitating partial epithelial-to-mesenchymal transition and extracellular matrix accumulation.
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Affiliation(s)
- Milica Bozic
- Vascular and Renal Translational Research Group, Institute for Biomedical Research in Lleida (IRBLleida) and RedInRen Retic, ISCIII, Spain.
| | - Maite Caus
- Vascular and Renal Translational Research Group, Institute for Biomedical Research in Lleida (IRBLleida) and RedInRen Retic, ISCIII, Spain
| | - Raul R Rodrigues-Diez
- Cellular and Molecular Biology in Renal and Vascular Pathology, IIS-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, Spain
| | - Neus Pedraza
- Cell Cycle, Department of Basic Medical Science, IRBLleida, University of Lleida, Lleida, Spain
| | - Marta Ruiz-Ortega
- Cellular and Molecular Biology in Renal and Vascular Pathology, IIS-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, Spain
| | - Eloi Garí
- Cell Cycle, Department of Basic Medical Science, IRBLleida, University of Lleida, Lleida, Spain
| | - Pilar Gallel
- Department of Pathology and Molecular Genetics, University Hospital Arnau de Vilanova and University of Lleida, IRBLleida, Spain
| | - Maria José Panadés
- Department of Pathology and Molecular Genetics, University Hospital Arnau de Vilanova and University of Lleida, IRBLleida, Spain
| | - Ana Martinez
- Vascular and Renal Translational Research Group, Institute for Biomedical Research in Lleida (IRBLleida) and RedInRen Retic, ISCIII, Spain
| | - Elvira Fernández
- Vascular and Renal Translational Research Group, Institute for Biomedical Research in Lleida (IRBLleida) and RedInRen Retic, ISCIII, Spain
| | - José Manuel Valdivielso
- Vascular and Renal Translational Research Group, Institute for Biomedical Research in Lleida (IRBLleida) and RedInRen Retic, ISCIII, Spain.
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Ballbè M, Nieva G, Mondon S, Pinet C, Bruguera E, Saltó E, Fernández E, Gual A. Tobacco control strategies in psychiatric services in catalonia (Spain). Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(11)71756-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IntroductionMortality and morbidity due to smoking in people with mental illnesses are higher than in the general population. However, smoking continues to be allowed in psychiatric premises of many countries despite being prohibited in workplaces including health care services.ObjectiveTo describe tobacco control strategies undertaken in psychiatric inpatient services and day centers in Catalonia.AimsTo study tobacco control strategies in psychiatric services in order to identify unmet needs.MethodsA cross-sectional study including all psychiatric services offering public service in Catalonia (n = 192). The managers answered an on-line questionnaire with 24 items grouped in four dimensions: staff's training & commitment, clinical intervention, management of smoking areas, and communication of smoke-free policies.Results186 of the managers (96.9%) responded to the questionnaire. Results showed low levels of implementation of tobacco control strategies, especially in the training and intervention dimensions. 41.0% of the services usually intervened in their patients’ tobacco use but an overall 65.9% didn’t have pharmacotherapy for smoking cessation available. 47.3% of the managers stated that their staff had not enough knowledge on smoking cessation interventions. 38.9% of the services had smoking indoor areas. Day Centers showed the lowest implementation of tobacco control measures while services belonging to the Network of Smoke-free Hospitals showed the highest implementation.ConclusionsCurrent Spanish partial law has failed to promote a desirable tobacco control in psychiatric services. There is a need to extend tobacco control policies, specifically in terms of smoking intervention and training, together with a higher availability of resources.
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Affiliation(s)
- M. Borràs
- Servei de Nefrología Hospital University Arnau de Vilanova Rovira Roure 80, 25198 Lleida and Department of Medicine Universitat de Lleida, Spain
| | - M.P. Marco
- Servei de Nefrología Hospital University Arnau de Vilanova Rovira Roure 80, 25198 Lleida and Department of Medicine Universitat de Lleida, Spain
| | - E. Fernández
- Servei de Nefrología Hospital University Arnau de Vilanova Rovira Roure 80, 25198 Lleida and Department of Medicine Universitat de Lleida, Spain
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Borràs M, Moreno S, Garcia M, Martín M, Manonelle A, Fernández E. Acinetobacter juniiCauses Refractory Peritonitis in a Patient on Automated Peritoneal Dialysis. Perit Dial Int 2020. [DOI: 10.1177/089686080702700126] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- M. Borràs
- Department of Nephrology, Hospital Arnau de Vilanova Lleida, Spain
| | - S. Moreno
- Department of Nephrology, Hospital Arnau de Vilanova Lleida, Spain
| | - M. Garcia
- Microbiology Services Hospital Arnau de Vilanova Lleida, Spain
| | - M.L. Martín
- Department of Nephrology, Hospital Arnau de Vilanova Lleida, Spain
| | - A. Manonelle
- Department of Nephrology, Hospital Arnau de Vilanova Lleida, Spain
| | - E. Fernández
- Department of Nephrology, Hospital Arnau de Vilanova Lleida, Spain
