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Rodríguez-Hernández A, Navarro-Villarán E, González R, Pereira S, Soriano-De Castro LB, Sarrias-Giménez A, Barrera-Pulido L, Álamo-Martínez JM, Serrablo-Requejo A, Blanco-Fernández G, Nogales-Muñoz A, Gila-Bohórquez A, Pacheco D, Torres-Nieto MA, Serrano-Díaz-Canedo J, Suárez-Artacho G, Bernal-Bellido C, Marín-Gómez LM, Barcena JA, Gómez-Bravo MA, Padilla CA, Padillo FJ, Muntané J. Corrigendum to 'Regulation of cell death receptor S-nitrosylation and apoptotic signaling by Sorafenib in hepatoblastoma cells'[Redox Biol 6(2015):174-182]. Redox Biol 2023:102744. [PMID: 37246098 DOI: 10.1016/j.redox.2023.102744] [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: 05/30/2023] Open
Affiliation(s)
- A Rodríguez-Hernández
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario "Virgen del Rocío"/CSIC/Universidad de Sevilla, Av. Manuel Siurot s/n, 41013, Sevilla, Spain
| | - E Navarro-Villarán
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario "Virgen del Rocío"/CSIC/Universidad de Sevilla, Av. Manuel Siurot s/n, 41013, Sevilla, Spain
| | - R González
- Department of Biochemistry and Molecular Biology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14071, Córdoba, Spain
| | - S Pereira
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario "Virgen del Rocío"/CSIC/Universidad de Sevilla, Av. Manuel Siurot s/n, 41013, Sevilla, Spain
| | - L B Soriano-De Castro
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario "Virgen del Rocío"/CSIC/Universidad de Sevilla, Av. Manuel Siurot s/n, 41013, Sevilla, Spain
| | - A Sarrias-Giménez
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario "Virgen del Rocío"/CSIC/Universidad de Sevilla, Av. Manuel Siurot s/n, 41013, Sevilla, Spain
| | - L Barrera-Pulido
- Department of General Surgery, Hospital Universitario "Virgen del Rocío"-"Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - J M Álamo-Martínez
- Department of General Surgery, Hospital Universitario "Virgen del Rocío"-"Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain; CENTRO DE INVESTIGACIÓN BIOMÉDICA EN RED de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain
| | - A Serrablo-Requejo
- Hepato-Biliary Surgery Unit, Hospital Universitario "Miguel Servet", Zaragoza, Spain
| | - G Blanco-Fernández
- Hepato-Biliary-Pancreatic and Liver Transplant Service, Hospital Universitario "Infanta Cristina", Badajoz, Spain
| | - A Nogales-Muñoz
- Department of General Surgery, Hospital Universitario "Virgen del Rocío"-"Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - A Gila-Bohórquez
- Department of General Surgery, Hospital Universitario "Virgen del Rocío"-"Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - D Pacheco
- Department of General Surgery and Department of Pathology, Hospital Universitario "Rio Hortega", Valladolid, Spain
| | - M A Torres-Nieto
- Department of Pathology, Hospital Universitario "Rio Hortega", Valladolid, Spain
| | - J Serrano-Díaz-Canedo
- Department of General Surgery, Hospital Universitario "Virgen del Rocío"-"Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - G Suárez-Artacho
- Department of General Surgery, Hospital Universitario "Virgen del Rocío"-"Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - C Bernal-Bellido
- Department of General Surgery, Hospital Universitario "Virgen del Rocío"-"Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - L M Marín-Gómez
- Department of General Surgery, Hospital Universitario "Virgen del Rocío"-"Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - J A Barcena
- Department of Biochemistry and Molecular Biology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14071, Córdoba, Spain
| | - M A Gómez-Bravo
- Department of General Surgery, Hospital Universitario "Virgen del Rocío"-"Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain; CENTRO DE INVESTIGACIÓN BIOMÉDICA EN RED de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain
| | - C A Padilla
- Department of Biochemistry and Molecular Biology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14071, Córdoba, Spain
| | - F J Padillo
- Department of General Surgery, Hospital Universitario "Virgen del Rocío"-"Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain; CENTRO DE INVESTIGACIÓN BIOMÉDICA EN RED de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain
| | - J Muntané
- Department of General Surgery, Hospital Universitario "Virgen del Rocío"-"Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain; CENTRO DE INVESTIGACIÓN BIOMÉDICA EN RED de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain.
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De la Rosa ÁJ, Rodríguez-Hernández Á, González R, Romero-Brufau S, Navarro-Villarán E, Barrera-Pulido L, Pereira S, Marín LM, López-Bernal F, Álamo JM, Gómez-Bravo MA, Padillo FJ, Muntané J. Correction: Antitumoral gene-based strategy involving nitric oxide synthase type III overexpression in hepatocellular carcinoma. Gene Ther 2023:10.1038/s41434-023-00397-y. [PMID: 36973445 DOI: 10.1038/s41434-023-00397-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Affiliation(s)
- Á J De la Rosa
- Oncology Surgery, Cell Therapy and Transplant Organs, Institute of Biomedicine of Seville (IBiS), 'Virgen del Rocío'-'Virgen Macarena' University Hospital/Universidad de Sevilla/CSIC, Sevilla, Spain
| | - Á Rodríguez-Hernández
- Oncology Surgery, Cell Therapy and Transplant Organs, Institute of Biomedicine of Seville (IBiS), 'Virgen del Rocío'-'Virgen Macarena' University Hospital/Universidad de Sevilla/CSIC, Sevilla, Spain
| | - R González
- Department of Biochemistry and Molecular Biology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | | | - E Navarro-Villarán
- Oncology Surgery, Cell Therapy and Transplant Organs, Institute of Biomedicine of Seville (IBiS), 'Virgen del Rocío'-'Virgen Macarena' University Hospital/Universidad de Sevilla/CSIC, Sevilla, Spain
| | - L Barrera-Pulido
- Department of General Surgery, "Virgen del Rocío"-"Virgen Macarena" University Hospital/IBiS/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - S Pereira
- Oncology Surgery, Cell Therapy and Transplant Organs, Institute of Biomedicine of Seville (IBiS), 'Virgen del Rocío'-'Virgen Macarena' University Hospital/Universidad de Sevilla/CSIC, Sevilla, Spain
| | - L M Marín
- Department of General Surgery, "Virgen del Rocío"-"Virgen Macarena" University Hospital/IBiS/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - F López-Bernal
- Department of General Surgery, "Virgen del Rocío"-"Virgen Macarena" University Hospital/IBiS/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - J M Álamo
- Department of General Surgery, "Virgen del Rocío"-"Virgen Macarena" University Hospital/IBiS/CSIC/Universidad de Sevilla, Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREH o Ciberehd), Instituto de Salud Carlos III, Madrid, Spain
| | - M A Gómez-Bravo
- Department of General Surgery, "Virgen del Rocío"-"Virgen Macarena" University Hospital/IBiS/CSIC/Universidad de Sevilla, Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREH o Ciberehd), Instituto de Salud Carlos III, Madrid, Spain
| | - F J Padillo
- Department of General Surgery, "Virgen del Rocío"-"Virgen Macarena" University Hospital/IBiS/CSIC/Universidad de Sevilla, Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREH o Ciberehd), Instituto de Salud Carlos III, Madrid, Spain
| | - J Muntané
- Department of General Surgery, "Virgen del Rocío"-"Virgen Macarena" University Hospital/IBiS/CSIC/Universidad de Sevilla, Sevilla, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREH o Ciberehd), Instituto de Salud Carlos III, Madrid, Spain.
