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Riudavets M, Auclin E, Mosteiro M, Dempsey N, Majem M, Prelaj A, López-Castro R, Bosch-Barrera J, Pilotto S, Escalera E, Tagliamento M, Mosquera J, Zalcman G, Aboubakar Nana F, Ponce S, Albarrán-Artahona V, Dal Maso A, Spotti M, Mielgo X, Mussat E, Reyes R, Benítez JC, Lupinacci L, Duchemann B, De Giglio A, Blaquier JB, Audigier-Valette C, Scheffler M, Nadal E, Lopes G, Signorelli D, Garcia-Campelo R, Menis J, Bluthgen V, Campayo M, Recondo G, Besse B, Mezquita L, Planchard D. Association Between Lung Immune Prognostic Index and Durvalumab Consolidation Outcomes in Patients With Locally Advanced Non-Small-Cell Lung Cancer. Clin Lung Cancer 2023:S1525-7304(23)00242-5. [PMID: 38105153 DOI: 10.1016/j.cllc.2023.11.007] [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: 08/22/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION The LIPI, based on pretreatment derived neutrophils/[leukocytes-neutrophils] ratio (dNLR) and LDH, is associated with immune checkpoint inhibitors (ICI) outcomes in advanced non-small-cell lung cancer (NSCLC). We aimed to assess baseline LIPI correlation with durvalumab consolidation outcomes in the locally advanced setting. MATERIAL AND METHODS Multicentre retrospective study (330 patients) with stage III unresectable NSCLC treated with durvalumab after chemo-radiotherapy between April 2015 and December 2020; 65 patients treated with chemo-radiotherapy only. Baseline LIPI characterized 3 groups: good (dNLR≤3+LDH≤ULN), intermediate (dNLR>3/LDH>ULN) and poor (dNLR>3+LDH>ULN). Primary endpoint was overall survival (OS). RESULTS In the durvalumab cohort, median age was 67 years, 95% smokers, 98% with a performance status of 0-1; 60% had nonsquamous histology and 16% a PD-L1 expression <1%. Radiotherapy was delivered concurrently in 81%. LIPI was evaluable in 216 patients: 66% good, 31% intermediate, 3% poor. LIPI significantly correlated with median OS (median follow-up: 19 months): 18.1 months vs. 47.0 months vs. not reached in poor, intermediate and good LIPI groups, respectively (P = .03). A trend between objective response rate and LIPI groups was observed: 0% vs. 41% vs. 45%, respectively (P = .05). The pooled intermediate/poor LIPI group was associated with shorter OS (HR 1.97; P = .03) and higher risk of progressive disease (OR 2.68; P = .047). Survivals and response were not influenced in the control cohort. CONCLUSION Baseline LIPI correlated with outcomes in patients with locally advanced NSCLC treated with durvalumab consolidation, but not in those who only received chemo-radiotherapy, providing further evidence of its prognostic and potential predictive role of ICI benefit in NSCLC.
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Affiliation(s)
- Mariona Riudavets
- Medical Oncology Department, Gustave Roussy cancer campus, Villejuif, France
| | - Edouard Auclin
- Medical Oncology Department, Hôpital Européen Georges Pompidou, AP-HP Centre, Université Paris Cité, Paris, France
| | - Miguel Mosteiro
- Medical Oncology Department, Institut Català d'Oncologia - ICO Hospitalet, Barcelona, Spain
| | - Naomi Dempsey
- Medical Oncology Department, Jackson Memorial Hospital, Miami, FL
| | - Margarita Majem
- Medical Oncology Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Arsela Prelaj
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milan, Milano, Italy
| | - Rafael López-Castro
- Medical Oncology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Joaquim Bosch-Barrera
- Medical Oncology Department, Catalan Institute of Oncology, Hospital Universitari Josep Trueta, Girona, Spain
| | - Sara Pilotto
- Medical Oncology Department, University and Hospital Trust of Verona, Verona, Italy
| | - Elena Escalera
- Medical Oncology Department, Hospital Clínico de Salamanca, Salamanca, Spain
| | - Marco Tagliamento
- Medical Oncology Department, Gustave Roussy cancer campus, Villejuif, France; Internal Medicine and Medical Specialties Department, University of Genova, Genova, Italy
| | - Joaquin Mosquera
- Medical Oncology Department, Hospital Universitario A Coruña, A Coruña, Spain
| | - Gérard Zalcman
- Université Paris Cité, Thoracic Oncology Department, CIC Inserm 1425, Hôpital Bichat-Claude Bernard, Paris, France
| | | | - Santiago Ponce
- Medical Oncology Department, Hospital 12 de Octubre, Madrid, Spain
| | - Víctor Albarrán-Artahona
- Medical Oncology Department, Department of Medicine, Hospital Clinic, Laboratory of Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Alessandro Dal Maso
- Medical Oncology Department, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Martina Spotti
- Medical Oncology Department, Hospital Alemán, Buenos Aires, Argentina
| | - Xabier Mielgo
- Medical Oncology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Elodie Mussat
- Medical Oncology Department, Hôpital Européen Georges Pompidou, AP-HP Centre, Université Paris Cité, Paris, France
| | - Roxana Reyes
- Medical Oncology Department, Department of Medicine, Hospital Clinic, Laboratory of Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Jose-Carlos Benítez
- Medical Oncology Department, Gustave Roussy cancer campus, Villejuif, France; Medical Oncology Department, Hospital Universitari Mutua Terrassa, Terrassa, Barcelona, Spain
| | - Lorena Lupinacci
- Medical Oncology Department, Hospital Italiano, Buenos Aires, Argentina
| | - Boris Duchemann
- Medical Oncology Department, Hôpital Avicenne, Bobigny, France
| | - Andrea De Giglio
- Medical Oncology Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Juan Bautista Blaquier
- Medical Oncology Department, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | | | - Matthias Scheffler
- Internal Medicine I Department, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ernest Nadal
- Medical Oncology Department, Institut Català d'Oncologia - ICO Hospitalet, Barcelona, Spain
| | - Gilberto Lopes
- Medical Oncology Department, Jackson Memorial Hospital, Miami, FL
| | - Diego Signorelli
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milan, Milano, Italy; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Jessica Menis
- Medical Oncology Department, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Virginia Bluthgen
- Medical Oncology Department, Hospital Alemán, Buenos Aires, Argentina
| | - Marc Campayo
- Medical Oncology Department, Hospital Universitari Mutua Terrassa, Terrassa, Barcelona, Spain
| | - Gonzalo Recondo
- Medical Oncology Department, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | - Benjamin Besse
- Medical Oncology Department, Gustave Roussy cancer campus, Villejuif, France
| | - Laura Mezquita
- Medical Oncology Department, Department of Medicine, Hospital Clinic, Laboratory of Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, University of Barcelona, Barcelona, Spain.