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Sanzana-Cuche R, Fernández E, Leiva AP, Rosas CC. Análisis de Expresión de Calreticulina en Vena Safena Parva. INT J MORPHOL 2020. [DOI: 10.4067/s0717-95022020000100182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Sánchez E, Sánchez M, Betriu À, Rius F, Torres G, Purroy F, Pamplona R, Ortega M, López-Cano C, Hernández M, Bueno M, Fernández E, Salvador J, Lecube A. Are Obesity Indices Useful for Detecting Subclinical Atheromatosis in a Middle-Aged Population? Obes Facts 2020; 13:29-39. [PMID: 31968341 PMCID: PMC7098313 DOI: 10.1159/000502696] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 08/12/2019] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE There is a close relationship between excess adiposity and cardiovascular disease. Although body mass index (BMI) is the most used approach to estimate excess weight, other anthropometric indices have been developed to measure total body and abdominal adiposity. Here, our objective was to assess the usefulness of these anthropometric indices to detect subclinical atheromatous disease. METHODS A cross-sectional study with 6,809 middle-aged subjects (mean age, 57 [53-63] years) with low to moderate cardiovascular risk from the ILERVAS project. Measures of total body fat (BMI, Clínica Universidad de Navarra - Body Adiposity Estimator [CUN-BAE], and Deurenberg's formula) and central adiposity (waist and neck circumferences, conicity index, waist-to-height ratio, Bonora's equation, the A body adiposity index, and body roundness index) were performed in all participants. Bilateral carotid and femoral ultrasound vascular studies allowed the identification of subjects with plaque. -Results: All measured indices were significantly higher in males with subclinical carotid or femoral plaques (p ≤ 0.021 for all). Also, a positive and significant correlation between all indices and the number of affected territories was found (p ≤ 0.013 for all). From the ROC analysis, all measurements identified patients with asymptomatic atheromatosis but none of them helped make clinical decisions. Regarding females, the results were less conclusive. CONCLUSION Obesity indices are related to subclinical atheromatosis, especially in men, in a large cohort of middle-aged subjects. However, the indices could not detect the presence of arterial plaque, so, when used in isolation, are unlikely to be decisive.
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Affiliation(s)
- Enric Sánchez
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Marta Sánchez
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Àngels Betriu
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R), University Hospital Arnau de Vilanova, Vascular and Renal Translational Research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Ferran Rius
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Gerard Torres
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Francesc Purroy
- Stroke Unit, University Hospital Arnau de Vilanova. Clinical Neurosciences Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Reinald Pamplona
- Experimental Medicine Department, IRBLleida, University of Lleida, Lleida, Spain
| | - Marta Ortega
- Institut Català de la Salut, Unitat de Suport a la Recerca Lleida, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Lleida, Spain
| | - Carolina López-Cano
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Marta Hernández
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Marta Bueno
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Elvira Fernández
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R), University Hospital Arnau de Vilanova, Vascular and Renal Translational Research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Javier Salvador
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Albert Lecube
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, Lleida, Spain,
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain,
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Sánchez E, Betriu À, López-Cano C, Hernández M, Fernández E, Purroy F, Bermúdez-López M, Farràs-Sallés C, Barril S, Pamplona R, Rius F, Hernández C, Simó R, Lecube A. Characteristics of atheromatosis in the prediabetes stage: a cross-sectional investigation of the ILERVAS project. Cardiovasc Diabetol 2019; 18:154. [PMID: 31729979 PMCID: PMC6857207 DOI: 10.1186/s12933-019-0962-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/02/2019] [Indexed: 12/23/2022] Open
Abstract
Background Prediabetes has recently been associated with subclinical atheromatous disease in the middle-aged population. Our aim was to characterize atheromatous plaque burden by the number of affected territories and the total plaque area in the prediabetes stage. Methods Atheromatous plaque burden (quantity of plaques and total plaque area) was assessed in 12 territories from the carotid and femoral regions using ultrasonography in 6688 non-diabetic middle-aged subjects without cardiovascular disease. Prediabetes was defined by glycosylated hemoglobin (HbA1c) between 5.7 and 6.4% according to the American Diabetes Association guidelines. Results Prediabetes was diagnosed in 33.9% (n = 2269) of the ILERVAS participants. Subjects with prediabetes presented a higher prevalence of subclinical atheromatous disease than participants