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de la Portilla F, García-Cabrera AM, Pereira S, de Marco F, Molero M, Muntane J, Padillo FJ. An Experimental Study on the Use of Calcium Alginate to Heal Colonic Anastomoses. J INVEST SURG 2015; 29:32-9. [PMID: 26375677 DOI: 10.3109/08941939.2015.1057305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Anastomotic leak is considered the major complication following abdominal surgery. In recent years, the use of a variety of sealing materials for the prevention of leaks has been analyzed. Different biomaterials have been employed as scaffolds to favour tissue repair and regeneration. Among these materials we must mention alginate, a natural polymer with different applications as temporary supporting matrix. The aim of the present study is to evaluate the behavior of both alginate-impregnated sutures and lyophilized alginate sponges in the healing process of colonic anastomes using an experimental animal model. MATERIAL AND METHODS A preliminary study was undertaken to select the adequate scaffold. Animals (n = 45) were distributed into three groups: control (colonic anastomosis using non-continuous 5-0 Polyglactin 910 suture), suture (colonic anastomosis using suture impregnated with alginate gel at 4%) and sponge (colonic anastomosis using suture reinforced with lyophilized alginate sponge). The macroscopic and histological variables were assessed at 4, 8 and 12 days after surgical intervention. RESULTS No statistically significant differences have been observed between the groups during the analysis of macroscopic variables. Animals with sponge implantation showed a greater degree of epithelial reepithalization, less acute and chronic inflammation and greater collagen deposit. CONCLUSIONS The use of lyophilized alginate sponges to reinforce colonic anastomoses in an animal model reduces inflammation and promotes the earlier formation of greater collagen deposits without increasing the number of adhesions or the incidence of stenosis.
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Affiliation(s)
- F de la Portilla
- a Department of General and Digestive Surgery, Unit Colorrectal Surgery , "Virgen del Rocío" University Hospital/IBiS/CSIC/University of Seville, Seville , Spain
| | - A M García-Cabrera
- a Department of General and Digestive Surgery, Unit Colorrectal Surgery , "Virgen del Rocío" University Hospital/IBiS/CSIC/University of Seville, Seville , Spain
| | - S Pereira
- b Institute of Biomedicine of Seville (IBiS), "Virgen del Rocío" University Hospital/IBiS/CSIC/University of Seville , Seville , Spain
| | - F de Marco
- b Institute of Biomedicine of Seville (IBiS), "Virgen del Rocío" University Hospital/IBiS/CSIC/University of Seville , Seville , Spain
| | - M Molero
- c Faculty of Chemistry, Department of Physical Chemistry, University of Seville , Seville , Spain
| | - J Muntane
- b Institute of Biomedicine of Seville (IBiS), "Virgen del Rocío" University Hospital/IBiS/CSIC/University of Seville , Seville , Spain
| | - F J Padillo
- a Department of General and Digestive Surgery, Unit Colorrectal Surgery , "Virgen del Rocío" University Hospital/IBiS/CSIC/University of Seville, Seville , Spain
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Rodríguez-Hernández A, Navarro-Villarán E, González R, Pereira S, Soriano-De Castro LB, Sarrias-Giménez A, Barrera-Pulido L, Álamo-Martínez JM, Serrablo-Requejo A, Blanco-Fernández G, Nogales-Muñoz A, Gila-Bohórquez A, Pacheco D, Torres-Nieto MA, Serrano-Díaz-Canedo J, Suárez-Artacho G, Bernal-Bellido C, Marín-Gómez LM, Barcena JA, Gómez-Bravo MA, Padilla CA, Padillo FJ, Muntané J. Regulation of cell death receptor S-nitrosylation and apoptotic signaling by Sorafenib in hepatoblastoma cells. Redox Biol 2015; 6:174-182. [PMID: 26233703 PMCID: PMC4534573 DOI: 10.1016/j.redox.2015.07.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 06/18/2015] [Revised: 07/17/2015] [Accepted: 07/20/2015] [Indexed: 12/15/2022] Open
Abstract
Nitric oxide (NO) plays a relevant role during cell death regulation in tumor cells. The overexpression of nitric oxide synthase type III (NOS-3) induces oxidative and nitrosative stress, p53 and cell death receptor expression and apoptosis in hepatoblastoma cells. S-nitrosylation of cell death receptor modulates apoptosis. Sorafenib is the unique recommended molecular-targeted drug for the treatment of patients with advanced hepatocellular carcinoma. The present study was addressed to elucidate the potential role of NO during Sorafenib-induced cell death in HepG2 cells. We determined the intra- and extracellular NO concentration, cell death receptor expression and their S-nitrosylation modifications, and apoptotic signaling in Sorafenib-treated HepG2 cells. The effect of NO donors on above parameters has also been determined. Sorafenib induced apoptosis in HepG2 cells. However, low concentration of the drug (10nM) increased cell death receptor expression, as well as caspase-8 and -9 activation, but without activation of downstream apoptotic markers. In contrast, Sorafenib (10 µM) reduced upstream apoptotic parameters but increased caspase-3 activation and DNA fragmentation in HepG2 cells. The shift of cell death signaling pathway was associated with a reduction of S-nitrosylation of cell death receptors in Sorafenib-treated cells. The administration of NO donors increased S-nitrosylation of cell death receptors and overall induction of cell death markers in control and Sorafenib-treated cells. In conclusion, Sorafenib induced alteration of cell death receptor S-nitrosylation status which may have a relevant repercussion on cell death signaling in hepatoblastoma cells.
