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Borjas G, Urdaneta A, Ramos E, Maldonado A. Magnetic liver retraction in bariatric surgery: Is it possible? Cir Esp 2024:S2173-5077(24)00089-9. [PMID: 38608757 DOI: 10.1016/j.cireng.2024.02.012] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/21/2024] [Indexed: 04/14/2024]
Abstract
One of the recent advances in bariatric surgery is the use of magnetic devices. This research paper describes magnetic liver retraction in morbidly obese patients during bariatric surgery. A descriptive, prospective and observational study was carried out, analyzing 100 patients in whom magnetic retraction was used. Mean and SD body mass index was 46.1 ± 5.09 kg/m2. The magnetic system was successfully used for liver retraction in 95% of cases; in only 5% of cases was its use not possible due to hepatomegaly and severe hepatic steatosis. According to the results, magnetic liver retraction can be safe and used in bariatric surgery, regardless of body mass index and with a low percentage of complications.
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Affiliation(s)
- G Borjas
- International Unit of Bariatric and Robotic Surgery, Clínica "La Sagrada Familia"/"Grupo Médico Santa Paula" - Maracaibo/Caracas, Venezuela.
| | - A Urdaneta
- International Unit of Bariatric and Robotic Surgery, Clínica "La Sagrada Familia"/"Grupo Médico Santa Paula" - Maracaibo/Caracas, Venezuela
| | - E Ramos
- International Unit of Bariatric and Robotic Surgery, Clínica "La Sagrada Familia"/"Grupo Médico Santa Paula" - Maracaibo/Caracas, Venezuela
| | - A Maldonado
- International Unit of Bariatric and Robotic Surgery, Clínica "La Sagrada Familia"/"Grupo Médico Santa Paula" - Maracaibo/Caracas, Venezuela
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Kasap C, Izgutdina A, Patiño-Escobar B, Kang A, Chilakapati N, Akagi N, Johnson H, Rashid T, Werner J, Barpanda A, Geng H, Lin YHT, Rampersaud S, Gil-Alós D, Sobh A, Dupéré-Richer D, Wicaksono G, Kawehi Kelii K, Dalal R, Ramos E, Vijayanarayanan A, Salangsang F, Phojanakong P, Serrano JAC, Zakraoui O, Tariq I, Steri V, Shanmugam M, Boise LH, Kortemme T, Stieglitz E, Licht JD, Karlon WJ, Barwick BG, Wiita AP. Targeting high-risk multiple myeloma genotypes with optimized anti-CD70 CAR-T cells. bioRxiv 2024:2024.02.24.581875. [PMID: 38463958 PMCID: PMC10925123 DOI: 10.1101/2024.02.24.581875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Despite the success of BCMA-targeting CAR-Ts in multiple myeloma, patients with high-risk cytogenetic features still relapse most quickly and are in urgent need of additional therapeutic options. Here, we identify CD70, widely recognized as a favorable immunotherapy target in other cancers, as a specifically upregulated cell surface antigen in high risk myeloma tumors. We use a structure-guided design to define a CD27-based anti-CD70 CAR-T design that outperforms all tested scFv-based CARs, leading to >80-fold improved CAR-T expansion in vivo. Epigenetic analysis via machine learning predicts key transcription factors and transcriptional networks driving CD70 upregulation in high risk myeloma. Dual-targeting CAR-Ts against either CD70 or BCMA demonstrate a potential strategy to avoid antigen escape-mediated resistance. Together, these findings support the promise of targeting CD70 with optimized CAR-Ts in myeloma as well as future clinical translation of this approach.
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Affiliation(s)
- Corynn Kasap
- Dept. of Medicine, Division of Hematology/Oncology, University of California, San Francisco, CA
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Adila Izgutdina
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | | | - Amrik Kang
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
- Medical Scientist Training Program, University of California, San Francisco, CA
| | - Nikhil Chilakapati
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Naomi Akagi
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Haley Johnson
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Tasfia Rashid
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Juwita Werner
- Dept. of Pediatrics, Division of Oncology, University of California, San Francisco, CA
| | - Abhilash Barpanda
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Huimin Geng
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Yu-Hsiu T. Lin
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Sham Rampersaud
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Daniel Gil-Alós
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
- Dept of Hematology, Hospital 12 de Octubre, Madrid, Spain
| | - Amin Sobh
- University of Florida Health Cancer Center, The University of Florida Cancer and Genetics Research Complex, Gainesville, Florida
- Division of Hematology/Oncology, The University of Florida College of Medicine, Gainesville, Florida
| | - Daphné Dupéré-Richer
- University of Florida Health Cancer Center, The University of Florida Cancer and Genetics Research Complex, Gainesville, Florida
- Division of Hematology/Oncology, The University of Florida College of Medicine, Gainesville, Florida
| | - Gianina Wicaksono
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - K.M. Kawehi Kelii
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Radhika Dalal
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA
| | - Emilio Ramos
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | | | - Fernando Salangsang
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Paul Phojanakong
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | | | - Ons Zakraoui
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Isa Tariq
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Veronica Steri
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Mala Shanmugam
- Department of Hematology and Medical Oncology, Winship Cancer Institute, School of Medicine, Emory University, Atlanta, GA
| | - Lawrence H. Boise
- Department of Hematology and Medical Oncology, Winship Cancer Institute, School of Medicine, Emory University, Atlanta, GA
| | - Tanja Kortemme
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA
- Chan Zuckerberg Biohub San Francisco, San Francisco, CA
| | - Elliot Stieglitz
- Dept. of Pediatrics, Division of Oncology, University of California, San Francisco, CA
| | - Jonathan D. Licht
- University of Florida Health Cancer Center, The University of Florida Cancer and Genetics Research Complex, Gainesville, Florida
- Division of Hematology/Oncology, The University of Florida College of Medicine, Gainesville, Florida
| | - William J. Karlon
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Benjamin G. Barwick
- Department of Hematology and Medical Oncology, Winship Cancer Institute, School of Medicine, Emory University, Atlanta, GA
| | - Arun P. Wiita
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
- Chan Zuckerberg Biohub San Francisco, San Francisco, CA
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Mils K, Lladó L, López-Domínguez J, Barrios O, Leiva D, Santos C, Serrano T, Ramos E. Have we improved postoperative and long-term outcomes of liver surgery for colorectal cancer metastasis? Analysis of 1736 hepatectomies performed over 3 decades in a single center. Cir Esp 2024:S2173-5077(24)00044-9. [PMID: 38346559 DOI: 10.1016/j.cireng.2023.11.025] [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: 10/16/2023] [Accepted: 11/27/2023] [Indexed: 02/27/2024]
Abstract
INTRODUCTION Surgery is the only potentially curative treatment for colorectal cancer liver metastases (CRLM) and its indication and results have varied in the last 30 years. METHODS All patients operated on for CRLM in our centre from 1990 to 2021 were prospectively collected, establishing 3 subgroups based on the year of the first surgery: group A 1990-1999, group B 2000-2010, group C 2011-2021. Clinical characteristics and the results of survival, recurrence and prognostic factors were compared. RESULTS 1736 hepatectomies were included (Group A n = 208; Group B n = 770; Group C n = 758). Patients in group C had better survival at 5 and 10 years (A 40.5%/28.2%; B 45.9%/32.2%; C 51.6%/33.1%, p = 0.013), although there were no differences between groups in overall recurrence at 5 and 10 years (A 73%/75.7%; B 67.6%/69.2%, and C 63.9%/66%, p = 0.524), nor in liver recurrence (A 46.4%/48.2%; B 45.8%/48.2%; and C 44.4%/48.4%, p = 0.899). An improvement was observed in median survival after recurrence, being 19 months, 23 months, and 31 months (groups A, B and C respectively). Prognostic factors of long-term survival changed over the 3 study periods. The only ones that remained relevant in the last decade were the presence of >4 liver metastasis, extrahepatic disease at the time of hepatectomy, and intraoperative blood transfusion. CONCLUSIONS Survival after surgery for CRLM has improved significantly, although this cannot be explained by a reduction in overall and hepatic recurrence, but rather by an improvement in post-recurrence survival. Involvement of the resection margin has lost prognostic value in the last decade.
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Affiliation(s)
- Kristel Mils
- Unidad de Cirugía Hepato-Biliar y Trasplante Hepático, Servicio de Cirugía General y Digestiva, Hospital Universitario de Bellvitge, Cataluña, Spain.
| | - Laura Lladó
- Unidad de Cirugía Hepato-Biliar y Trasplante Hepático, Servicio de Cirugía General y Digestiva, Hospital Universitario de Bellvitge, Cataluña, Spain
| | - Josefina López-Domínguez
- Unidad de Cirugía Hepato-Biliar y Trasplante Hepático, Servicio de Cirugía General y Digestiva, Hospital Universitario de Bellvitge, Cataluña, Spain
| | - Oriana Barrios
- Unidad de Cirugía Hepato-Biliar y Trasplante Hepático, Servicio de Cirugía General y Digestiva, Hospital Universitario de Bellvitge, Cataluña, Spain
| | - David Leiva
- Servicio de Radiología, Hospital Universitario de Bellvitge, Cataluña, Spain
| | - Cristina Santos
- Servicio de Oncología, Hospital Universitario de Bellvitge, Cataluña, Spain
| | - Teresa Serrano
- Servicio de Anatomía Patológica, Hospital Universitario de Bellvitge, Cataluña, Spain
| | - Emilio Ramos
- Unidad de Cirugía Hepato-Biliar y Trasplante Hepático, Servicio de Cirugía General y Digestiva, Hospital Universitario de Bellvitge, Cataluña, Spain
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Polette D, Mils K, López-Domínguez F, Barrios O, Leiva D, Puig I, Ramos E, Lladó L. Diagnosis and treatment of hepatic cysts. Usefulness of intracystic tumor markers (CEA and CA 19.9.). Cir Esp 2024; 102:19-24. [PMID: 37980963 DOI: 10.1016/j.cireng.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/08/2023] [Indexed: 11/21/2023]
Abstract
INTRODUCTION To decide treatment of hepatic cysts diagnosis between simple hepatic cyst (SHC) and cystic mucinous neoplasm (CMN). Radiological features are not patognomonic. Some studies have suggested the utility of intracystic tumor markers. METHODS Retrospective analysis of our prospective database including patients treated due to symptomatic SHC from 2003 to 2021. The aim of the study was to evaluate the results of treatment of symptomatic SHC and the usefulness of the determination of intracystic "carcinoembryonic antigen" (CEA) and "carbohydrate antigen" CA 19.9. RESULTS 50 patients diagnosed and treated for symptomatic SHC were included. In 15 patients the first treatment was percutaneous drainage. In 35 patients the first treatment was laparoscopic fenestration. Four patients were diagnosed of premalignant or malignant liver cystic lesions (MCN, IPMN, lymphoma B); three of them required surgery after initial fenestration and pathological diagnosis. Median CEA and CA 19-9 were 196 μg/L and 227.321 U/mL respectively. Patients with malignant or premalignant pathology did not have higher levels of intracystic tumor markers. Positive predictive value was 0% for both markers, and negative predictive value was 89% and 91% respectively. CONCLUSION Values of intracystic tumor markers CEA and CA 19-9 do not allow distinguishing simple cysts from cystic liver neoplasms. The most effective treatment for symptomatic simple liver cysts is surgical fenestration. The pathological analysis of the wall of the cysts enables the correct diagnosis, allowing to indicate a surgical reintervention in cases of hepatic cyst neoplasia.
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Affiliation(s)
- Daniela Polette
- Unidad de Cirugía Hepatobiliopancreática del Servicio de Cirugía General, Hospital Universitario de Bellvitge, Barcelona, Spain.
| | - Kristel Mils
- Unidad de Cirugía Hepatobiliopancreática del Servicio de Cirugía General, Hospital Universitario de Bellvitge, Barcelona, Spain
| | - Fina López-Domínguez
- Unidad de Cirugía Hepatobiliopancreática del Servicio de Cirugía General, Hospital Universitario de Bellvitge, Barcelona, Spain
| | - Oriana Barrios
- Unidad de Cirugía Hepatobiliopancreática del Servicio de Cirugía General, Hospital Universitario de Bellvitge, Barcelona, Spain
| | - David Leiva
- Unidad de Radiología Hepatobiliopancreática, Hospital Universitario de Bellvitge, Barcelona, Spain
| | - Isabel Puig
- Unidad de Radiología Hepatobiliopancreática, Hospital Universitario de Bellvitge, Barcelona, Spain
| | - Emilio Ramos
- Unidad de Cirugía Hepatobiliopancreática del Servicio de Cirugía General, Hospital Universitario de Bellvitge, Barcelona, Spain
| | - Laura Lladó
- Unidad de Cirugía Hepatobiliopancreática del Servicio de Cirugía General, Hospital Universitario de Bellvitge, Barcelona, Spain
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5
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Luna-Abanto J, Lopez-Dominguez J, Pina E, Camprubí I, Ramos E, Lladó L. Paraneoplastic acquired hemophilia A associated with hilar cholangiocarcinoma arising in an intraductal papillary neoplasm of the bile duct. Rev Esp Enferm Dig 2023; 115:729-731. [PMID: 36926935 DOI: 10.17235/reed.2023.9562/2023] [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] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
A 74-year-old female was admitted for painless jaundice. Laboratory tests showed hyperbilirubinemia, cholestasis, normal coagulation, and Ca19-9:163U/L. The CT-scan reported dilation of the intrahepatic and extrahepatic bile ducts secondary to a 24mm tumor in the intrapancreatic common bile duct. The magnetic cholangioresonance showed multiple endoluminal polypoid lesions, suggestive of intraductal papillary neoplasm of the bile duct (IPNB). The endoscopic bile duct brushing was non-conclusive.
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Affiliation(s)
| | | | - Elena Pina
- Thrombosis and Haemostasis, Hospital Universitari de Bellvitge
| | | | - Emilio Ramos
- Hepatobiliary Surgery, Hospital Universitari de Bellvitge
| | - Laura Lladó
- Hepatobiliary Surgery, Hospital Universitari de Bellvitge
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6
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Temple WC, Nix MA, Naik A, Izgutdina A, Huang BJ, Wicaksono G, Phojanakong P, Serrano JAC, Young EP, Ramos E, Salangsang F, Steri V, Xirenayi S, Hermiston M, Logan AC, Stieglitz E, Wiita AP. Framework humanization optimizes potency of anti-CD72 nanobody CAR-T cells for B-cell malignancies. J Immunother Cancer 2023; 11:e006985. [PMID: 38007238 PMCID: PMC10680002 DOI: 10.1136/jitc-2023-006985] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Approximately 50% of patients who receive anti-CD19 CAR-T cells relapse, and new immunotherapeutic targets are urgently needed. We recently described CD72 as a promising target in B-cell malignancies and developed nanobody-based CAR-T cells (nanoCARs) against it. This cellular therapy design is understudied compared with scFv-based CAR-T cells, but has recently become of significant interest given the first regulatory approval of a nanoCAR in multiple myeloma. METHODS We humanized our previous nanobody framework regions, derived from llama, to generate a series of humanized anti-CD72 nanobodies. These nanobody binders were inserted into second-generation CD72 CAR-T cells and were evaluated against preclinical models of B cell acute lymphoblastic leukemia and B cell non-Hodgkin's lymphoma in vitro and in vivo. Humanized CD72 nanoCARs were compared with parental ("NbD4") CD72 nanoCARs and the clinically approved CD19-directed CAR-T construct tisangenlecleucel. RNA-sequencing, flow cytometry, and cytokine secretion profiling were used to determine differences between the different CAR constructs. We then used affinity maturation on the parental NbD4 construct to generate high affinity binders against CD72 to test if higher affinity to CD72 improved antitumor potency. RESULTS Toward clinical translation, here we humanize our previous nanobody framework regions, derived from llama, and surprisingly discover a clone ("H24") with enhanced potency against B-cell tumors, including patient-derived samples after CD19 CAR-T relapse. Potentially underpinning improved potency, H24 has moderately higher binding affinity to CD72 compared with a fully llama framework. However, further affinity maturation (KD<1 nM) did not lead to improvement in cytotoxicity. After treatment with H24 nanoCARs, in vivo relapse was accompanied by CD72 antigen downregulation which was partially reversible. The H24 nanobody clone was found to have no off-target binding and is therefore designated as a true clinical candidate. CONCLUSION This work supports translation of H24 CD72 nanoCARs for refractory B-cell malignancies, reveals potential mechanisms of resistance, and unexpectedly demonstrates that nanoCAR potency can be improved by framework alterations alone. These findings may have implications for future engineering of nanobody-based cellular therapies.
