1
|
Borralleras C, Castrodeza Sanz J, Arrazola P, Cámara Hijón C, Eiros JM, Castrodeza Sanz J, Arrazola P, Cámara Hijón C, Fernández-Prada M, Gil de Miguel A, Mirada Masip G, Moraga-Llop F, Ocaña Rodríguez D, Puig-Barberà J, Vázquez J, Vergara-Alert J, de Cambra S. Update on Bimervax® immunogenicity amplitude. Insights on humoral response against XBB.1.5 from an extension study (NTC05142553). Rev Esp Quimioter 2023; 36:658-660. [PMID: 37675837 DOI: 10.37201/req/085.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - S de Cambra
- Salomé de Cambra Florensa, HIPRA Human Health, Spain. Phone. +34 972 430 660.
| |
Collapse
|
2
|
Martínez G, Begines B, Pajuelo E, Vázquez J, Rodriguez-Albelo LM, Cofini D, Torres Y, Alcudia A. Versatile Biodegradable Poly(acrylic acid)-Based Hydrogels Infiltrated in Porous Titanium Implants to Improve the Biofunctional Performance. Biomacromolecules 2023; 24:4743-4758. [PMID: 37677155 PMCID: PMC10646965 DOI: 10.1021/acs.biomac.3c00532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/27/2023] [Indexed: 09/09/2023]
Abstract
This research work proposes a synergistic approach to improve implants' performance through the use of porous Ti substrates to reduce the mismatch between Young's modulus of Ti (around 110 GPa) and the cortical bone (20-25 GPa), and the application of a biodegradable, acrylic acid-based polymeric coating to reduce bacterial adhesion and proliferation, and to enhance osseointegration. First, porous commercially pure Ti substrates with different porosities and pore size distributions were fabricated by using space-holder techniques to obtain substrates with improved tribomechanical behavior. On the other hand, a new diacrylate cross-linker containing a reduction-sensitive disulfide bond was synthesized to prepare biodegradable poly(acrylic acid)-based hydrogels with 1, 2, and 4% cross-linker. Finally, after the required characterization, both strategies were implemented, and the combination of 4% cross-linked poly(acrylic acid)-based hydrogel infiltrated in 30 vol % porosity, 100-200 μm average pore size, was revealed as an outstanding choice for enhancing implant performance.
Collapse
Affiliation(s)
- Guillermo Martínez
- Departamento
de Química Orgánica y Farmacéutica, Facultad
de Farmacia, Universidad de Sevilla, Seville 41012, Spain
| | - Belén Begines
- Departamento
de Química Orgánica y Farmacéutica, Facultad
de Farmacia, Universidad de Sevilla, Seville 41012, Spain
| | - Eloisa Pajuelo
- Departamento
de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Sevilla, Seville 41012, Spain
| | - Juan Vázquez
- Departamento
de Química Orgánica, Facultad de Química, Universidad de Sevilla, Seville 41004, Spain
| | - Luisa Marleny Rodriguez-Albelo
- Departamento
de Ingeniería y Ciencia de los Materiales y del Transporte,
Escuela Politécnica Superior, Universidad
de Sevilla, Seville 41011, Spain
| | - Davide Cofini
- Departamento
de Química Orgánica y Farmacéutica, Facultad
de Farmacia, Universidad de Sevilla, Seville 41012, Spain
| | - Yadir Torres
- Departamento
de Ingeniería y Ciencia de los Materiales y del Transporte,
Escuela Politécnica Superior, Universidad
de Sevilla, Seville 41011, Spain
| | - Ana Alcudia
- Departamento
de Química Orgánica y Farmacéutica, Facultad
de Farmacia, Universidad de Sevilla, Seville 41012, Spain
| |
Collapse
|
3
|
Borralleras C, Castrodeza Sanz J, Arrazola P, Cámara Hijón C, Eiros JM, Castrodeza Sanz J, Arrazola P, Cámara Hijón C, Fernández-Prada M, Gil de Miguel A, Mirada Masip G, Moraga-Llop F, Ocaña Rodríguez D, Puig-Barberà J, Vázquez J, Vergara-Alert J, de Cambra S. The PHH-1V HIPRA vaccine: a new tool in the vaccination strategy against COVID-19. Rev Esp Quimioter 2023; 36:507-515. [PMID: 37303137 PMCID: PMC10586735 DOI: 10.37201/req/046.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Vaccination against SARS-CoV-2 is essential to mitigate the personal, social and global impact of the coronavirus disease (COVID-19) as we move from a pandemic to an endemic phase. Vaccines are now required that offer broad, long-lasting immunological protection from infection in addition to protection from severe illness and hospitalisation. Here we present a review of the evidence base for a new COVID-19 vaccine, PHH-1V (Bimervax®; HIPRA HUMAN HEALTH S.L.U), and the results of an expert consensus. METHODS The expert committee consisted of Spanish experts in medicine, family medicine, paediatrics, immunology, microbiology, nursing, and veterinary medicine. Consensus was achieved using a 4-phase process consisting of a face-to-face meeting during which the scientific evidence base was reviewed, an online questionnaire to elicit opinions on the value of PHH-1V, a second face-to-face update meeting to discuss the evolution of the epidemiological situation, vaccine programmes and the scientific evidence for PHH-1V and a final face-to-face meeting at which consensus was achieved. RESULTS The experts agreed that PHH-1V constitutes a valuable novel vaccine for the development of vaccination programmes aimed towards protecting the population from SARS-CoV-2 infection and disease. Consensus was based on evidence of broad-spectrum efficacy against established and emerging SARS-CoV-2 variants, a potent immunological response, and a good safety profile. The physicochemical properties of the PHH-1V formulation facilitate handling and storage appropriate for global uptake. CONCLUSIONS The physicochemical properties, formulation, immunogenicity and low reactogenic profile of PHH-1V confirm the appropriateness of this new COVID-19 vaccine.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - S de Cambra
- Salomé de Cambra Florensa, HIPRA Human Health, Spain. Phone. +34 972 430 660.
| |
Collapse
|
4
|
Martínez G, Vázquez J, Begines B, Alcudia A. Emerging Strategies to Improve the Design and Manufacturing of Biocompatible Therapeutic Materials. Pharmaceutics 2023; 15:1938. [PMID: 37514123 PMCID: PMC10383592 DOI: 10.3390/pharmaceutics15071938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/14/2023] [Indexed: 07/30/2023] Open
Abstract
Currently, the field of medicine is drastically advancing, mainly due to the progress in emerging areas such as nanomedicine, regenerative medicine, and personalized medicine. For example, the development of novel drug delivery systems in the form of nanoparticles is improving the liberation, absorption, distribution, metabolism, and excretion (LADME) properties of the derived formulations, with a consequent enhancement in the treatment efficacy, a reduction in the secondary effects, and an increase in compliance with the dosage guidelines. Additionally, the use of biocompatible scaffolds is translating into the possibility of regenerating biological tissues. Personalized medicine is also benefiting from the advantages offered by additive manufacturing. However, all these areas have in common the need to develop novel materials or composites that fulfill the requirements of each application. Therefore, the aim of this Special Issue was to identify novel materials/composites that have been developed with specific characteristics for the designed biomedical application.
Collapse
Affiliation(s)
- Guillermo Martínez
- Departamento de Química Orgánica y Farmacéutica, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain
| | - Juan Vázquez
- Departamento de Química Orgánica, Facultad de Química, Universidad de Sevilla, 41012 Sevilla, Spain
| | - Belén Begines
- Departamento de Química Orgánica y Farmacéutica, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain
| | - Ana Alcudia
- Departamento de Química Orgánica y Farmacéutica, Facultad de Farmacia, Universidad de Sevilla, 41012 Sevilla, Spain
| |
Collapse
|
5
|
Cerro-Pardo I, Lindholt J, Núñez E, Roldan-Montero R, Ortega-Villanueva L, Vegas-Dominguez C, Gomez-Guerrero C, Michel JB, Blanco-Colio L, Vázquez J, Martín-Ventura J. Combined Immunoglobulin Free Light Chains Are Novel Predictors of Cardiovascular Events in Patients With Abdominal Aortic Aneurysm. J Vasc Surg 2022. [DOI: 10.1016/j.jvs.2022.04.019] [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: 11/28/2022]
|
6
|
Accioni F, Vázquez J, Merinero M, Begines B, Alcudia A. Latest Trends in Surface Modification for Dental Implantology: Innovative Developments and Analytical Applications. Pharmaceutics 2022; 14:pharmaceutics14020455. [PMID: 35214186 PMCID: PMC8876580 DOI: 10.3390/pharmaceutics14020455] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 12/27/2022] Open
Abstract
An increase in the world population and its life expectancy, as well as the ongoing concern about our physical appearance, have elevated the relevance of dental implantology in recent decades. Engineering strategies to improve the survival rate of dental implants have been widely investigated, focusing on implant material composition, geometry (usually guided to reduce stiffness), and interface surrounding tissues. Although efforts to develop different implant surface modifications are being applied in commercial dental prostheses today, the inclusion of surface coatings has gained special interest, as they can be tailored to efficiently enhance osseointegration, as well as to reduce bacterial-related infection, minimizing peri-implantitis appearance and its associated risks. The use of biomaterials to replace teeth has highlighted the need for the development of reliable analytical methods to assess the therapeutic benefits of implants. This literature review considers the state-of-the-art strategies for surface modification or coating and analytical methodologies for increasing the survival rate for teeth restoration.