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Affiliation(s)
- A Rodríguez-Hernández
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario "Virgen del Rocío"/CSIC/Universidad de Sevilla, Av. Manuel Siurot s/n, 41013 Sevilla, Spain
| | - E Navarro-Villarán
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario "Virgen del Rocío"/CSIC/Universidad de Sevilla, Av. Manuel Siurot s/n, 41013 Sevilla, Spain
| | - R González
- Departament of Biochemistry and Molecular Biology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14071 Córdoba, Spain
| | - S Pereira
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario "Virgen del Rocío"/CSIC/Universidad de Sevilla, Av. Manuel Siurot s/n, 41013 Sevilla, Spain
| | - L B Soriano-De Castro
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario "Virgen del Rocío"/CSIC/Universidad de Sevilla, Av. Manuel Siurot s/n, 41013 Sevilla, Spain
| | - A Sarrias-Giménez
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario "Virgen del Rocío"/CSIC/Universidad de Sevilla, Av. Manuel Siurot s/n, 41013 Sevilla, Spain
| | - L Barrera-Pulido
- Department of General Surgery, Hospital Universitario "Virgen del Rocío" - "Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - J M Álamo-Martínez
- Department of General Surgery, Hospital Universitario "Virgen del Rocío" - "Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain; CENTRO DE INVESTIGACIÓN BIOMÉDICA EN RED de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain
| | - A Serrablo-Requejo
- Hepato-Biliary Surgery Unit, Hospital Universitario "Miguel Servet", Zaragoza, Spain
| | - G Blanco-Fernández
- Hepato-Biliary-Pancreatic and Liver Transplant Service, Hospital Universitario "Infanta Cristina", Badajoz, Spain
| | - A Nogales-Muñoz
- Department of General Surgery, Hospital Universitario "Virgen del Rocío" - "Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - A Gila-Bohórquez
- Department of General Surgery, Hospital Universitario "Virgen del Rocío" - "Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - D Pacheco
- Department of General Surgery and Department of Pathology, Hospital Universitario "Rio Hortega", Valladolid, Spain
| | - M A Torres-Nieto
- Department of Pathology, Hospital Universitario "Rio Hortega", Valladolid, Spain
| | - J Serrano-Díaz-Canedo
- Department of General Surgery, Hospital Universitario "Virgen del Rocío" - "Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - G Suárez-Artacho
- Department of General Surgery, Hospital Universitario "Virgen del Rocío" - "Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - C Bernal-Bellido
- Department of General Surgery, Hospital Universitario "Virgen del Rocío" - "Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - L M Marín-Gómez
- Department of General Surgery, Hospital Universitario "Virgen del Rocío" - "Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - J A Barcena
- Departament of Biochemistry and Molecular Biology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14071 Córdoba, Spain
| | - M A Gómez-Bravo
- Department of General Surgery, Hospital Universitario "Virgen del Rocío" - "Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain; CENTRO DE INVESTIGACIÓN BIOMÉDICA EN RED de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain
| | - C A Padilla
- Departament of Biochemistry and Molecular Biology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14071 Córdoba, Spain
| | - F J Padillo
- Department of General Surgery, Hospital Universitario "Virgen del Rocío" - "Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain; CENTRO DE INVESTIGACIÓN BIOMÉDICA EN RED de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain
| | - J Muntané
- Department of General Surgery, Hospital Universitario "Virgen del Rocío" - "Virgen Macarena"/Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, Spain; CENTRO DE INVESTIGACIÓN BIOMÉDICA EN RED de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain.
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Alamo JM, Bernal C, Marín LM, Suárez G, Serrano J, Barrera L, Sousa JM, Padillo FJ, Gómez-Bravo MA. Antitumor efficacy of mammalian target of rapamycin inhibitor therapy in liver transplant recipients with oncological disease: a case-control study. Transplant Proc 2013; 44:2089-92. [PMID: 22974919 DOI: 10.1016/j.transproceed.2012.07.079] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The reported incidences of de novo malignancy following orthotopic liver transplantation (OLT) are significantly greater than those in the general population. We have analyzed the efficacy of mammalian target of rapamycin inhibitor (mTORi) as immunosuppressant therapy in patients with de novo malignancies or those engrafted because of a primary liver cancer. METHODS We performed a case-control study of patients with hepatocellular carcinoma (HCC; n = 119), cholangiocarcinoma (n = 1) or de novo malignancies (n = 73). Thirty-seven patients with these tumors were treated with mTORi, and 167, with calcineurin inhibitors (CNI). Switching to mTORi was performed progressively, withdrawing the CNI over 15 days, until obtaining levels of 5-10 ng/dL. RESULTS No incidence of rejection, serious adverse events, or death was observed with an overall actuarial survival of 68.5% in the mTORi group versus 45.7% among the CNI group. Overall rates of tumor recurrence were 15.2% and 36.8%, respectively (P < .05). Among patients with HCC, survival was 100% of mTORi with and 61.5% among CNI patients, with tumor recurrence rates of 6.2% and 19.1%, respectively (P < .05). DISCUSSION Surprising differences in survival and tumor recurrence rates were observed among the mTORi-treated group compared with controls. Switching from CNI to mTORi immunosuppressant therapy appeared to be safe. It seems to be reasonable to employ this strategy in liver transplant patients with primary hepatic or "de novo" neoplasms.