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Affiliation(s)
- William C Temple
- Department of Pediatrics, Division of Hematology/Oncology, University of California, UCSF Benioff Children's Hospital, San Francisco, California, USA
- Department of Pediatrics, Division of Allergy, Immunology, and Bone Marrow Transplantation, University of California, UCSF Benioff Children's Hospital, San Francisco, California, USA
- Department of Laboratory Medicine, University of California, San Francisco, California, USA
| | - Matthew A Nix
- Department of Laboratory Medicine, University of California, San Francisco, California, USA
| | - Akul Naik
- Department of Laboratory Medicine, University of California, San Francisco, California, USA
| | - Adila Izgutdina
- Department of Laboratory Medicine, University of California, San Francisco, California, USA
| | - Benjamin J Huang
- Department of Pediatrics, Division of Hematology/Oncology, University of California, UCSF Benioff Children's Hospital, San Francisco, California, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California, USA
| | - Gianina Wicaksono
- Department of Laboratory Medicine, University of California, San Francisco, California, USA
| | - Paul Phojanakong
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California, USA
| | | | - Elizabeth P Young
- Department of Pediatrics, Division of Hematology/Oncology, University of California, UCSF Benioff Children's Hospital, San Francisco, California, USA
| | - Emilio Ramos
- Department of Laboratory Medicine, University of California, San Francisco, California, USA
| | - Fernando Salangsang
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California, USA
| | - Veronica Steri
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California, USA
| | - Simayijiang Xirenayi
- Department of Pediatrics, Division of Hematology/Oncology, University of California, UCSF Benioff Children's Hospital, San Francisco, California, USA
| | - Michelle Hermiston
- Department of Pediatrics, Division of Hematology/Oncology, University of California, UCSF Benioff Children's Hospital, San Francisco, California, USA
- Department of Pediatrics, Division of Allergy, Immunology, and Bone Marrow Transplantation, University of California, UCSF Benioff Children's Hospital, San Francisco, California, USA
| | - Aaron C Logan
- Department of Medicine, Division of Hematology and Blood and Marrow Transplantation, University of California, San Francisco, California, USA
| | - Elliot Stieglitz
- Department of Pediatrics, Division of Hematology/Oncology, University of California, UCSF Benioff Children's Hospital, San Francisco, California, USA
| | - Arun P Wiita
- Department of Laboratory Medicine, University of California, San Francisco, California, USA
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, California, USA
- Chan Zuckerberg Biohub, San Francisco, California, USA
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7
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Ratti F, Marino R, Muiesan P, Zieniewicz K, Van Gulik T, Guglielmi A, Marques HP, Andres V, Schnitzbauer A, Irinel P, Schmelzle M, Sparrelid E, Fusai GK, Adam R, Cillo U, Lang H, Oldhafer K, Ruslan A, Ciria R, Ferrero A, Mazzaferro V, Cescon M, Giuliante F, Nadalin S, Golse N, Sulpice L, Serrablo A, Ramos E, Marchese U, Rosok B, Lopez-Lopez V, Clavien P, Aldrighetti L. Results from the european survey on preoperative management and optimization protocols for PeriHilar cholangiocarcinoma. HPB (Oxford) 2023; 25:1302-1322. [PMID: 37543473 DOI: 10.1016/j.hpb.2023.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/24/2023] [Accepted: 06/21/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Major surgery, along with preoperative cholestasis-related complications, are responsible for the increased risk of morbidity and mortality in perihilar cholangiocarcinoma (pCCA). The aim of the present survey is to provide a snapshot of current preoperative management and optimization strategies in Europe. METHODS 61 European centers, experienced in hepato-biliary surgery completed a 59-questions survey regarding pCCA preoperative management. Centers were stratified according to surgical caseload (<5 and ≥ 5 cases/year) and preoperative management protocols' application. RESULTS The overall case volume consisted of 6333 patients. Multidisciplinary discussion was routinely performed in 91.8% of centers. Most respondents (96.7%) recognized the importance of a well-structured preoperative protocol. The preferred method for biliary drainage was percutaneous transhepatic biliary drainage (60.7%) while portal vein embolization was the preferred technique for liver hypertrophy (90.2%). Differences in preoperative pathologic confirmation of malignancy (35.8% vs 28.7%; p < 0.001), number of mismanaged referred patients (88.2% vs 50.8%; p < 0.001), biliary drainage (65.1% vs 55.6%; p = 0.015) and liver function evaluation (37.2% vs 5.6%; p = 0.001) were found between centers according to groups' stratification. CONCLUSION The importance of a correct preoperative management is recognized. Nevertheless, the current lack of guidelines leads to wide heterogeneity of behaviors among centers. This survey can provide recommendations to improve pCCA perioperative outcomes.
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Affiliation(s)
- Francesca Ratti
- Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milano, Italy.
| | - Rebecca Marino
- Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milano, Italy
| | | | - Krzysztof Zieniewicz
- Dept of General, Transplant and Liver Surgery, Medical University, Warsaw, Poland
| | - Tomas Van Gulik
- Academic Medical Center, Erasmus Medica Center, Amsterdam, the Netherlands
| | - Alfredo Guglielmi
- General and Hepatobiliary Surgery, University of Verona, Verona, Italy
| | | | | | | | - Popescu Irinel
- Center of General Surgery and Liver Transplant, Fundeni Clinical Institut, Bucharest, Romania
| | | | | | | | - Renè Adam
- Paul Brousse University Hospital, Paris, France; Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Umberto Cillo
- Hepatobiliary Surgery and Liver Transplantation Unit, Padova, Italy
| | - Hauke Lang
- University Medical Center Mainz, Mainz, Germany
| | | | | | - Ruben Ciria
- University Hospital Reina Sofia, Cordoba, Spain
| | | | - Vincenzo Mazzaferro
- University of Milan, Department of Oncology and Hemato-Oncology, Istituto Nazionale Tumori, Milan, Italy
| | | | | | | | | | | | | | - Emilio Ramos
- Hospital Universitario de Bellvitge, Barcelona, Spain
| | | | | | | | | | - Luca Aldrighetti
- Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milano, Italy
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8
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Mandal K, Wicaksono G, Yu C, Adams JJ, Hoopmann MR, Temple WC, Izgutdina A, Escobar BP, Gorelik M, Ihling CH, Nix MA, Naik A, Xie WH, Hübner J, Rollins LA, Reid SM, Ramos E, Kasap C, Steri V, Serrano JAC, Salangsang F, Phojanakong P, McMillan M, Gavallos V, Leavitt AD, Logan AC, Rooney CM, Eyquem J, Sinz A, Huang BJ, Stieglitz E, Smith CC, Moritz RL, Sidhu SS, Huang L, Wiita AP. Structural surfaceomics reveals an AML-specific conformation of integrin β 2 as a CAR T cellular therapy target. Nat Cancer 2023; 4:1592-1609. [PMID: 37904046 PMCID: PMC10663162 DOI: 10.1038/s43018-023-00652-6] [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] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/12/2023] [Indexed: 11/01/2023]
Abstract
Safely expanding indications for cellular therapies has been challenging given a lack of highly cancer-specific surface markers. Here we explore the hypothesis that tumor cells express cancer-specific surface protein conformations that are invisible to standard target discovery pipelines evaluating gene or protein expression, and these conformations can be identified and immunotherapeutically targeted. We term this strategy integrating cross-linking mass spectrometry with glycoprotein surface capture 'structural surfaceomics'. As a proof of principle, we apply this technology to acute myeloid leukemia (AML), a hematologic malignancy with dismal outcomes and no known optimal immunotherapy target. We identify the activated conformation of integrin β2 as a structurally defined, widely expressed AML-specific target. We develop and characterize recombinant antibodies to this protein conformation and show that chimeric antigen receptor T cells eliminate AML cells and patient-derived xenografts without notable toxicity toward normal hematopoietic cells. Our findings validate an AML conformation-specific target antigen and demonstrate a tool kit for applying these strategies more broadly.
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Affiliation(s)
- Kamal Mandal
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Gianina Wicaksono
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Clinton Yu
- Department of Physiology and Biophysics, University of California Irvine, Irvine, CA, USA
| | - Jarrett J Adams
- The Donnelly Centre, University of Toronto, Toronto, Ontario, Canada
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | | | - William C Temple
- Department of Pediatrics, Division of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
- Department of Pediatrics, Division of Allergy, Immunology, and Bone Marrow Transplantation, University of California San Francisco, San Francisco, CA, USA
| | - Adila Izgutdina
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Bonell Patiño Escobar
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Maryna Gorelik
- The Donnelly Centre, University of Toronto, Toronto, Ontario, Canada
| | - Christian H Ihling
- Department of Pharmaceutical Chemistry and Bioanalytics, Institute of Pharmacy, Martin-Luther University Halle-Wittenberg, Halle, Germany
| | - Matthew A Nix
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Akul Naik
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - William H Xie
- UCSF/Gladstone Institute for Genomic Immunology, San Francisco, CA, USA
| | - Juwita Hübner
- Department of Pediatrics, Division of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Lisa A Rollins
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital-Texas Children's Hospital, Houston, TX, USA
| | - Sandy M Reid
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital-Texas Children's Hospital, Houston, TX, USA
| | - Emilio Ramos
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Corynn Kasap
- Department of Medicine, Division of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Veronica Steri
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Juan Antonio Camara Serrano
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Fernando Salangsang
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Paul Phojanakong
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Melanie McMillan
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Victor Gavallos
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Andrew D Leavitt
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Aaron C Logan
- Department of Medicine, Division of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Cliona M Rooney
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital-Texas Children's Hospital, Houston, TX, USA
| | - Justin Eyquem
- UCSF/Gladstone Institute for Genomic Immunology, San Francisco, CA, USA
- Department of Medicine, Division of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Andrea Sinz
- Department of Pharmaceutical Chemistry and Bioanalytics, Institute of Pharmacy, Martin-Luther University Halle-Wittenberg, Halle, Germany
| | - Benjamin J Huang
- Department of Pediatrics, Division of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Elliot Stieglitz
- Department of Pediatrics, Division of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Catherine C Smith
- Department of Medicine, Division of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
| | | | - Sachdev S Sidhu
- The Donnelly Centre, University of Toronto, Toronto, Ontario, Canada
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Lan Huang
- Department of Physiology and Biophysics, University of California Irvine, Irvine, CA, USA
| | - Arun P Wiita
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA.
- Chan Zuckerberg Biohub San Francisco, San Francisco, CA, USA.
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9
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Kwok DW, Stevers NO, Nejo T, Chen LH, Etxeberria I, Jung J, Okada K, Cove MC, Lakshmanachetty S, Gallus M, Barpanda A, Hong C, Chan GKL, Wu SH, Ramos E, Yamamichi A, Liu J, Watchmaker P, Ogino H, Saijo A, Du A, Grishanina N, Woo J, Diaz A, Chang SM, Phillips JJ, Wiita AP, Klebanoff CA, Costello JF, Okada H. Tumor-wide RNA splicing aberrations generate immunogenic public neoantigens. bioRxiv 2023:2023.10.19.563178. [PMID: 37904942 PMCID: PMC10614978 DOI: 10.1101/2023.10.19.563178] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
T-cell-mediated immunotherapies are limited by the extent to which cancer-specific antigens are homogenously expressed throughout a tumor. We reasoned that recurrent splicing aberrations in cancer represent a potential source of tumor-wide and public neoantigens, and to test this possibility, we developed a novel pipeline for identifying neojunctions expressed uniformly within a tumor across diverse cancer types. Our analyses revealed multiple neojunctions that recur across patients and either exhibited intratumor heterogeneity or, in some cases, were tumor-wide. We identified CD8+ T-cell clones specific for neoantigens derived from tumor-wide and conserved neojunctions in GNAS and RPL22 , respectively. TCR-engineered CD8 + T-cells targeting these mutations conferred neoantigen-specific tumor cell eradication. Furthermore, we revealed that cancer-specific dysregulation in splicing factor expression leads to recurrent neojunction expression. Together, these data reveal that a subset of neojunctions are both intratumorally conserved and public, providing the molecular basis for novel T-cell-based immunotherapies that address intratumoral heterogeneity.
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10
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Espinosa-Sotelo R, Fusté NP, Peñuelas-Haro I, Alay A, Pons G, Almodóvar X, Albaladejo J, Sánchez-Vera I, Bonilla-Amadeo R, Dituri F, Serino G, Ramos E, Serrano T, Calvo M, Martínez-Chantar ML, Giannelli G, Bertran E, Fabregat I. Dissecting the role of the NADPH oxidase NOX4 in TGF-beta signaling in hepatocellular carcinoma. Redox Biol 2023; 65:102818. [PMID: 37463530 PMCID: PMC10372458 DOI: 10.1016/j.redox.2023.102818] [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: 02/01/2023] [Revised: 07/05/2023] [Accepted: 07/12/2023] [Indexed: 07/20/2023] Open
Abstract
The NADPH oxidase NOX4 has been proposed as necessary for the apoptosis induced by the Transforming Growth Factor-beta (TGF-β) in hepatocytes and hepatocellular carcinoma (HCC) cells. However, whether NOX4 is required for TGF-β-induced canonical (SMADs) or non-canonical signals is not fully understood yet, neither its potential involvement in other parallel actions induced by TGF-β. In this work we have used CRISPR Cas9 technology to stable attenuate NOX4 expression in HCC cells. Results have indicated that NOX4 is required for an efficient SMAD2/3 phosphorylation in response to TGF-β, whereas non-canonical signals, such as the phosphorylation of the Epidermal Growth Receptor or AKT, are higher in NOX4 silenced cells. TGF-β-mediated inhibition of cell proliferation and viability is attenuated in NOX4 silenced cells, correlating with decreased response in terms of apoptosis, and maintenance of high expression of MYC and CYCLIN D1. These results would indicate that NOX4 is required for all the tumor suppressor actions of TGF-β in HCC. However, analysis in human HCC tumors has revealed a worse prognosis for patients showing high expression of TGF-β1-related genes concomitant with high expression of NOX4. Deepening into other tumorigenic actions of TGF-β that may contribute to tumor progression, we found that NOX4 is also required for TGF-β-induced migratory effects. The Epithelial-Mesenchymal transition (EMT) program does not appear to be affected by attenuation of NOX4 levels. However, TGF-β-mediated regulation of cytoskeleton dynamics and focal adhesions require NOX4, which is necessary for TGF-β-induced increase in the chaperone Hsp27 and correct subcellular localization of Hic-5 within focal adhesions, as well for upregulation of the metalloprotease MMP9. All these results together point to NOX4 as a key element in the whole TGF-β signaling in HCC cells, revealing an unknown role for NOX4 as tumor promoter in HCC patients presenting activation of the TGF-β pathway.
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Affiliation(s)
- Rut Espinosa-Sotelo
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBEREHD, ISCIII, Spain
| | - Noel P Fusté
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Irene Peñuelas-Haro
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBEREHD, ISCIII, Spain
| | - Ania Alay
- Unit of Bioinformatics for Precision Oncology, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Barcelona, Spain; Preclinical and Experimental Research in Thoracic Tumors (PReTT), Oncobell Program, IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Gabriel Pons
- Physiological Sciences Department, University of Barcelona, Oncobell-IDIBELL, Barcelona, Spain
| | - Xènia Almodóvar
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Júlia Albaladejo
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ismael Sánchez-Vera
- Physiological Sciences Department, University of Barcelona, Oncobell-IDIBELL, Barcelona, Spain
| | - Ricard Bonilla-Amadeo
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Francesco Dituri
- National Institute of Gastroenterology, IRCCS Saverio De Bellis Research Hospital, Castellana Wrotte, Bari, Italy
| | - Grazia Serino
- National Institute of Gastroenterology, IRCCS Saverio De Bellis Research Hospital, Castellana Wrotte, Bari, Italy
| | - Emilio Ramos
- CIBEREHD, ISCIII, Spain; Department of Surgery, Liver Transplant Unit, University Hospital of Bellvitge and Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Teresa Serrano
- CIBEREHD, ISCIII, Spain; Pathological Anatomy Service, University Hospital of Bellvitge and Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Mariona Calvo
- Oncología Médica, Institut Català d'Oncologia (ICO-IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - María Luz Martínez-Chantar
- CIBEREHD, ISCIII, Spain; Center for Cooperative Research in Biosciences (CIC BioGUNE), Basque Research and Technology Alliance (BRTA), Bizkaia Technology Park, Derio, Bizkaia, Spain
| | - Gianluigi Giannelli
- National Institute of Gastroenterology, IRCCS Saverio De Bellis Research Hospital, Castellana Wrotte, Bari, Italy
| | - Esther Bertran
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBEREHD, ISCIII, Spain
| | - Isabel Fabregat
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBEREHD, ISCIII, Spain.
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11
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Bejarano N, Busquets J, Peláez N, Secanella L, Sorribas M, Ramos E, Fabregat J. Experience in the resection of the uncinate process of the pancreas: Indications and results. Literature review. Cir Esp 2023; 101:522-529. [PMID: 36283601 DOI: 10.1016/j.cireng.2022.10.011] [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: 01/25/2022] [Revised: 07/25/2022] [Accepted: 08/21/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The aim of our study is to assess the accumulated experience in the use of uncinatectomy (UC) as a parenchymal-sparing pancreatectomy technique. METHOD We have carried out a observational and descriptive study including restrospectively all the patients undergoing UC at Hospital Universitary de Bellvitge (HUB) and an exhaustive review of the cases described in the english literature. RESULTS From 2003 to 2019, seven patients have been operated by UC in the HUB with a diagnostic orientation of pancreatic lesion considered premalignant. All patients have presented morbidity, mainly in the form of postoperative pancreatic fistula, and none of them have presented endocrine or exocrine pancreatic insufficiency. Currently, all patients are alive and without recurrence of neoplastic disease. Another 29 cases have been described in the literature. Of all the cases (36 patients), the approach was minimally invasive (laparoscopic or robotic) in 6 patients (16.7%), leading to a shorter hospital stay. The global incidence of pancreatic fistula is 50%, with a re-admission rate of less than 10%, but without requiring re-intervention. CONCLUSIONS UC is an infrequent and poorly standardized technique for the resection of benign lesions or those with low potential for malignancy located in the uncinate process of the pancreas. Although it is associated with equal or greater morbidity than standardized resection techniques, it offers excellent preservation of endocrine and exocrine pancreatic function, with the consequent long-term benefit in the patients life quality.