with HbA1c < 5.7% (70.4 vs. 67.5%, p = 0.017). In the population with prediabetes this was observed at the level of the carotid territory (p < 0.001), but not in the femoral arteries. Participants in the prediabetes stage also presented a significantly higher number of affected territories (2 [1;3] vs. 1 [0;3], p = 0.002), with a positive correlation between HbA1c levels and the number of affected territories (r = 0.068, p < 0.001). However, atheromatosis was only significantly (p = 0.016) magnified by prediabetes in those subjects with 3 or more cardiovascular risk factors. The multivariable logistic regression model showed that the well-established cardiovascular risk factors together with HbA1c were independently associated with the presence of atheromatous disease in participants with prediabetes. When males and females were analyzed separately, we found that only men with prediabetes presented both carotid and femoral atherosclerosis, as well as an increase of total plaque area in comparison with non-prediabetic subjects. Conclusions The prediabetes stage is accompanied by an increased subclinical atheromatous disease only in the presence of other cardiovascular risk factors. Prediabetes modulates the atherogenic effect of cardiovascular risk factors in terms of distribution and total plaque area in a sex-dependent manner. Trial registration NCT03228459 (clinicaltrials.gov)
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Affiliation(s)
- Enric Sánchez
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Àngels Betriu
- Vascular and Renal Translational Research Group, IRBLleida, RedinRen-ISCIII, Lleida, Spain
| | - Carolina López-Cano
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Marta Hernández
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Elvira Fernández
- Vascular and Renal Translational Research Group, IRBLleida, RedinRen-ISCIII, Lleida, Spain
| | - Francisco Purroy
- Stroke Unit, University Hospital Arnau de Vilanova, Clinical Neurosciences Group. IRBLleida, University of Lleida, Lleida, Spain
| | | | - Cristina Farràs-Sallés
- Applied Epidemiology Research Group, IRBLleida, Lleida, Spain.,Unitat de Suport a la Recerca Lleida, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Silvia Barril
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Reinald Pamplona
- Experimental Medicine Department, IRBLleida, University of Lleida, Lleida, Spain
| | - Ferran Rius
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - Cristina Hernández
- Endocrinology and Nutrition Department, University Hospital Vall d'Hebron. Diabetes and Metabolism Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Autonomous University of Barcelona, Pg. Vall d'Hebron 119-129, 08024, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Rafael Simó
- Endocrinology and Nutrition Department, University Hospital Vall d'Hebron. Diabetes and Metabolism Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Autonomous University of Barcelona, Pg. Vall d'Hebron 119-129, 08024, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Albert Lecube
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism (ODIM) research Group, IRBLleida, University of Lleida, Lleida, Spain. .,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
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Bersezio C, Estay J, Sáez M, Sánchez F, Vernal R, Fernández E. Six-month Follow-up of the Effect of Nonvital Bleaching on IL-1β and RANK-L: A Randomized Clinical Trial. Oper Dent 2019; 44:581-588. [DOI: 10.2341/18-023-c] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives:
It has been reported that bleaching generates an increase in the activity of osteoclasts in vitro. We quantified the RANK-L and IL-1β biomarkers in a double-blind, randomized clinical trial evaluating the in vivo effect of hydrogen peroxide (35%) and peroxide carbamide (37%) six months after whitening.
Methods and Materials:
Fifty volunteers participated, each with color change in a nonvital tooth. Fifty teeth were randomly divided into two groups (n=25), and the teeth were bleached using either 35% hydrogen peroxide (G1) or 37% carbamide peroxide (G2). Intracoronal bleaching was carried out by a technical “walking bleach” over four sessions. Gingival crevicular fluid samples were collected and used to quantify the IL-1β and RANK-L secreted levels. Samples of six periodontal sites (three vestibular and three palatal) were collected for up to six months (at the beginning of the study [baseline] and at one week, one month, and six months posttreatment). The color change was visually monitored using the Vita Bleached Guide (ΔSGU).
Results:
Comparing each time to baseline assessment, a significant increase in the levels of IL-1β and RANK-L across time points was detected (p<0.05). The color change was 4 in G1 and G2, and a statistically significant difference (p<0.05) was found at the month time point between the groups. Using the Spearman test, a strong correlation (>0.8) between the IL-1β and RANK-L levels in both groups at all time points was detected.
Conclusions:
Nonvital bleaching using a technical walking bleach induces an increase in the IL-1β and RANKL production in periodontal tissues, which persists for six months after treatment. Both biomarkers were highly correlated in both groups and at all time points.