Collapse
Affiliation(s)
- Francesca Accioni
- Departamento de Química Orgánica y Farmacéutica, Universidad de Sevilla, 41012 Seville, Spain; (F.A.); (M.M.)
| | - Juan Vázquez
- Departamento de Química Orgánica, Universidad de Sevilla, 41012 Seville, Spain;
| | - Manuel Merinero
- Departamento de Química Orgánica y Farmacéutica, Universidad de Sevilla, 41012 Seville, Spain; (F.A.); (M.M.)
- Departamento de Citología e Histología Normal y Patológica, Universidad de Sevilla, 41012 Seville, Spain
| | - Belén Begines
- Departamento de Química Orgánica y Farmacéutica, Universidad de Sevilla, 41012 Seville, Spain; (F.A.); (M.M.)
- Correspondence: (B.B.); (A.A.)
| | - Ana Alcudia
- Departamento de Química Orgánica y Farmacéutica, Universidad de Sevilla, 41012 Seville, Spain; (F.A.); (M.M.)
- Correspondence: (B.B.); (A.A.)
| |
Collapse
|
7
|
Candel FJ, Barreiro P, San-Román J, Sanz-Moreno JC, Carretero MM, Martínez-Peromingo FJ, Barba R, Lastra A, Vázquez J, Prados F, Canora J, Zapatero A. Approach to COVID-19 pandemic management in Madrid. Chronic of a year. Rev Esp Quimioter 2021; 34 Suppl 1:76-80. [PMID: 34598434 PMCID: PMC8683010 DOI: 10.37201/req/s01.22.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
After more than a year of pandemic, the international medical community has changed the perception of fear to one of respect for SARS-COV-2. This has been the consequence of the integral study of all the dimensions of the disease, from viral recombinant capacity to transmissibility, diagnosis, care and prevention. This document summarizes the main strategic lines of study and approach to the pandemic in Madrid.
Collapse
Affiliation(s)
- F J Candel
- Francisco Javier Candel, Public Health Laboratory. Community of Madrid.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Salinas Gómez F, Suárez Escobar NE, Vázquez J. RFID + Wi-Fi system to control the location of biomedical equipment within hospital areas and linked to an intelligent inventory. Health Technol 2019. [DOI: 10.1007/s12553-019-00393-6] [Citation(s) in RCA: 4] [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: 11/29/2022]
|
9
|
Vázquez J, Šindelář V. Phase-transfer extraction for the fast quantification of perchlorate anions in water. RSC Adv 2019; 9:35452-35455. [PMID: 35528105 PMCID: PMC9074507 DOI: 10.1039/c9ra08602a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 10/23/2019] [Indexed: 12/18/2022] Open
Abstract
Supramolecular approaches for the quantitative anion analysis in water remain scarce due to the lack of receptors that effectively bind anions in this medium. Herein, we present a novel, fast and easy, supramolecular approach for a selective and quantitative analysis of perchlorate anions in water, coupling the UV-Vis spectroscopic method and phase-transfer extraction of anions by a water-insoluble anion receptor.
Collapse
Affiliation(s)
- J Vázquez
- Department of Chemistry, RECETOX, Faculty of Science, Masaryk University Kamenice 5 625 00 Brno Czech Republic
| | - V Šindelář
- Department of Chemistry, RECETOX, Faculty of Science, Masaryk University Kamenice 5 625 00 Brno Czech Republic
| |
Collapse
|
10
|
Martinez P, Baldan-Martin M, López J, Martin-Lorenzo M, Santiago-Hernandez A, Agudiez M, Vázquez J, Calvo E, Ruiz-Hurtado G, Vivanco F, Ruilope L, Barderas M, Llamas GA. Molecular Profile Of Cardiovascular Risk In Young Population: A Promising Tool For Early Prevention. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
11
|
Martínez lópez D, Cedo L, Camafeita E, Montero Roldan R, Jorge I, Burillo E, Blanco Vaca F, Blanco Colio L, Egido J, Baptiste Michel J, Vázquez J, Escola Gil J, Martín Ventura J. ApoA-1 is oxidized in abdominal aortic aneurysm and promotes dysfunctional HDLs. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.047] [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: 10/28/2022]
|
12
|
Gonzalez A, Vizoso F, Vázquez J, Ruibal A, Balibrea JL. Clinical Significance of Preoperative Serum Levels of CA 125 and TAG-72 in Ovarian Carcinoma. Int J Biol Markers 2018; 12:112-7. [PMID: 9479593 DOI: 10.1177/172460089701200305] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
In a prospective study we evaluated in 48 patients with primary ovarian carcinoma the prognostic value of the preoperative circulating serum levels of CA 125 and TAG-72. Serum levels of CA 125 were above the cutoff level of 35 U/ml in 68% of patients, TAG-72 levels were higher than 6 U/ml in 50% of patients, while the simultaneous use of the two markers increased the sensitivity to 75%. Pretreatment CA 125 and TAG-72 levels were significantly lower (p < 0.05, for both) in patients with well differentiated tumors than in those with moderate or poor differentiation. Similarly, both marker levels were significantly higher (p < 0.001) in patients with residual disease after cytoreductive surgery than in those with no residual tumor. In addition, the CA 125 levels were also higher in initial stages (I-II) than in more advanced stages (III-IV) (p < 0.05), whereas TAG-72 levels were higher (p < 0.05) in patients with mucinous or endometrioid tumors than in those with serous carcinomas. The results further indicated that high preoperative serum levels of CA 125 and TAG-72 were associated with a shorter overall survival (p < 0.001 and p < 0.01, respectively). Finally, separate Cox multivariate analysis showed that preoperative CA 125 and TAG-72 serum levels were, after stage, the strongest factors to predict overall survival (p < 0.0001, p < 0.05 and p < 0.005, respectively) in patients with ovarian carcinoma.
Collapse
Affiliation(s)
- A Gonzalez
- Department of General Surgery, General Hospital of Segovia, Spain
| | | | | | | | | |
Collapse
|
13
|
Merino AM, Vázquez J, Rodríguez JC, Fernández R, Quintela I, González LO, Sánchez LM, Vizoso F. Pepsinogen C Expression in Tumors of Extragastric Origin. Int J Biol Markers 2018; 15:165-70. [PMID: 10883891 DOI: 10.1177/172460080001500207] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 11/16/2022]
Abstract
We have examined by immunohistochemistry the ability of human carcinomas of various origin to produce pepsinogen C, an aspartyl proteinase mainly involved in the digestion of proteins in the stomach and recently found to be associated with breast carcinomas. Of the 268 tumors analyzed 80 (29.8%) showed positive staining for pepsinogen C. These positive tumors included 12 gastric (38.7% of the 31 examined cases), nine pancreatic (42.8%), two renal (20%), 12 prostatic (40%), three bladder (27.3%), 14 endometrial (29.7%) and 18 ovarian (40%) carcinomas. We also detected 10 melanomas (50%) that were positive for pepsinogen C. By contrast, immunohistochemical staining for the proteinase was not detected in colorectal, cervical, lung and basal cell skin carcinomas. These results demonstrate that pepsinogen C, a proteolytic enzyme of highly restricted expression in human tissues, can also be expressed by a wide variety of human carcinomas. In addition, and similar to pepsinogen C expression in breast carcinomas, the production of this enzyme by different human tumors might be related to putative hormonal alterations associated with the development and progression of these tumors.
