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Olmos D, Lorente D, Alameda D, Cattrini C, Romero-Laorden N, Lozano R, Lopez-Casas PP, Jambrina A, Capone C, Vanden Broecke AM, Trevisan M, Van Sanden S, Jürgens A, Herrera-Imbroda B, Castro E. Treatment patterns and outcomes in metastatic castration-resistant prostate cancer patients with and without somatic or germline alterations in homologous recombination repair genes. Ann Oncol 2024; 35:458-472. [PMID: 38417742 DOI: 10.1016/j.annonc.2024.01.011] [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: 10/04/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Although germline BRCA mutations have been associated with adverse outcomes in prostate cancer (PC), understanding of the association between somatic/germline alterations in homologous recombination repair (HRR) genes and treatment outcomes in metastatic castration-resistant PC (mCRPC) is limited. The aim of this study was to investigate the prevalence and outcomes associated with somatic/germline HRR alterations, particularly BRCA1/2, in patients initiating first-line (1L) mCRPC treatment with androgen receptor signalling inhibitors (ARSi) or taxanes. PATIENTS AND METHODS Data from 729 mCRPC patients were pooled for CAPTURE from four multicentre observational studies. Eligibility required 1L treatment with ARSi or taxanes, adequate tumour samples and biomarker panel results. Patients underwent paired normal and tumour DNA analyses by next-generation sequencing using a custom gene panel including ATM, BRCA1, BRCA2, BRIP1, CDK12, CHEK2, FANCA, HDAC2, PALB2, RAD51B and RAD54L. Patients were divided into subgroups based on somatic/germline alteration(s): with BRCA1/2 mutations (BRCA); with HRR mutations except BRCA1/2 (HRR non-BRCA); and without HRR alterations (non-HRR). Patients without BRCA1/2 mutations were classified as non-BRCA. Radiographic progression-free survival (rPFS), progression-free survival 2 (PFS2) and overall survival (OS) were assessed. RESULTS Of 729 patients, 96 (13.2%), 127 (17.4%) and 506 (69.4%) were in the BRCA, HRR non-BRCA and non-HRR subgroups, respectively. BRCA patients performed significantly worse for all outcomes than non-HRR or non-BRCA patients (P < 0.05), while PFS2 and OS were significantly shorter for BRCA than HRR non-BRCA patients (P < 0.05). HRR non-BRCA patients also had significantly worse rPFS, PFS2 and OS than non-HRR patients. Exploratory analyses suggested that for BRCA patients, there were no significant differences in outcomes associated with 1L treatment choice (ARSi or taxanes) or with the somatic/germline origin of the alterations. CONCLUSIONS Worse outcomes were observed for mCRPC patients in the BRCA subgroup compared with non-BRCA subgroups, either HRR non-BRCA or non-HRR. Despite its heterogeneity, the HRR non-BRCA subgroup presented worse outcomes than the non-HRR subgroup. Screening early for HRR mutations, especially BRCA1/2, is crucial in improving mCRPC patient prognosis.
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Affiliation(s)
- D Olmos
- Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre, Madrid.
| | - D Lorente
- Instituto Valenciano de Oncología, Valencia; Hospital Provincial de Castellón, Castellón de la Plana
| | - D Alameda
- Instituto de Investigación Biomédica de Málaga, Málaga, Spain
| | - C Cattrini
- Maggiore della Carità University Hospital, Novara, Italy
| | - N Romero-Laorden
- Cátedra UAM-Fundación Instituto Roche de Medicina Personalizada de Precisión, Hospital Universitario de La Princesa, Madrid
| | - R Lozano
- Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - P P Lopez-Casas
- Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre, Madrid
| | - A Jambrina
- Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre, Madrid
| | - C Capone
- Janssen Inc., Issy-les-Moulineaux, France
| | | | - M Trevisan
- Janssen Pharmaceuticals, Zug, Switzerland
| | | | | | - B Herrera-Imbroda
- Instituto de Investigación Biomédica de Málaga, Málaga, Spain; Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - E Castro
- Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre, Madrid; Instituto de Investigación Biomédica de Málaga, Málaga, Spain.
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Tejera-Vaquerizo A, Boada A, Puig S, Nagore E, Fernández-de-Misa R, Ferrándiz L, Conde-Taboada A, Castro E, Richarz NA, Paradela S, Llambrich Á, Salgüero I, Diago A, Samaniego E, Flórez Á, Segura S, Maldonado-Seral C, Coronel-Pérez IM, Tomás-Velázquez A, Rodríguez P, Mayor A, García-Doval I, Grau-Pérez M. Melanoma Registry of the Spanish Academy of Dermatology and Venereology (REGESMEL): Description and Data in its First Year of Operation. Actas Dermosifiliogr 2024:S0001-7310(24)00184-4. [PMID: 38452890 DOI: 10.1016/j.ad.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/24/2024] [Accepted: 02/25/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION The incidence of melanoma is rising in Spain. The prognostic stages of patients with melanoma are determined by various biological factors, such as tumor thickness, ulceration, or the presence of regional or distant metastases. The Spanish Academy of Dermatology and Venereology (AEDV) has encouraged the creation of a Spanish Melanoma Registry (REGESMEL) to evaluate other individual and health system-related factors that may impact the prognosis of patients with melanoma. The aim of this article is to introduce REGESMEL and provide basic descriptive data for its first year of operation. METHODS REGESMEL is a prospective, multicentre cohort of consecutive patients with invasive cutaneous melanoma that collects demographic and staging data as well as individual and healthcare-related baseline data. It also records the medical and surgical treatment received by patients. RESULTS A total of 450 cases of invasive cutaneous melanoma from 19 participant centres were included, with a predominance of thin melanomas≤1mm thick (54.7%), mainly located on the posterior trunk (35.2%). Selective sentinel lymph node biopsy was performed in 40.7% of cases. Most cases of melanoma were suspected by the patient (30.4%), or his/her dermatologist (29.6%). Patients received care mainly in public health centers (85.2%), with tele-dermatology resources being used in 21.6% of the cases. CONCLUSIONS The distribution of the pathological and demographic variables of melanoma cases is consistent with data from former studies. REGESMEL has already recruited patients from 15 Spanish provinces and given its potential representativeness, it renders the Registry as an important tool to address a wide range of research questions.
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Affiliation(s)
| | - A Boada
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, España
| | - S Puig
- Servicio de Dermatología, Hospital Clínic de Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, España; Centro de investigación biomédica en red de enfermedades raras, CIBERER, Barcelona, España
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - R Fernández-de-Misa
- Servicio de Dermatología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - L Ferrándiz
- Unidad de Melanoma, Servicio de Dermatología médico-quirúrgico, Hospital Universitario Virgen Macarena, Sevilla, España
| | - A Conde-Taboada
- Servicio de Dermatología, Hospital Clínico San Carlos, Madrid, España
| | - E Castro
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España
| | - N A Richarz
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, España
| | - S Paradela
- Servicio de Dermatología, Complexo Hospitalario A Coruña, A Coruña, España
| | - Á Llambrich
- Servicio de Dermatología, Hospital Universitario Son Llàtzer, Palma de Mallorca, España
| | - I Salgüero
- Servicio de Dermatología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - A Diago
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - E Samaniego
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, España
| | - Á Flórez
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Grupo de Investigación DIPO, Instituto de Investigación Sanitaria Galicia Sur, SERGAS-UVIGO, Pontevedra, España
| | - S Segura
- Servicio de Dermatología, Hospital del Mar de Barcelona, Barcelona, España
| | - C Maldonado-Seral
- Servicio de Dermatología, Hospital Universitario Central de Asturias, Oviedo, España
| | - I M Coronel-Pérez
- Servicio de Dermatología, Hospital Universitario Virgen de Valme de Sevilla, Sevilla, España
| | - A Tomás-Velázquez
- Servicio de Dermatología, Clínica Universidad de Navarra, Madrid, España
| | - P Rodríguez
- Servicio de Dermatología, Hospital Universitario La Princesa, Madrid, España; Servicio de Dermatología, Hospital Ruber Internacional, Madrid, España
| | - A Mayor
- Servicio de Dermatología, Hospital Universitario La Paz, Madrid, España
| | - I García-Doval
- Unidad de Investigación, Academia Española de Dermatología y Venereología, Madrid, España; Servicio de Dermatología, Complexo Hospitalario Universitario de Vigo, Vigo, España
| | - M Grau-Pérez
- Unidad de Investigación, Academia Española de Dermatología y Venereología, Madrid, España; Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
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Chi KN, Sandhu S, Smith MR, Attard G, Saad M, Olmos D, Castro E, Roubaud G, Pereira de Santana Gomes AJ, Small EJ, Rathkopf DE, Gurney H, Jung W, Mason GE, Dibaj S, Wu D, Diorio B, Urtishak K, Del Corral A, Francis P, Kim W, Efstathiou E. Niraparib plus abiraterone acetate with prednisone in patients with metastatic castration-resistant prostate cancer and homologous recombination repair gene alterations: second interim analysis of the randomized phase III MAGNITUDE trial. Ann Oncol 2023; 34:772-782. [PMID: 37399894 PMCID: PMC10849465 DOI: 10.1016/j.annonc.2023.06.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Patients with metastatic castration-resistant prostate cancer (mCRPC) and BRCA alterations have poor outcomes. MAGNITUDE found patients with homologous recombination repair gene alterations (HRR+), particularly BRCA1/2, benefit from first-line therapy with niraparib plus abiraterone acetate and prednisone (AAP). Here we report longer follow-up from the second prespecified interim analysis (IA2). PATIENTS AND METHODS Patients with mCRPC were prospectively identified as HRR+ with/without BRCA1/2 alterations and randomized 1 : 1 to niraparib (200 mg orally) plus AAP (1000 mg/10 mg orally) or placebo plus AAP. At IA2, secondary endpoints [time to symptomatic progression, time to initiation of cytotoxic chemotherapy, overall survival (OS)] were assessed. RESULTS Overall, 212 HRR+ patients received niraparib plus AAP (BRCA1/2 subgroup, n = 113). At IA2 with 24.8 months of median follow-up in the BRCA1/2 subgroup, niraparib plus AAP significantly prolonged radiographic progression-free survival {rPFS; blinded independent central review; median rPFS 19.5 versus 10.9 months; hazard ratio (HR) = 0.55 [95% confidence interval (CI) 0.39-0.78]; nominal P = 0.0007} consistent with the first prespecified interim analysis. rPFS was also prolonged in the total HRR+ population [HR = 0.76 (95% CI 0.60-0.97); nominal P = 0.0280; median follow-up 26.8 months]. Improvements in time to symptomatic progression and time to initiation of cytotoxic chemotherapy were observed with niraparib plus AAP. In the BRCA1/2 subgroup, the analysis of OS with niraparib plus AAP demonstrated an HR of 0.88 (95% CI 0.58-1.34; nominal P = 0.5505); the prespecified inverse probability censoring weighting analysis of OS, accounting for imbalances in subsequent use of poly adenosine diphosphate-ribose polymerase inhibitors and other life-prolonging therapies, demonstrated an HR of 0.54 (95% CI 0.33-0.90; nominal P = 0.0181). No new safety signals were observed. CONCLUSIONS MAGNITUDE, enrolling the largest BRCA1/2 cohort in first-line mCRPC to date, demonstrated improved rPFS and other clinically relevant outcomes with niraparib plus AAP in patients with BRCA1/2-altered mCRPC, emphasizing the importance of identifying this molecular subset of patients.