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Affiliation(s)
- C Bersezio
- Cristian Bersezio, DDS, PhD, University of Chile, Restorative Dentistry, Santiago, Chile
| | - J Estay
- Juan Estay, DDS, PhD, Universidad de Chile, Restorative Dentistry, Santiago, Chile
| | - M Sáez
- Mildri Sáez, DDS, University of Chile, Restorative Dentistry, Santiago, Chile and Universidad Politécnica y Artística del Paraguay, Paraguay
| | | | - R Vernal
- Rolando Vernal, DDS, MsC, PhD, Conservative Dentistry Departament, University of Chile, and Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile
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Sánchez E, Betriu À, Yeramian A, Fernández E, Purroy F, Sánchez-de-la-Torre M, Pamplona R, Miquel E, Kerkeni M, Hernández C, Simó R, Lecube A, Hernández M, Rius F, Polanco D, Barbé F, Torres G, Suárez G, Portero-Otin M, Jové M, Colàs-Campàs L, Benabdelhak I, Farràs C, Ortega M, Manuel Valdivielso J, Bermúdez-López M, Martínez-Alonso M. Skin Autofluorescence Measurement in Subclinical Atheromatous Disease: Results from the ILERVAS Project. J Atheroscler Thromb 2019; 26:879-889. [PMID: 30842389 PMCID: PMC6800392 DOI: 10.5551/jat.47498] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Aim: Advanced glycation end-products (AGEs) have been involved in the atherogenic process in the high-risk population. The goal of this study was to demonstrate that AGEs are related to subclinical atheromatous disease in subjects with low to moderate vascular risk. Methods: A cross-sectional study in which 2,568 non-diabetic subjects of both sexes without cardiovascular disease were included. Subcutaneous content of AGEs was assessed by skin autofluorescence (SAF) and subclinical atheromatous disease was measured by assessing the atheromatous plaque burden in carotid and femoral regions using ultrasonography. In addition, serum pentosidine, carboxymethyl-lysine (CML) and AGE receptors (RAGE) were assessed in a nested case-control study with 41 subjects without plaque and 41 individuals subjects with generalized disease. Results: Patients with atheromatous plaque had a higher SAF than those with no plaque (1.9 [1.7 to 2.3] vs. 1.8 [1.6 to 2.1] arbitrary units (AU), p % 0.001). The SAF correlated with the total number of affected regions (r = 0.171, p < 0.001), increasing progressively from 1.8 [1.6 to 2.1] AU in those without atheromatous disease to 2.3 [1.9 to 2.7] AU in patients with ≥ 8 plaques (p < 0.001). A correlation was also observed between SAF and the total plaque area (r = 0.113, p < 0.001). The area under the Receiver Operating Characteristic curve was 0.65 (0.61 to 0.68) for identifying male subjects with atheromatous disease. The multivariable logistic regression model showed a significant and independent association between SAF and the presence of atheromatous disease. However, no significant differences in serum pentosidine, CML, and RAGE were observed. Conclusions: Increased subcutaneous content of AGEs is associated with augmented atheromatous plaque burden. Our results suggest that SAF may provide clinically relevant information to the current strategies for the evaluation of cardiovascular risk, especially among the male population.
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Affiliation(s)
- Enric Sánchez
- Endocrinology and Nutrition Department. University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) research group. IRBLleida. University of Lleida
| | - Àngels Betriu
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R). University Hospital Arnau de Vilanova. Vascular and Renal Translational Research Group. IRBLleida. University of Lleida
| | - Andree Yeramian
- Endocrinology and Nutrition Department. University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) research group. IRBLleida. University of Lleida
| | - Elvira Fernández
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R). University Hospital Arnau de Vilanova. Vascular and Renal Translational Research Group. IRBLleida. University of Lleida
| | - Francesc Purroy
- Stroke Unit. University Hospital Arnau de Vilanova. Clinical Neurosciences Group. IRBLleida. University of Lleida
| | - Manuel Sánchez-de-la-Torre
- Respiratory Department. University Hospital Arnau de Vilanova-Santa Maria. Translational Research in Respiratory Medicine. IRBLleida. University of Lleida.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII)
| | - Reinald Pamplona
- Department of Experimental Medicine. IRBLleida. University of Lleida
| | - Eva Miquel
- Borges Blanques Primary Health Care Unit
| | - Mohsen Kerkeni
- Laboratory of Biochemistry, LR12ES05, Faculty of Medicine, University of Monastir
| | - Cristina Hernández
- Endocrinology and Nutrition Department, University Hospital Vall d'Hebron. Diabetes and Metabolism Research Unit, Vall d'Hebron Institut de Recerca (VHIR). Universitat Autònoma de Barcelona.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII)
| | - Rafael Simó
- Endocrinology and Nutrition Department, University Hospital Vall d'Hebron. Diabetes and Metabolism Research Unit, Vall d'Hebron Institut de Recerca (VHIR). Universitat Autònoma de Barcelona.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII)
| | - Albert Lecube
- Endocrinology and Nutrition Department. University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) research group. IRBLleida. University of Lleida.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII)
| | | | | | - Marta Hernández
- Endocrinology and Nutrition Department. University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) research group. IRBLleida. University of Lleida
| | - Ferran Rius
- Endocrinology and Nutrition Department. University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) research group. IRBLleida. University of Lleida
| | - Dinora Polanco
- Respiratory Department. University Hospital Arnau de Vilanova-Santa Maria. Translational Research in Respiratory Medicine. IRBLleida. University of Lleida
| | - Ferran Barbé