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Affiliation(s)
- Natalia Bejarano
- Hepato-Bilio-Pancreatic Surgery Unit, General and Digestive Surgery Service, Hospital Universitari Parc Taulí, Universitat Autònoma de Barcelona (UAB), Sabadell, Barcelona, Spain.
| | - Juli Busquets
- Hepato-Bilio-Pancreatic Surgery and Liver Transplantation Unit, General and Digestive Surgery Service, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Research Group of Hepato-biliary and Pancreatic Diseases, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Sapin
| | - Núria Peláez
- Hepato-Bilio-Pancreatic Surgery and Liver Transplantation Unit, General and Digestive Surgery Service, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Research Group of Hepato-biliary and Pancreatic Diseases, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Sapin
| | - Lluís Secanella
- Hepato-Bilio-Pancreatic Surgery and Liver Transplantation Unit, General and Digestive Surgery Service, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Research Group of Hepato-biliary and Pancreatic Diseases, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Sapin; Department of Fundamental and Medicosurgical Nursing, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Maria Sorribas
- Hepato-Bilio-Pancreatic Surgery and Liver Transplantation Unit, General and Digestive Surgery Service, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Emilio Ramos
- Hepato-Bilio-Pancreatic Surgery and Liver Transplantation Unit, General and Digestive Surgery Service, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Research Group of Hepato-biliary and Pancreatic Diseases, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Sapin
| | - Juan Fabregat
- Hepato-Bilio-Pancreatic Surgery and Liver Transplantation Unit, General and Digestive Surgery Service, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Research Group of Hepato-biliary and Pancreatic Diseases, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Sapin
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12
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Peñuelas‐Haro I, Espinosa‐Sotelo R, Crosas‐Molist E, Herranz‐Itúrbide M, Caballero‐Díaz D, Alay A, Solé X, Ramos E, Serrano T, Martínez‐Chantar ML, Knaus UG, Cuezva JM, Zorzano A, Bertran E, Fabregat I. The NADPH oxidase NOX4 regulates redox and metabolic homeostasis preventing HCC progression. Hepatology 2023; 78:416-433. [PMID: 35920301 PMCID: PMC10344438 DOI: 10.1002/hep.32702] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 07/29/2022] [Accepted: 08/02/2022] [Indexed: 12/08/2022]
Abstract
BACKGROUND AND AIMS The NADPH oxidase NOX4 plays a tumor-suppressor function in HCC. Silencing NOX4 confers higher proliferative and migratory capacity to HCC cells and increases their in vivo tumorigenic potential in xenografts in mice. NOX4 gene deletions are frequent in HCC, correlating with higher tumor grade and worse recurrence-free and overall survival rates. However, despite the accumulating evidence of a protective regulatory role in HCC, the cellular processes governed by NOX4 are not yet understood. Accordingly, the aim of this work was to better understand the molecular mechanisms regulated by NOX4 in HCC in order to explain its tumor-suppressor action. APPROACH AND RESULTS Experimental models: cell-based loss or gain of NOX4 function experiments, in vivo hepatocarcinogenesis induced by diethylnitrosamine in Nox4 -deficient mice, and analyses in human HCC samples. Methods include cellular and molecular biology analyses, proteomics, transcriptomics, and metabolomics, as well as histological and immunohistochemical analyses in tissues. Results identified MYC as being negatively regulated by NOX4. MYC mediated mitochondrial dynamics and a transcriptional program leading to increased oxidative metabolism, enhanced use of both glucose and fatty acids, and an overall higher energetic capacity and ATP level. NOX4 deletion induced a redox imbalance that augmented nuclear factor erythroid 2-related factor 2 (Nrf2) activity and was responsible for MYC up-regulation. CONCLUSIONS Loss of NOX4 in HCC tumor cells induces metabolic reprogramming in a Nrf2/MYC-dependent manner to promote HCC progression.
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Affiliation(s)
- Irene Peñuelas‐Haro
- TGF‐β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain
- CIBEREHD, ISCIII, Madrid, Spain
| | - Rut Espinosa‐Sotelo
- TGF‐β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain
- CIBEREHD, ISCIII, Madrid, Spain
| | - Eva Crosas‐Molist
- TGF‐β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Macarena Herranz‐Itúrbide
- TGF‐β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain
- CIBEREHD, ISCIII, Madrid, Spain
| | - Daniel Caballero‐Díaz
- TGF‐β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain
- CIBEREHD, ISCIII, Madrid, Spain
| | - Ania Alay
- Unit of Bioinformatics for Precision Oncology, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain
- Preclinical and Experimental Research in Thoracic Tumors, Oncobell Program, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Xavier Solé
- Unit of Bioinformatics for Precision Oncology, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain
- Preclinical and Experimental Research in Thoracic Tumors, Oncobell Program, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Molecular Biology CORE, Center for Biomedical Diagnostics, Hospital Clínic of Barcelona, Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Emilio Ramos
- CIBEREHD, ISCIII, Madrid, Spain
- Department of Surgery, Liver Transplant Unit, University Hospital of Bellvitge, Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Teresa Serrano
- CIBEREHD, ISCIII, Madrid, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
- Pathological Anatomy Service, University Hospital of Bellvitge, Barcelona, Spain
| | - María L. Martínez‐Chantar
- CIBEREHD, ISCIII, Madrid, Spain
- Liver Disease Lab, Center for Cooperative Research in Biosciences, Basque Research and Technology Alliance, Bizkaia Technology Park, Spain
| | - Ulla G. Knaus
- Conway Institute, University College Dublin, Dublin, Ireland
| | - José M. Cuezva
- Center for Molecular Biology “Severo Ochoa,” Autonoma University of Madrid, Madrid, Spain
- CIBERER, ISCIII, Madrid, Spain
| | - Antonio Zorzano
- Biochemistry and Molecular Biomedicine Department, University of Barcelona, Barcelona, Spain
- Institute of Research in Biomedicine, Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
- CIBERDEM, ISCIII, Madrid, Spain
| | - Esther Bertran
- TGF‐β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain
- CIBEREHD, ISCIII, Madrid, Spain
| | - Isabel Fabregat
- TGF‐β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain
- CIBEREHD, ISCIII, Madrid, Spain
- Physiological Sciences Department, University of Barcelona, Barcelona, Spain
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13
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Del Carpio LP, Algarra MA, Sabaté-Llobera A, Rodriguez-Vida A, Rossi-Seoane S, Ruiz S, Leiva D, Ramos E, Lladò L, Lorenzo D, Gutierrez C, Cortes-Romera M, Caminal JM, Piulats JM. Differences in glucose metabolic activity in liver metastasis separates two groups of metastatic uveal melanoma patients with different prognosis. Cancer Med 2023. [PMID: 37211960 DOI: 10.1002/cam4.6058] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 04/24/2023] [Accepted: 04/28/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Uveal melanoma metastasizes to the liver. We aimed to explore the metabolic activity of liver metastases (LM) as a biomarker for survival. METHODS We analyzed newly diagnosed patients with metastatic UM (MUM) with LM detected by liver-directed imaging and had undergone a PET/CT at diagnosis. FINDINGS 51 patients were identified between 2004 and 2019. Median age was 62 years, 41% male and 22% ECOG ≥1. LDH, ALP, and GGT were elevated in 49%, 37%, and 57% of patients. Median LM SUVmax was 8.5 (3-42.2). Same size lesions presented a wide range of metabolic activity. Median OS was 17.3 m (95% CI:10.6-23.9). Patients with SUVmax ≥8.5 had an OS of 9.4 m (95% CI:6.4-12.3), whereas patients with SUVmax <8.5 had an OS of 38.4 m (95% CI:21.4-55.5; p < 0.0001, HR = 2.9). We observed similar results when studying M1a disease separately. Multivariate analysis showed SUVmax as an independent prognostic factor for the whole population and those with M1a disease. INTERPRETATION Increased metabolic activity of LM seems to be an independent predictor of survival. MUM is a heterogeneous disease and metabolic activity probably reflects a different intrinsic behavior.
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Affiliation(s)
- Luis P Del Carpio
- Medical Oncology Department, Institut Català d'Oncologia - ICO, L'Hospitalet de Llobregat, IDIBELL, Barcelona, Spain
- Cancer ImmunoTherapy (CIT) Group - iPROCURE, Bellvitge Biomedical Research Institute IDIBELL-OncoBell, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Aida Sabaté-Llobera
- Nuclear Medicine Department, Institut de Diagnòstic per la Imatge - IDI, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Susana Rossi-Seoane
- Nuclear Medicine Department, Institut de Diagnòstic per la Imatge - IDI, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
- Nuclear Medicine Department, Centro Uruguayo de Imagen Molecular - CUDIM, Montevideo, Uruguay
| | - Sandra Ruiz
- Radiology Department, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - David Leiva
- Radiology Department, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Emilio Ramos
- Hepatic Surgery Department, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Laura Lladò
- Hepatic Surgery Department, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Daniel Lorenzo
- Ophthalmology Department, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Cristina Gutierrez
- Radiation Oncology Department, Institut Català d'Oncologia - ICO, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Montserrat Cortes-Romera
- Nuclear Medicine Department, Institut de Diagnòstic per la Imatge - IDI, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Josep M Caminal
- Ophthalmology Department, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Josep M Piulats
- Medical Oncology Department, Institut Català d'Oncologia - ICO, L'Hospitalet de Llobregat, IDIBELL, Barcelona, Spain
- Cancer ImmunoTherapy (CIT) Group - iPROCURE, Bellvitge Biomedical Research Institute IDIBELL-OncoBell, L'Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer - CIBERONC, Madrid, Spain
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14
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Golestani S, Trust MD, Olson KA, Hill C, Bokenkamp M, Coopwood B, Teixeira P, Aydelotte J, Cardenas T, Brown L, Ramos E, Ngoue M, Ali S, Ng C, Brown CV. If at First You Do Not Succeed: Consideration of Attempts in Patients With Trauma. J Surg Res 2023; 283:778-782. [PMID: 36470203 DOI: 10.1016/j.jss.2022.08.026] [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: 03/01/2021] [Revised: 08/08/2022] [Accepted: 08/22/2022] [Indexed: 12/09/2022]
Abstract
INTRODUCTION Failed extubation in critically ill patients is associated with poor outcomes. In critically ill trauma patients who have failed extubation, providers must decide whether to proceed with tracheostomy or attempt extubation again. The aim of this study was to describe the natural history of failed extubation in trauma patients and determine whether tracheostomy or a second attempt at extubation is more appropriate. METHODS Trauma patients admitted to our level I trauma center from 2013 to 2019 were identified. Patients who failed extubation, defined as an unplanned reintubation within 48 h of extubation, were included. Patients who immediately underwent tracheostomy were compared with those who had subsequent attempts at extubation. The primary outcome was mortality, and the secondary outcomes were intensive care unit (ICU) length of stay (LOS), ventilator days, and hospital LOS. RESULTS The population included 93 patients who failed extubation and met inclusion criteria. A total of 53 patients were ultimately successfully extubated, whereas 40 patients underwent a tracheostomy. There was no statistically significant difference in demographics or injury patterns. Patients who underwent tracheostomy had a longer ICU LOS and more ventilator days. There was no difference in mortality or hospital LOS between the two groups. CONCLUSIONS In trauma patients, those who underwent subsequent attempts at extubation did not experience higher rates of mortality than those who received a tracheostomy. Tracheostomy was associated with longer ICU LOS and ventilator days. In certain situations, it is appropriate to consider subsequent attempts at extubation in trauma patients who fail extubation rather than proceeding directly to tracheostomy.
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Affiliation(s)
- Simin Golestani
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas.
| | - Marc D Trust
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Kristophor A Olson
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Charles Hill
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Mary Bokenkamp
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Ben Coopwood
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Pedro Teixeira
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Jayson Aydelotte
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Tatiana Cardenas
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Lawrence Brown
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Emilio Ramos
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Marielle Ngoue
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Sadia Ali
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Chloe Ng
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Carlos Vr Brown
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin, Texas
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15
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Bokenkamp ME, Teixeira PG, Trust M, Cardenas T, Aydelotte J, Ngoue M, Ramos E, Ali S, Ng C, Brown CVR. Agitation in the Trauma Bay Is an Early Indicator of Hemorrhagic Shock. J Surg Res 2023; 283:586-593. [PMID: 36442258 DOI: 10.1016/j.jss.2022.10.090] [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: 05/25/2022] [Revised: 09/15/2022] [Accepted: 10/16/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Agitation on arrival in trauma patients is known as a sign of impending demise. The aim of this study is to determine outcomes for trauma patients who present in an agitated state. We hypothesized that agitation in the trauma bay is an early indicator for hemorrhage in trauma patients. METHODS We performed a single-institution prospective observational study from September 2018 to December 2020 that included any trauma patient who arrived agitated, defined as a Richmond Agitation-Sedation Scale of +1 to +4. Variables collected included demographics, mechanism of injury, admission physiology, blood alcohol level, toxicity screen, and injury severity. The primary outcomes were need for massive transfusion (≥ 10 units) and need for emergent therapeutic intervention for hemorrhage control (laparotomy, preperitoneal pelvic packing, sternotomy, thoracotomy, or angioembolization). RESULTS Of 4657 trauma admissions, 77 (2%) patients arrived agitated. Agitated patients were younger (40 versus 46, P = 0.03), predominantly male (94% versus 66%, P < 0.0001) sustained more penetrating trauma (31% versus 12%, P < 0.0001), had a lower systolic blood pressure (127 versus 137, P < 0.0001), and a higher Injury Severity Score (17 versus 9, P < 0.0001). On multivariable logistic regression, agitation was independently associated with massive transfusion (odds ratio: 2.63 [1.20-5.77], P = 0.02) and emergent therapeutic intervention for hemorrhage control (odds ratio: 2.60 [1.35-5.03], P = 0.005). CONCLUSIONS Agitation in trauma patients may serve as an early indicator of hemorrhagic shock, as agitation is independently associated with a two-fold increase in the need for massive transfusion and emergent therapeutic intervention for hemorrhage control.
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Affiliation(s)
- Mary E Bokenkamp
- Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, Texas.
| | - Pedro G Teixeira
- Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, Texas
| | - Marc Trust
- Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, Texas
| | - Tatiana Cardenas
- Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, Texas
| | - Jayson Aydelotte
- Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, Texas
| | - Marielle Ngoue
- Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, Texas
| | - Emilio Ramos
- Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, Texas
| | - Sadia Ali
- Trauma Services, Dell Seton Medical Center at the University of Texas at Austin, Austin, Texas
| | - Chloe Ng
- Trauma Services, Dell Seton Medical Center at the University of Texas at Austin, Austin, Texas
| | - Carlos V R Brown
- Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, Texas
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16
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Borjas G, Sanchez N, Urdaneta A, Gonzalez M, Ramos E, Maldonado A. Technical Aspects of Using a Second Magnetic Grasper to Improve the Surgical Field in Single Port Revisional Bariatric Surgery. Obes Surg 2023; 33:984-985. [PMID: 36645558 DOI: 10.1007/s11695-022-06438-6] [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: 09/13/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND The future of minimally invasive surgery in revisional surgery is experiencing changes with new equipment such as the magnetic assistance that can be used with single port devices in order to perform an incisionless surgery (Luengas R, Galindo J, Castro M, et al. Surg Obes Relat Dis. 2021;17(1):147-152). Magnetic assistance through an auxiliary grasper with two internal magnets serves beyond liver retraction in different steps of the surgery improving the surgical field by obtaining a better visualization and triangulation. PURPOSE Expose the feasibility of using two internal magnetic graspers by single port performing a conversion surgery of sleeve gastrectomy (SG) to Roux-en-Y gastric bypass (RYGB). METHODS A 36-year-old female patient underwent a SG in 2015 and consults in 2021 because of severe GERD with a 33-point GERD-HRQL score. She has preoperative evaluation for a conversion surgery from SG to RYGB. Using a single port device through the umbilicus, an additional 5 mm trocar was placed in the left side of the abdomen. Two internal magnets were introduced through the umbilicus, and they were controlled by two external magnets placed over the abdomen with an articulated arm. The first magnet was used for liver retraction and the second one to perform both anastomoses, close the intermesenteric and Petersen defect, acting as an auxiliary grasper. The ethical committee approval was obtained through an informed consent from the participant included in the study.
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Affiliation(s)
- G Borjas
- International Unit of Bariatric and Robotic Surgery Unit, Centro Clinica "La Sagrada Familia", Prolongación Vial Amparo, Las Lomas Con Avenida 63, Maracaibo, Venezuela. .,International Unit of Bariatric and Robotic Surgery Unit, Grupo Medico Santa Paula, Av. Circunvalación del Sol, Sector F, Urb. Santa Paula, Caracas, Venezuela. .,International Unit of Bariatric and Robotic Surgery Unit, Clínica Portoazul, Barranquilla, Colombia.
| | - N Sanchez
- International Unit of Bariatric and Robotic Surgery Unit, Centro Clinica "La Sagrada Familia", Prolongación Vial Amparo, Las Lomas Con Avenida 63, Maracaibo, Venezuela.,International Unit of Bariatric and Robotic Surgery Unit, Grupo Medico Santa Paula, Av. Circunvalación del Sol, Sector F, Urb. Santa Paula, Caracas, Venezuela.,International Unit of Bariatric and Robotic Surgery Unit, Clínica Portoazul, Barranquilla, Colombia
| | - A Urdaneta
- International Unit of Bariatric and Robotic Surgery Unit, Centro Clinica "La Sagrada Familia", Prolongación Vial Amparo, Las Lomas Con Avenida 63, Maracaibo, Venezuela.,International Unit of Bariatric and Robotic Surgery Unit, Grupo Medico Santa Paula, Av. Circunvalación del Sol, Sector F, Urb. Santa Paula, Caracas, Venezuela.,International Unit of Bariatric and Robotic Surgery Unit, Clínica Portoazul, Barranquilla, Colombia
| | - M Gonzalez
- International Unit of Bariatric and Robotic Surgery Unit, Centro Clinica "La Sagrada Familia", Prolongación Vial Amparo, Las Lomas Con Avenida 63, Maracaibo, Venezuela.,International Unit of Bariatric and Robotic Surgery Unit, Grupo Medico Santa Paula, Av. Circunvalación del Sol, Sector F, Urb. Santa Paula, Caracas, Venezuela.,International Unit of Bariatric and Robotic Surgery Unit, Clínica Portoazul, Barranquilla, Colombia
| | - E Ramos
- International Unit of Bariatric and Robotic Surgery Unit, Centro Clinica "La Sagrada Familia", Prolongación Vial Amparo, Las Lomas Con Avenida 63, Maracaibo, Venezuela.,International Unit of Bariatric and Robotic Surgery Unit, Grupo Medico Santa Paula, Av. Circunvalación del Sol, Sector F, Urb. Santa Paula, Caracas, Venezuela.,International Unit of Bariatric and Robotic Surgery Unit, Clínica Portoazul, Barranquilla, Colombia
| | - A Maldonado
- International Unit of Bariatric and Robotic Surgery Unit, Centro Clinica "La Sagrada Familia", Prolongación Vial Amparo, Las Lomas Con Avenida 63, Maracaibo, Venezuela.,International Unit of Bariatric and Robotic Surgery Unit, Grupo Medico Santa Paula, Av. Circunvalación del Sol, Sector F, Urb. Santa Paula, Caracas, Venezuela.,International Unit of Bariatric and Robotic Surgery Unit, Clínica Portoazul, Barranquilla, Colombia
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17
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Sabaté-Llobera A, Reynés-Llompart G, Mestres-Martí J, Gràcia-Sánchez L, Lladó L, Serrano T, Ramos E, Cortés-Romera M. Imaging Gallbladder Lesions: What Can Positron Emission Tomography/Computed Tomography Add to the Conventional Imaging Approach? J Comput Assist Tomogr 2023; 47:343-349. [PMID: 36723426 DOI: 10.1097/rct.0000000000001431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Incidental gallbladder lesions are common in imaging studies, although it is not always easy to discriminate benign lesions from gallbladder cancer with conventional imaging procedures. The present study aims to assess the capacity of positron emission tomography/computed tomography (PET/CT) with 2-[18F]FDG to distinguish between benign and malignant pathology of the gallbladder, compared with conventional imaging techniques (contrast-enhanced CT or magnetic resonance imaging). METHODS Positron emission tomography/CT and conventional imaging studies of 53 patients with gallbladder lesions were evaluated and visually classified as benign, malignant, or inconclusive. Agreement between PET/CT and conventional imaging was determined, and imaging findings were correlated with histology or follow-up. Positron emission tomography/CT images were also analyzed semiquantitatively (SUVmax and maximum tumor-to-liver ratio [TLRmax]). The presence of adenopathies and distant metastases was assessed and compared between both imaging procedures. RESULTS According to histology or follow-up, 33 patients (62%) had a malignant process and 20 (38%) had benign lesions. Positron emission tomography/CT and conventional imaging showed a moderate agreement (κ = 0.59). Conventional imaging classified more studies as inconclusive compared with PET/CT (17.0% and 7.5%, respectively), although both procedures showed a similar accuracy. Malignant lesions had significantly higher SUVmax and, especially, TLRmax (0.89 and 2.38 [P = 0.00028] for benign and malignant lesions, respectively). Positron emission tomography/CT identified more pathologic adenopathies and distant metastases, and patients with regional or distant spread had higher SUVmax and TLRmax in the gallbladder. CONCLUSIONS Positron emission tomography/CT is accurate to distinguish between benign and malignant pathology of the gallbladder, with a similar performance to conventional imaging procedures but with less inconclusive results. Malignant lesions present higher SUVmax and TLRmax values.