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Affiliation(s)
- K N Chi
- University of British Columbia, BC Cancer-Vancouver Center, Vancouver, Canada.
| | - S Sandhu
- Peter MacCallum Cancer Center, Melbourne, Australia; University of Melbourne, Melbourne, Australia
| | - M R Smith
- Massachusetts General Hospital Cancer Center, Boston, USA; Harvard Medical School, Boston, USA
| | - G Attard
- University College London Cancer Institute, London, UK; University College London Hospitals, London, UK
| | - M Saad
- Department of Clinical Oncology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - D Olmos
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid
| | - E Castro
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - G Roubaud
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | | | - E J Small
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco
| | - D E Rathkopf
- Memorial Sloan Kettering Cancer Center, New York, USA; Weill Cornell Medicine, New York, USA
| | - H Gurney
- Macquarie University, Macquarie Park, Australia
| | - W Jung
- Keimyung University Dongsan Hospital, Daegu, South Korea
| | - G E Mason
- Janssen Research & Development, LLC, Spring House
| | - S Dibaj
- Janssen Research & Development, LLC, San Diego
| | - D Wu
- Janssen Research & Development, LLC, Los Angeles
| | - B Diorio
- Janssen Research & Development, LLC, Titusville
| | - K Urtishak
- Janssen Research & Development, LLC, Spring House
| | | | - P Francis
- Janssen Research & Development, LLC, Bridgewater
| | - W Kim
- Janssen Research & Development, LLC, Los Angeles
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Duarte Folle A, Flores M, Kusters C, Paul K, Del Rosario I, Zhang K, Ruiz C, Castro E, Bronstein J, Ritz B, Keener A. Ethnicity and Parkinson's Disease: Motor and Nonmotor Features and Disease Progression in Latino Patients Living in Rural California. J Gerontol A Biol Sci Med Sci 2023; 78:1258-1268. [PMID: 36645401 PMCID: PMC10329232 DOI: 10.1093/gerona/glad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is the second most common neurodegenerative disorder among older adults worldwide. Currently, studies of PD progression rely primarily on White non-Latino (WNL) patients. Here, we compare clinical profiles and PD progression in Latino and WNL patients enrolled in a community-based study in rural Central California. METHOD PD patients within 5 years of diagnosis were identified from 3 counties between 2001 and 2015. During up to 3 visits, participants were examined by movement disorders specialists and interviewed. We analyzed cross-sectional differences in PD clinical features severity at each study visit and used linear mixed models and Cox proportional hazards models to compare motor, nonmotor, and disability progression longitudinally and to assess time to death in Latinos compared to WNL patients. RESULTS Of 775 patients included, 138 (18%) self-identified as Latino and presented with earlier age at diagnosis (63.6 vs 68.9) and death (78.6 vs 81.5) than WNL. Motor (hazard ratio [HR] = 1.17 [0.71, 1.94]) and nonmotor symptoms did not progress faster in Latino versus WNL patients after accounting for differences in baseline symptom severity. However, Latino patients progressed to disability stages according to Hoehn and Yahr faster than WNL (HR = 1.81 [1.11, 2.96]). Motor and nonmotor symptoms in Latino patients were also medically managed less well than in WNL. CONCLUSIONS Our PD study with a large proportion of Latino enrollees and progression data reveals disparities in clinical features and progression by ethnicity that may reflect healthcare access and structural socioeconomic disadvantages in Latino patients with PD.
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Affiliation(s)
- Aline Duarte Folle
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Marie E S Flores
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
- Altamed, Pico Rivera, California, USA
| | - Cynthia Kusters
- Department of Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Kimberly C Paul
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Irish Del Rosario
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Keren Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Cristina Ruiz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Emily Castro
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Jeff Bronstein
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Beate Ritz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Adrienne M Keener
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Department of Neurology, Veterans Administration Greater Los Angeles Health Care System, Los Angeles, California, USA
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Li S, Ritz B, Gong Y, Cockburn M, Folle AD, Del Rosario I, Yu Y, Zhang K, Castro E, Keener AM, Bronstein J, Paul KC. Proximity to residential and workplace pesticides application and the risk of progression of Parkinson's diseases in Central California. Sci Total Environ 2023; 864:160851. [PMID: 36526213 DOI: 10.1016/j.scitotenv.2022.160851] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Pesticide exposure has consistently been associated with Parkinson's disease (PD) onset. Yet, fewer epidemiologic studies have examined whether pesticides influence PD motor and non-motor symptom progression. OBJECTIVES Using a geographic information system tool that integrates agricultural pesticide use reports and land use records to derive ambient exposures at residences and workplaces, we assessed associations between specific pesticides previously related to PD onset with PD symptom progression in two PD patient cohorts living in agricultural regions of California. METHODS We calculated the pounds of pesticide applied agriculturally near each participant's residential or occupational addresses from 1974 to the year of PD diagnosis, using a geographic information system tool that links the California Pesticide Use Reports database to land use data. We examined 53 pesticides selected a priori as they have previously been associated with PD onset. We longitudinally followed two PD patient cohorts (PEG1 N = 242, PEG2 N = 259) for an average of 5.0 years (SD ± 3.5) and 2.7 years (SD ± 1.6) respectively and assessed PD symptoms using the movement disorder specialist-administered Unified Parkinson's disease Rating Scale part III (UPDRS), Mini-Mental State Examination (MMSE), and Geriatric Depression Scale (GDS). Weighted time-to-event regression models were implemented to estimate effects. RESULTS Ten agricultural pesticides, including copper sulfate (pentahydrate), 2-methyl-4-chlorophenoxyacetic acid (MCPA) dimethylamine salt, tribufos, sodium cacodylate, methamidophos, ethephon, propargite, bromoxynil octanoate, monosodium methanearsonate (MSMA), and dicamba, were associated with faster symptom progression. Among these pesticides, residential or workplace proximity to higher amounts of copper sulfate (pentahydrate) and MCPA (dimethylamine salt) was associated with all three progression endpoints (copper sulfate: HRs = 1.22-1.36, 95 % CIs = 1.03-1.73; MCPA: HRs = 1.27-1.35, 95 % CIs = 1.02-1.70). CONCLUSIONS Our findings suggest that pesticide exposure may not only be relevant for PD onset but also PD progression phenotypes. We have implicated ten specific pesticide active ingredients in faster PD motor and non-motor decline.
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Affiliation(s)
- Shiwen Li
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Yufan Gong
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Myles Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, CA, USA
| | - Aline Duarte Folle
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Irish Del Rosario
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Yu Yu
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Keren Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Emily Castro
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Adrienne M Keener
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Jeff Bronstein
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Kimberly C Paul
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA.
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Kuzbari Z, Bandlamudi C, Loveday C, Garrett A, Mehine M, George A, Hanson H, Snape K, Kulkarni A, Allen S, Jezdic S, Ferrandino R, Westphalen CB, Castro E, Rodon J, Mateo J, Burghel GJ, Berger MF, Mandelker D, Turnbull C. Germline-focused analysis of tumour-detected variants in 49,264 cancer patients: ESMO Precision Medicine Working Group recommendations. Ann Oncol 2023; 34:215-227. [PMID: 36529447 DOI: 10.1016/j.annonc.2022.12.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/01/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The European Society for Medical Oncology Precision Medicine Working Group (ESMO PMWG) was reconvened to update its 2018/19 recommendations on follow-up of putative germline variants detected on tumour-only sequencing, which were based on an analysis of 17 152 cancers. METHODS We analysed an expanded dataset including 49 264 paired tumour-normal samples. We applied filters to tumour-detected variants based on variant allele frequency, predicted pathogenicity and population variant frequency. For 58 cancer-susceptibility genes, we then examined the proportion of filtered tumour-detected variants of true germline origin [germline conversion rate (GCR)]. We conducted subanalyses based on the age of cancer diagnosis, specific tumour types and 'on-tumour' status (established tumour-gene association). RESULTS Analysis of 45 472 nonhypermutated solid malignancy tumour samples yielded 21 351 filtered tumour-detected variants of which 3515 were of true germline origin. 3.1% of true germline pathogenic variants were absent from the filtered tumour-detected variants. For genes such as BRCA1, BRCA2 and PALB2, the GCR in filtered tumour-detected variants was >80%; conversely for TP53, APC and STK11 this GCR was <2%. CONCLUSION Strategic germline-focused analysis can prioritise a subset of tumour-detected variants for which germline follow-up will produce the highest yield of most actionable true germline variants. We present updated recommendations around germline follow-up of tumour-only sequencing including (i) revision to 5% for the minimum per-gene GCR, (ii) inclusion of actionable intermediate penetrance genes ATM and CHEK2, (iii) definition of a set of seven 'most actionable' cancer-susceptibility genes (BRCA1, BRCA2, PALB2, MLH1, MSH2, MSH6 and RET) in which germline follow-up is recommended regardless of tumour type.