Collapse
Affiliation(s)
- A M Merino
- Department of Pathology, Hospital de Cabueñes, Gijón, Spain
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Rodríguez J, Vázquez J, Corte MD, Lamelas M, Bongera M, Corte MG, Alvarez A, Allende M, Gonzalez L, Sánchez M, Vijande M, Garcia Muñiz J, Vizoso F. Clinical Significance of Cathepsin D Concentration in Tumor Cytosol of Primary Breast Cancer. Int J Biol Markers 2018; 20:103-11. [PMID: 16011040 DOI: 10.1177/172460080502000204] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 11/17/2022]
Abstract
Background Cathepsin D is the proteolytic enzyme most frequently implicated as a prognostic factor in primary breast cancer. In the present study we evaluated by means of an immunoradiometric assay the tumor content of this protease in primary breast cancer, its relationship with tumor-related clinical and pathological parameters, and its prognostic significance in a large series of breast cancer patients. Method The study comprised 1033 women with histologically established invasive breast cancer. Cathepsin D was measured in cytosol samples by means of an immunoradiometric assay to determine the total amount of cathepsin D (52 kDa, 48 kDa and 34 kDa). Evaluation of relapse-free survival and cause-specific survival was performed in the group of 1003 patients without evidence of metastasis at the time of initial diagnosis. The median follow-up of the patients who were free of recurrence was 54 months. Results Cathepsin D levels showed a wide range among the studied tumors (n=1033; median (range) 41 (0.9–2504) pmol/mg protein). Statistical analysis showed that the median cathepsin D levels were considerably higher in large tumors (T2–4) than in smaller ones (T1) (p=0.017), as well as in node-positive than in node-negative tumors (p=0.004). Cathepsin D levels were also higher in ductal tumors than in the other histological types (p=0.001), as well as in moderately or poorly differentiated tumors (p<0.001). Likewise, the median value of the protease was significantly higher in ER or PgR-positive tumors than in hormone receptor-negative ones (p=0.011 and p=0.004, respectively), as well as in aneuploid tumors than in diploid tumors (p=0.029). Multivariate analysis demonstrated that elevated cathepsin D levels (>59 pmol/mg protein) were notably associated with a shorter cause-specific survival in the whole group of patients with breast cancer, as well as in the subgroup of node-positive patients (p<0.05). Conclusions This study suggests that elevated intratumoral cathepsin D levels may identify a subset of node-positive breast cancer patients showing a high probability of earlier death.
Collapse
Affiliation(s)
- J Rodríguez
- Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Abstract
Bambusuril macrocycles bind and release sulfide and hydrosulfide anions in water.
Collapse
Affiliation(s)
- J. Vázquez
- Department of Chemistry and RECETOX
- Masaryk University
- 625 00 Brno
- Czech Republic
| | - V. Sindelar
- Department of Chemistry and RECETOX
- Masaryk University
- 625 00 Brno
- Czech Republic
| |
Collapse
|
16
|
Lasalvia-Prisco E, Dau C, Vázquez J, Goldschmidt P, Galmarini F. Geroprotection in cancer prevention. Adv Gerontol 2018; 31:21-24. [PMID: 29860724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Clinical records from individuals followed for 5 years, 2000 to 2005, were reviewed. They were distributed in 3 cohorts of ages ranging from 51 to 60, 61 to 70, and 71 to 80 years, respectively. Each cohort included 2 groups of patients with diabetes type 2, one group treated with Metformin 850 mg/day, and the other one without pharmacological treatment. In all groups, for each individual, the mean variation of glycosylated hemoglobin, ferritin, lymphocyte count, total and subpopulations, was determined in blood using the measurement at the beginning and at the end of the 5-year follow-up. The number of all living individuals and cancer cases were also recorded in all groups at the end of the 5-year period. The results were consistent with the reported significance as biomarkers of aging of: the increase of glycosylated hemoglobin and ferritin, the decrease of the number of total lymphocytes and CD8+T, and the increase of T-Regulators. In this preliminary observation, the protection of Metformin on the variations of aging biomarkers was associated with survival and decline of malignancy incidence.
Collapse
Affiliation(s)
- E Lasalvia-Prisco
- Telemedical Organization-Interdoctors Uruguay, Av. 8 de Octubre 2323, Of. 905, Montevideo, CP 11200, Uruguay;
| | - C Dau
- Telemedical Organization-Interdoctors Uruguay, Av. 8 de Octubre 2323, Of. 905, Montevideo, CP 11200, Uruguay;
| | - J Vázquez
- Telemedical Organization-Interdoctors Uruguay, Av. 8 de Octubre 2323, Of. 905, Montevideo, CP 11200, Uruguay;
| | - P Goldschmidt
- Telemedical Organization-Interdoctors France, 1, Place des Vosges, 75004 Paris, France
| | - F Galmarini
- Telemedical Organization-Interdoctors Argentina, Av. Corrientes 1250, 6 A, C1043AAZ, CABA, Argentina
| |
Collapse
|
17
|
Barreiro G, Bestilleiro A, Trobajo M, Vázquez J. Tratamiento de la Disociación Escafolunar mediante tenodesis y ligamentoplastia con el Extensor Carpi Radialis Brevis por un único abordaje. Rev Iberoam Cir Mano 2017. [DOI: 10.1055/s-0037-1607460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
ResumenPuede decirse que el conocimiento de la etiología, fisiopatología y estados evolutivos de la Disociación Escafolunar (DEL) actualmente es amplio, pero continúa existiendo mucha controversia en cuanto a su tratamiento, siendo ésta una cuestión de la patología carpiana aún no resuelta. En este artículo presentamos una nueva técnica quirúrgica basada en la perfecta reducción de la diástasis y en el mantenimiento del escafoides y semilunar en su posición idónea mediante una tenodesis en el escafoides y una ligamentoplastia entre éste y el semilunar. Con la ventaja de que para ambos fines se emplea el tendón del extensor carpi radialis brevis por una única vía de abordaje y con una técnica sencilla.
Collapse
Affiliation(s)
- G. Barreiro
- Unidad de Cirugía de la Mano Del Hospital HM-modelo. A Coruña, Spain
| | - A. Bestilleiro
- Unidad de Cirugía de la Mano Del Hospital HM-modelo. A Coruña, Spain
- Mutua Gallega, A Coruña, Spain
| | - M. Trobajo
- Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain
| | - J. Vázquez
- Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain
| |
Collapse
|
18
|
Villagrasa Gonzalez P, Prat A, Oliveira M, de la Pena L, Gonzalez X, Cortes Castan J, Rios J, Vázquez J, Martínez Jañez N, Perelló Martorell A, Garau I, Martinez de Dueñas E, Morales S, Melé M, Bermejo De Las Heras B, Ciruelos E. SOLTI-1303 PATRICIA: A phase II study of palbociclib and trastuzumab (with or without letrozole in ER+) in previously trastuzumab-pretreated, postmenopausal patients with HER2-positive metastatic breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
19
|
Morán Penco JM, Vázquez J, Forsheden Ahs E, Sanjuán Rodríguez S, Pairola A, García-Martínez V. [Complete and inverted esophagastric duplicity]. Cir Pediatr 2017; 30:169-171. [PMID: 29043696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
CASE REPORT A 4-month old girl affected by gastric duplication discovered as a palpable abdominal mass displacing the spleen and left kidney. During laparotomy, a yellowish secretion is aspirated and the gastric duplication is excised together with the common muscular Wall of the greater curvature of the stomach. Also excised, a tubular structure starting from the inferior pole of the malformation, and communicating with it, passing superior to the head of the pancreas and the second portion of the duodenum, followed by a posterior course before inserting into the right cruz of the diaphragm. The histology of the tubular formation was compatible with esophagus. CONCLUSION This type of duplication has not been reported in the literature and reinforces the theory that these malformations could be secondary to genetic transcription errors, in the differentiation of the endoderm of the primitive digestive tract and the notochord.