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Affiliation(s)
- Aida Sabaté-Llobera
- From the PET Unit, Department of Nuclear Medicine-IDI, University Hospital of Bellvitge-IDIBELL
| | | | - Judit Mestres-Martí
- From the PET Unit, Department of Nuclear Medicine-IDI, University Hospital of Bellvitge-IDIBELL
| | - Laura Gràcia-Sánchez
- From the PET Unit, Department of Nuclear Medicine-IDI, University Hospital of Bellvitge-IDIBELL
| | - Laura Lladó
- Hepato-biliary, Pancreatic and Liver Transplantation Unit, Department of Surgery
| | - Teresa Serrano
- Department of Pathology, University Hospital of Bellvitge-IDIBELL, Barcelona
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18
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Diaz M, Camargo L, Rojas A, Castillo E, Tavera L, López N, Ramos E, Porto M. Cognitive alterations in patients with alterations in sleep architecture in a court of Colombian patients. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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19
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Lopez-Lopez V, Kuemmerli C, Cutillas J, Maupoey J, López-Andujar R, Ramos E, Mils K, Valdivieso A, Valero AP, Martinez PA, Paterna S, Serrablo A, Reese T, Oldhafer K, Brusadin R, Conesa AL, Valladares LD, Loinaz C, Garcés-Albir M, Sabater L, Mocchegiani F, Vivarelli M, Pérez SA, Flores B, Lucena JL, Sánchez-Cabús S, Calero A, Minguillon A, Ramia JM, Alcazar C, Aguilo J, Ruiperez-Valiente JA, Grochola LF, Clavien PA, Petrowsky H, Robles-Campos R. Vascular injury during cholecystectomy: A multicenter critical analysis behind the drama. Surgery 2022; 172:1067-1075. [PMID: 35965144 DOI: 10.1016/j.surg.2022.06.020] [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: 03/10/2022] [Revised: 05/27/2022] [Accepted: 06/27/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The management of a vascular injury during cholecystectomy is still very complicated, especially in centers not specialized in complex hepatobiliary surgery. METHODS This was a multi-institutional retrospective study in patients with vascular injuries during cholecystectomy from 18 centers in 4 countries. The aim of the study was to analyze the management of vascular injuries focusing on referral, time to perform the repair, and different treatments options outcomes. RESULTS A total of 104 patients were included. Twenty-nine patients underwent vascular repair (27.9%), 13 (12.5%) liver resection, and 1 liver transplant as a first treatment. Eighty-four (80.4%) vascular and biliary injuries occurred in nonspecialized centers and 45 (53.6%) were immediately transferred. Intraoperative diagnosed injuries were rare in referred patients (18% vs 84%, P = .001). The patients managed at the hospital where the injury occurred had a higher number of reoperations (64% vs 20%, P ˂ .001). The need for vascular reconstruction was associated with higher mortality (P = .04). Two of the 4 patients transplanted died. CONCLUSION Vascular lesions during cholecystectomy are a potentially life-threatening complication. Management of referral to specialized centers to perform multiple complex multidisciplinary procedures should be mandatory. Late vascular repair has not shown to be associated with worse results.
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Affiliation(s)
- Victor Lopez-Lopez
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain.
| | - Christoph Kuemmerli
- Department of Surgery and Transplantation, University Hospital Zurich, Switzerland; Department of Surgery, Clarunis - University Center for Gastrointestinal and Liver Diseases Basel, Switzerland. https://twitter.com/ChristophKuemme
| | - Jose Cutillas
- Department of General Surgery, Hospital Francesc de Borja, Gandía, Valencia, Spain
| | - Javier Maupoey
- Department of Hepatobiliary Surgery and Transplants, Hospital Universitario La Fe, Valencia, Spain
| | - Rafael López-Andujar
- Department of Hepatobiliary Surgery and Transplants, Hospital Universitario La Fe, Valencia, Spain
| | - Emilio Ramos
- Department of Hepatobiliary Surgery and Liver Transplant Unit, Hospital Universitari Bellvitge, University of Barcelona, Barcelona, Spain
| | - Kristel Mils
- Department of Hepatobiliary Surgery and Liver Transplant Unit, Hospital Universitari Bellvitge, University of Barcelona, Barcelona, Spain
| | - Andres Valdivieso
- Hepatobiliary Surgery and Liver Transplant Unit, Cruces University Hospital, Bilbao, Spain
| | | | | | - Sandra Paterna
- Department of Surgery, Miguel Servet University Hospital, Zaragoza, Spain
| | - Alejando Serrablo
- Department of Surgery, Miguel Servet University Hospital, Zaragoza, Spain
| | - Tim Reese
- Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Asklepios Hospital Barmbek, Germany
| | - Karl Oldhafer
- Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Asklepios Hospital Barmbek, Germany
| | - Roberto Brusadin
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain
| | - Asunción López Conesa
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain
| | - Luis Díez Valladares
- Department of Surgery, Hepatopancreatobiliary Unit, Hospital Clínico San Carlos, Madrid, Spain
| | - Carmelo Loinaz
- Department of General Surgery, Digestive Tract and Abdominal Organ Transplantation, Hospital Universitario, 12 de Octubre, Madrid, Spain
| | - Marina Garcés-Albir
- Department of Surgery, Hospital Clinico Valencia, University of Valencia, Biomedical Research Institute (INCLIVA), Spain
| | - Luis Sabater
- Department of Surgery, Hospital Clinico Valencia, University of Valencia, Biomedical Research Institute (INCLIVA), Spain
| | - Federico Mocchegiani
- Hepatobiliary and Abdominal Transplantation Surgery, Department of Experimental and Clinical Medicine, Riuniti Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Marco Vivarelli
- Hepatobiliary and Abdominal Transplantation Surgery, Department of Experimental and Clinical Medicine, Riuniti Hospital, Polytechnic University of Marche, Ancona, Italy
| | | | - Benito Flores
- Department of Surgery, Morales University Hospital, Madrid, Spain
| | - Jose Luis Lucena
- Department of Surgery, Puerta del Hierro University Hospital, Madrid, Spain
| | - Santiago Sánchez-Cabús
- Hepatobiliopancreatic Surgery Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
| | - Alicia Calero
- Department of General Surgery, Elche University Hospital, University Miguel Hernández of Elche, Alicante, Spain
| | | | - Jose Manuel Ramia
- Department of Surgery, University Hospital of Alicante, Spain; Universidad Miguel Hernandez, Alicante, Spain
| | - Cándido Alcazar
- Department of Surgery, University Hospital of Alicante, Spain; Universidad Miguel Hernandez, Alicante, Spain
| | - Javier Aguilo
- Department of General Surgery, Hospital Lluís Alcanyís Hospital, Xàtiva, Valencia, Spain
| | | | - Lukasz Filip Grochola
- Clinic for Visceral and Thoracic Surgery, Cantonal Hospital of Winterthur, Switzerland
| | - Pierre-Alain Clavien
- Department of Surgery and Transplantation, University Hospital Zurich, Switzerland
| | - Henrik Petrowsky
- Department of Surgery and Transplantation, University Hospital Zurich, Switzerland
| | - Ricardo Robles-Campos
- Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain
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20
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Ferguson ID, Patiño-Escobar B, Tuomivaara ST, Lin YHT, Nix MA, Leung KK, Kasap C, Ramos E, Nieves Vasquez W, Talbot A, Hale M, Naik A, Kishishita A, Choudhry P, Lopez-Girona A, Miao W, Wong SW, Wolf JL, Martin TG, Shah N, Vandenberg S, Prakash S, Besse L, Driessen C, Posey AD, Mullins RD, Eyquem J, Wells JA, Wiita AP. The surfaceome of multiple myeloma cells suggests potential immunotherapeutic strategies and protein markers of drug resistance. Nat Commun 2022; 13:4121. [PMID: 35840578 PMCID: PMC9287322 DOI: 10.1038/s41467-022-31810-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 06/30/2022] [Indexed: 12/21/2022] Open
Abstract
The myeloma surface proteome (surfaceome) determines tumor interaction with the microenvironment and serves as an emerging arena for therapeutic development. Here, we use glycoprotein capture proteomics to define the myeloma surfaceome at baseline, in drug resistance, and in response to acute drug treatment. We provide a scoring system for surface antigens and identify CCR10 as a promising target in this disease expressed widely on malignant plasma cells. We engineer proof-of-principle chimeric antigen receptor (CAR) T-cells targeting CCR10 using its natural ligand CCL27. In myeloma models we identify proteins that could serve as markers of resistance to bortezomib and lenalidomide, including CD53, CD10, EVI2B, and CD33. We find that acute lenalidomide treatment increases activity of MUC1-targeting CAR-T cells through antigen upregulation. Finally, we develop a miniaturized surface proteomic protocol for profiling primary plasma cell samples with low inputs. These approaches and datasets may contribute to the biological, therapeutic, and diagnostic understanding of myeloma.
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Affiliation(s)
- Ian D Ferguson
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
- Cancer Biology Program, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Sami T Tuomivaara
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Yu-Hsiu T Lin
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Matthew A Nix
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Kevin K Leung
- Department of Pharmaceutical Chemistry, University of California, San Francisco, CA, USA
| | - Corynn Kasap
- Department of Medicine, Division of Hematology/Oncology, University of California, San Francisco, CA, USA
| | - Emilio Ramos
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Wilson Nieves Vasquez
- Department of Cellular and Molecular Pharmacology, University of California, San Francisco, CA, USA
| | - Alexis Talbot
- Department of Medicine, Division of Hematology/Oncology, University of California, San Francisco, CA, USA
- INSERM U976, Institut de Recherche Saint Louis, Université de Paris, Paris, France
| | - Martina Hale
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Akul Naik
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Audrey Kishishita
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
- Program in Chemistry and Chemical Biology, University of California, San Francisco, CA, USA
| | - Priya Choudhry
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | | | - Weili Miao
- Program in Epithelial Biology, Stanford University School of Medicine, Stanford, CA, USA
| | - Sandy W Wong
- Department of Pharmaceutical Chemistry, University of California, San Francisco, CA, USA
| | - Jeffrey L Wolf
- Department of Pharmaceutical Chemistry, University of California, San Francisco, CA, USA
| | - Thomas G Martin
- Department of Pharmaceutical Chemistry, University of California, San Francisco, CA, USA
| | - Nina Shah
- Department of Pharmaceutical Chemistry, University of California, San Francisco, CA, USA
| | - Scott Vandenberg
- Department of Pathology, University of California, San Francisco, CA, USA
| | - Sonam Prakash
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Lenka Besse
- Department of Medical Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Christoph Driessen
- Department of Medical Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Avery D Posey
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - R Dyche Mullins
- Department of Medicine, Division of Hematology/Oncology, University of California, San Francisco, CA, USA
- Howard Hughes Medical Institute, San Francisco, CA, USA
| | - Justin Eyquem
- Department of Pharmaceutical Chemistry, University of California, San Francisco, CA, USA
- Parker Institute for Cancer Immunotherapy, San Francisco, CA, USA
- Gladstone Institute for Genomic Immunology, San Francisco, CA, USA
| | - James A Wells
- Department of Pharmaceutical Chemistry, University of California, San Francisco, CA, USA
| | - Arun P Wiita
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA.
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21
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Alves J, Perelman J, Ramos E, Kunst AE. Intergenerational transmission of parental smoking: when are offspring most vulnerable? Eur J Public Health 2022; 32:741-746. [PMID: 35712820 PMCID: PMC9527976 DOI: 10.1093/eurpub/ckac065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Previous literature has showed that the likelihood of smoking is higher among offspring with smoking parents. The aim of this cohort study is to investigate during which smoking initiation stages and at what ages adolescents are more likely to be influenced by parental smoking. METHODS This study used the EPITeen Cohort, which recruited 13-year-old adolescents born in 1990, enrolled at schools in Porto, Portugal. Participants (n = 996) were followed across four waves at 13, 17, 21 and 24 years old. We computed the odds ratio (OR) and 95% confidence intervals for the prevalence of the different smoking states (never smoking, experimenter, less than daily smoker, daily smoker and former smoker), and incidence transitions between these states (to smoking experimenter; to less than daily smoker, to daily smoker; to former smoker) as function of age, parental smoking status and their interaction. RESULTS Compared with other participants, those with two smoking parents had an increased prevalence of experimentation at 13 years (OR for the interaction at 13 years compared with 24 years = 2.13 [1.50-3.01]) and daily smoking at all ages (OR for parental smoking =1.91 [1.52-2.40]). The latter increase is related to a significantly increased risk to transit from early smoking stages to daily smoking at all ages (OR for parental smoking = 1.83 [1.43-2.34]). CONCLUSIONS Parental smoking influences offspring's daily smoking prevalence especially by increasing the risk to transit to daily smoking up to early adulthood. Prevention should focus on parents and parental influences especially among offspring who may transition to daily smokers.
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Affiliation(s)
- J Alves
- NOVA National School of Public Health, Public Health Research Centre, CISP, NOVA University Lisbon, Lisbon, Portugal.,NOVA National School of Public Health, Comprehensive Health Research Centre, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | - J Perelman
- NOVA National School of Public Health, Public Health Research Centre, CISP, NOVA University Lisbon, Lisbon, Portugal.,NOVA National School of Public Health, Comprehensive Health Research Centre, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | - E Ramos
- Faculty of Medicine, Department of Public Health and Forensic Sciences, and Medical Education, University of Porto, Porto, Portugal.,EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
| | - A E Kunst
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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22
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Barrios O, Mils K, Lladó L, Lopez-Dominguez J, Ramos E. A complicated peribiliary cyst: An unusual hilar cholangiocarcinoma mimic. Hepatobiliary Pancreat Dis Int 2022; 21:193-195. [PMID: 34134942 DOI: 10.1016/j.hbpd.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 05/27/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Oriana Barrios
- Division of Hepatobiliary Surgery, Bellvitge University Hospital, Barcelona 08907, Spain.
| | - Kristel Mils
- Division of Hepatobiliary Surgery, Bellvitge University Hospital, Barcelona 08907, Spain
| | - Laura Lladó
- Division of Hepatobiliary Surgery, Bellvitge University Hospital, Barcelona 08907, Spain
| | | | - Emilio Ramos
- Division of Hepatobiliary Surgery, Bellvitge University Hospital, Barcelona 08907, Spain
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23
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Savier E, De Rycke Y, Lim C, Goumard C, Rousseau G, Perdigao F, Rufat P, Salloum C, Llado L, Ramos E, Lopez‐Dominguez J, Cachero A, Fabregat J, Azoulay D, Scatton O. Novel Composite Endpoint for Assessing Outcomes in Liver Transplantation: Arterial and Biliary Complication-Free Survival. Liver Transpl 2022; 28:75-87. [PMID: 34403191 PMCID: PMC9293155 DOI: 10.1002/lt.26269] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 07/02/2021] [Accepted: 07/19/2021] [Indexed: 01/13/2023]
Abstract
Transplant and patient survival are the validated endpoints to assess the success of liver transplantation (LT). This study evaluates arterial and biliary complication-free survival (ABCFS) as a new metric. ABC, considered as an event, was an arterial or biliary complication of Dindo-Clavien grade ≥III complication dated at the interventional, endoscopic, or surgical treatment required to correct it. ABCFS was defined as the time from the date of LT to the dates of first ABC, death, relisting, or last follow-up (transplant survival is time from LT to repeat LT or death). Following primary whole LT (n = 532), 106 ABCs occurred and 99 (93%) occurred during the first year after LT. An ABC occurring during the first year after LT (overall rate 19%) was an independent factor associated with transplant survival (hazard ratio [HR], 3.17; P < 0.001) and patient survival (HR, 2.7; P = 0.002) in univariate and multivariate analyses. This result was confirmed after extension of the cohort to split-liver graft, donation after circulatory death, or re-LT (n = 658). Data from 2 external cohorts of primary whole LTs (n = 249 and 229, respectively) confirmed that the first-year ABC was an independent prognostic factor for transplant survival but not for patient survival. ABCFS was correlated with transplant and patient survival (ρ = 0.85 [95% CI, 0.78-0.90] and 0.81 [95% CI, 0.71-0.88], respectively). Preoperative factors known to influence 5-year transplant survival influenced ABCFS after 1 year of follow-up. The 1-year ABCFS was indicative of 5-year transplant survival. ABCFS is a reproducible metric to evaluate the results of LT after 1 year of follow-up and could serve as a new endpoint in clinical trials.