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Affiliation(s)
- Z Kuzbari
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - C Bandlamudi
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - C Loveday
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK. https://twitter.com/LovedayChey
| | - A Garrett
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK. https://twitter.com/DrAliceGarrett
| | - M Mehine
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - A George
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK
| | - H Hanson
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK; South West Thames Regional Genetics Service, St George's University Hospitals NHS Foundation Trust, London, UK
| | - K Snape
- South West Thames Regional Genetics Service, St George's University Hospitals NHS Foundation Trust, London, UK. https://twitter.com/genetikos
| | - A Kulkarni
- South East Thames Regional Genetics Service, Guy's and St Thomas' NHS Foundation Trust, London, UK. https://twitter.com/Anju__Kulkarni
| | - S Allen
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - S Jezdic
- Scientific and Medical Division, European Society for Medical Oncology, Lugano, Switzerland
| | - R Ferrandino
- Scientific and Medical Division, European Society for Medical Oncology, Lugano, Switzerland
| | - C B Westphalen
- Department of Medicine III and Comprehensive Cancer Center (CCC Munich LMU) University Hospital, LMU Munich, Munich, Germany
| | - E Castro
- Genitourinary Cancers Translational Research Group, Institute of Biomedical Research in Málaga (IBIMA), Málaga, Spain. https://twitter.com/Ecastromarcos
| | - J Rodon
- Investigational Cancer Therapeutics, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J Mateo
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona; Vall d'Hebron University Hospital, Barcelona, Spain
| | - G J Burghel
- North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, UK. https://twitter.com/BurghelG
| | - M F Berger
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - D Mandelker
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - C Turnbull
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, London, UK.
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Mezquita L, Bucheit L, Laguna J, Pastor B, Teixido C, Gorria T, Albarran-Artahona V, Garcia de Herreros M, Reyes R, Reguart N, Viñolas N, Arcocha A, Puig-Butille J, Drusbosky L, Faull I, Auclin E, Castro E, Patel J, Prat A, Besse B. MA07.07 Clinical/Molecular Profile of Patients with Non-small Cell Lung Cancer (NSCLC) with Incidental Pathogenic Germline Variants Detected in cfDNA. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.116] [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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8
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Kanesvaran R, Castro E, Wong A, Fizazi K, Chua MLK, Zhu Y, Malhotra H, Miura Y, Lee JL, Chong FLT, Pu YS, Yen CC, Saad M, Lee HJ, Kitamura H, Prabhash K, Zou Q, Curigliano G, Poon E, Choo SP, Peters S, Lim E, Yoshino T, Pentheroudakis G. Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with prostate cancer. ESMO Open 2022; 7:100518. [PMID: 35797737 PMCID: PMC9434138 DOI: 10.1016/j.esmoop.2022.100518] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/28/2022] [Accepted: 05/22/2022] [Indexed: 11/03/2022] Open
Abstract
The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of prostate cancer was published in 2020. It was therefore decided, by both the ESMO and the Singapore Society of Oncology (SSO), to convene a special, virtual guidelines meeting in November 2021 to adapt the ESMO 2020 guidelines to take into account the differences associated with the treatment of prostate cancer in Asia. These guidelines represent the consensus opinions reached by experts in the treatment of patients with prostate cancer representing the oncological societies of China (CSCO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence and was independent of the current treatment practices and drug access restrictions in the different Asian countries. The latter were discussed when appropriate. The aim is to provide guidance for the optimisation and harmonisation of the management of patients with prostate cancer across the different regions of Asia.
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Affiliation(s)
- R Kanesvaran
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore; Oncology Academic Programme, Duke-NUS Medical School, Singapore, Singapore.
| | - E Castro
- Department of Medical Oncology, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Málaga, Malaga, Spain
| | - A Wong
- Division of Medical Oncology, National University Cancer Institute, Singapore, Singapore
| | - K Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | - M L K Chua
- Oncology Academic Programme, Duke-NUS Medical School, Singapore, Singapore; Division of Radiation Oncology, National Cancer Centre Singapore, Singapore; Division of Medical Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Y Zhu
- Department of Urology, Fudan University, Shanghai Cancer Center, Shanghai, China
| | - H Malhotra
- Department of Medical Oncology, Sri Ram Cancer Center, Mahatma Gandhi Medical College Hospital, Mahatma Gandhi University of Medical Sciences & Technology, Jaipur, India
| | - Y Miura
- Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan
| | - J L Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - F L T Chong
- Department of Radiotherapy and Oncology, Sabah Women and Children's Hospital, Kota Kinabalu, Malaysia
| | - Y-S Pu
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - C-C Yen
- Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Medical Oncology, Center for Immuno-oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan; National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan
| | - M Saad
- Department of Clinical Oncology, University of Malaya Medical Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - H J Lee
- Department of Medical Oncology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, South Korea
| | - H Kitamura
- Department of Urology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - K Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Q Zou
- Department of Urology, Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - G Curigliano
- European Institute of Oncology, IRCCS and University of Milano, Milan, Italy
| | - E Poon
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - S P Choo
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore; Medical Oncology, Curie Oncology, Singapore, Singapore
| | - S Peters
- Oncology Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - E Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
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9
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Ortega-Contreras B, Armella A, Appel J, Mennickent D, Araya J, González M, Castro E, Obregón AM, Lamperti L, Gutiérrez J, Guzmán-Gutiérrez E. Pathophysiological Role of Genetic Factors Associated With Gestational Diabetes Mellitus. Front Physiol 2022; 13:769924. [PMID: 35450164 PMCID: PMC9016477 DOI: 10.3389/fphys.2022.769924] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 03/15/2022] [Indexed: 11/13/2022] Open
Abstract
Gestational Diabetes Mellitus (GDM) is a highly prevalent maternal pathology characterized by maternal glucose intolerance during pregnancy that is, associated with severe complications for both mother and offspring. Several risk factors have been related to GDM; one of the most important among them is genetic predisposition. Numerous single nucleotide polymorphisms (SNPs) in genes that act at different levels on various tissues, could cause changes in the expression levels and activity of proteins, which result in glucose and insulin metabolism dysfunction. In this review, we describe various SNPs; which according to literature, increase the risk of developing GDM. These SNPs include: (1) those associated with transcription factors that regulate insulin production and excretion, such as rs7903146 (TCF7L2) and rs5015480 (HHEX); (2) others that cause a decrease in protective hormones against insulin resistance such as rs2241766 (ADIPOQ) and rs6257 (SHBG); (3) SNPs that cause modifications in membrane proteins, generating dysfunction in insulin signaling or cell transport in the case of rs5443 (GNB3) and rs2237892 (KCNQ1); (4) those associated with enzymes such as rs225014 (DIO2) and rs9939609 (FTO) which cause an impaired metabolism, resulting in an insulin resistance state; and (5) other polymorphisms, those are associated with growth factors such as rs2146323 (VEGFA) and rs755622 (MIF) which could cause changes in the expression levels of these proteins, producing endothelial dysfunction and an increase of pro-inflammatory cytokines, characteristic on GDM. While the pathophysiological mechanism is unclear, this review describes various potential effects of these polymorphisms on the predisposition to develop GDM.
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Affiliation(s)
- B. Ortega-Contreras
- Pregnancy Diseases Laboratory, Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Universidad de Concepción, Concepción, Chile
| | - A. Armella
- Pregnancy Diseases Laboratory, Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Universidad de Concepción, Concepción, Chile
| | - J. Appel
- Pregnancy Diseases Laboratory, Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Universidad de Concepción, Concepción, Chile
| | - D. Mennickent
- Pregnancy Diseases Laboratory, Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Universidad de Concepción, Concepción, Chile
- Department of Instrumental Analysis, Faculty of Pharmacy, Universidad de Concepción, Concepción, Chile
| | - J. Araya
- Department of Instrumental Analysis, Faculty of Pharmacy, Universidad de Concepción, Concepción, Chile
| | - M. González
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universidad de Concepción, Concepción, Chile
| | - E. Castro
- Departamento de Obstetricia y Puericultura, Facultad de Ciencias de la Salud, Universidad de Atacama, Copiapó, Chile
| | - A. M. Obregón
- Faculty of Health Care, Universidad San Sebastián, Concepción, Chile
| | - L. Lamperti
- Pregnancy Diseases Laboratory, Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Universidad de Concepción, Concepción, Chile
| | - J. Gutiérrez
- Faculty of Health Sciences, Universidad San Sebastián, Santiago,Chile
| | - E. Guzmán-Gutiérrez
- Pregnancy Diseases Laboratory, Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Universidad de Concepción, Concepción, Chile
- *Correspondence: E. Guzmán-Gutiérrez,
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10
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Castro E, Sánchez-Morales GE, Hernández-Acevedo JD, Sánchez García-Ramos E, Chan C. Ampullary adenocarcinoma in a patient with portal annular pancreas: Relevance of the surgical approach in the Whipple procedure. Rev Gastroenterol Mex (Engl Ed) 2021; 87:116-118. [PMID: 34969645 DOI: 10.1016/j.rgmxen.2021.12.007] [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] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/27/2021] [Indexed: 10/19/2022]
Affiliation(s)
- E Castro
- Departamento de Cirugía General, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - G E Sánchez-Morales
- Departamento de Cirugía General, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - J D Hernández-Acevedo
- Departamento de Cirugía General, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - E Sánchez García-Ramos
- Departamento de Cirugía General, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - C Chan
- Departamento de Cirugía Hepatopancreatobiliar, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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11
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Peinado Ferreira P, Llacer Perez C, Grau G, Oliva Fernandez L, Cañada-Higueras E, Herrera-Imbroda B, Hernández D, Sáez M, Villatoro R, Montesa Pino A, López F, Márquez M, Pineda A, Olmos D, Castro E. CN22 Importance of research nursing role determining the germline study in metastatic prostate cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.647] [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: 10/20/2022] Open
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12
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Romero Laorden N, Lorente D, Lozano Mejorada R, Sanchez-Soler N, De Velasco G, Puente J, Borrega P, Gonzalez-Billalabeitia E, Castillo-Morales V, Hernández A, Fernandez-Freire A, Campos FL, Villatoro R, Fernandez Calvo O, Anido U, Lainez N, Luque R, Ros Martínez S, Castro E, Olmos D. 606P Role of serum biomarkers of bone metabolism in metastatic castration-resistance prostate cancer (mCRPC) patients (pts) treated with radium-223 (Ra223): PRORADIUM study final results. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1119] [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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13