Collapse
Affiliation(s)
- J M Morán Penco
- Cátedra de Cirugía. Universidad de Extremadura. Clideba Quirón Salud. Badajoz
| | - J Vázquez
- Unidad de Cirugía Pediátrica. Hospital Universitario Quirón. Madrid
| | | | - S Sanjuán Rodríguez
- Servicio de Cirugía Pediátrica. Hospital Universitario Materno-Infantil. Badajoz
| | - A Pairola
- Clideba Hospital Quirón Salud. Badajoz
| | | |
Collapse
|
20
|
Vázquez J, Durante A, Hernández F, Moñivas Palomero V, Mingo S, Sayago I, García Pavía P, Alonso-Pulpón L, Segovia Cubero J. Should We Amplify Cardiac Response Criteria in Patients with Cardiac Light-Chain Amyloidosis Treated with Bortezomib? J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
21
|
Lasaga M, Arroyo Y, Avilés L, Otero W, Vázquez J, González M, Rodríguez-Gómez J. A-12Pilot Study: The Clock Test in a Sample of Elderly Puerto Ricans. Arch Clin Neuropsychol 2016. [DOI: 10.1093/arclin/acw043.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
22
|
Abstract
Amines are released from a cucurbituril macrocycle by photoinduced pH jump and modulation of the competitiveness of a fluorescent guest.
Collapse
Affiliation(s)
- J. Vázquez
- CIQSO – Centre for Research in Sustainable Chemistry and Department of Chemistry
- Campus El Carmen
- University of Huelva
- E-21071 Huelva
- Spain
| | - M. A. Romero
- CIQSO – Centre for Research in Sustainable Chemistry and Department of Chemistry
- Campus El Carmen
- University of Huelva
- E-21071 Huelva
- Spain
| | - R. N. Dsouza
- Department of Life Sciences and Chemistry
- Jacobs University Bremen
- 28759 Bremen
- Germany
| | - U. Pischel
- CIQSO – Centre for Research in Sustainable Chemistry and Department of Chemistry
- Campus El Carmen
- University of Huelva
- E-21071 Huelva
- Spain
| |
Collapse
|
23
|
Castellano S, Alcalá M, Vázquez J, Contreras J, Cid MC, Ramos R. FP676CLINICAL, ANALYTICAL AND BIOIMPEDANCE CHARACTERISTICS OF PERMANENTLY OVERHYDRATED PATIENTS. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv182.24] [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: 11/12/2022] Open
|
24
|
López-Pousa A, Martín Broto J, Garrido T, Vázquez J. Giant cell tumour of bone: new treatments in development. Clin Transl Oncol 2015; 17:419-30. [PMID: 25617146 PMCID: PMC4448077 DOI: 10.1007/s12094-014-1268-5] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 12/18/2014] [Indexed: 01/01/2023]
Abstract
Giant cell tumour of bone (GCTB) is a benign osteolytic tumour with three main cellular components: multinucleated osteoclast-like giant cells, mononuclear spindle-like stromal cells (the main neoplastic components) and mononuclear cells of the monocyte/macrophage lineage. The giant cells overexpress a key mediator in osteoclastogenesis: the RANK receptor, which is stimulated in turn by the cytokine RANKL, which is secreted by the stromal cells. The RANK/RANKL interaction is predominantly responsible for the extensive bone resorption by the tumour. Historically, standard treatment was substantial surgical resection, with or without adjuvant therapy, with recurrence rates of 20–56 %. Studies with denosumab, a monoclonal antibody that specifically binds to RANKL, resulted in dramatic treatment responses, which led to its approval by the United States Food and Drugs Administration (US FDA). Recent advances in the understanding of GCTB pathogenesis are essential to develop new treatments for this locally destructive primary bone tumour.
Collapse
Affiliation(s)
- A López-Pousa
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain,
| | | | | | | |
Collapse
|
25
|
|
26
|
Payá Barceló G, Anchuelo Latorre J, García Blanco A, Gómez Enriquez F, Cardenal Carro J, Acuña E, Vázquez J, Prada P. Permanent 125-Iodine implant for patients with intermediate risk prostate cancer. Rep Pract Oncol Radiother 2013. [DOI: 10.1016/j.rpor.2013.03.711] [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] Open
|
27
|
Monge D, Bermejo A, Vázquez J, Fernández R, Lassaletta JM. Design and synthesis of new bis-hydrazones and pyridine bis-hydrazones: application in the asymmetric Diels-Alder reaction. ARKIVOC 2012. [DOI: 10.3998/ark.5550190.0014.205] [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: 11/04/2022] Open
|
28
|
Hernández J, Rojo R, Salem A, Mirzaei F, Gonzalez A, Vázquez J, Montañez O, Lucero F. Influence of different levels of dried citrus pulp on in vitro ruminal fermentation kinetics of total mixed ration in goat rumen inocula. J Anim Feed Sci 2012. [DOI: 10.22358/jafs/66119/2012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
29
|
Carreño A, Pérez J, Vázquez J, Callejón AJ. Desarrollo de un procedimiento constructivo más seguro para invernaderos multitúnel. ACTA ACUST UNITED AC 2012. [DOI: 10.3989/ic.09.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
30
|
De La Torre CA, Hernández F, Sanabria P, Vázquez J, Miguel M, Luis AL, Barrena S, Aguilar R, Ramírez M, Hernández S, Borches D, Lassaletta L, Tovar JA. [Noninvasive positive pressure ventilation in postoperative period of tracheal surgery]. Cir Pediatr 2011; 24:75-78. [PMID: 22097652] [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: 05/31/2023]
Abstract
OBJECTIVES Reconstructive surgery of the airway often means prolonged periods of intubation during the post-operatory period, increasing the needs for drugs and favoring the appearance of infectious complications. We present an original system of ventilatory support with non-invasive positive pressure ventilation (NIPPV) using in patients subjected to reconstructive surgery of the airway. PATIENTS AND METHODS A retrospective study in patients undergoing reconstructive procedures of the airway in the year 2009 was carried out. We exclude those treated endoscopically and those who had vascular rings. The positive pressure mechanism used in the Surgery Critical Care Unit was a design made by the unit based on the circuit devised by Mapleson that provides optimum levels of ventilation without need for connection to a respiratory. We analyze the results, postoperatory intubation time, time dependent on NIPPV and medical treatment received. RESULTS A total of 7 patients (1 Female and 6 Males) with median age of 1.6 (0.1-7.5) years were included. The diagnoses were: 4 subglottic stenosis, 2 had tracheal stenosis and 1 subcarinal stenosis with involvement of both principal bronchioles. The techniques used were: laryngotracheoplasty with costal cartilage graft (4), tracheoplasty with costal cartilage (1) and sliding tracheoplasty (2) with bilateral bronchoplasty in one of them. The mean time of nasotracheal intubation was 3 days, and mean time of NIPPV was 2.3. No patient required reintubation and none had infectious complications. CONCLUSIONS Ventilatory support by VPPNI allows effective extubation in these patients, it being possible to maintain a safe airway. Infectious complications, frequent in prolonged intubations, were not observed in any of the cases.
Collapse
Affiliation(s)
- C A De La Torre
- Departamento de Cirugía Pediátrica, Hospital Universitario La Paz, Madrid.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
|
32
|
De La Torre CA, Miguel M, Vázquez J, Ramírez M, Barrena S, Hernández F, Mariño JM, Lassaletta L, Tovar JA. [Traumatic diaphragmatic hernia: a vital need for an early diagnosis]. Cir Pediatr 2011; 24:3-7. [PMID: 23155642] [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: 06/01/2023]
Abstract
INTRODUCTION Traumatic diaphragmatic hernia (HDT) is exceptional in children. Its diagnosis is usually delayed for appearing in the context of severe polytrauma. The aim is to analyze our series in relation to the severity scores. PATIENTS AND METHODS Five patients with HDT are presented. Age, biomechanics, clinical, ISS (injury severity score), ITP (pediatric trauma index), GCS (Glasgow coma scale), RTS (Revised Trauma Score) and treatment were studied. The probability of survival (Ps) was calculated with the TRISS method, Ps = 1/(1 + eb), b = b0 + bl (RTS) + b2 (ISS) + B3 (age). RESULTS There were two males and three females, mean age was six years old (range = 3-10). Traffic accident was the mechanism of the thoracoabdominal trauma in 80% and one was crushed by garage door. The affected side was right in two cases and left in three. Mean ISS was 41 (range = 32-57), ITP 6 (range = 2-9) and RTS 6.1 (range = 5.1 to 6.9). The main symptom was respiratory. Plain chest radiography was diagnostic in three patients, one by CT scann, and another was a finding at laparotomy. Two had liver herniation, one had tension gastrothorax and two had gastric perforations. All patients underwent surgery through the abdomen. Estimated survival by the TRISS method was respectively 86.6%, 78.2%, 57.2%, 84.7% and 57.1%, while the actual was 100%. One has a severe disability. DISCUSSION To study the biomechanics and semiology is essential in the early diagnosis of TDH in pediatric polytrauma and suspect it is mandatory prior to realize percutaneous chest procedures. The TRISS method has a great importance to assess the adult polytrauma, but specific scores are needed for children.