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Affiliation(s)
- Eric Savier
- Service de Chirurgie DigestiveHépato‐Bilio‐PancréatiqueTransplantation HépatiqueCentre Hospitalo‐Universitaire Pitié‐SalpêtriereAssistance Publique‐Hôpitaux de ParisSorbonne UniversitéParisFrance,Centre de Recherche Saint‐AntoineUnité Mixte de Recherche Scientifique‐938Institute of Cardiometabolism and NutritionSorbonne UniversitéInstitut National de la Santé et de la Recherche MédicaleParisFrance
| | - Yann De Rycke
- Institut Pierre Louis d’Epidémiologie et de Santé PubliqueSorbonne UniversitéInstitut National de la Santé et de la Recherche MédicaleParisFrance,Département de Santé PubliqueAssistance Publique‐Hôpitaux de ParisHôpital Pitié SalpêtrièreSorbonne UniversitéParisFrance,Centre de Pharmacoépidémiologie (Cephepi)CHU Pitié‐Salpêtrièrere, Assistance Publique‐Hôpitaux de Paris (APHP), Sorbonne UniversitéParisFrance
| | - Chetana Lim
- Service de Chirurgie DigestiveHépato‐Bilio‐PancréatiqueTransplantation HépatiqueCentre Hospitalo‐Universitaire Pitié‐SalpêtriereAssistance Publique‐Hôpitaux de ParisSorbonne UniversitéParisFrance
| | - Claire Goumard
- Service de Chirurgie DigestiveHépato‐Bilio‐PancréatiqueTransplantation HépatiqueCentre Hospitalo‐Universitaire Pitié‐SalpêtriereAssistance Publique‐Hôpitaux de ParisSorbonne UniversitéParisFrance,Centre de Recherche Saint‐AntoineUnité Mixte de Recherche Scientifique‐938Institute of Cardiometabolism and NutritionSorbonne UniversitéInstitut National de la Santé et de la Recherche MédicaleParisFrance
| | - Geraldine Rousseau
- Service de Chirurgie DigestiveHépato‐Bilio‐PancréatiqueTransplantation HépatiqueCentre Hospitalo‐Universitaire Pitié‐SalpêtriereAssistance Publique‐Hôpitaux de ParisSorbonne UniversitéParisFrance
| | - Fabiano Perdigao
- Service de Chirurgie DigestiveHépato‐Bilio‐PancréatiqueTransplantation HépatiqueCentre Hospitalo‐Universitaire Pitié‐SalpêtriereAssistance Publique‐Hôpitaux de ParisSorbonne UniversitéParisFrance
| | - Pierre Rufat
- Département d'Informatique MédicaleAssistance Publique‐Hôpitaux de ParisHôpitaux Universitaires Pitié Salpêtrière–Charles FoixSorbonne UniversitéParisFrance
| | - Chady Salloum
- Centre Hépato‐BiliaireAssistance Publique‐Hôpitaux de Paris Hôpital Paul BrousseVillejuifFrance
| | - Laura Llado
- Department of Hepato‐Biliary and Pancreatic Surgery and Liver TransplantationHospital Universitari de BellvitgeInstitut d'Investigacio Biomedica de BellvitgeBarcelonaSpain
| | - Emilio Ramos
- Department of Hepato‐Biliary and Pancreatic Surgery and Liver TransplantationHospital Universitari de BellvitgeInstitut d'Investigacio Biomedica de BellvitgeBarcelonaSpain
| | - Josefina Lopez‐Dominguez
- Department of Hepato‐Biliary and Pancreatic Surgery and Liver TransplantationHospital Universitari de BellvitgeInstitut d'Investigacio Biomedica de BellvitgeBarcelonaSpain
| | - Alba Cachero
- Department of Hepato‐Biliary and Pancreatic Surgery and Liver TransplantationHospital Universitari de BellvitgeInstitut d'Investigacio Biomedica de BellvitgeBarcelonaSpain
| | - Joan Fabregat
- Department of Hepato‐Biliary and Pancreatic Surgery and Liver TransplantationHospital Universitari de BellvitgeInstitut d'Investigacio Biomedica de BellvitgeBarcelonaSpain
| | - Daniel Azoulay
- Centre Hépato‐BiliaireAssistance Publique‐Hôpitaux de Paris Hôpital Paul BrousseVillejuifFrance
| | - Olivier Scatton
- Service de Chirurgie DigestiveHépato‐Bilio‐PancréatiqueTransplantation HépatiqueCentre Hospitalo‐Universitaire Pitié‐SalpêtriereAssistance Publique‐Hôpitaux de ParisSorbonne UniversitéParisFrance,Centre de Recherche Saint‐AntoineUnité Mixte de Recherche Scientifique‐938Institute of Cardiometabolism and NutritionSorbonne UniversitéInstitut National de la Santé et de la Recherche MédicaleParisFrance
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Consiglieri CF, Ramos E, Gornals JB. The Endoscopic-White test: detection of a Whipple anastomotic leakage using linoleic ac. as an endoscopic dye. Gastroenterología y Hepatología 2022; 45:464-465. [DOI: 10.1016/j.gastrohep.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/23/2021] [Accepted: 01/05/2022] [Indexed: 10/19/2022]
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25
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Busquets J, Lopez-Dominguez J, Gonzalez-Castillo A, Vila M, Pelaez N, Secanella L, Ramos E, Fabregat J. Pancreas sparing duodenectomy in the treatment of primary duodenal neoplasms and other situations with duodenal involvement. Hepatobiliary Pancreat Dis Int 2021; 20:485-492. [PMID: 33753002 DOI: 10.1016/j.hbpd.2021.02.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 02/26/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND There are no clearly defined indications for pancreas-preserving duodenectomy. The present study aimed to analyze postoperative morbidity and the outcomes of patients undergoing pancreas-preserving duodenectomy. METHODS Patients undergoing pancreas-preserving duodenectomy from April 2008 to May 2020 were included. We divided the series according to indication: scenario 1, primary duodenal tumors; scenario 2, tumors of another origin with duodenal involvement; and scenario 3, emergency duodenectomy. RESULTS We included 35 patients. Total duodenectomy was performed in 1 patient of adenomatous duodenal polyposis, limited duodenectomy in 7, and third + fourth duodenal portion resection in 27. The indications for scenario 1 were gastrointestinal stromal tumor (n = 13), adenocarcinoma (n = 4), neuroendocrine tumor (n = 3), duodenal adenoma (n = 1), and adenomatous duodenal polyposis (n = 1); scenario 2: retroperitoneal desmoid tumor (n = 2), recurrence of liposarcoma (n = 2), retroperitoneal paraganglioma (n = 1), neuroendocrine tumor in pancreatic uncinate process (n = 1), and duodenal infiltration due to metastatic adenopathies of a germinal tumor with digestive hemorrhage (n = 1); and scenario 3: aortoenteric fistula (n = 3), duodenal trauma (n = 1), erosive duodenitis (n = 1), and biliopancreatic limb ischemia (n = 1). Severe complications (Clavien-Dindo ≥ IIIb) developed in 14% (5/35), and postoperative mortality was 3% (1/35). CONCLUSIONS Pancreas-preserving duodenectomy is useful in the management of primary duodenal tumors, and is a technical option for some tumors with duodenal infiltration or in emergency interventions.
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Affiliation(s)
- Juli Busquets
- Department of Hepatobiliary and Pancreatic Surgery, Hospital Universitari de Bellvitge, Research Group of Hepato-biliary and Pancreatic Diseases, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, Barcelona University, L'Hospitalet de Llobregat, Barcelona 08907, Spain.
| | - Josefina Lopez-Dominguez
- Department of Hepatobiliary and Pancreatic Surgery, Hospital Universitari de Bellvitge, Research Group of Hepato-biliary and Pancreatic Diseases, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, Barcelona University, L'Hospitalet de Llobregat, Barcelona 08907, Spain
| | | | - Marina Vila
- Department of General Surgery, Hospital de Mataró, Barcelona 08907, Spain
| | - Nuria Pelaez
- Department of Hepatobiliary and Pancreatic Surgery, Hospital Universitari de Bellvitge, Research Group of Hepato-biliary and Pancreatic Diseases, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, Barcelona University, L'Hospitalet de Llobregat, Barcelona 08907, Spain
| | - Lluis Secanella
- Department of Hepatobiliary and Pancreatic Surgery, Hospital Universitari de Bellvitge, Research Group of Hepato-biliary and Pancreatic Diseases, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, Barcelona University, L'Hospitalet de Llobregat, Barcelona 08907, Spain
| | - Emilio Ramos
- Department of Hepatobiliary and Pancreatic Surgery, Hospital Universitari de Bellvitge, Research Group of Hepato-biliary and Pancreatic Diseases, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, Barcelona University, L'Hospitalet de Llobregat, Barcelona 08907, Spain
| | - Juan Fabregat
- Department of Hepatobiliary and Pancreatic Surgery, Hospital Universitari de Bellvitge, Research Group of Hepato-biliary and Pancreatic Diseases, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, Barcelona University, L'Hospitalet de Llobregat, Barcelona 08907, Spain
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26
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Maldonado AA, Ramos E, García-Alonso P, Jover JJ, Holguín P, Fernández-Cañamaque JL, Cristóbal L. [Multidisciplinary approach in the lymphedema patient: From rehabilitation to microsurgery]. Rehabilitacion (Madr) 2021; 56:150-158. [PMID: 34538653 DOI: 10.1016/j.rh.2021.06.003] [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: 11/08/2020] [Revised: 02/02/2021] [Accepted: 06/11/2021] [Indexed: 10/20/2022]
Abstract
Lymphedema is a chronic disease with a high incidence in our society. In this paper, we present a review with the latest advances in imaging techniques and surgical reconstructive treatment of lymphedema (lymphovenous anastomosis, vascularized lymph node transfer, and prophylactic lymphedema surgery). In addition, a protocol is established based on a multidisciplinary team (composed of physiatrists, plastic surgeons, radiologists and nuclear medicine radiologists) to optimize the treatment of these patients.
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Affiliation(s)
- A A Maldonado
- Departamento de Cirugía Plástica, Hospital Universitario Getafe, Getafe (Madrid), España; Department of Plastic, Hand and Reconstructive Surgery, BG Trauma Center Frankfurt am Main, Academic Hospital of the Goethe University Frankfurt am Main, Frankfurt am Main, Frankfurt, Alemania.
| | - E Ramos
- Departamento de Rehabilitación, Hospital Universitario Getafe, Getafe (Madrid), España
| | - P García-Alonso
- Departamento de Medicina Nuclear, Hospital Universitario Getafe, Getafe (Madrid), España
| | - J J Jover
- Departmento de Radiología, Hospital Universitario Getafe, Getafe (Madrid), España
| | - P Holguín
- Departamento de Cirugía Plástica, Hospital Universitario Getafe, Getafe (Madrid), España
| | | | - L Cristóbal
- Departamento de Cirugía Plástica, Hospital Universitario Getafe, Getafe (Madrid), España
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27
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Derksen M, Kourula S, Jacobs F, Lee Roos J, Van Heerden M, Frazer-Mendelewska E, Ramos E, Lai K, Jonkers S, Theuns V, Verboven P, Huybrechts T, van Asten S, Kunze A, Jardi F, Monshouwer M, Vries R, Boj S, Snoeys J, Pourfarzad F. HUB Organoids™ improve pre-clinical toxicology, metabolism, and pharmacokinetic studies for drug discovery and development. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00534-8] [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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28
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Rafecas A, Torras J, Fabregat J, Lladó L, Secanella L, Busquets J, Serrano T, Ramos E. Intrahepatic cholangiocarcinoma: Prognostic factors for recurrence and survival in a series of 67 patients treated surgically at a single center. Cir Esp 2021; 99:506-513. [PMID: 34229980 DOI: 10.1016/j.cireng.2021.06.015] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 07/04/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Intrahepatic cholangiocarcinoma is a primary liver neoplasm whose only curative treatment is surgery. The objective of this study was to determine the prognostic factors for survival of intrahepatic cholangiocarcinoma treated surgically with curative intent. METHODS Sixty-seven patients who had been treated surgically for this neoplasm were collected at Bellvitge University Hospital between 1996 and 2017. Epidemiological, clinical, surgical, anatomopathological, morbidity, mortality and survival data have been analysed. RESULTS Postoperative study reflects our centre's experience in the surgical treatment of intrahepatic cholangiocarcinoma over a period of 21 years. Lymphadenectomy was associated with increased morbidity, and vascular invasion in the pathological study was the most important risk factor in the survival analysis. CONCLUSIONS This study reflects our centre's experience in the surgical treatment of intrahepatic cholangiocarcinoma over a period of 21 years. Lymphadenectomy was associated with increased morbidity, and vascular invasion in the pathological study was the most important risk factor in the survival analysis.
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Affiliation(s)
- Antoni Rafecas
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), Spain.
| | - Jaume Torras
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Joan Fabregat
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Laura Lladó
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Lluís Secanella
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Juli Busquets
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Teresa Serrano
- Servicio de Anatomía Patológica, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Emilio Ramos
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), Spain
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Gracia Tello B, Ramos E, Simeón-Aznar CP, Fonollosa Pla V, Guillén-Del-Castillo A, Selva-O’callaghan A, Sáez-Comet L, Martínez Robles E, Rios JJ, Espinosa G, Todolí Parra JA, Callejas-Rubio JL, Ortego N, Marí-Alfonso B, Freire M, Fanlo P. POS1408 REPRODUCIBILITY OF A NEW AUTOMATIC SYSTEM (CAPILLARY.IO) IN THE ANALYSIS OF NAILFOLD CAPILLAROSCOPY IMAGES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4063] [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
Background:Nailfold Capillaroscopy is a simple, inexpensive and non-invasive technique that allows microvascular damage to be observed, gaining recent importance in the diagnosis, monitoring and prognosis of many diseases with microangiopathy. However, the variability in the results interpretation has led to the development of new computerized systems that allow the automatic analysis of capillaroscopic images.Objectives:to compare the degree of agreement between the automatic system Capillary.io and a gold standard obtained from the agreement of 9 expert capillaroscopists and to know the degree of the interobserver reliability To demonstrate the validity of the system to detect normal and enlarged capillaries, hemorrhages, megacapillaries, ramifications and tortuosities.Methods:a cross-sectional study was performed in which 300 random and anonymous nailfold capillaroscopic images (1165 capillaries) were analyzed by 9 experienced observers. The degree of interobserver agreement was calculated from the 5 users. Likewise, the system performed an automatic assessment of the images and their agreement with the gold standard was calculated (interobserver agreement greater than 5, 6, 7, 8 and 9 successively). The validity of the program for each variable was also analyzed using sensitivity and specificity, positive and negative predictive values, and likelihood ratios, as well as their degree of agreement using the weighted kappa statistic (95% CI, p <0.05). The programs used for statistical calculations were SPSS 22.0 and EPIDAT 3.0.Results:the degree of interobserver agreement was 76.5% for the agreement of 5 or more observers, progressively decreasing to 15.4% for the 9 observers. Capillary.io obtained higher levels of agreement, reaching 97.7% for the 9 observers. Statistically significant results were obtained in the automated detection of all the morphological alterations analyzed Capillary.io presented a sensitivity (S) of 79.82% and a specificity (E) of 82% in the recognition of normal capillaries. The automatized system was able to recognize enlarged capillaries with a sensitivity of 86.97% and a specificity of 81.38%. Megacapillaries were detected with 89.41% sensitivity and 78.75% specificity. Similarly, the system was able to detect tortuosities (S 66.94%; E 67.71%), ramifications (S 54.34%; E 58.61%) and hemorrhages (S 71.36; E 73.97%).Conclusion:Capillary.io demonstrated a high degree of agreement with the gold standard, stronger with greater consensus among observers. It was able to detect with great sensitivity and specificity hemorrhages and megacapillaries, very relevant alterations in microangiopathies.References:[1]Roldán LMC, Franco CJV, Navas MAM. Capillaroscopy in systemic sclerosis: A narrative literature review. Rev Colomb Reumatol; 2016; 23: 250-8.[2]Ingegnoli F, Gualtierotti R, Lubatti C, Bertolazzi C, Gutierrez M, Boracchi P, et al. Nailfold capillary patterns in healthy subjects: A real issue in capillaroscopy. Microvasc Res. 2013;90:90-5.[3]Cutolo M, Pizzorni C, Secchi ME, Sulli A. Capillaroscopy. Best Pract Res Clin Rheumatol. 2008; 22:1093-108.[4]Tavakol ME, Fatemi A, Karbalaie A, Emrani Z, Erlandsson BE. Nailfold Capillaroscopy in Rheumatic Diseases: Which Parameters Should Be Evaluated? BioMed Res Int. 2015; 2015: 974530.[5]Smith V, Herrick AL, Ingegnoli F, Damjanov N, De Angelis R, Denton CP, et al. Standardisation of nailfold capillaroscopy for the assessment of patients with Raynaud’s phenomenon and systemic sclerosis. Autoimmunity Reviews. 2020; 19: 102458.Disclosure of Interests:Borja Gracia Tello Shareholder of: Co-founder and shareholder of Capillary.io., Eduardo Ramos Shareholder of: Co-founder and shareholder of Capillary.io., Carmen Pilar Simeón-Aznar: None declared, Vicent Fonollosa Pla: None declared, Alfredo Guillén-Del-Castillo: None declared, Albert Selva-O’Callaghan: None declared, Luis Sáez-Comet: None declared, Elena Martínez Robles: None declared, Juan José Rios: None declared, Gerard Espinosa: None declared, Jose Antonio Todolí Parra: None declared, Jose Luis Callejas-Rubio: None declared, Norberto Ortego: None declared, Begoña Marí-Alfonso: None declared, Mayka Freire: None declared, Patricia Fanlo: None declared
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Llado L, Iborra E, Ramos E, Sabé N, Cachero A, Fabregat J. Extra-anatomic aortic bypass for the treatment of a mycotic pseudoaneurysm after liver transplantation for hilar cholangiocarcinoma. Hepatobiliary Pancreat Dis Int 2021; 20:285-287. [PMID: 32893144 DOI: 10.1016/j.hbpd.2020.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 08/18/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Laura Llado
- Liver Transplant Unit, Hospital Universitari Bellvitge, University of Barcelona, Barcelona, Spain.