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Llacer Perez C, Oliva Fernandez L, Cañada-Higueras E, Sáez M, Villatoro R, Montesa Pino A, Herrera Imbroda B, Hernández D, Lozano Mejorada R, Romero Laorden N, Marquez M, Grau G, Pineda A, López F, Peinado P, Alameda D, Olmos D, Castro E. 595P Correlation between genomic alterations and germline mutations in men with metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1108] [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: 10/20/2022] Open
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14
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Rubio-Novella S, Montes Á, Paredero Perez I, Lozano Mejorada R, Romero Laorden N, Castro E, Sanchez Hernandez A, Olmos D, Lorente Estelles D. 607P Impact of docetaxel on quality of life (QoL) in elderly and non-elderly metastatic castration-resistant prostate cancer (mCRPC) patients (Pts). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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15
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Castro E, Lozano Mejorada R, Medina A, Giorgi U, Romero Laorden N, Conteduca V, De Velasco G, Alameda D, Sanz A, Puente J, Gonzalez del Alba A, Borrega P, Villa Guzmán J, Fernández-Parra E, Rodriguez-Vida A, Chirivella I, Vazquez F, Morales Barrera R, Lorente D, Olmos D. 590P PRORADIUM: Prospective analysis of the impact of germline mutations in homologous recombination (HR) genes on the response to radium-223 for metastatic castration resistant prostate cancer (mCRPC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1103] [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: 10/20/2022] Open
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16
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Lopez Campos F, Lorente D, Llacer C, érez P, Gómez-Iturriaga A, Henriquez-López I, Peleteiro P, Ramirez-Backhaus M, Navarro-Castellón J, Lozano R, Romero N, Gajate P, Ana C, Gómez J, Álvarez S, Molina-Cerrillo J, Pelari L, Hernández-Corrales A, Morillo V, García R, Ferrer-Albiach C, Castro E, Olmos D. PD-0908 PSA Progression and survival in mCRPC patients treated with abiraterone or enzalutamide. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07187-5] [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: 10/20/2022]
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17
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Lopez Campos F, Lorente D, Llacer-Pérez C, Henríquez I, Peleteiro P, Gómez-Iturriaga A, Ramírez-Backhaus M, Álvarez S, Alonso-Gordoa T, Molina-Cerrillo J, Vallejo C, Hervás A, Navarro-Castellón J, Gómez J, Morillo V, Lozano R, Romero-Laorden N, García R, Hernández-Corrales A, Pelari L, Ferrer-Albiach C, Sancho S, Castro E, Olmos D. PD-0913 Local treatment to the primary tumor and PSA changes as prognostic factors in mCRPC. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07192-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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18
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Schenone CV, King A, Castro E, Ketwaroo P, Donepudi R, Sanz-Cortes M. Prenatal detection of disseminated extrarenal malignant rhabdoid tumor with placental metastases. Ultrasound Obstet Gynecol 2021; 57:1008-1010. [PMID: 32621313 DOI: 10.1002/uog.22136] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/12/2020] [Accepted: 06/19/2020] [Indexed: 06/11/2023]
Affiliation(s)
- C V Schenone
- Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - A King
- Department of Pediatric Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - E Castro
- Department of Pathology and Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - P Ketwaroo
- Edward B. Singleton Department of Radiology, Division of Fetal and Neonatal Imaging, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - R Donepudi
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA
| | - M Sanz-Cortes
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA
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19
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González Del Alba A, Méndez-Vidal MJ, Vazquez S, Castro E, Climent MA, Gallardo E, Gonzalez-Billalabeitia E, Lorente D, Maroto JP, Arranz JA. SEOM clinical guidelines for the treatment of advanced prostate cancer (2020). Clin Transl Oncol 2021; 23:969-979. [PMID: 33625671 PMCID: PMC8057980 DOI: 10.1007/s12094-021-02561-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 12/24/2022]
Abstract
The treatment of advanced prostate cancer has evolved due to recent advances in molecular research and new drug development. Dynamic aberrations in the androgen receptor, DNA repair genes, PTEN-PI3K, and other pathways drive the behavior of advanced prostate cancer allowing a better selection of therapies in each patient. Tumor testing for BRCA1 and BRCA2 is recommended for patients with metastatic prostate cancer, also considering a broad panel to guide decisions and genetic counseling. In symptomatic metastatic patients, castration should be stared to palliate symptoms and prolong survival. In high-risk or high-volume metastatic hormone-naïve patients, castration should be combined with docetaxel, abiraterone, enzalutamide or apalutamide. Radiotherapy to the primary tumor combined with systemic therapy is recommended in low-volume mHNPC patients. In patients with non-metastatic castration-resistant tumors, risk stratification can define the frequency of imaging. Adding enzalutamide, darolutamide or apalutamide to these patients prolongs metastasis-free and overall survival, but potential adverse events need to be taken into consideration. The choice of docetaxel, abiraterone or enzalutamide for treating metastatic castration-resistant patients depends on previous therapies, with cabazitaxel being also recommended after docetaxel. Olaparib is recommended in BRCA1/BRCA2 mutated castration-resistant patients after progression on at least one new hormonal therapy. Aggressive variants of prostate cancer respond to platinum-based chemotherapy. To optimize treatment efficiency, oncologists should incorporate all of these advances into an overall therapeutic strategy.
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Affiliation(s)
- A González Del Alba
- Medical Oncology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Joaquin Rodrigo 2, Majadahonda, 28222, Madrid, Spain.
| | - M J Méndez-Vidal
- Medical Oncology Department, Hospital Universitario Reina Sofía, Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), Córdoba, Spain
| | - S Vazquez
- Medical Oncology Department, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - E Castro
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria y Regional de Mälaga, Málaga, Spain
| | - M A Climent
- Medical Oncology Department, Fundación Instituto Valenciano de Oncología, València, Spain
| | - E Gallardo
- Medical Oncology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - E Gonzalez-Billalabeitia
- Medical Oncology Department, Hospital Universitario Doce de Octubre, Instituto Imas12, Madrid, Spain
- Universidad Católica San Antonio de Murcia (UCAM), Murcia, Spain
| | - D Lorente
- Medical Oncology Department, Hospital Provincial de Castellón, Castellon, Spain
| | - J P Maroto
- Medical Oncology Department, Hospital Universitari Santa Creu i San Pau, Barcelona, Spain
| | - J A Arranz
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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20
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Borque-Fernando A, Espílez R, Miramar D, Corbatón D, Rodríguez A, Castro E, Mateo J, Rello L, Méndez A, Gil Sanz MJ. Genetic counseling in prostate cancer: How to implement it in daily clinical practice? Actas Urol Esp 2021; 45:8-20. [PMID: 33059945 DOI: 10.1016/j.acuro.2020.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 08/22/2020] [Indexed: 11/16/2022]
Abstract
Prostate cancer plays an undeniably prominent role in public health in our days and health systems. Its epidemiological impact is quantitatively very close to that of other tumors such as colon cancer and breast cancer, in which genetic counseling is part of their routine clinical practice, both in the initial evaluation and in the selection of therapeutic strategies. Hereditary cancer syndromes, breast/ovarian and Lynch syndrome are part of genetic counseling in these tumors. Currently, we also know that they can be associated to prostate cancer. The time has come to implement genetic counseling in prostate cancer from the earliest stages of its approach, from initial suspicion to the most advanced tumors. We present an updated review carried out by our interdisciplinary working group on scientific literature, clinical practice guidelines and consensus documents, aimed at the creation and drafting of a'Protocol for genetic counseling in prostate cancer' for the study of germline, with easy application in different healthcare settings. This protocol is currently being implemented in our routine practice and provides answers to 3 specific questions: Who should receive genetic counseling for prostate cancer? Which gene panel should be analyzed? How should counseling be done according to the results obtained? Other aspects about who should perform genetic counseling, ethical considerations and regulations are also collected.
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Affiliation(s)
- A Borque-Fernando
- Servicio de Urología, Hospital Universitario Miguel Servet, IIS-Aragón, Zaragoza, España.
| | - R Espílez
- Servicio de Urología, Hospital Universitario Miguel Servet, IIS-Aragón, Zaragoza, España
| | - D Miramar
- Servicio de Bioquímica, Unidad de Genética, Hospital Universitario Miguel Servet, Zaragoza, España
| | - D Corbatón
- Servicio de Urología, Hospital Universitario Miguel Servet, IIS-Aragón, Zaragoza, España
| | - A Rodríguez
- Servicio de Bioquímica, Unidad de Genética, Hospital Universitario Miguel Servet, Zaragoza, España
| | - E Castro
- Departamento de Oncología Médica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga, Málaga, España
| | - J Mateo
- Instituto de Oncología Vall d'Hebron y Hospital Universitario Vall d'Hebron, Barcelona, España
| | - L Rello
- Servicio de Bioquímica, Unidad de Genética, Hospital Universitario Miguel Servet, Zaragoza, España
| | - A Méndez
- Servicio de Oncología Radioterápica, Hospital Universitario Miguel Servet, Zaragoza, España
| | - M J Gil Sanz
- Servicio de Urología, Hospital Universitario Miguel Servet, IIS-Aragón, Zaragoza, España
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21
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Bolivar S, Espitia-Corredor JA, Olivares-Silva F, Valenzuela P, Humeres C, Anfossi R, Castro E, Vivar R, Salas-Hernández A, Pardo-Jiménez V, Díaz-Araya G. In cardiac fibroblasts, interferon-beta attenuates differentiation, collagen synthesis, and TGF-β1-induced collagen gel contraction. Cytokine 2020; 138:155359. [PMID: 33160814 DOI: 10.1016/j.cyto.2020.155359] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/27/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022]
Abstract
Cardiac fibroblasts (CF) play a key role in the homeostasis of the extracellular matrix in cardiac tissue and are newly recognized as inflammatory supporter cells. Besides, CF-to-Cardiac myofibroblast differentiation is commanded by TGF-b, through SMAD signaling pathways, and these last cells are strongly implicated in cardiac fibrosis. In the heart IFN-β is produced by CF; however, the role of IFN-β, STAT proteins, and STAT-homo or heterodimers in the regulation of CF function with or without a fibrotic environment is unknown. CF were isolated from hearts of adult rats, and by western blot analysis we studied STAT1, STAT2, and STAT3 phosphorylation and through specific siRNA against these proteins we analyzed their role in CF functions such as differentiation (α-SMA expression); and pro-collagen type-I synthesis and secretion expression levels; collagen gels contraction and CF migration. In cultured adult rats CF, IFN-β increases phosphorylation of STAT1, STAT2, and STAT3. Both STAT1 and STAT2 were involved in decreasing α-SMA and CF migration induced by TGF-β1. Also, IFN-β through STAT1 regulated pro-collagen type-I protein expression levels, and collagen gels contraction induced by TGF-β1. STAT3 was not involved in any effects of IFN-β studied. In conclusion, IFN-β through STAT1 and STAT2 shows antifibrotic effects on CF TGF-β1-treated, whereas STAT3 did not participate in such effect.