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Affiliation(s)
- J M Alamo
- Liver Transplant Unit, Virgen del Rocío Hospital, Seville, Spain.
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Álamo JM, Bernal C, Barrera L, Marín LM, Suárez G, Serrano J, Gómez MA, Padillo FJ. Liver transplantation in patients with cryptogenic cirrhosis: long-term follow-up. Transplant Proc 2012; 43:2230-2. [PMID: 21839241 DOI: 10.1016/j.transproceed.2011.05.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate long-term survival, histological diagnoses, and mobility of patients with cryptogenic cirrhosis (CC) treated with orthotopic liver transplantation (OLT). PATIENTS AND METHODS We performed a retrospective analysis of 35 patients who underwent transplantation with CC among 800 OLT patients. There were no differences in gender, mean age of 47 years, average MELD (Model for End-stage Liver Disease) of 16, and hepatocellular carcinoma incidence (8%). RESULTS In 28.6% of patients, the diagnosis of CC was wrong. There was no incidence of an acute rejection episode and a low incidence of complications, although the postoperative mortality rate was 20%, of chronic rejection was 25%, and recurrence of disease was 4%. Cumulative at 3-, 5-, and 10-year survivals were lower than the other OLT. Survival was lower in patients receiving suboptimal grafts. CONCLUSIONS One of 3 patients who underwent transplantation for CC had a specific etiologic diagnosis. The chronic rejection rate and postoperative mortality rate were higher than other etiologies, and survivals at 5, 10, and 15 years were lower than other OLT.
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Affiliation(s)
- J M Álamo
- Liver Transplant Unit, Virgen del Rocío Hospital, Seville, Spain.
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Padillo FJ, Cruz A, Espejo I, Barcos M, Gómez-Alvarez M, Muntané J. Alteration of the renal regulatory hormonal pattern during experimental obstructive jaundice. Rev Esp Enferm Dig 2009; 101:408-12. [PMID: 19630464 DOI: 10.4321/s1130-01082009000600006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The alteration of hormones regulating sodium and water status is related to renal failure in obstructive jaundice (OJ). EXPERIMENTAL DESIGN OJ was induced by common bile duct ligation. Samples were obtained from the control (SO) and OJ groups at 24 and 72 hours, and at 7 days. Different parameters related to biliary obstruction, liver and renal injury, and vasoactive mediators such as renin, aldosterone, endothelin-1 (ET-1) and prostaglandin E2 (PGE2) were studied. RESULTS Bile duct ligation caused an increase in total bilirubin (p < 0.001) and alkaline phosphatase (AP) (p < 0.001). The SO and OJ groups had the same values for diuresis, renin, and creatinine clearance at 24 h. However, animals with OJ had a lower sodium concentration in urine than SO animals (p < 0.01), as well as an increase in aldosterone levels (p < 0.03). ANP levels were moderately increased during OJ but did not reach statistical significance when compared to the SO group. In contrast, OJ animals showed a rise in serum ET-1 concentration (p < 0.001) and increased PGE2 in urine (p < 0.001). CONCLUSIONS Biliary obstruction induced an increase in ET-1 release and PGE2 urine excretion. These hormones might play a role during the renal complications associated with renal disturbances that occur during OJ.
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Affiliation(s)
- F J Padillo
- Department of General Surgery, Reina Sofía University Hospital, Córdoba, Spain.
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Cruz A, Tasset I, Ramírez LM, Arjona A, Segura J, Túnez I, Montilla P, Muntané J, Padillo FJ. Effect of melatonin on myocardial oxidative stress induced by experimental obstructive jaundice. Rev esp enferm dig 2009; 101:460-3. [DOI: 10.4321/s1130-01082009000700002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Padillo FJ, Cruz A, Briceño J, Martin-Malo A, Pera-Madrazo C, Sitges-Serra A. Multivariate analysis of factors associated with renal dysfunction in patients with obstructive jaundice. Br J Surg 2005; 92:1388-92. [PMID: 16078295 DOI: 10.1002/bjs.5091] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The aim was to evaluate the factors determining preoperative renal dysfunction in patients with obstructive jaundice. METHODS In a prospective cross-sectional observational study, 63 patients, 27 with benign and 36 with malignant obstructive jaundice, were investigated at admission and compared with 25 healthy control subjects. Variables analysed included extracellular body water (ECW) compartment, plasma levels of aldosterone, renin, atrial natriuretic peptide, vasopressin, nitric oxide, endothelin (ET) 1 and prostaglandin E2 (PGE2), urinary nitric oxide and PGE2, serum albumin and renal function. RESULTS The metabolic profile of obstructive jaundice was characterized by a depletion of the ECW (P = 0.004), and increased plasma levels of atrial natriuretic peptide (P < 0.001), ET-1 (P = 0.044), vasopressin (P = 0.017), aldosterone (P = 0.005) and renin (P = 0.001). Increased plasma (P < 0.001) and urinary (P = 0.001) PGE2 levels were also found. Fifty-four per cent of patients had a creatinine clearance of less than 70 ml/min. In multivariate analysis, serum bilirubin, renin, ET-1, PGE2, decreased urinary sodium excretion and age were identified as predictors of renal dysfunction. CONCLUSIONS Renal dysfunction in patients with obstructive jaundice was associated with the degree of biliary obstruction, age of the patient and reduced urinary sodium excretion. These alterations were closely related to derangements in sodium- and water-regulating hormones.