| | - Elena Iborra
- Vascular Surgery Department, Hospital Universitari Bellvitge, University of Barcelona, Barcelona, Spain
| | - Emilio Ramos
- Liver Transplant Unit, Hospital Universitari Bellvitge, University of Barcelona, Barcelona, Spain
| | - Nuria Sabé
- Infectious Disease Department, Hospital Universitari Bellvitge, University of Barcelona, Barcelona, Spain
| | - Alba Cachero
- Liver Transplant Unit, Hospital Universitari Bellvitge, University of Barcelona, Barcelona, Spain
| | - Joan Fabregat
- Liver Transplant Unit, Hospital Universitari Bellvitge, University of Barcelona, Barcelona, Spain
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Ramos E, Guillén-Del-Castillo A, Simeón-Aznar CP, Gracia Tello B, Fonollosa Pla V, Selva-O’callaghan A, Sáez-Comet L, Martínez Robles E, Rios JJ, Espinosa G, Todolí Parra JA, Callejas-Rubio JL, Ortego N, Marí-Alfonso B, Freire M, Fanlo P. POS1409 AUTOMATED DETECTION OF SCLERODERMIFORM PATTERNS USING CAPILLARY.IO. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4112] [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
Background:A nailfold capillaroscopy procedure is a non-invasive, low-cost, and well-established examination that can be used to diagnose several rheumatic autoimmune diseases and support the necessary follow-up of patients. While the clinical implications of the technique are known, a rigorous and in-depth examination of nailfold capillaries remains as one of the major challenges to produce new advances in research and diagnosis, due to practical limitations for analysing the whole nailfold area of each patient. The difference between the different patterns established by Maricq and Cutolo makes it possible to predict the evolution that the patient will present. We introduce Capillary.io, an automatic image reading system able to recognize capillaries in images obtained with any microscope, generate automatic measurements of each capillary and take advantage of this information to report capillary morphology and patterns.Objectives:to determine the ability to detect active and early scerodermiform patterns of Capillary.io.Methods:Forty-nine complete capillaroscopies, reported by expert capillaroscopists according to the different patterns manually (gold standard), were compared with the pattern detection capability of Capillary.io. A scoring system based on the algorithm of the Spanish Capillaroscopy Study Group (GREC) was performed and interpreted by capillary.io for the global interpretation of each of the capillaroscopies analyzed.Results:Overall, 37 of the 49 capillaroscopies reported agreed with the diagnosed pattern (75.51%). Separately, the early pattern presented a concordance of 77.27% and the active pattern of 74.07%. In reference to the findings detected by the Capillary.io system, the mean overall density was 5.01 capillaries/mm in the group with the active pattern compared to 6.46 capillaries/mm in the early pattern. The density of dilations and megacapillaries was 2.81/mm and 1.21/mm in the active pattern group versus 4.69/mm and 0.4/mm in the early pattern group. Global diameters were greater in the active pattern group with an apical mean of 37.3 μm compared to 28.5 μm in the early pattern subgroup.Conclusion:Capillary.io is a simple, easy-to-learn web system for interpreting capillaroscopic images of nail folds. It can be a very useful tool to standardize the interpretation of capillaroscopic images, not only individually for each capillary, but also jointly through the detection of different patterns.References:[1]Chen K, Wang J, Pang J, Cao Y, Xiong Y, Li X, et al. MMDetection: Open MMLab Detection Toolbox and Benchmark. arXiv preprint arXiv:190607155 2019;.[2]Cutolo M, Pizzorni C, Sulli A. Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis - Reply. The Journal of Rheumatology 2000 11;27:2722–2723.[3]Cutolo M, Trombetta AC, Melsens K, Pizzorni C, Sulli A, Ruaro B, et al. Automated assessment of absolute nailfold capillary number on videocapillaroscopic images: Proof of principle and validation in systemic sclerosis. Microcirculation 2018 May;25(4):e12447.[4]Smith V, Vanhaecke A, Herrick AL, Distler O, Guerra MG, Denton CP, et al. Fast track algorithm: How to differentiate a “scleroderma pattern” from a “non-scleroderma pattern”. Autoimmu- nity Reviews 2019 nov;18(11):102394.[5]Tavakol ME, Fatemi A, Karbalaie A, Emrani Z, Erlandsson BE. Nailfold Capillaroscopy in Rheumatic Diseases: Which Parameters Should Be Evaluated? BioMed Research International 2015;2015:1–17.Disclosure of Interests:Eduardo Ramos Shareholder of: Co-founder and shareholder of Capillary.io, Alfredo Guillén-Del-Castillo: None declared, Carmen Pilar Simeón-Aznar: None declared, Borja Gracia Tello Shareholder of: Co-founder and shareholder of Capillary.io, Vicent Fonollosa Pla: None declared, Albert Selva-O’Callaghan: None declared, Luis Sáez-Comet: None declared, Elena Martínez Robles: None declared, Juan José Rios: None declared, Gerard Espinosa: None declared, Jose Antonio Todolí Parra: None declared, Jose Luis Callejas-Rubio: None declared, Norberto Ortego: None declared, Begoña Marí-Alfonso: None declared, Mayka Freire: None declared, Patricia Fanlo: None declared
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Sabaté-Llobera A, Mestres-Martí J, Reynés-Llompart G, Lladó L, Mils K, Serrano T, Cortés-Romera M, Bertran E, Fabregat I, Ramos E. 2-[ 18F]FDG PET/CT as a Predictor of Microvascular Invasion and High Histological Grade in Patients with Hepatocellular Carcinoma. Cancers (Basel) 2021; 13:2554. [PMID: 34070953 PMCID: PMC8196959 DOI: 10.3390/cancers13112554] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 05/19/2021] [Indexed: 12/14/2022] Open
Abstract
Hepatocellular carcinoma (HCC) generally presents a low avidity for 2-deoxy-2-[18F]fluoro-d-glucose (FDG) in PET/CT although an increased FDG uptake seems to relate to more aggressive biological factors. To define the prognostic value of PET/CT with FDG in patients with an HCC scheduled for a tumor resection, forty-one patients were prospectively studied. The histological factors of a poor prognosis were determined and FDG uptake in the HCC lesions was analyzed semi-quantitatively (lean body mass-corrected standardized uptake value (SUL) and tumor-to-liver ratio (TLR) at different time points). The PET metabolic parameters were related to the histological characteristics of the resected tumors and to the evolution of patients. Microvascular invasion (MVI) and a poor grade of differentiation were significantly related to a worse prognosis. The SULpeak of the lesion 60 min post-FDG injection was the best parameter to predict MVI while the SULpeak of the TLR at 60 min was better for a poor differentiation. Moreover, the latter parameter was also the best preoperative variable available to predict any of these two histological factors. Patients with an increased TLRpeak60 presented a significantly higher incidence of poor prognostic factors than the rest (75% vs. 28.6%, p = 0.005) and a significantly higher incidence of recurrence at 12 months (38% vs. 0%, p = 0.014). Therefore, a semi-quantitative analysis of certain metabolic parameters on PET/CT can help identify, preoperatively, patients with histological factors of a poor prognosis, allowing an adjustment of the therapeutic strategy for those patients with a higher risk of an early recurrence.
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Affiliation(s)
- Aida Sabaté-Llobera
- PET Unit, Department of Nuclear Medicine-IDI, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (J.M.-M.); (G.R.-L.); (M.C.-R.)
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (L.L.); (K.M.); (T.S.); (I.F.); (E.R.)
| | - Judit Mestres-Martí
- PET Unit, Department of Nuclear Medicine-IDI, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (J.M.-M.); (G.R.-L.); (M.C.-R.)
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (L.L.); (K.M.); (T.S.); (I.F.); (E.R.)
| | - Gabriel Reynés-Llompart
- PET Unit, Department of Nuclear Medicine-IDI, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (J.M.-M.); (G.R.-L.); (M.C.-R.)
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (L.L.); (K.M.); (T.S.); (I.F.); (E.R.)
- Department of Medical Physics, Catalan Institute of Oncology, Duran i Reynals Hospital, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Laura Lladó
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (L.L.); (K.M.); (T.S.); (I.F.); (E.R.)
- Faculty of Medicine and Health Sciences, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Hepato-Biliary, Pancreatic and Liver Transplantation Unit, Department of Surgery, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Kristel Mils
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (L.L.); (K.M.); (T.S.); (I.F.); (E.R.)
- Hepato-Biliary, Pancreatic and Liver Transplantation Unit, Department of Surgery, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Teresa Serrano
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (L.L.); (K.M.); (T.S.); (I.F.); (E.R.)
- Department of Pathology, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Oncology Program, Centro de Investigación Biomédica en Red, Enfermedades Hepáticas y Digestivas (CIBEREHD), National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Montserrat Cortés-Romera
- PET Unit, Department of Nuclear Medicine-IDI, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (J.M.-M.); (G.R.-L.); (M.C.-R.)
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (L.L.); (K.M.); (T.S.); (I.F.); (E.R.)
- Faculty of Medicine and Health Sciences, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Esther Bertran
- Oncology Program, Centro de Investigación Biomédica en Red, Enfermedades Hepáticas y Digestivas (CIBEREHD), National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, 28029 Madrid, Spain;
- TGF-ß and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Isabel Fabregat
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (L.L.); (K.M.); (T.S.); (I.F.); (E.R.)
- Oncology Program, Centro de Investigación Biomédica en Red, Enfermedades Hepáticas y Digestivas (CIBEREHD), National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, 28029 Madrid, Spain;
- TGF-ß and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Emilio Ramos
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (L.L.); (K.M.); (T.S.); (I.F.); (E.R.)
- Faculty of Medicine and Health Sciences, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Hepato-Biliary, Pancreatic and Liver Transplantation Unit, Department of Surgery, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Oncology Program, Centro de Investigación Biomédica en Red, Enfermedades Hepáticas y Digestivas (CIBEREHD), National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, 28029 Madrid, Spain;
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Salazar S, Gutiérrez N, Sánchez O, Ramos E, González A, Acosta J, Ramos T, Altamirano C, Toledo J, Montesino R. Establishment of a production process for a novel vaccine candidate against Lawsonia intracellularis. ELECTRON J BIOTECHN 2021. [DOI: 10.1016/j.ejbt.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Lim C, Goumard C, Casellas-Robert M, Lopez-Ben S, Lladó L, Busquets J, Salloum C, Albiol-Quer MT, Castro-Gutiérrez E, Rosmorduc O, Feray C, Ramos E, Figueras J, Scatton O, Azoulay D. Impact on Oncological Outcomes and Intent-to-Treat Survival of Resection Margin for Transplantable Hepatocellular Carcinoma in All-Comers and in Patients with Cirrhosis: A Multicenter Study. World J Surg 2021; 44:1966-1974. [PMID: 32095855 DOI: 10.1007/s00268-020-05424-2] [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] [Indexed: 12/24/2022]
Abstract
BACKGROUND The outcomes of liver resection (LR) with a narrow margin in patients with transplantable hepatocellular carcinoma (HCC) have not been studied. The aim was to assess whether narrow margin following up-front LR impacts the incidence, timing, pattern, and transplantability of tumor recurrence in patients with initially transplantable HCC. METHODS All initially transplantable HCC patients undergoing hepatectomy with either narrow (<10 mm) or wide (≥10 mm) margins from 2007 to 2016 at four Western university centers were compared in terms of recurrence, transplantability of recurrence, recurrence-free survival (RFS), and intention-to-treat overall survival (ITT-OS). Independent predictors of non-transplantability of recurrence were assessed. RESULTS This study included 187 patients (narrow group, n = 107 vs. wide group, n = 80). Recurrence was significantly more frequent in the narrow margin group (44% vs. 26%; p = 0.01) with a shorter RFS (p = 0.03). The transplantability of recurrence and ITT-OS were, however, not different between the two groups. The presence of satellite nodules on the resected specimens emerged as the sole independent predictor of non-transplantability of tumor recurrence. The stratification of the analysis according to the presence of cirrhosis achieved essentially the same results as in the whole study population. CONCLUSIONS Narrow margin was associated with a higher tumor recurrence rate and a shorter RFS for patients with initially transplantable HCC. However, transplantability of recurrence and long-term ITT-OS were not impaired.
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Affiliation(s)
- Chetana Lim
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpétrière Hospital, Paris, France
| | - Claire Goumard
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpétrière Hospital, Paris, France
| | - Margarida Casellas-Robert
- Department of Hepato-Biliary and Pancreatic Surgery, Hospital Universitari Dr. Josep Trueta, Girona, Catalonia, Spain
| | - Santiago Lopez-Ben
- Department of Hepato-Biliary and Pancreatic Surgery, Hospital Universitari Dr. Josep Trueta, Girona, Catalonia, Spain
| | - Laura Lladó
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, Hospital Universitari de Bellvitge, CIBERehd., Barcelona, Catalonia, Spain
| | - Juli Busquets
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, Hospital Universitari de Bellvitge, CIBERehd., Barcelona, Catalonia, Spain
| | - Chady Salloum
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Paul Brousse Hospital, Villejuif, France
| | - Maria Teresa Albiol-Quer
- Department of Hepato-Biliary and Pancreatic Surgery, Hospital Universitari Dr. Josep Trueta, Girona, Catalonia, Spain
| | - Ernest Castro-Gutiérrez
- Department of Hepato-Biliary and Pancreatic Surgery, Hospital Universitari Dr. Josep Trueta, Girona, Catalonia, Spain
| | - Olivier Rosmorduc
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpétrière Hospital, Paris, France
| | - Cyrille Feray
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Paul Brousse Hospital, Villejuif, France
| | - Emilio Ramos
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, Hospital Universitari de Bellvitge, CIBERehd., Barcelona, Catalonia, Spain
| | - Joan Figueras
- Department of Hepato-Biliary and Pancreatic Surgery, Hospital Universitari Dr. Josep Trueta, Girona, Catalonia, Spain
| | - Olivier Scatton
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpétrière Hospital, Paris, France
| | - Daniel Azoulay
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Paul Brousse Hospital, Villejuif, France. .,Department of Hepatobiliary and Pancreatic Surgery and Transplantation, Sheba Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. .,Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Avenue Paul Vaillant Couturier, 94000, Villejuif, France.
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Bulhões C, Ramos E, Severo M, Dias S, Barros H. Trajectories of depressive symptoms through adolescence and young adulthood: social and health outcomes. Eur Child Adolesc Psychiatry 2021; 30:65-74. [PMID: 32065326 DOI: 10.1007/s00787-020-01493-9] [Citation(s) in RCA: 6] [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: 02/17/2019] [Accepted: 02/07/2020] [Indexed: 10/25/2022]
Abstract
Depressive symptoms display heterogeneous trajectories across adolescence, which can lead to different consequences. This study aimed to identify trajectories of depressive symptoms from adolescence to young adulthood, assessing the association with social and health outcomes at young adulthood. Adolescents born in 1990, enrolled in schools of Porto, Portugal, in 2003-2004 (EPITeen study) completed the Beck Depression Inventory II (BDI-II) at 13, 17 and 21 years. Mixed models and model-based clustering were used to describe the trajectories in the BDI-II score (n = 2010). Outcomes were assessed at age 21 years with self-administered questionnaires and face-to-face interviews (n = 1594). Odds ratios or regression coefficients, with 95% confidence intervals, were estimated using logistic and linear regression. Three trajectory classes of depressive symptoms were identified, similar in shape in both sexes: High (8.4%), Moderate (31.3%) and Low (60.2%). Participants in High or Moderate classes were more likely to describe lower scores of community involvement, more medical appointments during the last year, higher levels of pain and had higher probability of self-rating health as "good" or "fair or poor". Females in the High and Moderate classes were more likely to be current smokers, to describe ever using drugs and to report more sexual partners, emergency room visits and the use of antidepressants. The risk of depressive symptoms in adulthood is likely to be early determined in adolescence. The trajectory classes with higher levels of symptoms were associated with worse social and health outcomes.