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Affiliation(s)
- S Bolivar
- Department of Pharmacological and Toxicological Chemistry, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile; Faculty of Chemistry and Pharmacy, Universidad del Atlántico, Barranquilla, Colombia
| | - J A Espitia-Corredor
- Department of Pharmacological and Toxicological Chemistry, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile
| | - F Olivares-Silva
- Department of Pharmacological and Toxicological Chemistry, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile
| | - P Valenzuela
- Department of Pharmacological and Toxicological Chemistry, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile
| | - C Humeres
- Department of Pharmacological and Toxicological Chemistry, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile
| | - R Anfossi
- Department of Pharmacological and Toxicological Chemistry, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile
| | - E Castro
- Department of Pharmacological and Toxicological Chemistry, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile
| | - R Vivar
- Department of Pharmacological and Toxicological Chemistry, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile
| | - A Salas-Hernández
- Department of Pharmacological and Toxicological Chemistry, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile
| | - V Pardo-Jiménez
- Department of Pharmacological and Toxicological Chemistry, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile
| | - G Díaz-Araya
- Department of Pharmacological and Toxicological Chemistry, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile; Advanced Center for Chronic Diseases (ACCDiS), Faculty of Chemical and Pharmaceutical Sciences and Faculty of Medicine, University of Chile, Santiago, Chile.
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22
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Castro E, Lang S, Swift S, Leadley R, Chalker A, Noake C, Fox K, Quek R. Comparing the characteristics of advanced Prostate Cancer (PC) patients with and without DNA Damage Repair mutations (DDRm): A systematic review. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)36211-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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23
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Parker C, Castro E, Fizazi K, Heidenreich A, Ost P, Procopio G, Tombal B, Gillessen S. Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2020; 31:1119-1134. [PMID: 32593798 DOI: 10.1016/j.annonc.2020.06.011] [Citation(s) in RCA: 431] [Impact Index Per Article: 107.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 02/07/2023] Open
Affiliation(s)
- C Parker
- Royal Marsden Hospital, Sutton, UK
| | - E Castro
- Department of Medical Oncology, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Málaga, Malaga, Spain
| | - K Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | - A Heidenreich
- Department of Urology, Uro-Oncology, Robot-Assisted and Specialized Urologic Surgery, University Hospital of Cologne, Cologne, Germany
| | - P Ost
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - G Procopio
- Department of Medical Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - B Tombal
- Institut de Recherche Clinique, Université catholique de Louvain, Brussels, Belgium
| | - S Gillessen
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Faculty of Biomedical Sciences, USI, Lugano, Switzerland; Division of Cancer Medicine, University of Manchester, Manchester, UK
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24
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Khalaf D, Aragón I, Annala M, Lozano R, Taavitsainen S, Lorente D, Finch D, Romero-Laorden N, Vergidis J, Cendón Y, Oja C, Pacheco M, Zulfiqar M, Gleave M, Wyatt A, Olmos D, Chi K, Castro E, Almagro E, Arranz J, Billalabeitia E, Borrega P, Castro E, Contreras J, Domenech M, Escribano R, Fernández-Parra E, Gallardo E, García-Carbonero I, García R, Garde J, González del Alba A, González B, Hernández A, Hernando S, Jiménez P, Laínez N, Lorente D, Luque R, Martínez E, Medina A, Méndez-Vidal M, Montesa A, Morales R, Olmos David, Pérez-Gracia J, Pérez-Valderrama B, Pinto Á, Piulats J, Puente J, Querol R, Rodríguez-Vida A, Romero-Laorden N, Sáez M, Vázquez S, Vélez E, Villa-Guzmán J, Villatoro R, Zambrana C. HSD3B1 (1245A>C) germline variant and clinical outcomes in metastatic castration-resistant prostate cancer patients treated with abiraterone and enzalutamide: results from two prospective studies. Ann Oncol 2020; 31:1186-1197. [DOI: 10.1016/j.annonc.2020.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/15/2020] [Accepted: 06/03/2020] [Indexed: 12/22/2022] Open
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25
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Rojas-Chamorro JA, Romero-García JM, Cara C, Romero I, Castro E. Improved ethanol production from the slurry of pretreated brewers' spent grain through different co-fermentation strategies. Bioresour Technol 2020; 296:122367. [PMID: 31727558 DOI: 10.1016/j.biortech.2019.122367] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/31/2019] [Accepted: 11/01/2019] [Indexed: 06/10/2023]
Abstract
The aim of this work was to bioconvert all sugars in BSG into ethanol using a process scheme that includes the enzymatic hydrolysis of the whole slurry resulting from the pretreatment of BSG with phosphoric and sulfuric acid using previously optimised conditions, followed by the co-fermentation of the mixed sugars. More than 90% of the sugars in raw BSG were recovered in the pretreatment and the subsequent enzymatic hydrolysis of the whole slurry. The co-fermentation of the enzymatic hydrolysates with Escherichia coli was then compared with that the co-culture of Scheffersomyces stipitis and Saccharomyces cerevisiae, which resulted in lower ethanol production. The co-fermentation strategy with a single microorganism (E. coli) when BSG was pretreated with phosphoric acid resulted into the highest ethanol concentration, 39 g/L, which means that 222 L of ethanol can be obtained from a ton of BSG without detoxification requirements.
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Affiliation(s)
- J A Rojas-Chamorro
- Dpt. Chemical, Environmental and Materials Engineering, Universidad de Jaén, Spain
| | - J M Romero-García
- Dpt. Chemical, Environmental and Materials Engineering, Universidad de Jaén, Spain; Center for Advanced Studies in Energy and Environment, Universidad de Jaén, Campus las Lagunillas, 23071 Jaén, Spain
| | - C Cara
- Dpt. Chemical, Environmental and Materials Engineering, Universidad de Jaén, Spain; Center for Advanced Studies in Energy and Environment, Universidad de Jaén, Campus las Lagunillas, 23071 Jaén, Spain
| | - I Romero
- Dpt. Chemical, Environmental and Materials Engineering, Universidad de Jaén, Spain; Center for Advanced Studies in Energy and Environment, Universidad de Jaén, Campus las Lagunillas, 23071 Jaén, Spain.