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Affiliation(s)
- F J Padillo
- Department of Surgery, Hospital Reina Sofía, Córdoba, Barcelona, Spain
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10
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Padillo FJ, Briceño J, Cruz A, Chicano M, Naranjo A, Vallejo J, Martín-Malo A, Pera-Madrazo C, Sitges-Serra A. Randomized clinical trial of the effect of intravenous fluid administration on hormonal and renal dysfunction in patients with obstructive jaundice undergoing endoscopic drainage. Br J Surg 2005; 92:39-43. [PMID: 15521079 DOI: 10.1002/bjs.4790] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Renal dysfunction in patients with biliary obstruction is associated with extracellular water depletion. This study examined the effect of preoperative saline infusion before biliary drainage on hormonal and renal functional derangements in patients with obstructive jaundice. METHODS In a randomized study, 49 patients with malignant obstructive jaundice were investigated at baseline, on the day of drainage, and at 24 h, 72 h and 7 days after internal endoscopic biliary drainage. Patients were randomized to receive (n = 22) or not to receive (n = 27) 3000 ml normal saline intravenously for 24 h before drainage. Variables analysed included extracellular water volume, creatinine clearance, and serum levels of aldosterone, renin, atrial natriuretic peptide (ANP), vasopressin and albumin. RESULTS Preoperative saline infusion produced a rise in creatinine clearance, diuresis, ANP concentration and extracellular water volume but this did not translate into better recovery of renal function after operation. Drainage produced a fall in creatinine clearance in all patients, but hormonal and renal function had recovered by 2 days after restoration of bile flow, independently of preoperative hydration. CONCLUSION Fluid administration expands the extracellular water compartment before drainage but fails to improve renal function after drainage. Definitive improvement in endocrine and renal function requires the restoration of bile flow into the duodenum.
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Affiliation(s)
- F J Padillo
- Department of Surgery, Hospital Universitari del Mar, Barcelona, Spain
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Affiliation(s)
- F J Padillo
- Department of Surgery, Hospital Universitario Reina Sofía, Córdoba, Spain.
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12
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Montilla P, Cruz A, Padillo FJ, Túnez I, Gascon F, Muñoz MC, Gómez M, Pera C. Melatonin versus vitamin E as protective treatment against oxidative stress after extra-hepatic bile duct ligation in rats. J Pineal Res 2001; 31:138-44. [PMID: 11555169 DOI: 10.1034/j.1600-079x.2001.310207.x] [Citation(s) in RCA: 113] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The aims of the present study were first to compare the effects of melatonin and vitamin E on the cholestasis syndrome and their protective effect on liver injury, and second, to evaluate the activity of antioxidant enzymes after treatment with these antioxidant drugs. Cholestasis was achieved in adult male Wistar rats by double ligature and section of the extra-hepatic biliary duct. Hepatic and plasma oxidative stress markers were evaluated by changes in the amount of lipid peroxides, measured as malondialdehyde (MDA) and reduced glutathione (GSH) in plasma and homogenates of hepatic tissue. Serum bilirubin, alkaline phosphatase (AP), and gamma-glutamyl-transpeptidase (GGT) were used to evaluate the severity of cholestasis, and serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were used to evaluate the hepatic injury. Both vitamin E and melatonin were administrated 1 day before and 7 days after bile duct ligation. Acute ligation of the bile duct was accompanied by a significant increased in MDA and a decrease in GSH levels in both plasma and liver, as well as a significant reduction in antioxidant enzymes activities. The overall analysis of both treatments showed that melatonin (500 microg/kg daily) offered significantly better protection against cholestasis and a superior protective effect on hepatic injury than did vitamin E (15 mg/kg daily). Although vitamin E treatment resulted in a reduction of parameters of oxidative stress, the results were significantly better after a much lower daily dose of melatonin. Moreover, melatonin treatment was associated with a significant recovery of antioxidative enzymes. In conclusion, the present paper demonstrates a correlation between the intensity of biliary tract obstruction and increased free radical generation, as well as a direct correlation between the level of oxidative stress and the biochemical markers of liver injury. Melatonin (at a much lower dose than vitamin E) was much more efficient than vitamin E in reducing the negative parameters of cholestasis, the degree of oxidative stress and provided a significantly greater hepatoprotective effect against the liver injury secondary to the acute ligation of the biliary duct.
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Affiliation(s)
- P Montilla
- Department of Biochemistry and Molecular Biology, School of Medicine, Reina Sofia University Hospital, Córdoba, Spain.
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Cruz A, Padillo FJ, Túnez I, Muñoz C, Granados J, Pera-Madrazo C, Montilla P. Melatonin protects against renal oxidative stress after obstructive jaundice in rats. Eur J Pharmacol 2001; 425:135-9. [PMID: 11502279 DOI: 10.1016/s0014-2999(01)01173-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The goals of this study were to analyze the renal oxidative status in experimental biliary obstruction and to evaluate the impact of melatonin on renal oxidative stress. Cholestasis was done by double ligature and section of the extra-hepatic biliary duct. Melatonin was injected i.p. (500 microg/kg/day). Malondialdehyde, reduced glutathione, catalase, superoxide dismutase, glutathione reductase, glutathione peroxidase and glutathione transferase were determined in the renal tissue. After biliary obstruction, an increase in malondialdehyde (P<0.0001) and a fall in reduced glutathione (P<0.0001) were seen. Moreover, the scavenger enzyme activity had significantly diminished. After melatonin administration, the malondialdehyde fell significantly (P<0.0001), whereas reduced glutathione showed an important increase (P<0.0001) compared with the ligated bile duct group. Experimental bile duct obstruction was associated to an increase of renal oxidative stress. Treatment with melatonin decreased the renal lipid peroxidation, and both the reduced glutathione as well as the scavenger enzyme activity recovered.