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Affiliation(s)
- C Bulhões
- EPIUnit, Instituto de Saúde Pública, Universidade Do Porto, Rua das Taipas, nº135, 4050-600, Porto, Portugal.
| | - E Ramos
- EPIUnit, Instituto de Saúde Pública, Universidade Do Porto, Rua das Taipas, nº135, 4050-600, Porto, Portugal.,Department of Public Health and Forensic Sciences, and Medical Education, Faculdade de Medicina, Universidade Do Porto, Porto, Portugal
| | - M Severo
- EPIUnit, Instituto de Saúde Pública, Universidade Do Porto, Rua das Taipas, nº135, 4050-600, Porto, Portugal.,Department of Public Health and Forensic Sciences, and Medical Education, Faculdade de Medicina, Universidade Do Porto, Porto, Portugal
| | - S Dias
- Escola Nacional de Saúde Pública, Centro de Investigação Em Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - H Barros
- EPIUnit, Instituto de Saúde Pública, Universidade Do Porto, Rua das Taipas, nº135, 4050-600, Porto, Portugal.,Department of Public Health and Forensic Sciences, and Medical Education, Faculdade de Medicina, Universidade Do Porto, Porto, Portugal
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Azoulay D, Ramos E, Casellas-Robert M, Salloum C, Lladó L, Nadler R, Busquets J, Caula-Freixa C, Mils K, Lopez-Ben S, Figueras J, Lim C. Liver resection for hepatocellular carcinoma in patients with clinically significant portal hypertension. JHEP Rep 2020; 3:100190. [PMID: 33294830 PMCID: PMC7689549 DOI: 10.1016/j.jhepr.2020.100190] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/10/2020] [Accepted: 09/16/2020] [Indexed: 02/08/2023] Open
Abstract
Background & Aims Liver resection (LR) in patients with hepatocellular carcinoma (HCC) and clinically significant portal hypertension (CSPH) defined as a hepatic venous pressure gradient (HVPG) ≥10 mmHg is not encouraged. Here, we reappraised the outcomes of patients with cirrhosis and CSPH who underwent LR for HCC in highly specialised liver centres. Methods This was a retrospective multicentre study from 1999 to 2019. Predictors for postoperative liver decompensation and textbook outcomes were identified. Results In total, 79 patients with a median age of 65 years were included. The Child-Pugh grade was A in 99% of patients, and the median model for end-stage liver disease (MELD) score was 8. The median HVPG was 12 mmHg. Major hepatectomies and laparoscopies were performed in 28% and 34% of patients, respectively. Ninety-day mortality and severe morbidity rates were 6% and 27%, respectively. Postoperative and persistent liver decompensation occurred in 35% and 10% of patients at 3 months. Predictors of liver decompensation included increased preoperative HVPG (p = 0.004), increased serum total bilirubin (p = 0.02), and open approach (p = 0.03). Of the patients, 34% achieved a textbook outcome, of which the laparoscopic approach was the sole predictor (p = 0.004). The 5-year overall survival and recurrence-free survival rates were 55% and 43%, respectively. Conclusions Patients with cirrhosis, HCC and HVPG ≥10 mmHg can undergo LR with acceptable mortality, morbidity, and liver decompensation rates. The laparoscopic approach was the sole predictor of a textbook outcome. Lay summary Patients with cirrhosis, hepatocellular carcinoma, and clinically significant portal hypertension (defined as a hepatic venous pressure gradient ≥10 mmHg) can undergo resection with acceptable mortality, morbidity, liver decompensation rates, and a textbook outcome. These results can be achieved in selected patients with preserved liver function, good general status, and sufficient remnant liver volume. Patients with HCC and CSPH can undergo resection, with mortality of 6% and severe morbidity of 27%. Postoperative and persistent liver decompensation occurred in 35% and 10% of patients, respectively. Textbook outcome was achieved in 34% of patients. The laparoscopic approach was identified as a predictor of postoperative liver decompensation and textbook outcome.
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Key Words
- AFP, alpha-fetoprotein
- ASA, American Society of Anesthesiologists
- BCLC, Barcelona-Clinic Liver Cancer
- CCI, Comprehensive Complication Index
- CSPH, clinically significant portal hypertension
- CT, computed tomography
- Clinically significant portal hypertension
- EASL, European Association for the Study of the Liver
- HVPG, hepatic venous pressure gradient
- Hepatectomy
- Hepatic venous pressure gradient
- LLR, laparoscopic liver resection
- LR, liver resection
- MELD, model for end-stage liver disease
- PHT, portal hypertension
- PVE, portal vein embolisation
- Postoperative liver decompensation
- TACE, transarterial chemoembolisation
- Textbook outcome
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Affiliation(s)
- Daniel Azoulay
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Paul Brousse Hospital, Villejuif, France.,Department of Hepato-Biliary and Pancreatic Surgery and Transplantation, Sheba Medical Center, Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Emilio Ramos
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, Hospital Universitari de Bellvitge, CIBERehd, Barcelona, Catalonia, Spain
| | - Margarida Casellas-Robert
- Unit of Hepato-Biliary and Pancreatic Surgery, Department of General Surgery, Hospital Universitari Dr Josep Trueta, Girona, Catalonia, Spain
| | - Chady Salloum
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Paul Brousse Hospital, Villejuif, France
| | - Laura Lladó
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, Hospital Universitari de Bellvitge, CIBERehd, Barcelona, Catalonia, Spain
| | - Roy Nadler
- Department of Hepato-Biliary and Pancreatic Surgery and Transplantation, Sheba Medical Center, Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Juli Busquets
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, Hospital Universitari de Bellvitge, CIBERehd, Barcelona, Catalonia, Spain
| | - Celia Caula-Freixa
- Unit of Hepato-Biliary and Pancreatic Surgery, Department of General Surgery, Hospital Universitari Dr Josep Trueta, Girona, Catalonia, Spain
| | - Kristel Mils
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, Hospital Universitari de Bellvitge, CIBERehd, Barcelona, Catalonia, Spain
| | - Santiago Lopez-Ben
- Unit of Hepato-Biliary and Pancreatic Surgery, Department of General Surgery, Hospital Universitari Dr Josep Trueta, Girona, Catalonia, Spain
| | - Joan Figueras
- Hepato-Biliary and Pancreatic Surgery, Department of Surgery, "Sagrat Cor" Hospital University of Barcelona, Barcelona, Spain
| | - Chetana Lim
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpêtrière Hospital, Paris, France
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Rafecas A, Torras J, Fabregat J, Lladó L, Secanella L, Busquets J, Serrano T, Ramos E. Intrahepatic cholangiocarcinoma: Prognostic factors for recurrence and survival in a series of 67 patients treated surgically at a single center. Cir Esp 2020. [PMID: 32921420 DOI: 10.1016/j.ciresp.2020.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Intrahepatic cholangiocarcinoma is a primary liver neoplasm whose only curative treatment is surgery. The objective of this study was to determine the prognostic factors for survival of intrahepatic cholangiocarcinoma treated surgically with curative intent. METHODS Sixty-seven patients who had been treated surgically for this neoplasm were collected at Bellvitge University Hospital between 1996 and 2017. Epidemiological, clinical, surgical, anatomopathological, morbidity, mortality and survival data have been analysed. RESULTS Postoperative morbidity was 47.76%, and postoperative mortality was 1.5%. Lymphadenectomy was associated with increased morbidity. Overall survival was 91%, 49.2% and 39.8% after 12, 36 and 60 months, respectively, and disease-free survival was 67.2%, 32.8% and 22.4%. Postoperative morbidity (reoperation, vascular invasion, adjuvant chemotherapy) were shown to be factors for a poor prognosis. Vascular invasion in the pathological study was the most important risk factor in the survival analysis. CONCLUSIONS This study reflects our centre's experience in the surgical treatment of intrahepatic cholangiocarcinoma over a period of 21 years. Lymphadenectomy was associated with increased morbidity, and vascular invasion in the pathological study was the most important risk factor in the survival analysis.
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Affiliation(s)
- Antoni Rafecas
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), España.
| | - Jaume Torras
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), España
| | - Joan Fabregat
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), España
| | - Laura Lladó
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), España
| | - Lluís Secanella
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), España
| | - Juli Busquets
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), España
| | - Teresa Serrano
- Servicio de Anatomía Patológica, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), España
| | - Emilio Ramos
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), España
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Casellas-Robert M, Lim C, Lopez-Ben S, Lladó L, Salloum C, Codina-Font J, Comas-Cufí M, Ramos E, Figueras J, Azoulay D. Laparoscopic Liver Resection for Hepatocellular Carcinoma in Child-Pugh A Patients With and Without Portal Hypertension: A Multicentre Study. World J Surg 2020; 44:3915-3922. [PMID: 32661688 DOI: 10.1007/s00268-020-05687-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Laparoscopic liver resection (LLR) may improve outcomes for cirrhotic patients with hepatocellular carcinoma (HCC) and portal hypertension (PHT). The aim of this study was to compare the short-term outcomes after LLR for HCC in cirrhotic patients with and without PHT. METHODS This multicentric study included 96 HCC patients who underwent LLR. Clinically significant portal hypertension (CSPH) was defined by a hepatic venous pressure gradient ≥10 mmHg. Short-term outcomes and liver-specific complications including post-hepatectomy liver failure (PHLF), ascites and encephalopathy were compared between patients with and without CSPH. RESULTS Thirty-one patients (32%) had CSPH. The CSPH group had higher post-operative morbidity (52% vs. 15%; p < 0.001), PHLF (10% vs. 0%; p = 0.03) and encephalopathy (10% vs. 0%; p = 0.03). There was no difference in terms of post-operative ascites between the two groups (CSPH: 16% vs. no CPSH: 8%, p = 0.28). The length of stay was longer in patients with CSPH than in those without CSPH (6 vs. 4 days; p < 0.001). CONCLUSIONS The laparoscopic approach is feasible in selected HCC patients with CSPH, at the price of significant increases in liver-specific complications and length of stay.
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Affiliation(s)
- Margarida Casellas-Robert
- Unit of Hepato-Biliary and Pancreatic Surgery, Department of General Surgery, Hospital Universitari de Girona Dr. Josep Trueta, Av de França s/n, 17007, Girona, Catalonia, Spain.
| | - Chetana Lim
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpêtrière Hospital, Paris, France
| | - Santiago Lopez-Ben
- Unit of Hepato-Biliary and Pancreatic Surgery, Department of General Surgery, Hospital Universitari de Girona Dr. Josep Trueta, Av de França s/n, 17007, Girona, Catalonia, Spain
| | - Laura Lladó
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, Hospital Universitari de Bellvitge, CIBERehd, Barcelona, Catalonia, Spain
| | - Chady Salloum
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Paul Brousse Hospital, Villejuif, France
| | - Jaume Codina-Font
- Department of Interventional Radiology, Hospital Universitari Dr. Josep Trueta, Girona, Catalonia, Spain
| | - Marc Comas-Cufí
- Department of Computer Science, Applied Mathematics and Statistics, Universitat de Girona, Girona, Catalonia, Spain.,Research Unit in Primary Care, Catalan Institute of Health, Barcelona, Catalonia, Spain.,The Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina, Barcelona, Catalonia, Spain
| | - Emilio Ramos
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, Hospital Universitari de Bellvitge, CIBERehd, Barcelona, Catalonia, Spain
| | - Joan Figueras
- Unit of Hepato-Biliary and Pancreatic Surgery, Department of General Surgery, Hospital Universitari de Girona Dr. Josep Trueta, Av de França s/n, 17007, Girona, Catalonia, Spain
| | - Daniel Azoulay
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Paul Brousse Hospital, Villejuif, France.,Department of Hepatobiliary and Pancreatic Surgery and Transplantation, Faculty of Medicine, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
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Ramos E, Lluis N, Llado L, Torras J, Busquets J, Rafecas A, Serrano T, Mils K, Leiva D, Fabregat J. Prognostic value and risk stratification of residual disease in patients with incidental gallbladder cancer. World J Surg Oncol 2020; 18:18. [PMID: 31980034 PMCID: PMC6982379 DOI: 10.1186/s12957-020-1794-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 01/16/2020] [Indexed: 12/13/2022] Open
Abstract
Background and aim Given their poor prognosis, patients with residual disease (RD) in the re-resection specimen of an incidental gallbladder carcinoma (IGBC) could benefit from a better selection for surgical treatment. The Gallbladder Cancer Risk Score (GBRS) has been proposed to preoperatively identify RD risk more precisely than T-stage alone. The aim of this study was to assess the prognostic value of RD and to validate the GBRS in a retrospective series of patients. Material and methods A prospectively collected database including 59 patients with IGBC diagnosed from December 1996 to November 2015 was retrospectively analyzed. Three locations of RD were established: local, regional, and distant. The effect of RD on overall survival (OS) was analyzed with the Kaplan-Meier method. To identify variables associated with the presence of RD, characteristics of patients with and without RD were compared using Fisher’s exact test. The relative risk of RD associated with clinical and pathologic factors was studied with a univariate logistic regression analysis. Results RD was found in 30 patients (50.8%). The presence of RD in any location was associated with worse OS (29% vs. 74.2%, p = 0.0001), even after an R0 resection (37.7% vs 74.2%, p = 0.003). There was no significant difference in survival between patients without RD and with local RD (74.2% vs 64.3%, p = 0.266), nor between patients with regional RD and distant RD (16.1% vs 20%, p = 0.411). After selecting patients in which R0 resection was achieved (n = 44), 5-year survival rate for patients without RD, local RD, and regional RD was, respectively, 74.2%, 75%, and 13.9% (p = 0.0001). The GBRS could be calculated in 25 cases (42.3%), and its usefulness to predict the presence of regional or distant RD (RDRD) was confirmed (80% in high-risk patients and 30% in intermediate risk p = 0.041). Conclusion RDRD, but not local RD, represents a negative prognostic factor of OS. The GBRS was useful to preoperatively identify patients with high risk of RDRD. An R0 resection did not improve OS of patients with regional RD.
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Affiliation(s)
- Emilio Ramos
- Department of Surgery, IDIBELL, Hospital Universitario de Bellvitge, CIBERehd, Servicio de Cirugía General y Digestiva, Universidad de Barcelona, Av Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Nuria Lluis
- Department of Surgery, IDIBELL, Hospital Universitario de Bellvitge, CIBERehd, Servicio de Cirugía General y Digestiva, Universidad de Barcelona, Av Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Laura Llado
- Department of Surgery, IDIBELL, Hospital Universitario de Bellvitge, CIBERehd, Servicio de Cirugía General y Digestiva, Universidad de Barcelona, Av Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jaume Torras
- Department of Surgery, IDIBELL, Hospital Universitario de Bellvitge, CIBERehd, Servicio de Cirugía General y Digestiva, Universidad de Barcelona, Av Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Juli Busquets
- Department of Surgery, IDIBELL, Hospital Universitario de Bellvitge, CIBERehd, Servicio de Cirugía General y Digestiva, Universidad de Barcelona, Av Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Antoni Rafecas
- Department of Surgery, IDIBELL, Hospital Universitario de Bellvitge, CIBERehd, Servicio de Cirugía General y Digestiva, Universidad de Barcelona, Av Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Teresa Serrano
- Department of Pathology, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Kristel Mils
- Department of Surgery, IDIBELL, Hospital Universitario de Bellvitge, CIBERehd, Servicio de Cirugía General y Digestiva, Universidad de Barcelona, Av Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - David Leiva
- Department of Radiology, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Joan Fabregat
- Department of Surgery, IDIBELL, Hospital Universitario de Bellvitge, CIBERehd, Servicio de Cirugía General y Digestiva, Universidad de Barcelona, Av Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
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Bribiesca A, Montoya F, Hernández P, Ramos E, Corkidi G. Device for experimental characterization of the 4D flow inside an evaporating sessile water droplet. Rev Sci Instrum 2020; 91:016101. [PMID: 32012599 DOI: 10.1063/1.5126112] [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] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/08/2019] [Indexed: 06/10/2023]
Abstract
We describe an experimental system based on optical microscopy, permitting the analysis of the four dimensional structure of the flow inside evaporating sessile droplets by monitoring the motion of tracers in horizontal planes localized at different heights. Inter-plane particle identification is accomplished via 3D tracking algorithms. The multiple plane observation is achieved using a piezoelectric device to make the microscope objective oscillate vertically, while a high-speed camera captures images. The droplet evaporation process lasts several minutes and greatly accelerates as the fluid advances toward complete evaporation. In order to capture the dynamics of the whole process, two cameras with the same optical output but different temporal resolution are used sequentially. Using image processing algorithms, we obtain the full trajectories of multiple tracers, velocities of particles on the free surface of the droplets, and velocity fields. The information available may be used to understand the geometry of the sedimentation pattern.
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Affiliation(s)
- A Bribiesca
- Computer Vision Laboratory, Institute of Biotechnology, Universidad Nacional Autónoma de México, 62210 Cuernavaca, Morelos, Mexico
| | - F Montoya
- Computer Vision Laboratory, Institute of Biotechnology, Universidad Nacional Autónoma de México, 62210 Cuernavaca, Morelos, Mexico
| | - P Hernández
- Computer Vision Laboratory, Institute of Biotechnology, Universidad Nacional Autónoma de México, 62210 Cuernavaca, Morelos, Mexico
| | - E Ramos
- Renewable Energy Institute, Universidad Nacional Autónoma de México, 62580 Temixco, Morelos, Mexico
| | - G Corkidi
- Computer Vision Laboratory, Institute of Biotechnology, Universidad Nacional Autónoma de México, 62210 Cuernavaca, Morelos, Mexico
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Caballero-Díaz D, Bertran E, Peñuelas-Haro I, Moreno-Càceres J, Malfettone A, López-Luque J, Addante A, Herrera B, Sánchez A, Alay A, Solé X, Serrano T, Ramos E, Fabregat I. Clathrin switches transforming growth factor-β role to pro-tumorigenic in liver cancer. J Hepatol 2020; 72:125-134. [PMID: 31562907 DOI: 10.1016/j.jhep.2019.09.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 10/08/2018] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND & AIMS Upon ligand binding, tyrosine kinase receptors, such as epidermal growth factor receptor (EGFR), are recruited into clathrin-coated pits for internalization by endocytosis, which is relevant for signalling and/or receptor degradation. In liver cells, transforming growth factor-β (TGF-β) induces both pro- and anti-apoptotic signals; the latter are mediated by the EGFR pathway. Since EGFR mainly traffics via clathrin-coated vesicles, we aimed to analyse the potential role of clathrin in TGF-β-induced signalling in liver cells and its relevance in liver cancer. METHODS Real-Time PCR and immunohistochemistry were used to analyse clathrin heavy-chain expression in human (CLTC) and mice (Cltc) liver tumours. Transient knockdown (siRNA) or overexpression of CLTC were used to analyse its role on TGF-β and EGFR signalling in vitro. Bioinformatic analysis was used to determine the effect of CLTC and TGFB1 expression on prognosis and overall survival in patients with hepatocellular carcinoma (HCC). RESULTS Clathrin expression increased during liver tumorigenesis in humans and mice. CLTC knockdown cells responded to TGF-β phosphorylating SMADs (canonical signalling) but showed impairment in the anti-apoptotic signals (EGFR transactivation). Experiments of loss or gain of function in HCC cells reveal an essential role for clathrin in inhibiting TGF-β-induced apoptosis and upregulation of its pro-apoptotic target NOX4. Autocrine TGF-β signalling in invasive HCC cells upregulates CLTC expression, switching its role to pro-tumorigenic. A positive correlation between TGFB1 and CLTC was found in HCC cells and patients. Patients expressing high levels of TGFB1 and CLTC had a worse prognosis and lower overall survival. CONCLUSIONS This work describes a novel role for clathrin in liver tumorigenesis, favouring non-canonical pro-tumorigenic TGF-β pathways. CLTC expression in human HCC samples could help select patients that would benefit from TGF-β-targeted therapy. LAY SUMMARY Clathrin heavy-chain expression increases during liver tumorigenesis in humans (CLTC) and mice (Cltc), altering the cellular response to TGF-β in favour of anti-apoptotic/pro-tumorigenic signals. A positive correlation between TGFB1 and CLTC was found in HCC cells and patients. Patients expressing high levels of TGFB1 and CLTC had a worse prognosis and lower overall survival. CLTC expression in HCC human samples could help select patients that would benefit from therapies targeting TGF-β.