Collapse
Affiliation(s)
- C A De La Torre
- Departamento de Cirugía Pediátrica, Hospital Universitario La Paz, Madrid.
| | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Ramírez H, Glaria I, de Andrés X, Martínez HA, Hernández MM, Reina R, Iráizoz E, Crespo H, Berriatua E, Vázquez J, Amorena B, de Andrés D. Recombinant small ruminant lentivirus subtype B1 in goats and sheep of imported breeds in Mexico. Vet J 2010; 190:169-72. [PMID: 20932787 DOI: 10.1016/j.tvjl.2010.09.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 08/29/2010] [Accepted: 09/01/2010] [Indexed: 02/05/2023]
Abstract
Nucleotide sequences of small ruminant lentiviruses (SRLVs) were determined in sheep and goats, including progeny of imported animals, on a farm in Mexico. On the basis of gag-pol, pol, env and LTR sequences, SRLVs were assigned to the B1 subgroup, which comprises caprine arthritis-encephalitis virus (CAEV)-like prototype sequences mainly from goats. In comparison with CAEV-like env sequences of American and French origin, two putative recombination events were identified within the V3-V4 and V4-V5 regions of the env gene of a full length SRLV sequence (FESC-752) derived from a goat on the farm.
Collapse
Affiliation(s)
- H Ramírez
- Institute of Agrobiotechnology, CSIC-UPNA-Gobierno de Navarra, Ctra. Mutilva Baja, Navarra, Spain
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Agramunt S, Martinez-Zapata M, Vázquez J, Requena A, Checa M, Espinós J. Non conventional uses of human chorionic gonadotrophin (hCG) for ovulation induction: a systematic review and meta-analysis. Fertil Steril 2010. [DOI: 10.1016/j.fertnstert.2010.07.625] [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]
|
35
|
Alonso F, Vázquez J, Ovejero I, Garcimartín MA, Mateos A, Sánchez E. Belt separation system under slat in fattening pig housing: effect of belt type and extraction frequency. Bioresour Technol 2010; 101:6230-6234. [PMID: 20338748 DOI: 10.1016/j.biortech.2010.02.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Revised: 02/23/2010] [Accepted: 02/26/2010] [Indexed: 05/29/2023]
Abstract
The efficiency of manure separation by a conveyor belt under a partially slatted floor for fattening pigs was determined for two types of belts, a flat belt with an incline of up to 6 degrees transversely and a concave belt with an incline of up to 1 degrees longitudinally. A 31.20% and 23.75% dry matter content of the solid fraction was obtained for the flat and concave belt, respectively. The flat belt was more efficient at 6 degrees than other slope angles. The residence time of the manure on the two belt types influenced the separation efficiency from a live weight of 63.00 kg upwards. The quantity of residue produced with this system was reduced to 25-40% with respect to a pit system under slat. This could mean a remarkable reduction in costs of storage, transport and application of manure.
Collapse
Affiliation(s)
- F Alonso
- GI. Instalaciones Agroganaderas y Medio Ambiente, Universidad Politécnica de Madrid (UPM), Ciudad Universitaria, 28040 Madrid, Spain.
| | | | | | | | | | | |
Collapse
|
36
|
Gariglio P, Gutiérrez J, Cortés E, Vázquez J. The role of retinoid deficiency and estrogens as cofactors in cervical cancer. Arch Med Res 2010; 40:449-65. [PMID: PMID: 19853185 DOI: 10.1016/j.arcmed.2009.08.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2009] [Accepted: 07/09/2009] [Indexed: 12/18/2022]
Abstract
Persistent infection with high-risk human papillomaviruses (HR-HPVs) is involved in cervical cancer (CC), a major cause of cancer mortality worldwide. Infection occurs primarily at the transformation zone (TZ), the most estrogen- and retinoid-sensitive region of the cervix. Development of CC affects a small percentage of HR-HPV-infected women and often takes decades after infection, suggesting that HR-HPV is a necessary but not sufficient cause of CC. Thus, other cofactors are necessary for progression from cervical HR-HPV infection to cancer such as long-term use of hormonal contraceptives, multiparity, smoking, as well as micronutrient depletion and in particular retinoid deficiency, which alters epithelial differentiation, cellular growth and apoptosis of malignant cells. Therefore, early detection of HR-HPV and management of precancerous lesions together with a profound understanding of additional risk factors could be a strategy to avoid this disease. In this review we focus on the synergic effect of estrogens, retinoid deficiency and HR-HPVs in the development of CC. These risk factors may act in concert to induce neoplastic transformation in squamous epithelium of the cervix, setting the stage for secondary genetic or epigenetic events leading to cervical cancer.
Collapse
Affiliation(s)
- Patricio Gariglio
- Departamento de Genética y Biología Molecular, Cinvestav-IPN, México D.F., México.
| | | | | | | |
Collapse
|
37
|
Carrera N, Cerdá JA, Cañizo A, Parente A, Laín A, Fanjul M, Corona C, Molina E, de Tomás E, Vázquez J. [Hypertrophic pyloric stenosis: comparison between transversal and supraumbilical incision]. Cir Pediatr 2010; 23:77-81. [PMID: 21298914] [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: 05/30/2023]
Abstract
BACKGROUND/PURPOSE The treatment of hypertrophic pyloric stenosis is the Fredet-Ramstedt pyloromyotomy. It is controversial what surgical approach to choose. We evaluate our outcome with the right upper quadrant (RUQ) and the supraumbilical (SU) approach. METHODS Between 2003 and 2007, we performed 38 pyloromyotomies through a RUQ incision and 18 through a SU approach. We analyze patient demographics and pre and postoperative data. We group the complications in major (duodenal perforation, inadequate pyloromyotomy, and wound dehiscence) and minor (seroma, hematoma, wound infection and incisional hernia). A nonrandomized comparison was performed between the two groups. RESULTS We find significant differences in morbidity: 22.2% of major complications ocurred in the SU group versus 2.6% in the RUQ group, and 44.4% of minor complications were encountered in the SU group versus 2.6% in the RUQ group (P < 0.005). CONCLUSIONS In our study we found a significantly higher overall complication rate in the SU group (p < 0.005), possibly because of a more difficult delivery of the pylorus through the SU incision and because of a probably increased rate of wound infection associated with the supraumbilical approach in the pediatric population.
Collapse
Affiliation(s)
- N Carrera
- Hospital General Universitario Gregorio Marañón, Madrid.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
del Moral F, Vázquez JA, Ferrero JJ, Willisch P, Ramírez RD, Teijeiro A, López Medina A, Andrade B, Vázquez J, Salvador F, Medal D, Salgado M, Muñoz V. From the limits of the classical model of sensitometric curves to a realistic model based on the percolation theory for GafChromic EBT films. Med Phys 2009; 36:4015-26. [PMID: 19810474 DOI: 10.1118/1.3187226] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Modern radiotherapy uses complex treatments that necessitate more complex quality assurance procedures. As a continuous medium, GafChromic EBT films offer suitable features for such verification. However, its sensitometric curve is not fully understood in terms of classical theoretical models. In fact, measured optical densities and those predicted by the classical models differ significantly. This difference increases systematically with wider dose ranges. Thus, achieving the accuracy required for intensity-modulated radiotherapy (IMRT) by classical methods is not possible, plecluding their use. As a result, experimental parametrizations, such as polynomial fits, are replacing phenomenological expressions in modern investigations. This article focuses on identifying new theoretical ways to describe sensitometric curves and on evaluating the quality of fit for experimental data based on four proposed models. METHODS A whole mathematical formalism starting with a geometrical version of the classical theory is used to develop new expressions for the sensitometric curves. General results from the percolation theory are also used. A flat-bed-scanner-based method was chosen for the film analysis. Different tests were performed, such as consistency of the numeric results for the proposed model and double examination using data from independent researchers. RESULTS Results show that the percolation-theory-based model provides the best theoretical explanation for the sensitometric behavior of GafChromic films. The different sizes of active centers or monomer crystals of the film are the basis of this model, allowing acquisition of information about the internal structure of the films. Values for the mean size of the active centers were obtained in accordance with technical specifications. In this model, the dynamics of the interaction between the active centers of GafChromic film and radiation is also characterized by means of its interaction cross-section value. CONCLUSIONS The percolation model fulfills the accuracy requirements for quality-control procedures when large ranges of doses are used and offers a physical explanation for the film response.