| | - David Planchard
- Medical Oncology Department, Gustave Roussy cancer campus, Villejuif, France
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Rodriguez-Candela Mateos M, Santiago-Freijanes P, Röder J, Oberoi P, Vigo N, Almenar E, Calleja Chucla T, Mosquera J, Acea-Nebril B, Wels W, Mayán M. 17P New therapeutic target in triple-negative breast cancer for enhancing PARP inhibitor efficacy and stimulating the anti-tumour immune response. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.100983] [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: 03/11/2023] Open
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Romero A, Serna R, Nadal E, Larriba JG, Martínez-Martí A, Bernabé R, Bosch-Barrera J, Fernandez AG, Calvo V, Insa A, Ponce S, Reguart N, De Castro J, Massutí B, Palmero R, Aguado de la Rosa C, Mosquera J, Cobo M, Aguilar A, Vivanco GL, Camps C, Trancho FH, Castro RL, Moran T, Barneto I, Rodríguez-Abreu D, Cruz A, Provencio M. MA06.03 Pre-treatment ctDNA Levels Significantly Predicts of OS and PFS in NADIM II Trial. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Provencio M, Serna R, Nadal E, Glez Larriba J, Martínez-Martí A, Bernabé R, Bosch-Barrera J, Garcia Benito C, Calvo V, Insa A, Ponce S, Reguart N, De Castro J, Massutí B, Palmero R, Aguado de la Rosa C, Mosquera J, Cobo M, Aguilar A, López Vivanco G, Camps C, Hernando Trancho F, López Castro R, Moran T, Barneto I, Rodríguez-Abreu D, Romero A. PL03.12 Progression Free Survival and Overall Survival in NADIM II Study. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.014] [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: 10/14/2022]
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Nadal E, Cantero A, Ortega A, Dómine M, Barba A, Blasco A, García J, Mosquera J, Vázquez S, Rodríguez D, López-Castro R, Juan-Vidal O, Sánchez A, Paz-Ares L, Hernández A, Iranzo P, Diz P, Provencio M, Simó M, Navarro V, Bruna J. EP08.01-029 NIVIPI-BRAIN, A Phase II Study of Nivolumab plus Ipilimumab Combined with Chemotherapy for Patients with NSCLC and Synchronous Brain Metastases. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.601] [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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Lado L, Piñeiro C, Luna V, Sánchez M, Otero C, Mosquera J, Lobato R, Pombar M. Positioning accuracy and reproducibility of the PTW TruFix system. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00153-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Barba Joaquín A, Mosquera J, Riudavets Melià M, Gomez-Randulfe M, García Campelo M, Sullivan I, Serra Lopez J, Aguado M, Piedra A, Majem M. P42.03 Predictive Factors of Response to PD-(L)1 Inhibitors in Patients With Advanced Non-Small Cell Lung and High PD-L1 Expression. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.462] [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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Calvo V, Carcereny E, Abreu DR, Lopez-Castro R, Guirado M, Camps C, Cobo M, Ortega A, Bernabé R, Massuti B, Mosquera J, Del Barco E, Gonzalez - Larriba J, Bosch - Barrera J, Ojeda CG, Domine M, Juan O, Martínez-Cutillas M, Benítez G, Collazo-Lorduy A, Cucurull M, Provencio M. OA14.01 Family History of Cancer and Lung Cancer: Information from the Thoracic Tumors Registry (TTR Study). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.080] [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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Nadal E, Massuti B, Huidobro G, Castro RL, Estival A, Mosquera J, Sullivan I, Felip E, Blasco A, Guirado M, Simó M, Pereira E, Navarro V, Bruna J. OA09.02 Atezo-Brain: Single Arm Phase II Study of Atezolizumab Plus Chemotherapy in Stage IV NSCLC With Untreated Brain Metastases. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.062] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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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Ioaquín AB, Piedra A, Mosquera J, Riudavets M, Gomez-Randulfe M, Campelo MG, Sullivan I, Serra J, Aguado M, Tarruella MM. 131P Predictive factors of response to PD-(L)1 inhibitors in patients with advanced non-small cell lung (NSCLC) and high PD-L1 expression. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01973-0] [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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Franco F, Carcereny E, Rodríguez-Abreu D, Castro RL, Cobo M, Guirado M, Massuti B, Granados AO, Mosquera J, Juan O, Blasco A, Del Barco E, Caro RB, Bosch-Barrera J, Gonzalez-Larriba J, Sala M, Pérez JT, Oramas J, Estival A, Provencio M. P52.10 Profile of Comorbidities and Cancer History in Patients with mNSCLC in the Spanish Population (Thoracic Tumors Registry). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Calvo V, Ruano-Ravina A, Carcereny E, Moran T, Rodríguez-Abreu D, López-Castro R, Cuadrado-Albite E, Guirado M, Gomez-Gonzalez L, Massuti B, Granados AO, Blasco A, Dols MC, Mosquera J, Hernandez-Martinez A, Trigo J, Juan O, De La Rosa CA, Gómez MD, Sala M, Oramas J, Ojea CG, Cerezo S, Provencio M. P52.05 Lung Cancer Symptoms at Diagnosis: Data from the Thoracic Tumors Registry (TTR Study). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.918] [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: 10/21/2022]
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Cruz-Bermudez A, Casarrubios M, Briviesca RL, Nadal E, Insa A, Mosquera J, Huidobro G, Gómez MD, Massuti B, Tarruella MM, Rodríguez-Abreu D, Martinez-Marti A, De Castro Campeño J, Dols MC, Vivanco GL, Del Barco E, Caro RB, Viñolas N, Barneto I, Viteri S, Jove M, Romero A, Franco F, Provencio M. P60.07 TMB and Selected Mutations in Resectable Stage IIIA NSCLC Patients Receiving Neo-Adjuvant Chemo-Immunotherapy from NADIM Trial. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.966] [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: 10/21/2022]
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Riudavets M, Mezquita L, Auclin E, Benitez J, Le Pechoux C, Majem M, Dempsey N, Lobefaro R, Nadal E, Amores A, Menis J, Tagliamento M, López-Castro R, Ponce S, Bosch-Barrera J, Aboubakar F, Mosquera J, Pilotto S, Reyes R, Mielgo X, Duchemann B, Mosteiro M, Mussat E, De Giglio A, Scheffler M, Campayo M, Botticella A, Naltet C, Lavaud P, Lopes G, Signorelli D, Garcia-Campelo R, Besse B, Planchard D. MA08.04 LIPI and outcomes of durvalumab as consolidation therapy after ChRT in patients with locally-advanced NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rodriguez-Candela M, Varela M, Diaz C, Santiago P, Mosquera J, Acea B, Mayan M. New potential therapeutics based on natural polyphenol and SASP inhibitor combination for treating cutaneous sequelae following radiotherapy and chemotherapy in breast cancer patients. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30824-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Riudavets M, Mosquera J, Garcia-Campelo R, Serra J, Anguera G, Gallardo P, Sullivan I, Barba A, Del Carpio L, Barnadas A, Gich I, Majem M. Immune-Related Adverse Events and Corticosteroid Use for Cancer-Related Symptoms Are Associated With Efficacy in Patients With Non-small Cell Lung Cancer Receiving Anti-PD-(L)1 Blockade Agents. Front Oncol 2020; 10:1677. [PMID: 33014837 PMCID: PMC7505083 DOI: 10.3389/fonc.2020.01677] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 07/29/2020] [Indexed: 12/26/2022] Open
Abstract
Background: Immune-related adverse events (irAEs) have been associated with improved efficacy in advanced non-small cell lung cancer (NSCLC) patients receiving anti-PD-(L)1 blockade agents, while the concurrent use of corticosteroids seems to worsen it. We evaluated outcomes in advanced NSCLC patients treated with anti-PD-(L)1 blockade agents in relation to the presence of irAEs and the reasons for using corticosteroids: whether for palliative cancer-related reasons or for the management of irAEs. Methods: Clinical outcomes in advanced NSCLC patients treated with anti-PD-(L)1 blockade agents were calculated with regard to the presence of irAEs and the use of corticosteroids. A landmark analysis was performed to avoid immortal time bias due to the time-dependent nature of irAEs. Results: Out of a total of 267 patients, the 56.9% of patients who experienced irAEs had significantly improved outcomes. In the landmark analysis, median progression-free survival (PFS) was 12.4 months for patients with irAEs vs. 4.1 months for patients without irAEs (p < 0.001), while median overall survival (OS) was 28.2 vs. 12.5 months, respectively (p < 0.001). Likewise, objective response and disease control rates were significantly higher in patients experiencing irAEs: 48.6 vs. 22.8% and 77.1 vs. 39.6% (p < 0.001), respectively. Median OS was significantly shorter for patients receiving ≥10 mg of prednisone equivalent daily for cancer-related symptoms than for the rest of patients (<10 mg prednisone equivalent daily or for management of irAEs): 6 vs. 15.9 months (p < 0.001). Conclusions: IrAEs were associated with improved efficacy in advanced NSCLC patients when a landmark analysis was applied. Patients receiving corticosteroids had significantly poorer outcomes when they were used for cancer-related symptoms.