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Affiliation(s)
- A Cruz
- Department of General Surgery, Reina Sofía University Hospital, Córdoba, Spain
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14
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Padillo FJ, Andicoberry B, Naranjo A, Miño G, Pera C, Sitges-Serra A. Anorexia and the effect of internal biliary drainage on food intake in patients with obstructive jaundice. J Am Coll Surg 2001; 192:584-90. [PMID: 11333095 DOI: 10.1016/s1072-7515(01)00841-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Anorexia is a frequent finding in patients with biliary obstruction (BO). This study investigates the role of biochemical and hormonal factors in the pathogenesis of reduced food intake in BO and the effects of internal biliary drainage. STUDY DESIGN Sixty-two patients with BO were prospectively investigated. Transaminases, amylase, cholecystokinin, secretin, bile acids, tumor necrosis factor-alpha, and endotoxin were determined at admission. Caloric intake was quantified by a controlled diet. In a subset of 27 patients, studies were repeated after internal biliary drainage. RESULTS Sixty-six percent of patients had spontaneous food intakes below the estimated caloric requirements. Serum bilirubin, alkaline phosphatase, and cholecystokinin plasma levels were independent predictor factors for calorie intake (p = 0.0001). After internal biliary drainage, cholestasis parameters and cholecystokinin concentrations decreased significantly; this was associated with an improvement of spontaneous food intake in both benign and malignant biliary obstruction (p < 0.01 and p < 0.05, respectively). CONCLUSIONS Decreased food intake in BO was associated with the degree of obstruction and with increased cholecystokinin plasma levels. Biliary drainage improved biochemical and food intake derangements.
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Affiliation(s)
- F J Padillo
- Department of Surgery, Hospital Universitario Reina Sofía, Córdoba, Spain
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15
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Padillo FJ, Andicoberry B, Muntane J, Lozano JM, Miño G, Sitges-Serra A, Pera-Madrazo C. Factors predicting nutritional derangements in patients with obstructive jaundice: multivariate analysis. World J Surg 2001; 25:413-8. [PMID: 11344390 DOI: 10.1007/s002680020043] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Patients with obstructive jaundice (OJ) that requires surgery often have malnutrition associated with increased perioperative morbidity. This study investigated the factors influencing nutritional derangements in these patients. A series of 46 OJ patients were investigated prospectively (28 malignant tumors, 18 benign obstructions). A nutritional risk index of < 83.5 was used to define protein-calorie malnutrition. Liver function, cholecystokinin (CCK), tumor necrosis factor-alpha (TNFalpha), and endotoxin levels were determined. A multivariate analysis was performed, and an obstructive jaundice malnutrition index (OJMI) was obtained. Altogether, 22 (48%) OJ patients had malnutrition (33% with benign obstructions, 57% with malignant disease). Malnourished patients had higher serum bilirubin levels (258 +/- 120 vs. 154 +/- 62 mmol/L; p = 0.005), longer duration of jaundice (16 +/- 9 vs. 9 +/- 5 days; p = 0.03), and higher plasma levels of CCK (4.0 +/- 1.3 vs. 1.7 +/- 1.0 pmol/L; p = 0.005), alanine aminotransferase (ALT) (226 +/- 209 vs. 187 +/- 161 UI/L; p = 0.01), endotoxin (15 +/- 10 vs. 6.5 +/- 7.0 EU/L; p = 0.007), and TNFalpha (69 +/- 82 vs. 23 +/- 15 pg/ml; p = 0.008) than those without malnutrition. However, only serum bilirubin, CCK, ALT, and patient age were predictors for malnutrition by multivariate analysis. Malnutrition might be expected (95% confidence interval) in patients older than 68 years with increased bilirubin (> 290 mmol/L) and ALT (> 210 UI/L) levels that corresponded with an OJMI > 55. It was concluded that nutritional alterations in patients with obstructive jaundice were determined by the intensity of the biliary obstruction correlated with increased plasma CCK levels as well as with liver dysfunction and patient age.
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Affiliation(s)
- F J Padillo
- Department of Surgery, Hospital Universitario Reina Sofía, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain.
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16
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Padillo FJ, Andicoberry B, Muntane J, Lozano JM, Miño G, Sitges-Serra A, Solorzano G, Pera-Madrazo C. Cytokines and acute-phase response markers derangements in patients with obstructive jaundice. Hepatogastroenterology 2001; 48:378-81. [PMID: 11379313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND/AIMS Prolonged acute-phase response and increase of cytokines have been associated with higher mortality and surgical complications. This study investigated the status of cytokines and acute-phase response markers in patients with obstructive jaundice. METHODOLOGY Forty-one patients were investigated. Endotoxin, tumor necrosis factor-alpha, interleukin-6, nitric oxide, C-reactive protein, liver enzymes, albumin and percentage of weight loss were determined at admission. RESULTS Endotoxin, interleukin-6 and C-reactive protein were significantly elevated in both benign and malignant obstructive jaundice. Increased plasma levels of tumor necrosis factor-alpha were only detected in malignant tumors (68 vs. 24 pg/mL; P < 0.001). Patients with positive acute-phase response (C-reactive protein > mean + 2 SD of controls) had greater weight loss (P = 0.02), endotoxin (P = 0.03) and interleukin-6 plasma levels (P = 0.05) than those with no inflammatory response. Prolonged biliary obstruction (> 10 days) was associated with higher weight loss (P = 0.04), tumor necrosis factor-alpha (P = 0.003) and interleukin-6 (P = 0.05) plasma levels. CONCLUSIONS A prolonged high-grade biliary tract obstruction prompted an increase in endotoxin levels, associated with a positive acute-phase response and cytokine elevation.
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Affiliation(s)
- F J Padillo
- Department of Surgery, Hospital Reina Sofia, Cordoba, Spain.
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17
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Padillo FJ, Rodriguez M, Gallardo JM, Andicoberry B, Naranjo A, Martín-Malo A, Miño G, Sitges-Serra A, Pera-Madrazo C. Preoperative assessment of body fluid disturbances in patients with obstructive jaundice. World J Surg 1999; 23:681-7; discussion 687. [PMID: 10390586 DOI: 10.1007/pl00012368] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Postoperative renal dysfunction in obstructive jaundice (OJ) patients has been associated with hypovolemia and depletion of the extracellular water compartment (ECW). The aim of the study was to evaluate the preoperative status of body compartments in OJ patients measured by two methods. In a prospective study 39 OJ patients (11 benign and 28 malignant obstructions) were investigated, with 15 healthy subjects used as a control group (CG). Bioelectrical impedance analysis (BIA) determinations and values derived from anthropometric measurements were used to assess body compartment status. The coefficient of variation of BIA was below 4% in both OJ and CG subjects. No differences were found in intracellular water. However total body water (TBW) and ECW were reduced in OJ patients (50.5 +/- 4.6 vs. 56 +/- 8% body weight, p = 0.05; and 21 +/- 4.5 vs. 23.8 +/- 2.5% body weight, p < 0.05, respectively). There were no differences between benign and malignant obstructions. Seventy four percent of OJ patients had an ECW volume below the mean +/- 2 SD in the CG subjects. Anthropometric and BIA determinations correlated closely for TBW measurements in both CG (r = 0.92, p < 0.001) and OJ patients (r = 0.91, p < 0.001). Bland-Altman analysis also showed that for TBW the BIA was in agreement with anthropometry. In the present study, BIA offered a good correlation with anthropometric determinations and was a reliable method for body fluid disturbances assessment in jaundiced patients.