Collapse
Affiliation(s)
- F del Moral
- Department of Medical Physics, Hospital do Meixoeiro, Pontevedra 36200, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Menéndez C, Fariñas M, Parente A, Laín A, Fanjul M, Chimenti P, Carrera N, Huerga A, Corona C, Marsinyach I, Cañizo A, Villar S, Sánchez-Luna M, Vázquez J. [Long-term results of patients with congenital diaphragmatic hernia]. Cir Pediatr 2009; 22:205-209. [PMID: 20405656] [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: 05/29/2023]
Abstract
OBJECTIVE Introduction of advanced therapeutic modalities for diaphragmatic congenital hernia (CDH) has allowed to reach considerable improvements in survival rate. Nevertheless, there are few studies which analyze the clinical evolution of the long-term survivors. The aim of this work is to analyze the outcomes of the patients with CDH in our hospital. METHODS Fifty-five neonates with CDH were treated in our center between 1998 and 2005. We included in the study those patients that were alive at the moment of first hospital discharge (72%; n=40 patients). ECMO therapy was needed in 6 of them during neonatal treatment. A descriptive transverse review of the clinical record as well as a telephonic interview to the parents was performed for the respiratory, cardiological, digestive and neurological conditions, following standard diagnostic studies in every case. The mean age of the children in the moment of the study was 4.2 years (1-9). RESULTS The 8.3% of the children needed domiciliary oxygen therapy during a maximum of 3 months in all the cases. 22% of the cases suffered from respiratory problems, being bronchiolitis and pneumonia the most frequent diagnoses. Only a patient developed asthma. The gastroesophageal reflux is the most frequent long-term condition (47%), but only 8.3% needs surgical treatment. Regarding to cardiological problems, 14% developed pulmonary hypertension, being slight - moderate in all the cases but in one case who was the only deceased of the series. Regarding to neurological problems only 1 patient developed serious alterations (brain paralysis), having suffered a hemorrhage parenquimatosa during the treatment with ECMO. No other patient presents motor, visual nor auditory alterations in the development, last mild alteration in language (4 patients). Differences do not exist with the group of patients that did not need ECMO during the treatment in cardiological and digestive complications, being higher percentage with respiratory problems. CONCLUSION In our sample only 2 patients present serious sequels (5%). Of this preliminary study we can conclude that the comorbility in the CDH is very low having these patient a good development and good quality of life.
Collapse
Affiliation(s)
- C Menéndez
- Servicio Neonatología, Hospital Infantil Gregorio Marañón, Madrid
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Fanjul M, García-Casillas MA, Laín A, Matute JA, Parente A, Corona C, Vázquez J. [Prognostic value of pH and glucose in complicated parapneumonic pleural effusion]. Cir Pediatr 2009; 22:173-176. [PMID: 20405648] [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: 05/29/2023]
Abstract
INTRODUCTION AND AIMS Although the incidence of emphyema is increasing it continues to be a widely debated pathology in relation to its management. We analyzed the last 36 cases treated by our service in the last 2 years. MATERIAL AND METHODS We retrospectively studied the last 36 cases of parapneum6nic pleural effusions that needed some type of treatment at our service from March, 2005 to May, 2007. For this we analyzed: average age, time of evolution before admission to hospital, time of evolution from admission to surgery, location of the pneumonia, echographic characteristics, value of the pH and glucose, the relation between the presence of echoes in the ultrasound scan with the value of the pH and of the glucose, the relation between value of the pH and glucose with the evolution, type of treatment and evolution. We used for the statistical study ANOVA's test and paired t-test and the student's T test. RESULT The average age was 5.4 years (range 9 months-15 years). The average time of evolution prior to admission to the hospital was 5.6 days (range 0.5-20 days) and the average time from admission to surgery was 5.1 days (range 0-65 days). The pneumonia was multilobar in 38.2% of the cases, in low lobes in 52.9% (29.4% in the left lower lobe and 23.5% in the right lower lobe). Ultrasound scan was performed in 97.2% of the patients, being severely septated in 31.4% of the cases, clear liquid 25.7%, moderately septated 22.8% and minimally septated 17.1%. The pH was analyzed in 69.4% of the effusions, the average value being 7.16 (range 6.75-7.45). The glucose was analyzed in 61.1% of the effusions, the average value being 61.1 (range 1-123). Septated effusions in the ultrasound scans were related to the lowest values of pH and glucose (p = 0.0001 in both cases). When we analyzed the relationship between clinical evolution and the pH we observed that a lower value of pH was related to a worse evolution, finding that pH values below 7 are related to a bad evolution (p = 0.001). The same results were found when we analyzed the relationship between the evolution and glucose (p < 0.005). CONCLUSIONS The pH and the glucose in complicated parapneumonic pleural effusion have a pronostic value for evolution, regardless of what treatment was used. We found that pH values below 7 are related to a bad evolution.
Collapse
Affiliation(s)
- M Fanjul
- Servicio de Cirugía Torácica y Vía Aérea, Hospital infantil Gregorio Marañón, Madrid.
| | | | | | | | | | | | | |
Collapse
|
41
|
Laín A, García-Casillas MA, Matute JA, Parente A, Fanjul M, Corona C, Vázquez J. [Analysis of the surgical treatment of complex subglottic stenosis]. Cir Pediatr 2009; 22:197-200. [PMID: 20405654] [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: 05/29/2023]
Abstract
INTRODUCTION The management of complex subglottic stenosis is difficult, existing different surgical techniques for its treatment, depending on type and grade of stenosis, comorbidities and the state of the patient. We studied the management of the complicated patients in our centre analyzing the applied treatment, the type and grade of stenosis, and the results in order to develop a treatment protocol of complex subglottic stenosis. MATERIAL AND METHODS Of a total of 120 patients diagnosed of subglottic stenosis in follow-up in our centre we retrospectively reviewed 15 patients (5 boys, 10 girls; medium age 1.63 years, range 0.05 to 13 years) who had suffered mayor complications and who had required reinterventions (1 to 6). We analyzed the employed techniques in relation to the observed complications and the previous treatment, the results and the decanulation index. All diagnoses were established by fiberbronchoscopy and the initial treatment was realized following the actuation guidelines of Cotton. RESULTS The global decanulation index in this group of patients was 80%. The patients in who initially a anterior cricoid split had been done and who developed a subglottic stenosis grade III were 8. Rescue treatment consisted in anterior laringotracheoplasty in 7 cases managing decanulation in 6 patients (75%). The medium number of reinterventions was 2.5. Patients treated initially with Laser (n=4) developed a subglottic stenosis grade III in two cases and grade IV in the rest. Subglottic stenosis grade IV were corrected by cricotracheal resection and subglottic stenosis grade IV by anterior laringotracheoplasties with a medium reoperation Lumber of 1.25. All patients achieved decanulation (100%). Failed anterior laringotracheoplasties with cartilaginous grafts (n=2) developed grade III subglottic stenosis, one was treated with a double laringotracheoplasty and the other with a cricotracheal resection reaching decanu-lation in both patients (100%). Reintervention number was one to four. Only one cricotracheal resection as initial treatment failed. This patient required 3 reinterventions not being decanulation possible (0%). CONCLUSIONS Patients with complex subglottic stenosis often require more than one reintervention until reaching decanulation. Decanulation index in these patients is satisfactory. The development of a management protocol for these cases is very difficult and treatment should be individualized.