- Respiratory Department. University Hospital Arnau de Vilanova-Santa Maria. Translational Research in Respiratory Medicine. IRBLleida. University of Lleida.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII)
| | - Gerard Torres
- Respiratory Department. University Hospital Arnau de Vilanova-Santa Maria. Translational Research in Respiratory Medicine. IRBLleida. University of Lleida.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII)
| | - Guillermo Suárez
- Respiratory Department. University Hospital Arnau de Vilanova-Santa Maria. Translational Research in Respiratory Medicine. IRBLleida. University of Lleida.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII)
| | | | - Mariona Jové
- Department of Experimental Medicine. IRBLleida. University of Lleida
| | - Laura Colàs-Campàs
- Stroke Unit. University Hospital Arnau de Vilanova. Clinical Neurosciences Group. IRBLleida. University of Lleida
| | - Ikram Benabdelhak
- Stroke Unit. University Hospital Arnau de Vilanova. Clinical Neurosciences Group. IRBLleida. University of Lleida
| | | | | | - José Manuel Valdivielso
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R). University Hospital Arnau de Vilanova. Vascular and Renal Translational Research Group. IRBLleida. University of Lleida
| | - Marcelino Bermúdez-López
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R). University Hospital Arnau de Vilanova. Vascular and Renal Translational Research Group. IRBLleida. University of Lleida
| | - Montse Martínez-Alonso
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R). University Hospital Arnau de Vilanova. Vascular and Renal Translational Research Group. IRBLleida. University of Lleida
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Fernández P, Fernández E, Fernández P, Arellano M. Vaginal moisturizing post PDR-pulse dose rate brachytherapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz277.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sánchez E, Gutiérrez-Carrasquilla L, Barbé F, Betriu À, López-Cano C, Gaeta AM, Purroy F, Pamplona R, Ortega M, Fernández E, Hernández C, Lecube A, Simó R. Lung function measurements in the prediabetes stage: data from the ILERVAS Project. Acta Diabetol 2019; 56:1005-1012. [PMID: 30989377 DOI: 10.1007/s00592-019-01333-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/25/2019] [Indexed: 12/31/2022]
Abstract
AIMS Patients with type 2 diabetes have been considered a susceptible group for pulmonary dysfunction. Our aim was to assess pulmonary function on the prediabetes stage. METHODS Pulmonary function was assessed in 4,459 non-diabetic subjects, aged between 45 and 70 years, without cardiovascular disease or chronic pulmonary obstructive disease from the ongoing study ILERVAS. A "restrictive spirometric pattern", an "abnormal FEV1" and an "obstructive ventilatory defect" were assessed. Prediabetes was defined by glycosylated hemoglobin (HbA1c) between 5.7 and 6.4% according to the American Diabetes Association criteria. RESULTS Population was composed of 52.1% women, aged 57 [53;63] years, a BMI of 28.6 [25.8;31.8] kg/m2, and with a prevalence of prediabetes of 29.9% (n = 1392). Subjects with prediabetes had lower forced vital capacity (FVC: 93 [82;105] vs. 96 [84;106], p < 0.001) and lower forced expired volume in the first second (FEV1: 94 [82;107] vs. 96 [84;108], p = 0.011), as well as a higher percentage of the restrictive spirometric pattern (16.5% vs. 13.6%, p = 0.015) and FEV1 < 80% (20.3% vs. 17.2%, p = 0.017) compared to non-prediabetes group. In the prediabetes group, HbA1c was negatively correlated with both pulmonary parameters (FVC: r = - 0.113, p < 0.001; FEV1: r = - 0.079, p = 0.003). The multivariable logistic regression model in the whole population showed that there was a significant and independent association between HbA1c with both restrictive spirometric pattern [OR = 1.42 (1.10-1.83), p = 0.008] and FEV1 < 80% [OR = 1.50 (1.19-1.90), p = 0.001]. CONCLUSIONS The deleterious effect of type 2 diabetes on pulmonary function appears to be initiated in prediabetes, and it is related to metabolic control. TRIAL REGISTRATION CLINICALTRIALS.GOV: NCT03228459.
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Affiliation(s)
- Enric Sánchez
- Endocrinology and Nutrition Department, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University Hospital Arnau de Vilanova, University of Lleida, Avda. Rovira Roure 80. 25198, Lleida, Catalonia, Spain
| | - Liliana Gutiérrez-Carrasquilla
- Endocrinology and Nutrition Department, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University Hospital Arnau de Vilanova, University of Lleida, Avda. Rovira Roure 80. 25198, Lleida, Catalonia, Spain
| | - Ferrán Barbé
- Respiratory Department, Translational Research in Respiratory Medicine, IRBLleida, University Hospital Arnau de Vilanova-Santa María, University of Lleida, Lleida, Catalonia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Àngels Betriu
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R), Vascular and Renal Translational Research Group. IRBLleida, University Hospital Arnau de Vilanova, University of Lleida, Lleida, Catalonia, Spain
| | - Carolina López-Cano
- Endocrinology and Nutrition Department, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University Hospital Arnau de Vilanova, University of Lleida, Avda. Rovira Roure 80. 25198, Lleida, Catalonia, Spain
| | - Anna Michela Gaeta
- Respiratory Department, Translational Research in Respiratory Medicine, IRBLleida, University Hospital Arnau de Vilanova-Santa María, University of Lleida, Lleida, Catalonia, Spain
| | - Francesc Purroy
- Stroke Unit, Clinical Neurosciences Group, IRBLleida, University Hospital Arnau de Vilanova, University of Lleida, Lleida, Catalonia, Spain
| | - Reinald Pamplona
- Department of Experimental Medicine, IRBLleida, University of Lleida, Lleida, Catalonia, Spain
| | - Marta Ortega
- Primary Health Care Unit, Lleida, Catalonia, Spain
| | - Elvira Fernández