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Affiliation(s)
- Mariona Riudavets
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Department of Medicine, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain
| | - Joaquin Mosquera
- Department of Medical Oncology, Hospital Universitario a Coruña, a Coruña, Spain
| | | | - Jorgina Serra
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Georgia Anguera
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Pablo Gallardo
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ivana Sullivan
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Andrés Barba
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Luís Del Carpio
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Agustí Barnadas
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ignasi Gich
- Department of Clinical Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Margarita Majem
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Antolin S, Reboredo C, Lesta R, Molina A, Mosquera J, Cordeiro P, Pérez E, Calvo L. Abstract P1-18-28: Myocet or carboplatin as part of chemotherapy in HER2-positive operable breast cancer treated with trastuzumab and pertuzumab in the neoadjuvant setting: Efficacy data and cardiotoxicity in 60 patients diagnosed from 2016-2019 at a single institution. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p1-18-28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objectives: To evaluate the efficacy and cardiotoxicity profile of liposomal anthracycline or Carboplatin as part of neoadjuvant therapy added to taxanes and dual blockade in HER2-positive operable breast cancer patients.
Methods: A total of 60 patients diagnosed from August 2016 to May 2019 were included in the study. The treatment consisted of a sequential regimen of taxanes and non- pegilated liposomal anthracycline (Myocet) plus trastuzumab and pertuzumab, or taxanes in combination with carboplatin plus trastuzumab and pertuzumab. The clinical and pathologic responses were evaluated and correlated with clinical and biological factors. Pathologic complete response was defined as the total absence of invasive tumor in both breast and axillary nodes (ypT0/is ypN0).The cardiotoxicity profile was also analyzed.
Results: The median age was 52(26-77) years and 5%, 62% and 33% of patients had stage I, II and III breast cancer, respectively, while 7% had inflammatory breast cancer at diagnosis. Hormone receptor (HR) status was negative in 48%, and 65% and 50% had grade III and ki-67 value up to 35%, respectively breast cancer. 65% of patients received weekly paclitaxelx12-trastuzumab-pertuzumab followed by Myocet-cyclophosphamide with -trastuzumab x 4 cycles or this sequence but beginning with the anthracycline, 23% of patients the same regimen but with pertuzumab concurrently with all chemotherapy treatment. The remaining 12% received docetaxel-carboplatin x6 cycles plus trastuzumab and pertuzumab. All treatment was administered previous surgery.
The clinical complete response rate, was 57% and 63%, as assessed using ultrasound and MRI, respectively, and this allowed a high rate of conservative surgery (60%). The pathologic complete response (pCR) rate was 52%, and it was higher in HR-negative (61%) than in HR-positive (39%), in grade 3 (71%) than in grade 2(29%) tumors. There were not statistical significant differences in pCR between different chemotherapy treatments. Five patients showed a 10% decrease in left ventricular ejection fraction (LVEF) to below 50% at the end of neoadjuvant treatment. Asymptomatic drops in 2 patients and with heart failure symptoms in 3 of them. Myocet was part of chemotherapy in all of them. All patients recovered after discontinuation of adjuvant trastuzumab and heart medication. Two of these patients did not complete all preplanned adjuvant trastuzumab doses.
Conclusion: A sequential regimen of taxanes and non-pegilated liposomal anthracycline or carboplatin plus trastuzumab and pertuzumab was effective, with high pCR rates and a good cardiotoxicity profile.
Citation Format: Silvia Antolin, Cristina Reboredo, Rocío Lesta, Aurea Molina, Joaquin Mosquera, Patricia Cordeiro, Eva Pérez, Lourdes Calvo. Myocet or carboplatin as part of chemotherapy in HER2-positive operable breast cancer treated with trastuzumab and pertuzumab in the neoadjuvant setting: Efficacy data and cardiotoxicity in 60 patients diagnosed from 2016-2019 at a single institution [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-18-28.
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Affiliation(s)
| | | | - Rocío Lesta
- A Coruña University Hospital, A Coruña, Spain
| | | | | | | | - Eva Pérez
- A Coruña University Hospital, A Coruña, Spain
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Riudavets M, Mosquera J, Campelo RG, Serra J, Anguera G, Gallardo P, Sullivan I, Barba A, Majem M. P2.04-52 Impact of Corticosteroids and Antibiotics on Efficacy of Immune-Checkpoint Inhibitors in Patients with Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1557] [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: 10/25/2022]
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Grana Suarez B, Molina A, Mosquera J, Martinez A, Lado M, Forjan M, Liste R, Reboredo C, Gomez-Randulfe I, Cordeiro P, Coroas O, Deben M. Socio-demographic characteristics and quality of life analysis of cancer survivors followed at a primary care center. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz275.019] [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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Riudavets M, Mosquera J, Campelo RG, Serra J, Anguera G, Gallardo P, Sullivan I, Barba A, Majem M. P1.04-19 Association Between Efficacy and irAEs in Patients with Advanced Non-Small Cell Lung Cancer Receiving Immune-Checkpoint Inhibitors. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Affiliation(s)
- C. Lado
- Real Jardín Botánico (CSIC), Plaza de Murillo, 2. 28014 Madrid. SPAIN
| | - J. Mosquera
- Dpto. de Biología Vegetal (Botánica), Univ. de La Laguna. 38071 La Laguna, Tenerife. SPAIN
| | - E. Beltrán Tejera
- Dpto. de Biología Vegetal (Botánica), Univ. de La Laguna. 38071 La Laguna, Tenerife. SPAIN
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Antolin S, Calvo L, Prato J, Molina A, Reboredo C, Mosquera J. Abstract P1-15-17: Liposomal-encapsulated doxorubicin (Myocet)as part of primary systemic therapy in HER2-positive operable breast cancer: Efficacy data, cardiotoxicity and long-term follow-up in 81 patients diagnosed from 2005-2016 at a single institution. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-15-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objectives
To evaluate the efficacy, cardiotoxicity profile and long-term benefits of liposomal doxorubicin (Myocet) as part of neoadjuvant therapy in HER2-positive operable breast cancer patients.
Methods
The treatment consisted of a sequential regimen of paclitaxel and liposomal doxorubicin (Myocet) plus trastuzumab. Clinical and pathologic response were evaluated and correlated with clinical and biological factors. Cardiotoxicity profile and long-term benefits were analyzed.
Results
Median age was 48 years and 4%, 69%, and 27% were stage I, II, and III, respectively, while 12% had inflammatory breast cancer at diagnosis. Hormone receptor (HR) status was negative in 43% and 70% were grade III.