| | - E Castro
- Dpt. Chemical, Environmental and Materials Engineering, Universidad de Jaén, Spain; Center for Advanced Studies in Energy and Environment, Universidad de Jaén, Campus las Lagunillas, 23071 Jaén, Spain
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26
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Aragon I, Cendón Y, Lorente D, Mejorada RL, Laorden NR, Colmenero AM, Puente J, Villatoro R, Estevez SV, Piulats J, Lainez N, Fernandez-Parra E, del Alba AG, Jorge AH, Olmos B, Rivera L, Pacheco M, Hidalgo DO, Castro E. Implications of single nucleotide polymorphisms (SNPs) in androgen related-genes in outcome of metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone (Abi) and enzalutamide (Enza). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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27
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Castro E, Mejorada RL, Saez M, De Giorgi U, Aragón I, Laorden NR, De Velasco Oria de Rueda G, Magraner L, Pacheco M, Puente J, del Alba AG, Garcia PB, Conteduca V, Guzman JCV, Parra EF, Rodriguez-Vida A, Colmenero AM, Barrera RM, Lorente D, Hidalgo DO. Impact of germline mutations in homologous recombination (HR) genes on the response to Radium-223 for metastatic castration resistant prostate cancer (mCRPC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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28
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Laorden NR, Mejorada RL, Jorge AH, Lainez N, Casado EA, Calvo OF, Hernando S, Freire AF, Billalabeitia EG, Chirivella I, Domínguez RG, Herranz UA, Mazon FJV, Ros S, Montesa A, De Velasco Oria de Rueda G, Barrera RM, Lorente D, Castro E, Hidalgo DO. Serum biomarkers of bone metabolism in metastatic castration-resistant prostate cancer (mCRPC) patients (pts) treated with radium-223 (Ra223): Results from a prospective multicentre study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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29
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Cattrini C, Laorden NR, Castro E, García-Carbonero I, Piulats J, Puente J, Valderrama B, Guzman JCV, Billalabeitia EG, Barrera RM, Mejorada RL, Luque R, Ortega EM, Arija JAA, Diaz EG, Marin AP, Casado EA, Vidal MJM, Hidalgo DO, Lorente D. Impact of treatment sequence in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC): Data from the prospective PROREPAIR-B study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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30
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Mejorada RL, Lorente D, Castro E, Bianchini D, Nombela P, Sandhu S, Laorden NR, Cendón Y, Sharp A, Casado EA, Pacheco M, Rescigno P, LLácer C, Saez M, Rivera L, Vitrone F, Moreno C, Mateo J, de Bono J, Hidalgo DO. Circulating tumour cells (CTC) count and prostate-specific antigen (PSA) response measures in metastatic castration-resistant prostate cancer (mCRPC) patients (pts) treated with docetaxel (Doc). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Guzman E, Gonzalez M, Fuenzalida B, Leiva A, Castro E, Guzman-Gutierrez E. Deiodinases expression is altered in human trophoblast from gestational diabetes mellitus pregnancies. Placenta 2019. [DOI: 10.1016/j.placenta.2019.06.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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32
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Guzman-Gutierrez E, Gutierrez-Vega S, Castro E, Gonzalez M, Leiva A. Low levels of free thyroxine in umbilical cord blood is associated with a reduce in deiodinase 2 activity in human trophoblast from gestational diabetes pregnancies. Placenta 2019. [DOI: 10.1016/j.placenta.2019.06.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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33
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van Cleef F, van Cleef E, Almeida M, Paschoaloto J, Castro E, Barducci R, Soragni G, Zampieri E, Ezequiel J. PSI-13 In vitro digestibility and gas production of diets containing different levels of soybean molasses for feedlot sheep. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- F van Cleef
- University of Florida, North Florida Research and Education Center,Marianna, Gainesville, FL, United States
| | - E van Cleef
- Federal University of Triangulo Mineiro,Uberaba, Brazil
| | - M Almeida
- Sao Paulo State University,Sao Paulo, Brazil
| | | | - E Castro
- Sao Paulo State University,Sao Paulo, Brazil
| | - R Barducci
- Sao Paulo State University,Sao Paulo, Brazil
| | - G Soragni
- Sao Paulo State University,Sao Paulo, Brazil
| | - E Zampieri
- Sao Paulo State University,Sao Paulo, Brazil
| | - J Ezequiel
- Sao Paulo State University,Sao Paulo, Brazil
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34
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Gonçalves C, Marques M, Valdoleiros S, Santos FV, Furtado I, Horta A, Mendez J, Sarmento R, Castro E. Directly observed therapy of direct acting antivirals (DAA) for the treatment of chronic hepatitis C in HIV co-infected patients with a drug use history. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3961] [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: 10/28/2022] Open
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35
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Dashora U, Murphy HR, Temple RC, Stanley KP, Castro E, George S, Dhatariya K, Haq M, Sampson M. Managing hyperglycaemia during antenatal steroid administration, labour and birth in pregnant women with diabetes. Diabet Med 2018; 35:1005-1010. [PMID: 30152588 DOI: 10.1111/dme.13674] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2018] [Indexed: 11/28/2022]
Abstract
Optimal glycaemic control before and during pregnancy improves both maternal and fetal outcomes. This article summarizes the recently published guidelines on the management of glycaemic control in pregnant women with diabetes on obstetric wards and delivery units produced by the Joint British Diabetes Societies for Inpatient Care and available in full at www.diabetes.org.uk/joint-british-diabetes-society and https://abcd.care/joint-british-diabetes-societies-jbds-inpatient-care-group. Hyperglycaemia following steroid administration can be managed by variable rate intravenous insulin infusion (VRIII) or continuous subcutaneous insulin infusion (CSII) in women who are willing and able to safely self-manage insulin dose adjustment. All women with diabetes should have capillary blood glucose (CBG) measured hourly once they are in established labour. Those who are found to be higher than 7 mmol/l on two consecutive occasions should be started on VRIII. If general anaesthesia is used, CBG should be monitored every 30 min in the theatre. Both the VRIII and CSII rate should be reduced by at least 50% once the placenta is delivered. The insulin dose needed after delivery in insulin-treated Type 2 and Type 1 diabetes is usually 25% less than the doses needed at the end of first trimester. Additional snacks may be needed after delivery especially if breastfeeding. Stop all anti-diabetes medications after delivery in gestational diabetes. Continue to monitor CBG before and 1 h after meals for up to 24 h after delivery to pick up any pre-existing diabetes or new-onset diabetes in pregnancy. Women with Type 2 diabetes on oral treatment can continue to take metformin after birth.
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MESH Headings
- Administration, Intravenous
- Adult
- Delivery, Obstetric/methods
- Delivery, Obstetric/standards
- Diabetes Mellitus, Type 1/blood
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/therapy
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/therapy
- Female
- Fetal Organ Maturity/drug effects
- Glucocorticoids/therapeutic use
- Humans
- Hyperglycemia/blood
- Hyperglycemia/therapy
- Hypoglycemic Agents/administration & dosage
- Insulin/administration & dosage
- Insulin Infusion Systems
- Labor, Obstetric/drug effects
- Labor, Obstetric/physiology
- Parturition/drug effects
- Parturition/physiology
- Pregnancy
- Pregnancy in Diabetics/blood
- Pregnancy in Diabetics/therapy
- Prenatal Care/methods
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Affiliation(s)
- U Dashora
- Conquest Hospital, St Leonards on Sea, UK
| | - H R Murphy
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - R C Temple
- Norfolk and Norwich University Hospital, Norwich, UK
| | - K P Stanley
- Norfolk and Norwich University Hospital, Norwich, UK
| | - E Castro
- East Sussex Healthcare NHS Trust, St Leonards on Sea, UK
| | - S George
- East and North Hertfordshire NHS Trust, Stevenage, UK
| | - K Dhatariya
- Norwich Medical School, University of East Anglia, Norwich, UK
- Norfolk and Norwich University Hospital, Norwich, UK
| | - M Haq
- Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, UK
| | - M Sampson
- Norwich Medical School, University of East Anglia, Norwich, UK
- Norfolk and Norwich University Hospital, Norwich, UK
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36
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Santarelli L, Diyakonova O, Betti S, Esposito D, Castro E, Cavallo F. Development of a Novel Wearable Ring-Shaped Biosensor. Annu Int Conf IEEE Eng Med Biol Soc 2018; 2018:3750-3753. [PMID: 30441182 DOI: 10.1109/embc.2018.8513330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We report on the preliminary results obtained out of a wearable module designed to be encompassed within a ring-shaped system aimed at providing healthcare services. The module is composed of two sensors for the measuring of Galvanic Skin Response (GSR) and Heart Rate Variability (HRV). A first device validation was carried out by involving four subjects who were asked to perform tasks providing different stress-related statuses. A comparison of physiological parameters measured by the module with those measured by a commercial HRV-GSR sensor chosen as gold standard was made. Two out of the three HRV parameters and all of the GSR parameters measured with the module resulted consistent (mostly differing less than 10%) with the same parameters measured by the gold standard. The work reported in this paper set a milestone for the realization of a system exploiting sensor fusion to provide active ageing, stress detection, activity recognition and e-health services has been achieved.
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37
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Maselli M, Fiorini L, Castro E, Baldoli I, Tocchini S, Sportiello MT, Cavallo F, Cecchi F, Laschi C. Development and testing of a new cognitive technological tool for episodic memory: A feasibility study. Annu Int Conf IEEE Eng Med Biol Soc 2018; 2017:893-896. [PMID: 29060016 DOI: 10.1109/embc.2017.8036968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cognitive Rehabilitation Therapy refers to any systemic therapy specifically designed to enhance cognitive performance. Recent studies have shown that physical exercise is beneficial for cognitive activity in patients with degenerative diseases. Therefore, the objective of the present study is to provide training for cognitive functions that take advantage of the physical activity in the execution of the task. A feasibility study concerning the application of a new bioengineering technique in cognitive rehabilitation is presented and it divided into two parts. The first one aims at developing a new cognitive tool, called SmartTapestry (ST), for motor and cognitive rehabilitation. The second part aims at understanding its technical viability and its level of sensitivity in measuring the same cognitive domains covered by the standardized tests. The hypothesis of this study is that, despite the introduction of this new variable, the proposed system has the same sensitivity of the traditional tests. The results suggest a good correlation between the two approaches and that SmartTapestry can train the same cognitive functions of traditional cognitive tasks.
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Fiorini L, Maselli M, Castro E, Tocchini S, Sportiello MT, Laschi C, Cecchi F, Cavallo F. Feasibility study on the assessment of auditory sustained attention through walking motor parameters in mild cognitive impairments and healthy subjects. Annu Int Conf IEEE Eng Med Biol Soc 2018; 2017:897-900. [PMID: 29060017 DOI: 10.1109/embc.2017.8036969] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Dementia and other cognitive disorders affect more than 35 million people worldwide. Over the last years, cognitive training tools were used to improve the brain functioning, thus to slow down the cognitive decline. Recently, research studies have demonstrated that aerobic exercise could play an important restorative role toward cognitive impairments. Therefore, the aim of this work is to present an innovative sensorized approach which combines aerobic exercise and traditional cognitive tools for daily training.
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39
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Romero-Laorden N, Piñeiro-Yañez E, Gutierrez-Pecharroman A, Pacheco MI, Calvo E, Al-Shahrour F, Castro E, Olmos D. Somatic BRCA2 bi-allelic loss in the primary prostate cancer was associated to objective response to PARPi in a sporadic CRPC patient. Ann Oncol 2018; 28:1158-1159. [PMID: 28453706 DOI: 10.1093/annonc/mdx067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Romero-Laorden
- Prostate Cancer Unit, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Madrid.,Prostate Cancer Unit, Spanish National Cancer Research Centre
| | - E Piñeiro-Yañez
- Bioinformatics Unit, Spanish National Cancer Research Centre (CNIO), Madrid
| | - A Gutierrez-Pecharroman
- Prostate Cancer Unit, Spanish National Cancer Research Centre.,Pathology Department, Hospital Universitario de Móstoles, Mostoles
| | - M I Pacheco
- Prostate Cancer Unit, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Madrid.,Prostate Cancer Unit, Spanish National Cancer Research Centre
| | - E Calvo
- START Madrid, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Madrid
| | - F Al-Shahrour
- Bioinformatics Unit, Spanish National Cancer Research Centre (CNIO), Madrid
| | - E Castro
- Prostate Cancer Unit, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Madrid.,Prostate Cancer Unit, Spanish National Cancer Research Centre
| | - D Olmos
- Prostate Cancer Unit, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Madrid.,Prostate Cancer Unit, Spanish National Cancer Research Centre.,CNIO-IBIMA Genito-Urinary Cancer Unit, Medical Oncology Department, Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, Málaga, Spain
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40
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Costa E, Rocha S, Rocha-Pereira P, Castro E, Reis F, Teixeira F, Miranda V, Faria MDS, Loureiro A, Quintanilha A, Belo L, Santos-Silva A. Cross-Talk between Inflammation, Coagulation/Fibrinolysis and Vascular access in Hemodialysis Patients. J Vasc Access 2018. [DOI: 10.1177/112972980800900405] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This work aimed to study the association between fibrinolytic/endothelial cell function and inflammatory markers in chronic kidney disease (CKD) patients undergoing hemodialysis (HD) and recombinant human erythropoietin (rhEPO) therapies, and its relationship with the type of vascular access (VA) used for the HD procedure. As fibrinolytic/endothelial cell function markers we evaluated plasminogen activator inhibitor type-1 (PAI-1), tissue plasminogen activator (tPA) and D-dimers, and as inflammatory markers; C-reactive protein (CRP), soluble interleukin (IL)-2 receptor (s-IL2R), IL-6 and serum albumin levels. The study was performed in 50 CKD patients undergoing regular HD, 11 with a central venous dialysis catheter (CVC) and 39 with an arteriovenous fistula (AVF), and in 25 healthy controls. Compared to controls, CKD patients presented with significantly higher levels of CRP, s-IL2R, IL-6 and D-dimers, and significantly lower levels of PAI-1. The tPA/PAI-1 ratio was significantly higher in CKD patients. We also found statistical significant correlations in CKD patients between D-dimers levels and inflammatory markers: CRP, albumin, s-IL2R and IL-6. When comparing the two groups of CKD patients, we found that those with a CVC presented statistically significant lower levels of hemoglobin concentration and albumin, and higher levels of CRP, IL-6, D-dimers and tPA. Our results showed an association between fibrinolytic/endothelial cell function and increased inflammatory markers in CKD patients. The increased levels of D-dimer, tPA and inflammatory markers in CKD patients using a CVC, led us to propose a relationship between the type of VA chosen for HD, and the risk of thrombogenesis.