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Affiliation(s)
- Daniel Caballero-Díaz
- Oncology Program, CIBEREHD, National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, 28029 Madrid, Spain; TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), Gran Via de L'Hospitalet, 199, 08908 Barcelona, Spain.
| | - Esther Bertran
- Oncology Program, CIBEREHD, National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, 28029 Madrid, Spain; TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), Gran Via de L'Hospitalet, 199, 08908 Barcelona, Spain
| | - Irene Peñuelas-Haro
- Oncology Program, CIBEREHD, National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, 28029 Madrid, Spain; TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), Gran Via de L'Hospitalet, 199, 08908 Barcelona, Spain
| | - Joaquim Moreno-Càceres
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), Gran Via de L'Hospitalet, 199, 08908 Barcelona, Spain
| | - Andrea Malfettone
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), Gran Via de L'Hospitalet, 199, 08908 Barcelona, Spain
| | - Judit López-Luque
- Oncology Program, CIBEREHD, National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, 28029 Madrid, Spain; TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), Gran Via de L'Hospitalet, 199, 08908 Barcelona, Spain
| | - Annalisa Addante
- Dept. Biochemistry and Molecular Biology, Faculty of Pharmacy, Complutense University of Madrid, Health Research Institute of the Hospital Clínico San Carlos, Madrid, Spain
| | - Blanca Herrera
- Dept. Biochemistry and Molecular Biology, Faculty of Pharmacy, Complutense University of Madrid, Health Research Institute of the Hospital Clínico San Carlos, Madrid, Spain
| | - Aránzazu Sánchez
- Dept. Biochemistry and Molecular Biology, Faculty of Pharmacy, Complutense University of Madrid, Health Research Institute of the Hospital Clínico San Carlos, Madrid, Spain
| | - Ania Alay
- Oncology Data Analytics Program, Bellvitge Biomedical Research Institute (IDIBELL), CIBER Epidemiología y Salud Pública (CIBERESP), L'Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Xavier Solé
- Oncology Data Analytics Program, Bellvitge Biomedical Research Institute (IDIBELL), CIBER Epidemiología y Salud Pública (CIBERESP), L'Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Teresa Serrano
- Oncology Program, CIBEREHD, National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, 28029 Madrid, Spain; TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), Gran Via de L'Hospitalet, 199, 08908 Barcelona, Spain; Pathological Anatomy Service, University Hospital of Bellvitge, Barcelona, Spain; Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet, 08907 Barcelona, Spain
| | - Emilio Ramos
- Oncology Program, CIBEREHD, National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, 28029 Madrid, Spain; TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), Gran Via de L'Hospitalet, 199, 08908 Barcelona, Spain; Department of Surgery, Liver Transplant Unit, University Hospital of Bellvitge, Barcelona, Spain; Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet, 08907 Barcelona, Spain
| | - Isabel Fabregat
- Oncology Program, CIBEREHD, National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, 28029 Madrid, Spain; TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), Gran Via de L'Hospitalet, 199, 08908 Barcelona, Spain; Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet, 08907 Barcelona, Spain.
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Lopez Gordo S, Busquets J, Peláez N, Secanella L, Martinez-Carnicero L, Ramos E, Fabregat J. Long-term results of resection of the head of the pancreas due to chronic pancreatitis: Pancreaticoduodenectomy or duodenum-preserving cephalic pancreatectomy? Cir Esp 2019; 98:267-273. [PMID: 31848016 DOI: 10.1016/j.ciresp.2019.10.009] [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: 05/06/2019] [Revised: 10/12/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Chronic pain in chronic pancreatitis is difficult to manage. The objective of our study is to assess the control of pain that is refractory to medical treatment in patients with an inflammatory mass in the head of the pancreas, as well as to compare the two surgical techniques. METHODS A retrospective study included patients treated surgically between 1989 and 2011 who had been refractory to medical treatment with inflammation of the head of the pancreas. An analysis of the short and long-term results was done to compare patients who had undergone pancreaticoduodenectomy (PD) and/or resection of the head of the pancreas with duodenal preservation (RHPDP). RESULTS 22 PD and 12 RHPDP were performed. Postoperative complications were observed in 14% of patients, the most frequent being delayed gastric emptying (14.7%) and pancreatic fistula (11.7%). No statistically significant differences were found in terms of surgical technique. Pain control was satisfactory in 85% of patients, 43% presented de novo diabetes mellitus, and 88% returned to their work activities. Fourteen patients died during follow-up, 7 due to malignancies, and some were related to tobacco use and alcohol consumption. The overall 5 and 10 year survival rates were 88% and 75% respectively. CONCLUSION Cephalic resection in patients with intractable pain in chronic pancreatitis is an effective therapy that provides good long-term results in terms of pain control, with no significant differences between the two surgical techniques. Patients with chronic pancreatitis have a high mortality rate associated with de novo malignancies.
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Affiliation(s)
- Sandra Lopez Gordo
- Consorcio Sanitario Alt Penedés-Garraf, Sant Pere de Ribes, Barcelona, España
| | - Juli Busquets
- Unitat de Cirurgia Hepatobiliopancreàtica, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España.
| | - Nuria Peláez
- Unitat de Cirurgia Hepatobiliopancreàtica, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - Lluís Secanella
- Unitat de Cirurgia Hepatobiliopancreàtica, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - Laura Martinez-Carnicero
- Servei de Radiodiagnòstic, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - Emilio Ramos
- Unitat de Cirurgia Hepatobiliopancreàtica, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - Joan Fabregat
- Unitat de Cirurgia Hepatobiliopancreàtica, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
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Fraga S, Severo M, Ramos E, Kelly-Irving M, Silva S, Ribeiro AI, Petrovic D, Barros H, Stringhini S. Parental socioeconomic position and chronic inflammation during adolescence. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Early life adversity has been associated with increased risk of inflammation and inflammation-related diseases in adulthood. This study aimed to examine the association of parental socioeconomic position with chronic inflammation over adolescence.
Methods
We used information on 2942 members (1507 girls and 1435 boys) of the EPITeen cohort that was established in 2003 in Porto, Portugal, and included 13 years old adolescents that were further evaluated at 17 and 21 years. Mother’ and father’s education and occupation were used as indicators of parental socioeconomic position. High-sensitivity C-reactive protein (CRP) was measured at three points in time (13, 17 and 21 years). CRP levels were categorized in tertiles separately for each wave; chronic inflammation in adolescence was defined as having CRP levels in the highest tertile in at least 2 waves and never in the lowest tertile.
Results
Over adolescence, the prevalence of chronic inflammation was significantly higher among participants with low parental socioeconomic position. Low parental socioeconomic position was associated with chronic inflammation in adolescence, after adjustment for sex, perinatal and physical environment factors, health-related behaviours and health status in adolescence OR = 1.63; 95%CI: 1.11, 2.40 for lowest vs. highest mother’s education and OR = 1.61; 95%CI: 1.12, 2.30 for lowest vs. highest father’s education.
Conclusions
Low parental socioeconomic position is associated with chronic inflammation during adolescence. Our results suggest that the early life socioeconomic environment has an impact on inflammatory processes over adolescence.
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Affiliation(s)
- S Fraga
- EPIUNIT- Instituto de Saúde Pública, University of Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública, University of Porto, Porto, Portugal
| | - M Severo
- EPIUNIT- Instituto de Saúde Pública, University of Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública, University of Porto, Porto, Portugal
| | - E Ramos
- EPIUNIT- Instituto de Saúde Pública, University of Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública, University of Porto, Porto, Portugal
| | - M Kelly-Irving
- UMR1027 LEASP, Inserm & Université Toulouse III, University of Toulouse, France
| | - S Silva
- EPIUNIT- Instituto de Saúde Pública, University of Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública, University of Porto, Porto, Portugal
| | - A I Ribeiro
- EPIUNIT- Instituto de Saúde Pública, University of Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública, University of Porto, Porto, Portugal
| | - D Petrovic
- Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
| | - H Barros
- EPIUNIT- Instituto de Saúde Pública, University of Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública, University of Porto, Porto, Portugal
| | - S Stringhini
- Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
- Population Epidemiology Unit, Geneva University Hospitals, Geneva, Switzerland
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López-Luque J, Bertran E, Crosas-Molist E, Maiques O, Malfettone A, Caja L, Serrano T, Ramos E, Sanz-Moreno V, Fabregat I. Downregulation of Epidermal Growth Factor Receptor in hepatocellular carcinoma facilitates Transforming Growth Factor-β-induced epithelial to amoeboid transition. Cancer Lett 2019; 464:15-24. [PMID: 31465839 PMCID: PMC6853171 DOI: 10.1016/j.canlet.2019.08.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 12/19/2022]
Abstract
The Epidermal Growth Factor Receptor (EGFR) and the Transforming Growth Factor-beta (TGF-β) are key regulators of hepatocarcinogenesis. Targeting EGFR was proposed as a promising therapy; however, poor success was obtained in human hepatocellular carcinoma (HCC) clinical trials. Here, we describe how EGFR is frequently downregulated in HCC patients while TGF-β is upregulated. Using 2D/3D cellular models, we show that after EGFR loss, TGF-β is more efficient in its pro-migratory and invasive effects, inducing epithelial to amoeboid transition. EGFR knock-down promotes loss of cell-cell and cell-to-matrix adhesion, favouring TGF-β-induced actomyosin contractility and acquisition of an amoeboid migratory phenotype. Moreover, TGF-β upregulates RHOC and CDC42 after EGFR silencing, promoting Myosin II in amoeboid cells. Importantly, low EGFR combined with high TGFB1 or RHOC/CDC42 levels confer poor patient prognosis. In conclusion, this work reveals a new tumour suppressor function for EGFR counteracting TGF-β-mediated epithelial to amoeboid transitions in HCC, supporting a rational for targeting the TGF-β pathway in patients with low EGFR expression. Our work also highlights the relevance of epithelial to amoeboid transition in human tumours and the need to better target this process in the clinic. EGFR expression is low and heterogeneous in a great percentage of HCC patients. EGFR loss in HCC cells facilitates TGF-β pro-migratory and invasive functions. EGFR silenced HCC cells respond to TGF-β inducing epithelial-amoeboid transition. TGF-β upregulates RHOC and CDC42 and actomyosin contractility in EGFR silenced cells. Low EGFR combined with high TGFB1 or RHOC/CDC42 levels confer poor HCC prognosis.
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Affiliation(s)
- Judit López-Luque
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Oncology Program, CIBEREHD, National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, Madrid, Spain.
| | - Esther Bertran
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Oncology Program, CIBEREHD, National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, Madrid, Spain.
| | - Eva Crosas-Molist
- Barts Cancer Institute- a Cancer Research UK Centre of Excellence Queen Mary University of London, John Vane Science Building Charterhouse Square, London, EC1M 6BQ, UK.
| | - Oscar Maiques
- Barts Cancer Institute- a Cancer Research UK Centre of Excellence Queen Mary University of London, John Vane Science Building Charterhouse Square, London, EC1M 6BQ, UK.
| | - Andrea Malfettone
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Laia Caja
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Teresa Serrano
- Oncology Program, CIBEREHD, National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, Madrid, Spain; Pathological Anatomy Service, University Hospital of Bellvitge, Barcelona, Spain.
| | - Emilio Ramos
- Oncology Program, CIBEREHD, National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, Madrid, Spain; Department of Surgery, Liver Transplant Unit, University Hospital of Bellvitge, Barcelona, Spain.
| | - Victoria Sanz-Moreno
- Barts Cancer Institute- a Cancer Research UK Centre of Excellence Queen Mary University of London, John Vane Science Building Charterhouse Square, London, EC1M 6BQ, UK.
| | - Isabel Fabregat
- TGF-β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Oncology Program, CIBEREHD, National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, Madrid, Spain; Department of Physiological Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Spain.
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Prendes CF, Iribarren AM, Alumà A, Moreno F, Tejedor X, Checa S, Ramos E, Molina ML, Llopis M, Indiano CM. Diagnostic utility of tumour markers for malignant effusions. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cabral M, Severo M, Barros H, Guimarães JT, Ramos E. Longitudinal association of adiposity and high-sensitivity C-reactive protein from adolescence into early adulthood. Nutr Metab Cardiovasc Dis 2019; 29:590-597. [PMID: 31078361 DOI: 10.1016/j.numecd.2019.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 03/09/2019] [Accepted: 03/11/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND AIMS Longitudinal studies relating adiposity with low-grade inflammation are scarce. We aimed to examine the longitudinal association between the cumulative exposure to adiposity and low-grade inflammation from adolescence into early adulthood. METHODS AND RESULTS Data from a population-based cohort (EPITeen) (n = 1147) was analyzed. Body mass index (BMI), body fat percentage (BF%), waist circumference (WC), and waist-to-height ratio (WHtR) and high-sensitivity C-reactive protein (hsCRP) were ascertained at 13, 17 and 21 years of age and standardized for each wave. Generalized least squares models with a compound symmetry correlation structure were fitted to estimate the longitudinal effect of adiposity on hsCRP and results were presented as linear regression coefficients and 95% confidence intervals [β (95%CI)].The final model estimated the association between the difference in adiposity between two consecutive evaluations (13-17 and 17 to 21-years-old), adjusted for previous adiposity and hsCRP levels, sex, parental education, leisure-time physical activity and fruits and vegetables intake. A positive association between the cumulative exposure to adiposity and final hsCRP was observed, in which the difference between adiposity indicators of two consecutive study waves was independently associated with hsCRP: 0.382 (0.299; 0.465) for BMI, 0.234 (0.164; 0.304) for WC, 0.395 (0.314; 0.477) for BF% and 0.195 (0.133; 0.258) for WHtR. CONCLUSION A significant longitudinal effect of the accumulation of adiposity on low-grade inflammation was observed. The change in adiposity from consecutive study waves was shown to have a stronger effect on final hsCRP concentrations than both previous adiposity and hsCRP levels.
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Affiliation(s)
- M Cabral
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - M Severo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - H Barros
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - J T Guimarães
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600, Porto, Portugal; Departamento de Biomedicina, Faculdade de Medicina, Universidade do Porto & Serviço de Patologia Clínica, Centro Hospitalar de São João, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - E Ramos
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
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Llado L, Ramos E, Bravo A, Baliellas C, Mils K, Busquets J, Cachero A, Secanella L, Pelaez N, Gonzalez‐Vilatarsana E, Fabregat J. Short‐ and long‐term outcomes of arterial reconstruction on recipient splenic artery in adult liver transplantation. Single‐center prospective study 25 years after first description. Transpl Int 2019; 32:1053-1060. [DOI: 10.1111/tri.13447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/12/2019] [Accepted: 04/26/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Laura Llado
- Liver Transplant Unit Department of Surgery IDIBELL Hospital Universitari de Bellvitge Barcelona Spain
| | - Emilio Ramos
- Liver Transplant Unit Department of Surgery IDIBELL Hospital Universitari de Bellvitge Barcelona Spain
| | - Alex Bravo
- Liver Transplant Unit Department of Surgery IDIBELL Hospital Universitari de Bellvitge Barcelona Spain
| | - Carme Baliellas
- Liver Transplant Unit Department of Gastroenterology IDIBELL Hospital Universitari de Bellvitge Barcelona Spain
| | - Kristel Mils
- Liver Transplant Unit Department of Surgery IDIBELL Hospital Universitari de Bellvitge Barcelona Spain
| | - Juli Busquets
- Liver Transplant Unit Department of Surgery IDIBELL Hospital Universitari de Bellvitge Barcelona Spain
| | - Alba Cachero
- Liver Transplant Unit Department of Gastroenterology IDIBELL Hospital Universitari de Bellvitge Barcelona Spain
| | - Lluis Secanella
- Liver Transplant Unit Department of Surgery IDIBELL Hospital Universitari de Bellvitge Barcelona Spain
| | - Nuria Pelaez
- Liver Transplant Unit Department of Surgery IDIBELL Hospital Universitari de Bellvitge Barcelona Spain
| | - Emma Gonzalez‐Vilatarsana
- Liver Transplant Unit Department of Clinical Nurse Specialist IDIBELL Hospital Universitari de Bellvitge Barcelona Spain
| | - Joan Fabregat
- Liver Transplant Unit Department of Surgery IDIBELL Hospital Universitari de Bellvitge Barcelona Spain
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Martin-Granizo R, Ramos E, Celotti C, Naranjo N, Colorado L, Encinas A, Alonso M, Alonso A, De Pedro M. The correlation between wilkes and bronstein-merril classifications after TMJ arthroscopy is moderate after a 800-procedure study. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.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: 10/26/2022]
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Martin-Granizo R, Colorado L, Naranjo N, Celotti C, Maniegas L, Ramos E, Falahat F. Pathological findings in asymptomatic joints in cases of bilateral arthroscopies of the tmj. a long-term single-center study. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Martín-Granizo R, Ramos E, Celotti C, Naranjo N, Colorado L, Martinez I, Varela E, Alonso M, De Pedro M. Infiltration of botulinum toxin type a associated with arthroscopy in patients with temporomandibular joint dysfunction. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.866] [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: 11/30/2022]
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