Collapse
Affiliation(s)
- A Laín
- Servicio Cirugía Pedidtrica, Unidad Cirugía Vía Aérea y Cirugía Torácica, Hospital Infantil Gregorio Marañón, Madrid.
| | | | | | | | | | | | | |
Collapse
|
42
|
Parente A, Cañizo A, Huerga A, Laín A, Fanjul M, Carrera N, Corona C, Fariñas M, Menéndez C, Cerdá J, Molina E, Vázquez J. [Is it correct to use neonatal intensive care units as operating rooms?]. Cir Pediatr 2009; 22:61-64. [PMID: 19715126] [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: 05/28/2023]
Abstract
AIM The neonatal intensive care unit (NICU) is used in many centres as operating room in order to avoid the co-morbidities that there produces the movement of critical patients. The motive of this work is to analyze the advantages and disadvantages of this type of surgical interventions. METHODOLOGY Between January, 2004 and December, 2007 405 newborns were operated in the NICU. The most frequent surgical realized interventions were: deferred closing breastbone (172), placement of ECMO (42), ligation of patent ductus arteriosus (45), laparotomies for necrotising enterocolitis (27), repair of congenital diaphragmatic hernia (20), plicate of diaphragms (5) and closing of gastroschisis (4). We realize a retrospective study of a group of 40 patients operated by diaphragmatic hernia and necrotising enterocolitis in the UCIN (group A) and compare them with a group of patients operated in the operating room with the same pathology (group B). We study 22 variables preoperatory, intraoperatory and postoperatory. For the statistical analysis T-student and Chi-square was in use, being considered to be statistically significant p < 0.05. RESULTS The average ages of the patients to the intervention were 11.1 +/- 8 days being the predominant sex the masculine one (60 %). The age gestational and the average weight for the group A was 31.9 +/- 5.7 weeks and 1,735 +/- 123 grams being for the group B of 34 +/- 3.5 weeks and 2,037 +/- 728 grams respectively (p = N.S.). 89.3% of the patients of the group A was with intubation orotracheal before the surgery, being 57.2% for the group B. The needs of high frequency ventilation and vasoactives drugs were higher for the group A (p < 0.01) and the operative time was similar in both groups (81 +/- 34 vs. 98 +/- 33 minutes). We find a difference of corporal temperature pre-post surgery of 0.60 +/- 0.48 degrees C for the group A and 2.18 +/- 0.93 degrees C in the B (p < 0.01). We don't estimate differences as for episodes of infection of wound, intraabdominal infection or need of reintervention. The survival of the patients was discreetly higher for the group operated in the operating room (82.3%) with regard to the group operated in the NICU (60%) without statistically significant differences existed. CONCLUSIONS In our experience the NICU is a suitable place to realize surgical interventions in critical patients. The higher mortality for the group controlled in the UCIN explains for a major instability preoperatory. The maintenance of the corporal temperature avoiding the hypothermia it's one of the decisive factors to diminish the morbi-mortality.
Collapse
Affiliation(s)
- A Parente
- Servicio Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Del Casar JM, González LO, Alvarez E, Junquera S, Marín L, González L, Bongera M, Vázquez J, Vizoso FJ. Comparative analysis and clinical value of the expression of metalloproteases and their inhibitors by intratumor stromal fibroblasts and those at the invasive front of breast carcinomas. Breast Cancer Res Treat 2009; 116:39-52. [PMID: 19241156 DOI: 10.1007/s10549-009-0351-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2008] [Accepted: 02/12/2009] [Indexed: 11/26/2022]
Abstract
An immunohistochemical study was performed using tissue arrays and specific antibodies against MMPs -1, -2, -7, -9, -11, -13, -14, and TIMPs -1, -2 and -3. More than 5,000 determinations on cancer specimens from 124 patients with invasive breast cancer were performed at the center of the tumor and the invasive front. Immunostaining for MMPs/TIMPs by fibroblasts was evaluated. To identify specific groups of tumors with distinct expression profiles, the data obtained from both fibroblast populations were analyzed by unsupervised hierarchical cluster analysis. Intratumor stromal fibroblasts more frequently showed expression of MMP-2, -7, and -14, and TIMP-3, but less frequently of MMP-9 than fibroblasts at the invasive front. Multivariate analysis showed that a high profile of MMPs and TIMPs staining in both fibroblast populations was the most potent predictor factor of distant metastases, whereas a low staining profile in fibroblasts was associated with a low risk of metastases.
Collapse
Affiliation(s)
- J M Del Casar
- Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Laín A, García-Casillas MA, Matute JA, Cañizo A, Parente A, Fanjul M, Carrera N, Vázquez J. [Tracheal stenosis: outcome analysis of the last 14 years]. Cir Pediatr 2008; 21:138-142. [PMID: 18756866] [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: 05/26/2023]
Abstract
UNLABELLED Tracheal stenosis (TS) is an unusual and sometimes lethal condition. It's treatment is basically surgical and different techniques have been proposed. AIM Analyze the outcome of patients with TS diagnosed and treated in our institution realted to the applied surgical technique during the study period. MATERIAL AND METHODS The clinical records of patients with TS (period 1991 to 2006) were reviewed analyzing the following variables: age, gender, associated malformations, intubation time, medium hospital stay and outcome. Patients were divided in 4 groups: conservative and endoscopic management (2 conservative, 1 dilatation, 1 laser), tracheal resection with termino-terminal anastomosis (RTA) (9 patients), tracheoplasties (slide or modified plasties) (20 patients) and anterior tracheoplasty with costal cartilage graft (TAIC) (6 patients). Results are expressed as media +/- standard error, comparative analysis was done using Chi square with continuity correction. Differences were considered statistically significant with a p < 0.05. RESULTS 39 patients were reviewed (23 male, 16 female), medium age was 2.23 years. Associated malformations were: 12 vascular rings, 7 cardiac malformations, 4 Down syndromes, 1 pulmonary agenesia, 2 hemivertebtebrae, 1 renal agenesia and 1 cervicothoracic angiomatosis. Nineteen patients had short segment stenosis, 15 long segment stenosis (more than 1/3 of tracheal length) and 5 patients presented associated bronchial stenosis (most frequently right main bronchus). All TAIC failed: 4 deaths, 1 reestenosis and 1 persistent stenosis. In the tracheoplasty-group there were 2 exitus (1 due to a neurological lesion after a prolonged preoperative cardiorrespiratory arrest, one due to a surgical treatment delay with previous inadequate management). Patients treated with tracheoplasties and RTA had a favourable evolution and are asymptomatic in more than 80% of the cases after a mean follow-up of 59.9 +/- 7.4 months. In the conservative management group 2 patients died and 2 had a uneventful outcome. Global mortality was 20.5% (8 deaths). Differences observed in the mortality percentage between the study groups were statistically significant. (p = 0.0034) (50% in conservative management, 0% in RTA, 10% in tracheoplasties, 66.67% in TAIC). No statistically significant differences were found in the medium intubation time, medium hospital stay and medium follow-up time. CONCLUSIONS The fundamental treatment of the tracheal stenosis is the surgical approach. Patients should be studied with great detail taking into account associated malformations (mostly heart defects and vascular rings) and should be treated by a multidisciplinary group. Short segmental TS should be corrected with RTA, long TS with tracheoplasties (slide), remaining the TAIC technique obsolete.
Collapse
Affiliation(s)
- A Laín
- Unidad de Cirugía Torácica y Vía Aérea, Servicio de Cirugía Pediátrica, Hospital Gregorio Marañón, Madrid.