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R), Vascular and Renal Translational Research Group. IRBLleida, University Hospital Arnau de Vilanova, University of Lleida, Lleida, Catalonia, Spain
| | - Cristina Hernández
- Endocrinology and Nutrition Department, Hospital Universitari Vall d'Hebron, Diabetes and Metabolism Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Albert Lecube
- Endocrinology and Nutrition Department, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University Hospital Arnau de Vilanova, University of Lleida, Avda. Rovira Roure 80. 25198, Lleida, Catalonia, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Rafael Simó
- Endocrinology and Nutrition Department, Hospital Universitari Vall d'Hebron, Diabetes and Metabolism Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Palanca A, Castelblanco E, Betriu À, Perpiñán H, Soldevila B, Valdivielso JM, Bermúdez-Lopez M, Puig-Jové C, Puig-Domingo M, Groop PH, Fernández E, Alonso N, Mauricio D. Subclinical atherosclerosis burden predicts cardiovascular events in individuals with diabetes and chronic kidney disease. Cardiovasc Diabetol 2019; 18:93. [PMID: 31324183 PMCID: PMC6639953 DOI: 10.1186/s12933-019-0897-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/12/2019] [Indexed: 01/08/2023] Open
Abstract
Background Individuals with diabetes have remarkably high rates of cardiovascular morbidity and mortality. However, the incremental cardiovascular risk in diabetes is heterogeneous and has often been related to renal involvement. The purpose of this study was to analyse the prognostic value of subclinical atherosclerosis in determining the incidence of first cardiovascular events (CVEs) in individuals with diabetes and chronic kidney disease (CKD) compared to CKD individuals without diabetes. Methods We included data from individuals with CKD with and without diabetes, free from pre-existing cardiovascular disease, from the NEFRONA cohort. Participants underwent baseline carotid and femoral ultrasound and were followed up for 4 years. All CVEs during follow-up were registered. Bivariate analysis and Fine–Gray competing risk models were used to perform the statistical analysis. Results During the mean follow-up time of 48 months, a total of 203 CVE was registered. 107 CVE occurred among participants without diabetes (19.58 per 1000 person-years) and 96 CVE occurred among participants with diabetes (44.44 per 1000 person-years). Following the competing risk analysis, the variables predicting CVEs in CKD individuals without diabetes were the number of territories with plaque at baseline (HR 1.862, 95% CI [1.432;2.240]), age (HR 1.026, 95% CI [1.003;1.049]) and serum concentrations of 25-OH vitamin D (HR 0.963, 95% CI [0.933;0.094]). The only variable predicting CVEs among CKD participants with diabetes was the number of territories with plaque at baseline (HR 1.782, 95% CI [1.393, 2.278]). For both models, concordance (C) index yielded was over 0.7. Conclusions The burden of subclinical atherosclerosis is the strongest predictor of future CVEs in diabetic individuals with CKD. Early detection of subclinical atherosclerotic burden by multiterritorial vascular ultrasound could improve CVE prediction in this population. Electronic supplementary material The online version of this article (10.1186/s12933-019-0897-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ana Palanca
- Department of Endocrinology & Nutrition, Health Sciences Research Institute & University Hospital Germans Trias i Pujol, Carretera Canyet S/N, 08916, Badalona, Spain.,Department of Medicine, Barcelona Autonomous University (UAB), Barcelona, Spain
| | - Esmeralda Castelblanco
- Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau & Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Sant Quintí, 89, 08041, Barcelona, Spain.,Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Barcelona, Spain
| | - Àngels Betriu
- Vascular and Renal Translational Research Group, Institut de Recerca Biomèdica de Lleida, Lleida, Spain
| | - Hèctor Perpiñán
- Biostatistics Unit, Institut de Recerca Biomèdica de Lleida, Lleida, Spain
| | - Berta Soldevila
- Department of Endocrinology & Nutrition, Health Sciences Research Institute & University Hospital Germans Trias i Pujol, Carretera Canyet S/N, 08916, Badalona, Spain.,Department of Medicine, Barcelona Autonomous University (UAB), Barcelona, Spain.,Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Barcelona, Spain
| | - José Manuel Valdivielso
- Vascular and Renal Translational Research Group, Institut de Recerca Biomèdica de Lleida, Lleida, Spain
| | - Marcelino Bermúdez-Lopez
- Vascular and Renal Translational Research Group, Institut de Recerca Biomèdica de Lleida, Lleida, Spain
| | - Carlos Puig-Jové
- Department of Endocrinology & Nutrition, Health Sciences Research Institute & University Hospital Germans Trias i Pujol, Carretera Canyet S/N, 08916, Badalona, Spain
| | - Manel Puig-Domingo
- Department of Endocrinology & Nutrition, Health Sciences Research Institute & University Hospital Germans Trias i Pujol, Carretera Canyet S/N, 08916, Badalona, Spain.,Department of Medicine, Barcelona Autonomous University (UAB), Barcelona, Spain
| | - Per-Henrik Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.,Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Elvira Fernández
- Vascular and Renal Translational Research Group, Institut de Recerca Biomèdica de Lleida, Lleida, Spain
| | - Núria Alonso
- Department of Endocrinology & Nutrition, Health Sciences Research Institute & University Hospital Germans Trias i Pujol, Carretera Canyet S/N, 08916, Badalona, Spain. .,Department of Medicine, Barcelona Autonomous University (UAB), Barcelona, Spain. .,Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Barcelona, Spain.
| | - Didac Mauricio
- Department of Medicine, Barcelona Autonomous University (UAB), Barcelona, Spain. .,Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau & Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Sant Quintí, 89, 08041, Barcelona, Spain. .,Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Barcelona, Spain.