Patients Characteristics Total number (%)Age, years Median (Range)48 (30-79)Tumor (cT)* Tx1 (1)T14 (5)T253 (66)T313 (16)T410 (12)Nodal Status N024 (30)N1-257 (70)Stage I3 (4)II56 (69)III22 (27)Hormone Receptor Status HR+35 (43)HR-46 (57)HER2 IHC 3+74 (91)IHC 2+7 (9)FISH/SISH21 (26)Grade I1(1)II22 (27)III57 (71)Unknown1 (1)Ki-67 <20%6 (7)20-35%32 (40)>35%43 (53)Surgical Indication at Diagnosis Mastectomy58 (72)Tumorectomy22 (27)Any surgery in breast*1 (1)* One patient had an occult carcinoma.
pCR by SubgroupsPathologic ResponsepCRNo pCR(n=81)n (%)n (%)Tumor Size (MRI) </=5 cm26 (49)27 (51)> 5 cm10 (67)5 (33)Nodes Positive26 (46)31 (54)Negative18 (75)6 (25)Histological Subtype Ductal43 (56)34 (44)Lobular0 (0)2 (100)Other1 (50)1 (50)Hormone Receptor Negative23 (66)12 (34)Positive21 (46)25 (54)Ki-67 <204 (67)2 (33)20-3512 (38)20 (62)>3528 (65)15 (35)Grade I0 (0)1 (100)II12 (55)10 (45)III31 (54)26 (46)
The clinical complete response rate by ultrasound and MRI were 47% and 65%, respectively, and allowed a high rate of conservative surgery (72%).
The pathologic complete response (pCR) rate in breast and axilla was 54%, higher in HR-negative (66%) than in HR-positive (46%),in ki-67>35% (65%) than ki-67 between 20-35% (38%) and similar in grade III (54%) and grade II (55%).
Patients who achieved pCR had longer DFS and a trend to improve OS.
Four percent of patients showed a decrease in the left ventricular ejection fraction below 50% during treatment. All except one of them recovered after discontinuation of trastuzumab.
Conclusion: A sequential regimen of taxanes and liposomal doxorubicin (Myocet) plus trastuzumab was active with high pCR rates and long-term benefit with a very good cardiotoxicity profile.
Citation Format: Antolin S, Calvo L, Prato J, Molina A, Reboredo C, Mosquera J. Liposomal-encapsulated doxorubicin (Myocet)as part of primary systemic therapy in HER2-positive operable breast cancer: Efficacy data, cardiotoxicity and long-term follow-up in 81 patients diagnosed from 2005-2016 at a single institution [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-15-17.
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Affiliation(s)
- S Antolin
- A Coruña University Hospital, A Coruña, Spain
| | - L Calvo
- A Coruña University Hospital, A Coruña, Spain
| | - J Prato
- A Coruña University Hospital, A Coruña, Spain
| | - A Molina
- A Coruña University Hospital, A Coruña, Spain
| | - C Reboredo
- A Coruña University Hospital, A Coruña, Spain
| | - J Mosquera
- A Coruña University Hospital, A Coruña, Spain
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23
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Areses MC, Campelo RG, García González J, Afonso FJ, Lazaro ME, Campos B, Azpitarte C, Amenedo M, Santomé L, Ron DA, Alonso-Jaudenes G, Baron F, Vilchez R, Casal J, Fernandez N, Carou I, Mosquera J, Anido U, Garcia Mata J, Firvida JL. The real-world experience with nivolumab in previously treated patients with advanced non small cell lung cancer (NSCLC): A Galician Lung Cancer Group clinical practice. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e20564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20564 Background: Nivolumab, was the first checkpoint inhibitor to show a survival benefit in previously treated patients with advanced NSCLC in two randomized trials (CheckMate 017 and 057). Experience in routine clinical practice may differ from that seen in a controlled clinical trial. This is an observational study that represents the real-world experience. Methods: Elegibility criteria included, histologically confirmed NSCLC stage IIIB vs IV, evaluable disease and at least one prior therapy. Patients received nivolumab 3 mg/kg IV (60 min) every 2 weeks until progressive disease or unacceptable toxicity. The aim of the study was to report the efficacy and safety profile of Nivolumab in pretreated patients with advanced NSCLC of our everyday clinical practice. The exploratory assessments include response rate (RR), progression-free survival (PFS), overall survival (OS) and treatment related adverse events (AEs). Results: From August 2015 to January 2017, with a median follow time of 18 months, 188 patients were enrolled from 9 different centers. Patients demographics were: median age 62 years, 44 female and 144 male; 17 never smoker and 171 former or current smoker; 105 adenocarcinoma, 7 large-cell carcinoma, 66 squamous, 3 adenosquamous and 7 NSCLC; 61 stage IIIB and 129 stage IV; 42 with central nervous system metastasis; and 70 received 2 or more prior therapy lines. Among 156 patients evaluated, 1,3% had CR, 28,2% PR, 29,7% SD and 40,8% PD. At the time of database lock, the median of PFS was 2.9 IC 95% (2,3-3.4) and OS was 12,8 IC 95% (9,2-16,4). The evaluation of PFS and OS by baseline characteristics doesn´t revealed statistical significance. Grade 1-2 treatment related adverse events (AEs) occurred in 58% of the patients: asthenia (22%), rash (14%), diarrhea (8%), anorexia (7%), endocrine (6%) and neumonitis (1,5%). Grade 3-4 AEs occurred in 5 patients; (3) diarrhea and (2) neumonitis and there were 3 treatment-related deaths. Conclusions: This study represents the real-word experience with nivolumab and the results are consistent with those previously reported in the CheckMate 017 and 057 trials.
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Affiliation(s)
- MC Areses
- Complejo Hospitalario Universitario de Ourense, Ourense, Spain
| | | | - Jorge García González
- Complejo Hospitalario Universitario de Santiago de Compostela, Santiago De Compostela, Spain
| | | | | | | | | | | | | | - David Arias Ron
- Complejo Hospitalario Universitario de Ourense, Orense, Spain
| | | | - Francisco Baron
- Complejo Hospitalario Universitario de Santiago, Santiago De Compostela, Spain
| | - Rocio Vilchez
- Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain
| | - Joaquin Casal
- Complejo Hospitalario Universitario de Vigo, Vigo, Spain
| | | | - Iria Carou
- Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - Joaquin Mosquera
- Medical Oncology Service, University Hospital A Coruña (XXIAC-SERGAS), A Coruña, Spain
| | - Urbano Anido
- Complejo Hospitalario Universitario de Santiago de Compostela, Santiado De Complostela, Spain
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Giuffrida MJ, Valero N, Mosquera J, Duran A, Arocha F, Chacín B, Espina LM, Gotera J, Bermudez J, Mavarez A, Alvarez-Mon M. Increased Systemic Cytokine/Chemokine Expression in Asthmatic and Non-asthmatic Patients with Bacterial, Viral or Mixed Lung Infection. Scand J Immunol 2017; 85:280-290. [PMID: 28168862 PMCID: PMC7169570 DOI: 10.1111/sji.12532] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 01/29/2017] [Indexed: 12/12/2022]
Abstract
This study was aimed to determine the profiles of serum cytokines (IL-1β, TNF-α, IL-4, IL-5) and chemokines (MCP-1: monocyte chemoattract protein-1 and RANTES: regulated on activation normal T cell expressed and secreted) in individuals with an asthmatic versus a non-asthmatic background with bacterial, viral or mixed acute respiratory infection. Asthmatic (n = 14) and non-asthmatic (n = 29) patients with acute viral, bacterial or mixed (bacterial and viruses) respiratory infection were studied. Patients were also analysed as individuals with pneumonia or bronchitis. Healthy individuals with similar age and sex (n = 10) were used as controls. Cytokine/chemokine content in serum was determined by ELISA. Increased cytokine/chemokine concentration in asthmatic and non-asthmatic patients was observed. However, higher concentrations of chemokines (MCP-1 and RANTES) in asthmatic patients infected by viruses, bacteria or bacteria and viruses (mixed) than in non-asthmatic patients were observed. In general, viral and mixed infections were better cytokine/chemokine inducers than bacterial infection. Cytokine/chemokine expression was similarly increased in both asthmatic and non-asthmatic patients with pneumonia or bronchitis, except that RANTES remained at normal levels in bronchitis. Circulating cytokine profiles induced by acute viral, bacterial or mixed lung infection were not related to asthmatic background, except for chemokines that were increased in asthmatic status.