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Affiliation(s)
- E. Costa
- Instituto de Ciências da Saúde da Universidade Católica Portuguesa, Porto - Portugal
- Faculdade Farmácia, Serviço de Bioquímica, Universidade do Porto - Portugal
- Instituto Biologia Molecular e Celular (IBMC), Universidade do Porto - Portugal
| | - S. Rocha
- Faculdade Farmácia, Serviço de Bioquímica, Universidade do Porto - Portugal
- Instituto Biologia Molecular e Celular (IBMC), Universidade do Porto - Portugal
| | - P. Rocha-Pereira
- Instituto Biologia Molecular e Celular (IBMC), Universidade do Porto - Portugal
- Centro Investigação Ciências Saúde, Universidade Beira Interior, Covilhã - Portugal
| | - E. Castro
- Faculdade Farmácia, Serviço de Bioquímica, Universidade do Porto - Portugal
- Instituto Biologia Molecular e Celular (IBMC), Universidade do Porto - Portugal
| | - F. Reis
- Instituto de Farmacologia e Terapêutica Experimental, Faculdade Medicina, Universidade Coimbra - Portugal
| | - F. Teixeira
- Instituto de Farmacologia e Terapêutica Experimental, Faculdade Medicina, Universidade Coimbra - Portugal
| | - V. Miranda
- FMC, Dinefro - Diálises e Nefrologia, SA - Portugal
| | | | - A. Loureiro
- Uninefro – Sociedade Prestadora de cuidados Médicos e de Diálise, SA - Portugal
| | - A. Quintanilha
- Faculdade Farmácia, Serviço de Bioquímica, Universidade do Porto - Portugal
- Instituto Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto - Portugal
| | - L. Belo
- Faculdade Farmácia, Serviço de Bioquímica, Universidade do Porto - Portugal
- Instituto Biologia Molecular e Celular (IBMC), Universidade do Porto - Portugal
| | - A. Santos-Silva
- Faculdade Farmácia, Serviço de Bioquímica, Universidade do Porto - Portugal
- Instituto Biologia Molecular e Celular (IBMC), Universidade do Porto - Portugal
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41
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Strik M, Korver F, Castro E, Van Moorsel F, Engels E, Ploux S, Bordachar P, Smid M, Sipers W, Prinzen F. P886Qt-duration behavior during haloperidol use in the frail admitted elderly with delirium. Europace 2018. [DOI: 10.1093/europace/euy015.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Strik
- Maastricht University, CARIM, Department of Physiology, Maastricht, Netherlands
| | - F Korver
- Maastricht University, CARIM, Department of Physiology, Maastricht, Netherlands
| | - E Castro
- Maastricht University, CARIM, Department of Physiology, Maastricht, Netherlands
| | - F Van Moorsel
- Maastricht University, CARIM, Department of Physiology, Maastricht, Netherlands
| | - E Engels
- Maastricht University, CARIM, Department of Physiology, Maastricht, Netherlands
| | - S Ploux
- Haut-Lévêque Hospital, Centre Hospitalier Universitaire de Bordeaux; LIRYC institute, Bordeaux-Pessac, France
| | - P Bordachar
- Haut-Lévêque Hospital, Centre Hospitalier Universitaire de Bordeaux; LIRYC institute, Bordeaux-Pessac, France
| | - M Smid
- Zuyderland Medical Center, Sittard, Netherlands
| | - W Sipers
- Zuyderland Medical Center, Sittard, Netherlands
| | - F Prinzen
- Maastricht University, CARIM, Department of Physiology, Maastricht, Netherlands
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Bidoli F, Castro E, Azevedo V, Nima G, De Andrade O, Giannini M. Effect of toothbrushing with fluoride-containing dentifrices on ceramic optical properties. Dent Mater 2018. [DOI: 10.1016/j.dental.2018.08.051] [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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Moynihan C, Bancroft E, Mitra A, Ardern‐Jones A, Castro E, Page E, Eeles R. Ambiguity in a masculine world: Being a BRCA1/2 mutation carrier and a man with prostate cancer. Psychooncology 2017; 26:1987-1993. [PMID: 28812325 PMCID: PMC5698714 DOI: 10.1002/pon.4530] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 07/06/2017] [Accepted: 08/08/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Increased risk of prostate cancer (PCa) is observed in men with BRCA1/BRCA2 mutations. Sex and gender are key determinants of health and disease although unequal care exists between the sexes. Stereotypical male attitudes are shown to lead to poor health outcomes. METHODS Men with BRCA1/2 mutations and diagnosed with PCa were identified and invited to participate in a qualitative interview study. Data were analysed using a framework approach. "Masculinity theory" was used to report the impact of having both a BRCA1/2 mutation and PCa. RESULTS Eleven of 15 eligible men were interviewed. The umbrella concept of "Ambiguity in a Masculine World" was evident. Men's responses often matched those of women in a genetic context. Men's BRCA experience was described, as "on the back burner" but "a bonus" enabling familial detection and early diagnosis of PCa. Embodiment of PCa took precedence as men revealed stereotypical "ideal" masculine responses such as stoicism and control while creating new "masculinities" when faced with the vicissitudes of having 2 gendered conditions. CONCLUSION Health workers are urged to take a reflexive approach, void of masculine ideals, a belief in which obfuscates men's experience. Research is required regarding men's support needs in the name of equality of care.
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Affiliation(s)
| | - E.K. Bancroft
- The Institute of Cancer ResearchLondonUK
- The Royal Marsden NHS Foundation TrustLondonUK
| | - A. Mitra
- The Institute of Cancer ResearchLondonUK
- University College HospitalsLondonUK
| | | | - E. Castro
- The Institute of Cancer ResearchLondonUK
- Spanish National Cancer Research Centre (CNIO)MadridSpain
| | - E.C. Page
- The Institute of Cancer ResearchLondonUK
| | - R.A. Eeles
- The Institute of Cancer ResearchLondonUK
- The Royal Marsden NHS Foundation TrustLondonUK
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García-Herranz N, Cuervo D, Sabater A, Rucabado G, Sánchez-Cervera S, Castro E. Multiscale neutronics/thermal-hydraulics coupling with COBAYA4 code for pin-by-pin PWR transient analysis. Nuclear Engineering and Design 2017. [DOI: 10.1016/j.nucengdes.2017.03.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Amyai N, Darling K, D'Acremont V, Castro E, Ebert S, Diserens MM, Perdrix J, Fossati AH, Bodenmann P, Cavassini M. A prospective multicentre study of healthcare provider preference in rapid HIV testing kits: Determine versus INSTI. Int J STD AIDS 2017; 29:51-56. [PMID: 28669324 DOI: 10.1177/0956462417717648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rapid HIV testing may circumvent the practical barriers to HIV testing in several settings. User preference of the testing kits available has been relatively underexplored. We examined healthcare provider (HCP) ratings of two validated rapid testing kits in clinical practice. From 1 July to 1 December 2012 we prospectively recruited HCPs (clinic nurses) from three outpatient clinics linked to Lausanne University Hospital, Lausanne, Switzerland. The HCPs had experience in taking blood samples but varying experience in rapid HIV testing. Participating HCPs performed rapid HIV testing using Determine™ Combo (DETE) or INSTI™ (INSTI), according to a predefined randomization sequence, and rated practical aspects of each test using a Likert scale. Seventeen HCPs of 23 approached (74%) were eligible and agreed to participate, performing a total of 336 HIV tests. Globally, the testing procedure was rated as easy or very easy by 97% (DETE) to 99% (INSTI) of tests performed. Among experienced HCPs, DETE was rated easier than INSTI for kit storage (p < 0.001) and blood collection ( P = 0.012) while INSTI was rated easier than DETE for blood application ( P = 0.001) and test interpretation ( P = 0.005). Among less experienced HCPs, both tests performed equally with the exception of test interpretation ( P < 0.001) and overall ease of use ( P = 0.05) in favour of INSTI. Of all HCPs, 94% stated they would recommend INSTI over DETE based on the time to result, ease of test interpretation and overall ease of use. Rapid HIV testing was considered easy to perform, even by inexperienced nursing staff. Whilst both tests were considered easy to use, the HCPs in this study preferred INSTI to DETE overall, due to rapid time to result, ease of test interpretation and general ease of use.