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Lasalvia-Prisco EM, Garcia-Giralt E, Lasalvia-Galante EM, Vázquez J, Cucchi S, Spera G, Valentine JP. Erythrocytes as autologous-vaccine carriers in advanced prostate cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.14017] [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: 11/20/2022] Open
|
46
|
Garcia-Giralt E, Lasalvia-Prisco EM, Lasalvia-Galante EM, Vázquez J, Cucchi S, Spera G, Valentine JP. Erythrocytes as autologous-vaccine carriers targeted in breast cancer sentinel lymph node. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.14018] [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: 11/20/2022] Open
|
47
|
Fanjul M, García-Casillas MA, Parente A, Cañizo A, Laín A, Matute JA, Vázquez J. [Diode laser application for the treatment of pediatric airway pathologies]. Cir Pediatr 2008; 21:79-83. [PMID: 18624274] [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: 05/26/2023]
Abstract
UNLABELLED Laser application for the treatment of pediatric airway pathologies represents a very attractive option because of the limited inflammatory reaction after photocoagulation. One novel laser used for such pathologies is the diode laser. AIM The purpose of this report is to present our preliminary experience in the use of diode laser in the treatment of pediatric airway lesions. METHODS A retrospective review of 22 patients (11 males and 11 females) who underwent laser procedures from 1999 to 2006 was performed. Nineteen patients were treated at our center while 3 were referred after a laser application from other institution. In all procedures flexible bronchoscopy was used. The mean age was 1.25 years (range 1 month-4.8 years). Lasers were applied for various lesions: laryngomalacia and arytenoid lesions (n = 5), angiomas (n = 3), lymphangiomas (n = 3), sacular cyst and other mucous lesions (n = 3), granulomas, scarring lesions (n = 4) and paralysis of vocal cord in adduction (n = 1). RESULTS None of the patient developed complications related to the endoscopic laser application. The mean number of laser therapy attempts were 1.4 per patient (range 1-3). The patients remained intubated for a mean of 2.8 days (range 4 hours-13 days) after the procedure. The duration of PICU stay after laser therapy was a mean of 4.6 days (range 1-8 days). The best outcomes were seen in sacular cysts (excelent in 3 patients). Also, all 3 patients with granulomas showed a good response to treatment. Multiple laser sessions (1-3; mean 1.4) were required to sucessfully manage the artynenoid lesions. However, the children with vascular lesions demonstrated differents outcomes. Of the 3 patients with subglottic angioma, 2 underwent a subsequent surgical procedure due to the development of subglottic stenosis; and one requiered further systemic steroid therapy. Of the children with lymphangioma, one needed 3 laser sessions and two required surgi- cal resections. Despite laser treatment, 3 of the 4 patients with scarring lesions required surgery. CONCLUSIONS The endoscopic application of diode laser for the management of pediatric airways lesions provides good outcomes in selected patients. Sacular lesions, granulomas and arytenoid lesions are, in our experience, excellents indications. In other anomalies laser is a good adjuvant. The application of laser should be tailored according to the pathology.
Collapse
Affiliation(s)
- M Fanjul
- Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid.
| | | | | | | | | | | | | |
Collapse
|
48
|
Laín A, Parente A, Cañiizo A, Fanjul M, García-Casillas MA, Matute JA, Vázquez J. [Modified "trap-door" thoracotomy for pediatric patients]. Cir Pediatr 2008; 21:111-115. [PMID: 18624282] [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: 05/26/2023]
Abstract
INTRODUCTION Surgical approach of the cervicothoracic junction has been traditionally done by cervicotomy and/or thoracotomy. Nevertheless, this access does not allow a suitable control of vasculonervous structures. Due to this we present our experience with a variation of the "Trap-door" thoracotomy which gives the best access to this area applied to pediatric patients METHODS We present 4 patients of 2.8 +/- 1.9 years of age treated in our hospital by a cervicothoracotomy transmanubrial approach without clavicular luxation. One patient presented a stage IV cervicothoracic neuroblastoma, 1 patient had a cervicothoracic lymphangioma, one a severe cervicothoracic scoliosis and one a total cricoid atresia associated to an oesophageal atresia type IIIc (Vogt). This surgical approach allowed a perfect control of brachiocefalic and nervous structures as well as a correct visualization of all the cervicothoracic intervertebral foramina. Postoperative pain was controlled by epidural catheters, oral analgesic treatment was introduced in the fifth postoperative day. RESULTS Complete resection and surgical treatment was possible in all patients, not being necessary the section of any vascular or nervous structure. There were no intraoperatory or postoperative complications. One patient presented a temporary Homer's syndrome. No tumoral recurrence has been noted after a mean follow-up of 2.3 +/- 3.1 years. CONCLUSION. The modified "Trap-door" approach allows a good control of the brachiocephalic structures and a complete visualization of the upper thorax and posterior mediastinum. Due to its low morbidity this access may be very useful since it allows an important vascular control and an excellent surgical field. Our modification of the "Trap-door" approach avoids clavicular luxation and has the advantage of no sequelaes in the functionality of the escapulo-humeral articulation.
Collapse
Affiliation(s)
- A Laín
- Servicio Cirugía Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid.
| | | | | | | | | | | | | |
Collapse
|
49
|
Cañizo A, Fanjul M, Cerdá J, Menárguez J, Parente A, Laín A, Carrera N, Rodríguez-Arnao MD, Rodríguez-Sánchez A, Polo JR, Vázquez J. [Is immediate prophylactic thyroidectomy indispensable in familiar medullary thyroid carcinoma?]. Cir Pediatr 2008; 21:100-103. [PMID: 18624279] [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: 05/26/2023]
Abstract
PURPOSE To emphasize the importance of genetic studies in family members and early prophylactic thyroidectomy in oncogene mutation carriers in the management of familiar medullary thyroid carcinoma. METHODS A retrospective review of families with familiar medullary thyroid carcinoma treated at our center in the last 7 years was performed. We identified a total of 7 families who has isolated prevalences with thyroid malignancies. Forty members of the 7 families were screened for gene RET mutations. Prophylactic total thyroidectomy was performed in every RET mutation gene carriers. RESULTS In all families the index case were patients with medullary thyroid carcinoma presenting at a mean age of 37.25 years (range 23-42). The RET oncogen mutation was in codon 634 in exon 11 (multiple endocrine neoplasia type 2A) in all these patients. Fourteen gene carriers were identified with a mean age of 20 years (range 7-37), eleven of whom had medullary thyroid carcinoma at the time of surgery. Five of the gene carriers were children, with a mean age of 11 years (range 7-16), four of whom had microcarcinoma and one had metastatic carcinoma at the time of surgery. After surgery no hypoparathyroidism or recurrent nerve paralysis were documented. No pediatric patient has presented with phaeochromocytoma or hypoparathyroidism to date Four of the five children have normal calcitonin levels (< 2 pg/ml) and they are free of disease. The one who presented metastatic carcinoma has recurrent disease and is awaiting surgical treatment. CONCLUSIONS Genetic studies of family members related to patients with familiar medullary thyroid carcinoma and RET mutations is indispensable. The RET mutation in codon 634 exon 11 was found to be the most frequent association. Prophylactic thyroidectomy is the only curative treatment and has minimal complications when performed by expert surgeons. Early thyroidectomy is recommended since distant metastatic spread can occur at early age.
Collapse
Affiliation(s)
- A Cañizo
- Servicio de Cirugía Pediátrica, Hospital infantil Gregorio Marañón, Madrid.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Parente A, Molina E, Cerdá J, Cañizo A, Rodriguez A, Laín A, Fanjul M, Vázquez J. [Neovagina with intestine: 13 cases]. Cir Pediatr 2008; 21:37-42. [PMID: 18444389] [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: 05/26/2023]
Abstract
INTRODUCTION The absence or hipoplasia vaginal can turn out to be isolated, associated with ambiguous genitalia, or as anatomical variant in a syndrome of sewer. The fundamental aim in the creation of a new vagina is: to obtain a good aesthetic result, to fulfil functional criteria (elasticity, sensibility, physiological inclination) and to improve the quality of life of the patients avoiding the use of molds and minimizing the morbidity of the zones donors. In this work let's sense beforehand our experience in the accomplishment of neovaginas with intestine. AIM AND METHODS We analyze the clinical record of 13 patients treated surgically in the last ten years. We differentiate two groups according to the age, the diagnosis and the type of surgery: a) the first group of 8 patients present syndrome of insensibility to the androgens (4), syndrome of Rokitansky (2), extrofia of sewer (1) and mixed gonadal disgenesia (1). This group of patients were controlled in the adolescence by an average of age of 19 years (11-35 years), they fulfilling a neovagina with sigma; b) the second group of 5 patients with sewer (3), extrofia of sewer (1) and congenital suprarrenal hiperplasia (1). This group was controlled prematurely by a middle ages of one year (4 months-3 years). The intestinal segment used as neovagina was sigma (2), ileon (2) and rectum (1), and was performed during the surgical correction of her congenital malformation. RESULTS Two patients have presented intestinal obstruction in the postoperatory immediate one. Four patients have needed removal of a small vaginal prolapse, and three have needed vaginal transitory expansions for introit stenosis. The long-term evolution has been favorable with an excellent aesthetic aspect. Four patients recount sexual fully satisfactory relations. CONCLUSIONS We believe that the neovagina with sigma is at present the best option in patients with absence or hipoplasia vaginal. The advantages are the possibility of precocious and one time correction, a neovagina of dimensions and oiling adapted without need of expansions or molds, an aesthetic excellent aspect, and sexual satisfactory sexual relations.
Collapse
Affiliation(s)
- A Parente
- Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid
| | | | | | | | | | | | | | | |
Collapse
|