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Affiliation(s)
- M J Giuffrida
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - N Valero
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - J Mosquera
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - A Duran
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - F Arocha
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - B Chacín
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - L M Espina
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - J Gotera
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - J Bermudez
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - A Mavarez
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - M Alvarez-Mon
- Servicio de Enfermedades del Sistema Inmune y Oncología, Hospital Universitario "Príncipe de Asturias", Universidad de Alcalá, Madrid, Spain
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Affiliation(s)
| | - J. Mosquera
- Real Jardín Botánico, CSIC, Plaza de Murillo 2, 28014, Madrid, España
| | - A. Estrada-Torres
- Centro de Investigación en Ciencias Biológicas, Universidad Autónoma de Tlaxcala, km 10.5 carretera Texmelucan-Tlaxcala, Ixtacuixtla, 90122, Tlaxcala, México
| | - E. Beltrán-Tejera
- Departamento de Biología Vegetal (Botínica), Universidad de La Laguna, 38071, La Laguna, Tenerife, España
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26
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Graña B, Martinez A, Lado M, Forjan M, Campelo RG, Mosquera J, Molina A, Deben M. Surveillance of cancer survivors: Results from a survey of primary care physicians working in the Spanish National Health System. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e21562] [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: 11/20/2022] Open
Affiliation(s)
- Begoña Graña
- Medical Oncology Service.University Hospital A Coruña (XXIAC-SERGAS), A Coruña, Spain
| | - Ana Martinez
- Primary Care Center- Culleredo (XXIAC-SERGAS), Culleredo, Spain
| | - Manuel Lado
- Primary Care Center- Culleredo (XXIAC-SERGAS), Culleredo, Spain
| | - Maria Forjan
- Primary Care Center- Culleredo (XXIAC-SERGAS), Culleredo, Spain
| | | | - Joaquin Mosquera
- Medical Oncology Service.University Hospital A Coruña (XXIAC-SERGAS), A Coruña, Spain
| | - Aurea Molina
- Medical Oncology Service.University Hospital A Coruña (XXIAC-SERGAS), A Coruña, Spain
| | - Martin Deben
- Primary Care Center- Culleredo (XXIAC-SERGAS), Culleredo, Spain
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27
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Cereijo C, Acea B, Albaina L, Jüaneda M, Varela J, Soler R, Castro A, Mosquera J. 94 Multimedia education in a program of health education to women with breast cancer. Eur J Oncol Nurs 2014. [DOI: 10.1016/s1462-3889(14)70113-9] [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: 11/24/2022]
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28
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Correa M, Restrepo R, Arboleda C, Mosquera J, García Martínez G. Factores de riesgo para el desarrollo de infección de injerto protésico infrainguinal en un Servicio de Cirugía Vascular en Medellín (Colombia). Angiología 2011. [DOI: 10.1016/j.angio.2011.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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29
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Sonneveld MPW, Schröder JJ, de Vos JA, Monteny GJ, Mosquera J, Hol JMG, Lantinga EA, Verhoeven FPM, Bouma J. A whole-farm strategy to reduce environmental impacts of nitrogen. J Environ Qual 2008; 37:186-195. [PMID: 18178892 DOI: 10.2134/jeq2006.0434] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Dutch regulations for ammonia emission require farmers to inject slurry into the soil (shallow) or to apply it in narrow bands at the surface. For one commercial dairy farm in the Netherlands it was hypothesized that its alternative farming strategy, including low-protein feeding and surface spreading, could be an equally effective tool for ammonia emission abatement. The overall objective of the research was to investigate how management at this farm is related to nitrogen (N) losses to the environment, including groundwater and surface water. Gaseous emission of ammonia and greenhouse gasses from the naturally ventilated stables were 8.1 and 3.1 kg yr(-1) AU(-1) on average using the internal tracer (SF(6))-ratio method. Measurements on volatilization of ammonia from slurry application to the field using an integrated horizontal flux method and the micrometeorological mass balance method yielded relatively low values of ammonia emissions per ha (3.5-10.9 kg NH(3)-N ha(-1)). The mean nitrate concentration in the upper ground water was 6.7 mg L(-1) for 2004 and 3.0 mg L(-1) for 2005, and the half-year summer means of N in surface water were 2.3 mg N L(-1) and 3.4 mg N L(-1) for 2004 and 2005, respectively. Using a nutrient budget model for this farm, partly based on these findings, it was found that the calculated ammonia loss per ton milk (range 5.3-7.5 kg N Mg(-1)) is comparable with the estimated ammonia loss of a conventional farm that applies animal slurry using prescribed technologies.
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Affiliation(s)
- M P W Sonneveld
- Wageningen University and Research Centre, Land Dynamics Group, P.O. Box 47, 6700 AA, Wageningen, The Netherlands.
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30
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Valero N, Larreal Y, Espina LM, Reyes I, Maldonado M, Mosquera J. Elevated levels of interleukin-2 receptor and intercellular adhesion molecule 1 in sera from a venezuelan cohort of patients with dengue. Arch Virol 2007; 153:199-203. [PMID: 18080798 DOI: 10.1007/s00705-007-1080-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2007] [Accepted: 09/16/2007] [Indexed: 10/22/2022]
Abstract
This study evaluated the levels of soluble interleukin-2 receptor (sIL-2R) and soluble intercellular adhesion molecule-1 (sICAM-1) in patients with dengue. Sera from 17 patients with dengue fever (DF), 15 with dengue hemorrhagic fever (DHF) and 12 healthy individuals were obtained. Increased levels of sIL-2R and sICAM-1 were found in patients with DF and DHF when compared to normal; those were not correlated with leukocytes, hepatic serum enzyme levels or haemostatic parameters. Levels of sIL-2R were related to the different grades of DHF. These results suggest that increased levels of sIL-2R and sICAM-1 are a common feature of dengue.
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Affiliation(s)
- N Valero
- Seccion de Virologia, Facultad de Medicina, Instituto de Investigaciones Clinicas Dr. Americo Negrette, Universidad del Zulia, Zulia, Venezuela.
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31
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Lado C, Mosquera J, Estrada-Torres A, Beltran-Tejera E, de Basanta DW. Description and culture of a new succulenticolous Didymium (Myxomycetes). Mycologia 2007; 99:602-11. [DOI: 10.3852/mycologia.99.4.602] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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32
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Castro E, Otero C, Luna V, Ares L, Lobato R, Mosquera J, Cascallar L, Porto C. Comparing techniques for conformal irradiation of head and neck cancer using dose-volume histograms from spinal cord and ntcp from parotid glands. Radiother Oncol 2007. [DOI: 10.1016/s0167-8140(07)80142-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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34
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Sosa M, Saavedra P, Valero C, Guañabens N, Nogués X, del Pino-Montes J, Mosquera J, Alegre J, Gómez-Alonso C, Muñoz-Torres M, Quesada M, Pérez-Cano R, Jódar E, Torrijos A, Lozano-Tonkin C, Díaz-Curiel M. Inhaled steroids do not decrease bone mineral density but increase risk of fractures: data from the GIUMO Study Group. J Clin Densitom 2006; 9:154-8. [PMID: 16785074 DOI: 10.1016/j.jocd.2005.11.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2005] [Revised: 10/25/2005] [Accepted: 11/27/2005] [Indexed: 11/17/2022]
Abstract
Although the negative effect of systemic steroids on bone is well documented, there is not clear evidence about possible adverse effects of inhaled steroids on bone metabolism and fractures. A cross-sectional study was performed on 105 women suffering from bronchial asthma treated with inhaled steroids and 133 controls. Bone mineral density (BMD) was measured by quantitative ultrasonography (QUS) at the calcaneus and by dual X-ray absorptiometry (DXA), at both the lumbar spine and proximal femur. Patients suffering from bronchial asthma showed no statistically significant changes in BMD as measured by DXA or QUS, compared with controls. A higher prevalence of fractures was found in the group of women with bronchial asthma, with an age-adjusted odds ratio of 2.79 (95% CI: 1.19-6.54). Inhaled steroids do not appear to decrease BMD, but are associated with an increased risk of fracture in women.