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Affiliation(s)
- F J Padillo
- Department of Surgery, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal s/n, 14.005 Córdoba, Spain
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18
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Padillo FJ, Rodriguez M, Gallardo JM, Andicoberry B, Naranjo A, Minõ G, Sitges-Serra A, Pera-Madrazo C. Changes in the pattern of visceral protein concentrations after internal biliary drainage in patients with obstructive jaundice. Eur J Surg 1999; 165:550-5. [PMID: 10433138 DOI: 10.1080/110241599750006442] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To evaluate the influence of internal drainage on status of nutritional markers in patients with obstructive jaundice. DESSING: Prospective longitudinal study. SETTING University hospital, Spain. SUBJECTS 39 patients with obstructive jaundice (18 benign and 21 malignant obstructions). INTERVENTIONS Nutritional state was assessed before and 10 days after endoscopic drainage. MAIN OUTCOME MEASURES One anthropometric (body weight <95% of ideal) and two biochemical (albumin <35 g/L and prealbumin < 170 mg/L) as an indication of protein calorie malnutrition. Retinol binding protein and transferrin concentrations, total lymphocyte count, and nutritional prognostic index (NPI) were also measured. RESULTS Thirty patients (77%) had protein calorie malnutrition. After internal drainage, 6 patients with benign obstruction and 11 with malignant tumours remained malnourished. No anthropometric variables or concentrations of proteins with long half-lives were affected by drainage. However, prealbumin (p < 0.01) and transferrin (p < 0.01) concentrations, and total lymphocyte count (p < 0.001) increased significantly in both groups. NPI also improved significantly after drainage from 43 (9) compared with 37 (5) in benign obstructions (p < 0.05) and 58.7 (14) compared with 52 (12) in malignant (p < 0.05), although in the latter group the mean nutritional risk index remained high. CONCLUSIONS Concentrations of some of the visceral proteins studied (prealbumin and transferrin) improved 10 days after internal biliary drainage for both benign and malignant obstruction. However, many patients with malignant tumours remained malnourished with a high nutritional risk index.
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Affiliation(s)
- F J Padillo
- Department of Surgery, Hospital Reine Sofía, Córdoba, Spain
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19
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Padillo FJ, Regueiro JC, Canis M, Zurera L, Perez R, Del Castillo D, Diaz C, Solorzano G, Pera-Madrazo C. Percutaneous management of a high-output duodenal fistula after pancreas transplantation using occluding coiled embolus and fibrin sealant. Transplant Proc 1999; 31:1715-6. [PMID: 10331048 DOI: 10.1016/s0041-1345(99)00074-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- F J Padillo
- Department of Surgery, University of Cordoba, Reina Sofia Hospital, Spain
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20
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Andicoberry B, Padillo FJ, Gómez-Alvarez M, Gómez-Barbadillo J, Cruz A, Daza JJ, Infante F, Miño G, Sitges-Serra A, Pera Madrazo C. [Evaluation of anorexia in patients with bile duct obstruction]. NUTR HOSP 1999; 14:38-43. [PMID: 10361816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
INTRODUCTION Obstructive jaundice is often accompanied by protein-caloric malnutrition. The objective of the present study is to analyze the incidence and the degree of alterations in the food ingestion of patients with obstructive jaundice. MATERIAL AND METHODS In a prospective, cross-sectional study 50 patients with obstructive jaundice (19 benign and 31 malignant) were evaluated. The anorexia was evaluated using Welch's test (subjective evaluation) and by means of quantifying the caloric ingestion. An anthropometric parameter (ideal weigh < 95%) and two biochemical ones (albumin < 3.5 g/dl and pre-albumin < 17 mg/dl) were used to define the degree of malnutrition. RESULTS 96% of the patients presented alterations in the Welch test and in 72% of the patients the caloric ingestion was below the estimated needs. Overall, the ingestion of food was reduced by 76.3 +/- 30% of the estimated needs (84.7 +/- 28% in the benign cases and 70.9 +/- 32% in the malignant cases). Both the Welch test (r = 0.59; p = 0.01) and the caloric ingestion (r = 0.53; p < 0.001) were inversely correlated with the serum bilirubin. In patients with malnutrition criteria, the caloric ingestion was reduced by 30% against the 12% reduction in the non-malnourished patients (p < 0.05). There was a direct correlation between the two methods used in the assessment of the anorexia (r = 0.71; p < 0.001). CONCLUSIONS Obstructive jaundice is associated with an important reduction in the caloric ingestion, and this is manifested in both biliary obstructions of a benign origin, and in those of neoplasic origins.
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Affiliation(s)
- B Andicoberry
- Departamento de Nutrición, Hospital Reina Sofía, Córdoba, España
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21
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Padillo FJ, Rufián S, Briceño J, Izquierdo N, Varo E, Miño G, Pera Madrazo C. [Prognostic factors in severe acute pancreatitis. Univariate and multivariate study]. Rev Esp Enferm Dig 1995; 87:32-7. [PMID: 7727165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The aim of this study was to analyze the prediction of mortality in patients with severe acute pancreatitis. PATIENTS AND METHODS In a retrospective study 43 patients with severe acute pancreatitis were included. All patients required ICU admittance and surgical treatment. We evaluated severity according to Ranson's criteria, APACHE II score, CT scan classification (Hill), intraoperative findings (Vankemmel's classification) and number of organs failure. We performed a univariant and multivariant statistic study with lineal discriminant analysis. RESULTS The overall mortality was 46.5%. Ranson's score and APACHE II did not correlate with mortality. Hill's classification did not reach significance either. However, only the Vankemmel's classification and the number of organs failure had statistic value (p < 0.01). After lineal discriminant analysis, the association of more than 4 Ranson's criteria, APACHE II up to 9 points, grades IV and V in Hill's classification and 4 organs failure had a predictive value for mortality. CONCLUSIONS In our limited experience the Vankemmel's classification and the number of organs failure had a predictive value for mortality in patients with acute pancreatitis. The association of more than 4 Ranson's criteria. APACHE II up to 8 points, grades IV-V in Hill's classification and 4 organs failure disclosed poor prognosis.