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Núñez Medrano JA, Fernández E, Georgescu D, Díaz Díaz AL, Graue Moreno G. Consensus of the Iberoamerican Oculoplastic Society for diagnosis and management of facial dystonia. ACTA ACUST UNITED AC 2019; 94:436-440. [PMID: 31272707 DOI: 10.1016/j.oftal.2019.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 03/26/2019] [Accepted: 03/29/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To propose guidelines for the diagnosis and treatment of facial dystonia prepared by a group of experts in orbit and oculoplastics from the Iberoamerican Oculoplastic Society. MATERIAL AND METHODS An interactive discussion between the expert panel and those attending the 6th Iberoamerican Society of Oculoplastics Congress, which took place at the Hospital Nuestra Señora de la Luz in Mexico City on 22 October 2018, providing their personal experience based on evidence for diagnosis and treatment of facial dystonia. Around 200 ophthalmologists specialised in oculoplastics from North, Central and South America, Spain, and Portugal were involved. Discussion was focused on the following themes: pathophysiology, diagnosis, medical management, and surgical management. CONCLUSIONS Facial dystonia diagnosis is clinical; therefore, image studies are rarely needed. The ophthalmologist is generally the first physician to be consulted, and is able to be the treating physician, with the exception of specific cases of hemifacial spasm where management with neurosurgery may be beneficial. Botulinum toxin is the treatment of choice. Treatment with oral neuroleptics and myectomy of the orbicularis oculi muscle are reserved for refractory cases, since these do not have an adequate clinical response as first choice treatments. Persistent use of botulinum toxin does not modify the natural course of the disease.
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Affiliation(s)
| | - E Fernández
- Práctica particular, Palma de Mallorca, España
| | - D Georgescu
- Práctica particular, Estados Unidos de América
| | | | - G Graue Moreno
- Departamento de Órbita y Oculoplástica, Hospital Nuestra Señora de la Luz, Ciudad de México, México
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Sánchez M, Sánchez E, Hernández M, González J, Purroy F, Rius F, Pamplona R, Farràs-Sallés C, Gutiérrez-Carrasquilla L, Fernández E, Bermúdez-López M, Salvador J, Salas-Salvadó J, Lecube A. Dissimilar Impact of a Mediterranean Diet and Physical Activity on Anthropometric Indices: A Cross-Sectional Study from the ILERVAS Project. Nutrients 2019; 11:nu11061359. [PMID: 31212934 PMCID: PMC6627626 DOI: 10.3390/nu11061359] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/11/2019] [Accepted: 06/14/2019] [Indexed: 12/16/2022] Open
Abstract
There is a close relationship between lifestyle behaviors and excess adiposity. Although body mass index (BMI) is the most used approach to estimate excess weight, other anthropometric indices have been developed to measure total body and abdominal adiposity. However, little is known about the impact of physical activity and adherence to a Mediterranean diet on these indices. Here we report the results of a cross-sectional study with 6672 middle-aged subjects with low to moderate cardiovascular risk from the Ilerda Vascular (ILERVAS) project. The participants' adherence to physical activity (International Physical Activity Questionnaire short form) and MedDiet (Mediterranean Diet Adherence Screener) was evaluated. Measures of total adiposity (BMI, Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), and Deurenberg's formula), central adiposity (waist and neck circumferences, conicity index, waist to height ratio, Bonora's equation, A body adiposity index, and body roundness index), and lean body mass (Hume formula) were assessed. Irrespective of sex, lower indices of physical activity were associated with higher values of total body fat and central adiposity. This result was constant regardless of the indices used to estimate adiposity. However, the association between MedDiet and obesity indices was much less marked and more dependent on sex than that observed for physical activity. Lean body mass was influenced by neither physical activity nor MedDiet adherence. No joint effect between physical activity and MedDiet to lower estimated total or central adiposity indices was shown. In conclusion, physical activity is related to lower obesity indices in a large cohort of middle-aged subjects. MedDiet showed a slight impact on estimated anthropometric indices, with no joint effect when considering both lifestyle variables. ClinTrials.gov Identifier: NCT03228459.
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Affiliation(s)
- Marta Sánchez
- Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, 25198 Lleida, Spain.
| | - Enric Sánchez
- Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, 25198 Lleida, Spain.
| | - Marta Hernández
- Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, 25198 Lleida, Spain.
| | - Jessica González
- Respiratory Department, Arnau de Vilanova-Santa María University Hospital, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, 25198 Lleida, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
| | - Francesc Purroy
- Stroke Unit, Arnau de Vilanova University Hospital, Clinical Neurosciences Group, IRBLleida, University of Lleida, 25198 Lleida, Spain.
| | - Ferran Rius
- Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, 25198 Lleida, Spain.
| | - Reinald Pamplona
- Department of Experimental Medicina, IRBLleida, University of Lleida, 25198 Lleida, Spain.
| | - Cristina Farràs-Sallés
- Applied Epidemiology Research Group, IRB Lleida, 25198 Lleida, Spain.