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Affiliation(s)
- M Sosa
- University of Las Palmas de Gran Canria, Hospital University Insular, Bone Metabolic Unit, Apartado 550, 35080 Las Palmas de Gran Canaria, Canary Islands, Spain.
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35
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Sosa M, Saavedra P, Gómez-Alonso C, Mosquera J, Torrijos A, Muñoz-Torres M, Valero Díaz de la Madrid C, Díaz Curiel M, Martínez Díaz Guerra G, Pérez-Cano R, Alegre J, Del Pino J. Postmenopausal women with Colles' fracture have bone mineral density values similar to those of controls when measured with calcaneus quantitative ultrasound. Eur J Intern Med 2005; 16:561-6. [PMID: 16314236 DOI: 10.1016/j.ejim.2005.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2004] [Revised: 04/08/2005] [Accepted: 06/02/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND It is a matter of controversy whether or not Colles' fracture is an osteoporotic fracture. Indeed, the usefulness of quantitative ultrasound in distinguishing Colles' fracture from normal fractures is also unclear. METHODS A cross-sectional case-control study was done on 469 postmenopausal Spanish women, 121 with Colles' fracture and 348 controls. Assessment of risk factors for osteoporosis and measurement of calcaneus quantitative ultrasound were carried out using a Sahara, Hologic device. RESULTS Patients with Colles' fracture had BUA, SOS, and QUI values that were similar to those of controls, and no statistically significant differences were found. We estimated ROC curves for SOS and a score based on a linear combination of height and SOS (SH-Score). The areas under both curves were 0.56 and 0.61, respectively, which was statistically significant. To obtain 5% false-negative and 10% false-positive figures, the T-score cut-off for SOS was -2.45 and -0.045, respectively. Of these, only 9.2% were classified as high risk and 11% as low risk with 79.8% undetermined. CONCLUSIONS Patients with Colles' fracture had BUA, SOS, and QUI values that were similar to those of controls. Nevertheless, ROC curves calculated by a combination of height and SOS showed that quantitative calcaneus ultrasound may be a useful tool for identifying postmenopausal women with Colles' fracture. These results indicate that measuring bone mineral density with ultrasound only captures limited aspects of the pathophysiology of Colles' fractures.
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Affiliation(s)
- M Sosa
- University of Las Palmas de Gran Canaria, Faculty of Medicine, Department of Medical and Surgery Sciences, Hospital University Insular, Service of Internal Medicine, Bone Metabolic Unit, Spain.
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Mosquera J, Monteny GJ, Erisman JW. Overview and assessment of techniques to measure ammonia emissions from animal houses: the case of the Netherlands. Environ Pollut 2005; 135:381-388. [PMID: 15749536 DOI: 10.1016/j.envpol.2004.11.011] [Citation(s) in RCA: 7] [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] [Received: 08/20/2004] [Accepted: 11/15/2004] [Indexed: 05/24/2023]
Abstract
In order to comply with the ammonia (NH(3)) emission reduction assigned to the Netherlands development of new measures are needed, which should be supported by fast and accurate measurements to arrive at new estimates of the NH(3) emission from each agricultural source. This paper gives an overview of the current methods used in the Netherlands to measure NH(3) emissions from animal houses, and provides alternative methods for some particular situations. For mechanically ventilated animal houses, passive flux samplers placed in the ventilation shafts of the animal house are presented as alternative to measure a larger number of animal houses (replicates) with the same housing system at a low price. For naturally ventilated animal houses, when mixing in the animal house is not good enough to allow measurements within the animal house (internal tracer gas ratio method), two measurement methods are discussed: the Gaussian plume dispersion model, which is usually not suitable for agricultural situations, and the flux frame method, which is not always applicable because of distortion of the flow around the building. Finally, for animal houses with outside yards for the animals, there are at this moment no methods available to measure the NH(3) emissions from these complex situations, although quick box methods (for the outside yards) and a combination of a backward Lagrangian stochastic model with open-path concentration measurements with a tunable diode laser (TDL), look promising.
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Affiliation(s)
- J Mosquera
- Wageningen UR, Agrotechnology and Food Innovations, P.O. Box 17, 6700 AA Wageningen, Netherlands.
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Pardo J, Franco L, Gómez F, Iglesias A, Pazos A, Pena J, Lobato R, Mosquera J, Pombar M, Sendón J. Development and operation of a pixel segmented liquid-filled linear array for radiotherapy quality assurance. Phys Med Biol 2005; 50:1703-16. [PMID: 15815091 DOI: 10.1088/0031-9155/50/8/006] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [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: 11/12/2022]
Abstract
A liquid isooctane (C(8)H(18)) filled ionization linear array for radiotherapy quality assurance has been designed, built and tested. The detector consists of 128 pixels, each of them with an area of 1.7 mm x 1.7 mm and a gap of 0.5 mm. The small pixel size makes the detector ideal for high gradient beam profiles such as those present in intensity modulated radiation therapy (IMRT) and radiosurgery. As the read-out electronics we use the X-ray Data Acquisition System with the Xchip developed by the CCLRC. Studies concerning the collection efficiency dependence on the polarization voltage and on the dose rate have been made in order to optimize the device operation. In the first tests, we have studied dose rate and energy dependences. Dose rate dependence was found to be lower than 2.1% up to 5 Gy min(-1), and energy dependence lower than 2.5% up to 20 cm depth in solid water. Output factors and penumbras for several rectangular fields have been measured with the linear array and were compared with the results obtained with a 0.125 cm(3) air ionization chamber and radiographic film, respectively. Finally, we have acquired profiles for an IMRT field and for a virtual wedge. These profiles have also been compared with radiographic film measurements. All the comparisons show a good correspondence. The device has proved its capability to verify on-line therapy beams with good spatial resolution and signal-to-noise ratio.
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Affiliation(s)
- J Pardo
- Departamento de Física de Partículas, Facultade de Física, Santiago de Compostela, Spain.
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38
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Cruz R, Vilas C, Mosquera J, García C. The close relationship between estimated divergent selection and observed differentiation supports the selective origin of a marine snail hybrid zone. J Evol Biol 2005; 17:1221-9. [PMID: 15525407 DOI: 10.1111/j.1420-9101.2004.00802.x] [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: 11/29/2022]
Abstract
To study the role of divergent selection in the differentiation of the two morphs in a hybrid zone of the intertidal snail Littorina saxatilis, we compared the strength of the divergent selection acting on a series of shell characters (as estimated by the viability of snails in a reciprocal transplant experiment) with the contribution of these characters to the phenotypic differences between the morphs. We found a close correlation between selection and differentiation, which suggests a cause-effect relationship, i.e. that all present differentiation is the result of past divergent selection. In addition, divergent selection was a very important component of the total natural selection acting on shell measures. These novel results support previous evidence, based on allozyme analysis, of a parapatric origin for this hybrid zone. We discuss possible limitations of this interpretation and the circumstances under which allopatric differentiation would produce the same results. Phenotypic analysis of divergent selection may be a useful method of investigating the evolutionary mechanisms involved in differentiation processes.