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Affiliation(s)
- F J Padillo
- Departamento de Cirugía, Hospital Universitario Reina Sofía, Córdoba
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22
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Pera Madrazo C, Padillo FJ, Solorzano G, Varo E, Rufián S, López Cillero P. [The results of duodenopancreatectomy in periampullar pathology]. Rev Esp Enferm Dig 1994; 86:661-4. [PMID: 7986599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To examine mortality and morbidity rates after pancreaticoduodenectomy in 69 consecutive patients with periampullar disease operated on between 1985 and 1993 at the Reina Sofía Hospital, Córdoba, Spain. PATIENTS Fifty five patients (79.7%) had malignant neoplasm whereas 14 (20.3%) had benign disease. In 58 patients a Whipple procedure was performed; pancreaticoduodenectomy with preservation of the pylorus (Traverso-Longmire) was performed in the remaining 11 patients. RESULTS Eighteen patients (26%) had postoperative complications; peritoneal bleeding (1); biliary fistula (3); pancreatic fistula (4); digestive fistula (2); and pancreatitis (2). Two patients with pancreatic and duodenal carcinoma died. Thirteen patients were readmitted: 3 bleeding episodes in anastomotic ulcer; 3 hepaticojejunostomy obstruction; and the remaining 6 patients with tumor recurrence. CONCLUSIONS In our experience duodenopancreatectomy was a safe procedure in periampullar disease, with an acceptable morbidity and mortality rates.
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Affiliation(s)
- C Pera Madrazo
- Servicio de Cirugía General, Hospital Universitario, Reina Sofía, Córdoba
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23
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Padillo FJ, Canis M, Zurera L, Varo E, López P, Rufián S, Miño G, Pera Madrazo C. [Self-expanding metallic endoprostheses in the palliative treatment of biliary obstructions in nonresectable carcinoma of the head of the pancreas]. Rev Esp Enferm Dig 1994; 86:527-31. [PMID: 7522497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE A study of immediate and long-term results with the self-expandable metallic stent (Wallstent), in the treatment of biliary obstruction in 25 patients with non resectable carcinoma of the head of the pancreas was carried out. Stent placement was successful in all patients. RESULTS Complication rate was 4% (n = 1); one patient had venous bleeding after percutaneous catheter placement. There was no procedure related mortality (30-day mortality); hospital stay was 6, 7 days (2-12). Average survival was 6 months (+/- 2.97). Average patency of the initial stent lasted 5 months (+/- 2.01); comfort index was 83%. Five patients required re-admission. Late complications were cholangitis in 2 and stent occlusion in 4. Disimpaction in one patient and placement of additional stent (PAL-MAZ) in the remaining 3 patients were performed. One patient required surgical treatment; hepaticojejunostomy was performed. Elapse time between prostheses placement and stent occlusion was 3.4 months (2-4.5). CONCLUSIONS We conclude that metallic stent placement has low morbidity without mortality and provide good quality of live. The most frequent late complication was prostheses obstruction.
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Affiliation(s)
- F J Padillo
- Departamento de Cirugía, Hospital Clínico Universitario Reina Sofía Córdoba
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Padillo FJ, Varo E, Membrives A, Rufián S, López P, Miño G, Canis M, Pera Madrazo C. [Hepatic confluence tumors: results and quality of life according to the type of treatment]. Rev Esp Enferm Dig 1994; 85:107-13. [PMID: 7514429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We analyzed survival rate and quality of life according to the treatment modality in 52 patients with hilar tumors. Six of them underwent resection (11.5%); 4 without hepatectomy, one left hepatectomy and one trisegmentectomy. The remaining 46 patients were treated by: radiologic external-internal drainage (12), placement of percutaneous endoprostheses (14), surgical intubation (18), and cholangioanastomoses to segment III in 2. Prognostic factors (PITT and A.P.A.C.H.E. II), survival time and quality of life were analyzed. Survival and comfort index were significantly better (p < 0.001) in the resection group than in the palliation one. Among palliative procedures percutaneous endoprostheses and surgical intubation offered better quality of life (p < 0.001) than radiologic external-internal drainage. We conclude that resection improves survival and offers better quality of life than palliative procedures. Our results suggest that resection during laparotomy should be attempted in order to improve results in the treatment of hepatic confluence tumors.
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Affiliation(s)
- F J Padillo
- Departamento de Cirugía, Hospital Universitario Reina Sofía, Córdoba
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Padillo FJ, Canis M, Rufian S, Varo E, Díaz C, Membrives A, Pera Madrazo C. [The palliative treatment of pancreatic cancer: percutaneous drainage versus surgical diversion]. Rev Esp Enferm Dig 1992; 81:337-40. [PMID: 1377480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In a retrospective study, the outcome of 56 patients with unresectable carcinoma of the exocrine pancreas undergoing two palliative operations (bypass surgery vs percutaneous transhepatic biliary drainage with endoprosthesis) for the management of biliary obstruction was evaluated. Morbidity and mortality were similar in the two groups. Postop hospital stay was 8 days for the intubated, and 15 days for operated patients (p less than 0.01). Although the symptom-free period was similar in both groups, intubated patients had a shorter period of poor-quality life.
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Affiliation(s)
- F J Padillo
- Servicio de Cirugía, Hospital Clínico Universitario Reina Sofía, Córdoba
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