- Unitat de Suport a la Recerca Lleida. Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08006 Barcelona, Spain.
| | - Liliana Gutiérrez-Carrasquilla
- Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, 25198 Lleida, Spain.
| | - Elvira Fernández
- Vascular and Renal Translational Research Group, IRBLleida, RedinRen-ISCIII, 25198 Lleida, Spain.
| | - Marcelino Bermúdez-López
- Vascular and Renal Translational Research Group, IRBLleida, RedinRen-ISCIII, 25198 Lleida, Spain.
| | - Javier Salvador
- Endocrinology and Nutrition Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain.
- Human Nutrition Unit, Biochemistry and Biotechnology Department, University Hospital of Sant Joan de Reus, IISPV, Rovira i Virgili University, 43201 Reus, Spain.
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, Biochemistry and Biotechnology Department, University Hospital of Sant Joan de Reus, IISPV, Rovira i Virgili University, 43201 Reus, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
| | - Albert Lecube
- Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital, Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida, University of Lleida, 25198 Lleida, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
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Macías L, Fernández E, Martín M, Imaz M, Torra M. Selenium status differences between schizophrenia patients and healthy subjects living in Barcelona (North-Eastern Spain). Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Farfán FD, Soto-Sánchez C, Pizá AG, Albarracín AL, Soletta JH, Lucianna FA, Fernández E. Comparative study of extracellular recording methods for analysis of afferent sensory information: Empirical modeling, data analysis and interpretation. J Neurosci Methods 2019; 320:116-127. [PMID: 30849435 DOI: 10.1016/j.jneumeth.2019.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/02/2019] [Accepted: 03/04/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Physiological studies of sensorial systems often require the acquisition and processing of data extracted from their multiple components to evaluate how the neural information changes in relation to the environment changes. In this work, a comparative study about methodological aspects of two electrophysiological approaches is described. NEW METHOD Extracellular recordings from deep vibrissal nerves were obtained by using a customized microelectrode Utah array during passive mechanical stimulation of rat´s whiskers. These recordings were compared with those obtained with bipolar electrodes. We also propose here a simplified empirical model of the electrophysiological activity obtained from a bundle of myelinated nerve fibers. RESULTS The peripheral activity of the vibrissal system was characterized through the temporal and spectral features obtained with both recording methods. The empirical model not only allows the correlation between anatomical structures and functional features, but also allows to predict changes in the CAPs morphology when the arrangement and the geometry of the electrodes changes. COMPARISON WITH EXISTING METHOD(S) This study compares two extracellular recording methods based on analysis techniques, empirical modeling and data processing of vibrissal sensory information. CONCLUSIONS This comparative study reveals a close relationship between the electrophysiological techniques and the processing methods necessary to extract sensory information. This relationship is the result of maximizing the extraction of information from recordings of sensory activity.
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Affiliation(s)
- F D Farfán
- Laboratorio de Medios e Interfases (LAMEIN), Departamento de Bioingeniería, Facultad de Ciencias Exactas y Tecnología, Universidad Nacional de Tucumán, Tucumán, Argentina; Instituto Superior de Investigaciones Biológicas (INSIBIO), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Tucumán, Argentina.
| | - C Soto-Sánchez
- Bioengineering Institute, Miguel Hernández University (UMH), Alicante, Spain; Biomedical Research Networking center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Zaragoza, Spain.
| | - A G Pizá
- Laboratorio de Medios e Interfases (LAMEIN), Departamento de Bioingeniería, Facultad de Ciencias Exactas y Tecnología, Universidad Nacional de Tucumán, Tucumán, Argentina; Instituto Superior de Investigaciones Biológicas (INSIBIO), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Tucumán, Argentina.
| | - A L Albarracín
- Laboratorio de Medios e Interfases (LAMEIN), Departamento de Bioingeniería, Facultad de Ciencias Exactas y Tecnología, Universidad Nacional de Tucumán, Tucumán, Argentina; Instituto Superior de Investigaciones Biológicas (INSIBIO), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Tucumán, Argentina.
| | - J H Soletta
- Laboratorio de Medios e Interfases (LAMEIN), Departamento de Bioingeniería, Facultad de Ciencias Exactas y Tecnología, Universidad Nacional de Tucumán, Tucumán, Argentina; Instituto Superior de Investigaciones Biológicas (INSIBIO), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Tucumán, Argentina.
| | - F A Lucianna
- Laboratorio de Medios e Interfases (LAMEIN), Departamento de Bioingeniería, Facultad de Ciencias Exactas y Tecnología, Universidad Nacional de Tucumán, Tucumán, Argentina; Instituto Superior de Investigaciones Biológicas (INSIBIO), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Tucumán, Argentina.
| | - E Fernández
- Bioengineering Institute, Miguel Hernández University (UMH), Alicante, Spain; Biomedical Research Networking center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Zaragoza, Spain.
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De la Pinta Alonso C, Fernández E, Martin M, Hernanz R, Vallejo C, Martín M, Capúz A, Rojo J, Villodre I, Sancho S. PO-0743 Single dose versus FSRT for brain metastases: a retrospective study. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31163-6] [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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