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Affiliation(s)
- R Cruz
- Departamento de Xenética, Facultade de Bioloxía, Universidade de Santiago de Compostela. Coruña, Galiza, Spain
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39
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Sosa M, Saavedra P, del Pino-Montes J, Alegre J, Pérez-Cano R, Guerra GMD, Díaz-Curiel M, Valero C, Muñoz-Torres M, Torrijos A, Mosquera J, Gómez-Alonso C. Postmenopausal women with colles' fracture have lower values of bone mineral density than controls as measured by quantitative ultrasound and densitometry. J Clin Densitom 2005; 8:430-5. [PMID: 16311428 DOI: 10.1385/jcd:8:4:430] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2005] [Revised: 06/02/2005] [Accepted: 06/02/2005] [Indexed: 11/11/2022]
Abstract
Measurement of ultrasonographic parameters provides information concerning not only bone density but also bone architecture. We investigated the usefulness of ultrasonographic parameters and bone mineral density (BMD) to evaluate the probability of Colles' fracture. Two-hundred eighty-nine postmenopausal women (62.3 +/- 8.7 yr) with (n = 76) and without (n = 213) Colles' fracture were studied. BMD of lumbar spine and proximal femur was evaluated in all women by dual-energy X-ray absorptiometry (DXA) and speed of sound (SOS), broadband ultrasound attenuation (BUA), and stiffness in the calcaneus were measured by a Sahara ultrasonometer (Hologic). Patients suffering from Colles' fracture had lower values of BMD adjusted by height at the lumbar spine, L2-L4 (0.797 g/cm2 vs 0.860 g/cm2), femoral neck (0.685 g/cm2 vs 0.712 g/cm2 ), SOS (1518 m/sg vs 1525 m/sg), and stiffness (74.6 vs 77.7) (p < 0.05). Nevertheless, BUA values were similar in both groups. After stepwise logistic regression analysis, the area found under receiver operating characteristic (ROC) curves was 0.60 for L2L4 and 0.63 for a formula combining L2L4 and height. Our data suggest that patients suffering from Colles' fracture have lower values of BMD by DXA, SOS, and stiffness. However, the ability of these techniques to discriminate is low because the values for the area under ROC curve are 0.60 for L2-L4 and 0.63 for a formula derived of the combination of L2-L4 and height.
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Affiliation(s)
- Manuel Sosa
- University of Las Palmas de Gran Canaria, Hospital University Insular, Bone Metabolic Unit, Las Palmas de Gran Canaria, Canary Islands, Spain.
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40
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Vázquez Martul E, Tettamazzi F, Mosquera J. [Glomerular pathology and HCV]. Nefrologia 2005; 25:345-9. [PMID: 16231499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
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41
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Pena J, Franco L, Gómez F, Iglesias A, Lobato R, Mosquera J, Pazos A, Pardo J, Pombar M, Rodríguez A, Sendón J. Commissioning of a medical accelerator photon beam Monte Carlo simulation using wide-field profiles. Phys Med Biol 2004; 49:4929-42. [PMID: 15584528 DOI: 10.1088/0031-9155/49/21/006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A method for commissioning an EGSnrc Monte Carlo simulation of medical linac photon beams through wide-field lateral profiles at moderate depth in a water phantom is presented. Although depth-dose profiles are commonly used for nominal energy determination, our study shows that they are quite insensitive to energy changes below 0.3 MeV (0.6 MeV) for a 6 MV (15 MV) photon beam. Also, the depth-dose profile dependence on beam radius adds an additional uncertainty in their use for tuning nominal energy. Simulated 40 cm x 40 cm lateral profiles at 5 cm depth in a water phantom show greater sensitivity to both nominal energy and radius. Beam parameters could be determined by comparing only these curves with measured data.
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Affiliation(s)
- J Pena
- Departamento de Física de Partículas, Facultade de Física, 15782 Santiago de Compostela, Spain.
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42
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Pardo J, Franco L, Gómez F, Iglesias A, Lobato R, Mosquera J, Pazos A, Pena J, Pombar M, Rodríguez A, Sendón J. Free ion yield observed in liquid isooctane irradiated by rays. Comparison with the Onsager theory. Phys Med Biol 2004; 49:1905-14. [PMID: 15214532 DOI: 10.1088/0031-9155/49/10/006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We have analysed data on the free ion yield observed in liquid isooctane irradiated by 60Co gamma rays within the framework of the Onsager theory about initial recombination. Several distribution functions describing the electron thermalization distance have been used and compared with the experimental results: a delta function, a Gaussian-type function and an exponential function. A linear dependence between the free ion yield and the external electric field has been found at low-electric-field values (E < or = 1.2 x 10(3) V mm(-1)) in excellent agreement with the Onsager theory. At higher electric field values, we obtain a solution in power series of the external field using the Onsager theory.
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Affiliation(s)
- J Pardo
- Departamento de Física de Partículas, Facultade de Física, 15782 Santiago de Compostela, Spain.
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43
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Bernal Sprekelsen M, Mosquera J, Til Pérez G, Sandiumenge A, Cardesín Revilla A, Sabater Mata de la Barata F. [Sinusitis in immunocompromised patients. A multicenter study]. Acta Otorrinolaringol Esp 2003; 54:195-201. [PMID: 12825342 DOI: 10.1016/s0001-6519(03)78404-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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: 10/27/2022]
Abstract
This paper evaluates different aspects of sinusitis in patients with a decreased immunological system, such as its prevalence and clinical evolution, its peculiar bacteriology and the altered response to treatment, and the prognosis, especially in patients with AIDS. There seems to be an increased prevalence of sinusitis in these patients, with a relationship between their immunological status and the severity and aggressiveness of the sinusitis. Bacteriological studies reveal the pressure of more aggressive species, such as P. aeruginosa, and specific sinusitis are more frequent, which may explain why the treatment with common antibiotics often remains uneffective. The simultaneous therapy of concomitant infections leads to a higher resistance towards common drugs. A standard treatment is therefore needed. The results of three studies, retrospective and prospective, on HIV-infected patients reveal a high incidence of acute sinusitis with aggressive bacteria.
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Affiliation(s)
- M Bernal Sprekelsen
- Servicio de ORL, Hospital Clínic de Barcelona, c/Villarroel, 170, 08036 Barcelona
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44
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Mosquera J, de Castro M, Gómez-Gesteira M. Parasites as Biological Tags of Fish Populations: Advantages and Limitations. ACTA ACUST UNITED AC 2003. [DOI: 10.1080/08948550302442] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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45
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Mosquera J, Sharp A, Moore CB, Warn PA, Denning DW. In vitro interaction of terbinafine with itraconazole, fluconazole, amphotericin B and 5-flucytosine against Aspergillus spp. J Antimicrob Chemother 2002; 50:189-94. [PMID: 12161398 DOI: 10.1093/jac/dkf111] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.7] [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: 11/14/2022] Open
Abstract
We investigated the in vitro interaction of terbinafine with itraconazole, fluconazole, amphotericin B and 5-flucytosine, against Aspergillus spp. We tested three isolates of Aspergillus fumigatus (one resistant to itraconazole), and two each of Aspergillus flavus, Aspergillus niger and Aspergillus terreus. We employed a broth microdilution-based method derived from an in vivo validated method capable of detecting itraconazole resistance in A. fumigatus. We studied the effect on the MICs by calculation of the fractional inhibitory concentration (FIC) and fractional fungicidal concentration (FFC) (99.99% kill). Itraconazole and terbinafine were synergic or additive in all strains (FIC = 0.15-1.0). Fluconazole and terbinafine were synergic with A. fumigatus, A. terreus and A. flavus (FIC = 0.3-0.5) and indifferent with A. niger (FIC = 2) isolates. Amphotericin B and terbinafine were mostly indifferent or antagonistic (FIC = 1.0-4.02). Flucytosine and terbinafine were usually indifferent or antagonistic (FIC = 0.63-8.5). FFCs were generally in accord with FICs. The use of terbinafine in combination therapy for Aspergillus infections with azoles seems promising, whereas terbinafine and amphotericin B or flucytosine in combination were less effective.