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Affiliation(s)
- N Amyai
- 1 Infectious Diseases Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Kea Darling
- 1 Infectious Diseases Service, Lausanne University Hospital, Lausanne, Switzerland
| | - V D'Acremont
- 2 Department of Ambulatory Care and Community Medicine, 30635 University of Lausanne , Lausanne, Switzerland
| | - E Castro
- 3 Addiction Medicine Centre Saint-Martin, Service of Community Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - S Ebert
- 2 Department of Ambulatory Care and Community Medicine, 30635 University of Lausanne , Lausanne, Switzerland
| | - M Monnat Diserens
- 3 Addiction Medicine Centre Saint-Martin, Service of Community Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - J Perdrix
- 4 Department of Ambulatory Care, Flon, Lausanne, Switzerland
| | - A Hérard Fossati
- 2 Department of Ambulatory Care and Community Medicine, 30635 University of Lausanne , Lausanne, Switzerland
| | - P Bodenmann
- 2 Department of Ambulatory Care and Community Medicine, 30635 University of Lausanne , Lausanne, Switzerland
| | - M Cavassini
- 1 Infectious Diseases Service, Lausanne University Hospital, Lausanne, Switzerland
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Valero Albarran J, Ruiz Herrero A, Montero A, Sanchez E, Castro E, Olmos D, Hernandez M, Ciervide R, Chen X, Alvarez B, Garcia Aranda M, Lopez M, Serrano M, Osorio L, Asenjo M, Fernandez Leton P, Acosta A, Hernando Requejo O, Rubio C. EP-1357: moderate hypofractionated-imrt of prostate bed after radical prostatectom : acute toxicity. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31792-9] [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: 10/19/2022]
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Abstract
BACKGROUND Staff in the surgical intensive care unit (SICU) had several concerns about mobilizing patients receiving mechanical ventilation. OBJECTIVE To assess and improve the mindset of SICU staff toward early mobilization of patients receiving mechanical ventilation before, 6 months after, and 1 year after implementation of early mobilization. METHODS The Plan-Do-Study-Act model was used to guide the planning, implementation, evaluation, and interventions to change the mindset and practice of SICU staff in mobilizing patients receiving mechanical ventilation. Interventions to overcome barriers to early mobilization included interdisciplinary collaboration, multimodal education, and operational changes. The mindset of the SICU staff toward early mobilization of patients receiving mechanical ventilation was assessed by using a survey questionnaire distributed 2 weeks before, 6 months after, and 1 year after implementation of early mobilization. RESULTS The median score on 6 of 7 survey questions changed significantly from before, to 6 months after, to 1 year after implementation, indicating a change in the mindset of SICU staff toward early mobilization of patients receiving mechanical ventilation. The SICU staff agreed that most patients receiving mechanical ventilation are able to get out of bed safely with coordination among personnel and that early mobilization of intubated patients decreases length of stay and decreases occurrence of ventilator-associated pneumonia, deep vein thrombosis, and skin breakdown. CONCLUSIONS SICU interdisciplinary team collaboration, multimodal education, and operational support contribute to removing staff bias against mobilizing patients receiving mechanical ventilation.
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Affiliation(s)
- Emily Castro
- Emily Castro is a critical care nurse educator at North Shore University Hospital, Manhasset, New York.Michael Turcinovic is a critical care physical therapist and wound care certified provider at North Shore University Hospital.John Platz is an attending physician in the surgical intensive care unit and trauma service at North Shore University Hospital, Long Island Jewish Medical Center in New Hyde Park, New York, and SouthSide Hospital in Bay Shore, New York.Isabel Law was the nurse manager during the inception of the early mobilization quality improvement project at North Shore University Hospital. She is now director of patient care services at Franklin General Hospital, Valley Stream, New York.
| | - Michael Turcinovic
- Emily Castro is a critical care nurse educator at North Shore University Hospital, Manhasset, New York.Michael Turcinovic is a critical care physical therapist and wound care certified provider at North Shore University Hospital.John Platz is an attending physician in the surgical intensive care unit and trauma service at North Shore University Hospital, Long Island Jewish Medical Center in New Hyde Park, New York, and SouthSide Hospital in Bay Shore, New York.Isabel Law was the nurse manager during the inception of the early mobilization quality improvement project at North Shore University Hospital. She is now director of patient care services at Franklin General Hospital, Valley Stream, New York
| | - John Platz
- Emily Castro is a critical care nurse educator at North Shore University Hospital, Manhasset, New York.Michael Turcinovic is a critical care physical therapist and wound care certified provider at North Shore University Hospital.John Platz is an attending physician in the surgical intensive care unit and trauma service at North Shore University Hospital, Long Island Jewish Medical Center in New Hyde Park, New York, and SouthSide Hospital in Bay Shore, New York.Isabel Law was the nurse manager during the inception of the early mobilization quality improvement project at North Shore University Hospital. She is now director of patient care services at Franklin General Hospital, Valley Stream, New York
| | - Isabel Law
- Emily Castro is a critical care nurse educator at North Shore University Hospital, Manhasset, New York.Michael Turcinovic is a critical care physical therapist and wound care certified provider at North Shore University Hospital.John Platz is an attending physician in the surgical intensive care unit and trauma service at North Shore University Hospital, Long Island Jewish Medical Center in New Hyde Park, New York, and SouthSide Hospital in Bay Shore, New York.Isabel Law was the nurse manager during the inception of the early mobilization quality improvement project at North Shore University Hospital. She is now director of patient care services at Franklin General Hospital, Valley Stream, New York
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González R, Hernández D, Castro E, Egüez G. Modificación simplificada de la técnica de Zancolli para la corrección de la garra cubital. Rev Iberoam Cir Mano 2016. [DOI: 10.1016/j.ricma.2016.08.006] [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: 10/20/2022] Open
Abstract
Objetivos: Estudiar los resultados obtenidos con la técnica de Chevallard, versión simplificada de la técnica de Zancolli, para corregir la deformidad de la mano en garra secundaria a una parálisis cubital.Material y método: Estudio retrospectivo (enero 2006-diciembre 2013) de 16 pacientes (16 manos) que fueron intervenidos quirúrgicamente por deformidad en garra de la mano secundaria a parálisis del nervio cubital. Siguiendo los criterios de Brand, los pacientes fueron evaluados a las 6 semanas, 3 meses, 6 meses y al año.Resultados: Los resultados al año de la intervención fueron: excelentes en el 18,75% (3 pacientes); buenos en el 75% (12 pacientes) y malos en el 6,25% (un paciente). Este último requirió una nueva intervención para solucionar la recidiva de la garra.Conclusión: La técnica simplificada de Zancolli, o técnica de Chevallard, permite corregir fácilmente la deformidad de la mano en garra secundaria a una parálisis cubital, no hipotecando una ulterior intervención en el caso de recidiva.
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Affiliation(s)
| | - D. Hernández
- Hospital Universitario Madrid Torrelodones, Torrelodones, Madrid, España
| | - E. Castro
- Centro Médico MEDEX, San Isidro, Lima, Perú
| | - G. Egüez
- Hospital Obrero N.º 3, Caja Nacional de Salud, Santa Cruz, Bolivia
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Ballari D, Castro E, Campozano L. VALIDATION OF SATELLITE PRECIPITATION (TRMM 3B43) IN ECUADORIAN COASTAL PLAINS, ANDEAN HIGHLANDS AND AMAZONIAN RAINFOREST. ACTA ACUST UNITED AC 2016. [DOI: 10.5194/isprsarchives-xli-b8-305-2016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Precipitation monitoring is of utmost importance for water resource management. However, in regions of complex terrain such as Ecuador, the high spatio-temporal precipitation variability and the scarcity of rain gauges, make difficult to obtain accurate estimations of precipitation. Remotely sensed estimated precipitation, such as the Multi-satellite Precipitation Analysis TRMM, can cope with this problem after a validation process, which must be representative in space and time. In this work we validate monthly estimates from TRMM 3B43 satellite precipitation (0.25° x 0.25° resolution), by using ground data from 14 rain gauges in Ecuador. The stations are located in the 3 most differentiated regions of the country: the Pacific coastal plains, the Andean highlands, and the Amazon rainforest. Time series, between 1998 – 2010, of imagery and rain gauges were compared using statistical error metrics such as bias, root mean square error, and Pearson correlation; and with detection indexes such as probability of detection, equitable threat score, false alarm rate and frequency bias index. The results showed that precipitation seasonality is well represented and TRMM 3B43 acceptably estimates the monthly precipitation in the three regions of the country. According to both, statistical error metrics and detection indexes, the coastal and Amazon regions are better estimated quantitatively than the Andean highlands. Additionally, it was found that there are better estimations for light precipitation rates. The present validation of TRMM 3B43 provides important results to support further studies on calibration and bias correction of precipitation in ungagged watershed basins.
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Romero-García J, Martínez-Patiño C, Ruiz E, Romero I, Castro E. Ethanol production from olive stone hydrolysates by xylose fermenting microorganisms. ACTA ACUST UNITED AC 2016. [DOI: 10.1515/bioeth-2016-0002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractOlive stones are the main solid byproducts obtained from olive oil production and from table olives production. As a lignocellulosic material, the use of olive stones for ethanol and other chemicals production has been proposed, particularly under the biorefinery concept. As part of such a process, this work deals with the fractionation of the lignocellulosic material by dilute acid autoclave pretreatment at 2% sulfuric acid, 130°C, 60 min and 1:1 liquid to solid ratio. Moreover, the work addresses the fermentation of the liquors obtained after pretreatment. The released sugars are composed mainly by xylose and other hemicellulosic sugars. The fermentation performance of three xylose-fermenting microorganisms, e.g. two Escherichia coli species and Scheffersomyces stipitis, are compared. The study analyzes in a first step the microorganism behavior on synthetic liquors, with a similar composition to that of the real liquors. Finally, and taken into account the results from the previous steps, the real liquor obtained from olive stones pretreatment is fermented. Results show that E. coli MM160 is the best ethanol producer out of the three microorganisms studied. Globally, the pretreatment produced a liquor containing 140 g hemicellulosic sugars/l and requiring firstly dilution by 50% and a detoxification step by overliming. The fermentation of this liquor by E. coli MM160 results in a 25 g ethanol/l solution equivalent to 50 g ethanol/kg olive stone, in spite of 20 g acetic acid/l also present. These results confirm both olive stones and E. coli MM160 as promising feedstock and microorganism for ethanol production.
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