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Affiliation(s)
- J Mosquera
- School of Medicine, University of Manchester, Hope Hospital, Salford, Manchester M6 8HD, UK
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46
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Abstract
We susceptibility tested 17 clinical isolates of Aspergillus fumigatus, for most of which MICs of itraconazole were elevated (MIC at which 50% of the isolates tested are inhibited, 16 microg/ml), against itraconazole, posaconazole, ravuconazole, and voriconazole. Posaconazole was the most active against itraconazole-susceptible isolates. A complex pattern of cross-resistance and hypersusceptibility was seen with voriconazole and ravuconazole, suggesting marked differences in activity and mechanisms of resistance.
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Affiliation(s)
- J Mosquera
- School of Medicine, University of Manchester, Manchester M13 9PT, United Kingdom
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47
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Sosa M, Saavedra P, Muñoz-Torres M, Alegre J, Gómez C, González-Macías J, Guañabens N, Hawkins F, Lozano C, Martínez M, Mosquera J, Pérez-Cano R, Quesada M, Salas E. Quantitative ultrasound calcaneus measurements: normative data and precision in the spanish population. Osteoporos Int 2002; 13:487-92. [PMID: 12107663 DOI: 10.1007/s001980200059] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.5] [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: 11/30/2022]
Abstract
Quantitative ultrasound (QUS) assessment at the calcaneus has been found to be a safe and reliable method for evaluating skeletal status. In this study we have determined the normative QUS data in the Spanish population for the Sahara Clinical Sonometer (Hologic). Broadband ultrasound attenuation (BUA), speed of sound (SOS), quantitative ultrasound index (QUI) and estimated bone mineral density (BMD) were determined. We also studied the precision in vivo and in vitro. The short-term in vivo precision (CV) was 4.88% for BUA, 0.36% for SOS, 3.45% for QUI and 4.15% for BMD, while in vitro precision was 0.40% for SOS and 2.67% for BUA. Our results are comparable to reference population data previously published in other countries and may serve as reference normative data for both genders in Spain.
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Affiliation(s)
- M Sosa
- University of Las Palmas de Gran Canaria Health Sciences Center and Department of Clinical Sciences, Hospital University Insular, Bone Metabolic Unit, Canary Islands, Spain.
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48
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Mosquera J, Warn PA, Rodriguez-Tudela JL, Denning DW. Treatment of Absidia corymbifera infection in mice with amphotericin B and itraconazole. J Antimicrob Chemother 2001; 48:583-6. [PMID: 11581243 DOI: 10.1093/jac/48.4.583] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [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] Open
Abstract
The activities of amphotericin B and itraconazole were studied in a temporarily neutropenic murine model of disseminated Absidia corymbifera infection, caused by two different strains. Amphotericin B MICs were 0.25 mg/L for both strains and itraconazole MICs were 1 and 2 mg/L. Amphotericin B was effective in vivo with both isolates. Itraconazole was less effective.
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Affiliation(s)
- J Mosquera
- School of Medicine, Section of Infectious Diseases, University of Manchester, Hope Hospital, Salford, Manchester M6 8HD, UK
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49
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Mosquera J, Warn PA, Morrissey J, Moore CB, Gil-Lamaignere C, Denning DW. Susceptibility testing of Aspergillus flavus: inoculum dependence with itraconazole and lack of correlation between susceptibility to amphotericin B in vitro and outcome in vivo. Antimicrob Agents Chemother 2001; 45:1456-62. [PMID: 11302810 PMCID: PMC90488 DOI: 10.1128/aac.45.5.1456-1462.2001] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2000] [Accepted: 01/30/2001] [Indexed: 11/20/2022] Open
Abstract
We have attempted to validate in Aspergillus flavus the main in vitro methodologies that have been used to detect resistance in Aspergillus fumigatus. We developed a murine model with two A. flavus isolates, one that was apparently resistant in vitro to amphotericin B (AFL5) and another that was resistant to itraconazole (AFL8). No correlation was found for amphotericin B in AFL5, since the in vivo response was compatible with a susceptible isolate. Modification of the in vitro susceptibility test methodology for amphotericin B was unsuccessful. Although AFL8 was apparently resistant to itraconazole in vitro, it was found to be susceptible in vivo. Additional in vitro work has detected weaknesses in the in vitro susceptibility methodology validated for A. fumigatus when applied to A. flavus. The principal problems are that changes in the inoculum have a large effect on the MICs of itraconazole for some A. flavus strains and that a trailing end point and spore sediment often appear when an inoculum with a higher colony count is used. We propose a modified method using a final inoculum of 2.5 x 10(4) CFU per ml of RPMI 1640 medium with 2% glucose buffered to pH 7.0 in a microtiter format, incubated for 48 h with no growth end point. Validation of this methodology requires one or more itraconazole-resistant A. flavus isolates, which have yet to be identified.
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Affiliation(s)
- J Mosquera
- Section of Infectious Diseases, Department of Medicine, Hope Hospital, University of Manchester, United Kingdom
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50
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Abstract
Acute puromycin aminonucleoside nephrosis (PAN) in rats is characterized by heavy proteinuria associated with renal hypercellularity. The role of apoptosis in the resolution of renal hypercellularity was investigated in PAN. To study the participation of apoptosis in PAN, renal tissues were collected from nephrotic and control rats on weeks 1, 2 and 7 after a single puromycin aminonucleoside injection. Apoptosis was evaluated by light and electron microscopy. Apoptotic DNA fragmentation was detected by TUNEL staining. Renal tissues were also evaluated by the presence of leukocyte common antigen (LCA), ED1 (macrophages) and proliferating cell nuclear antigen (PCNA) with corresponding monoclonal antibodies. An increased number of apoptotic (TUNEL+) cells was observed in the glomerulus at week 1. Electron microscopy analysis showed glomerular apoptosis mainly in endothelial cells. In the interstitium and tubules, increased apoptosis was observed at weeks 1 and 2. Increased apoptosis was accompanied with increased LCA+, ED1+ and PCNA+ cells in the interstitium and with increased PCNA+ cells in tubules. There was a high significant correlation between the number of apoptotic cells and the number of interstitial LCA+, ED1+ and PCNA+ cells. Tubular PCNA expression was correlated with tubular apoptosis. We also observed significant correlation between glomerular, interstitial and tubular apoptosis with proteinuria during the nephrosis. Double staining analysis showed that about 13% of interstitial or tubular apoptotic cells were positive for PCNA. All these values returned to normal by week 7. These results indicate that apoptosis is involved in the repairing process of this disease model.
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Affiliation(s)
- L Fernandez
- Instituto de Investigaciones Clínicas Dr Américo Negrette, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
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