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Paglialunga PL, Molins L, Guzmán R, Guirao A, Grando L, Sanchez-Lorente D, Guerrero C, Bello I, Quiroga N, Boada M. Starting a robotic thoracic surgery program: From wedge resection to sleeve lobectomy in six months. Initial conclusions. Cir Esp 2023; 101:833-840. [PMID: 37544607 DOI: 10.1016/j.cireng.2023.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 04/08/2023] [Indexed: 08/08/2023]
Abstract
INTRODUCTION Robot-assisted thoracic surgery (RATS) is a rapidly expanding technique. In our study, we aimed to analyze the results of the process to adopt robotic surgery in our Department of Thoracic Surgery. METHODS This is an intention-to-treat analysis of a series of consecutive patients operated on using the RATS approach in our hospital from January 2021 to March 2022. Data were registered for patient characteristics, type of surgery, operative times, conversion rate, chest tube duration, length of hospital stay and complications. The IBM SPSS® statistical software was used for the statistical analysis. A cumulative sum analysis of the operating time was performed to define the learning curve. RESULTS During the study period, 51 patients underwent robotic surgery, including pulmonary and non-pulmonary interventions. In addition, 15 patients (29.4%) underwent non-pulmonary interventions: one pleural (2%), 2 diaphragmatic (3.9%), and 12 mediastinal (23.5%). Among the mediastinal surgeries, one conversion was necessary (8.3%) for a complex vascular malformation, and 11 were completed by RATS, including 7 (58.3%) thymomas, 3 (25%) pleuro-pericardial cysts, and one (8.3%) neurogenic tumor. Mean operative time was 141 min (104-178), mean chest tube duration was 0.9 days (0-2), and mean length of stay was 1.45 days (1-2). Thirty-six patients underwent lung surgery (70.6%). The complete RATS resections (34; 94.4%) included: 3 wedge resections (11.1%), 2 segmentectomies (3.7%), 28 lobectomies (81.5%), and one sleeve lobectomy (3.7%). Mean surgery time was 194.56 min (141-247), chest tube duration was 3.92 days (1-8), and length of stay was 4.6 days (1-8). Complications occurred in 4 patients (11.1%). No 90-day mortalities were registered. CONCLUSIONS The implementation of RATS was achieved with good clinical results and operative times for all indications. A rapid learning curve was accomplished in short time. Previous VATS experience, patient selection, team training and program continuity are fundamental to successfully develop a RATS program.
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Affiliation(s)
- Pablo Luis Paglialunga
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Laureano Molins
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Rudith Guzmán
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain
| | - Angela Guirao
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Leandro Grando
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain
| | - David Sanchez-Lorente
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain
| | - Carlos Guerrero
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain
| | - Irene Bello
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Nestor Quiroga
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain
| | - Marc Boada
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain
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Guzmán R, Guirao A, Grando L, Boada M, Sanchez D, Quiroga N, Paglialunga P, Molins L. A look ahead to promote the early detection of lung cancer: technical and cost implications of a confirmed diagnosis before surgery. Cir Esp 2023; 101:693-700. [PMID: 37633520 DOI: 10.1016/j.cireng.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/16/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVE To compare the costs and length of hospital stay among patients with a confirmed diagnosis of lung cancer (LC) prior to surgery versus those without confirmation. METHODS This retrospective, single-center study was conducted in patients who underwent a surgical procedure for LC, with or without a pathologically confirmed LC diagnosis prior to surgery, between March 2017 and December 2019. The main outcomes were costs and length of hospital stay (LOS). RESULTS Among the 269 patients who underwent surgery for lung cancer between March 2017 and December 2019, 203 (75.5%) patients underwent surgery due to a histopathological diagnosis, and 66 (24.5%) because of a Multidisciplinary Cancer Committee indication. The unadjusted mean cost was significantly lower in Group II (patients with surgery based on Multidisciplinary Cancer Committee criteria) (Є2,581.80 ± Є1,002.50) than in Group I (patients with histopathological diagnosis) (Є4,244.60 ± Є2,008.80), P < 0.0001. Once adjusted for covariables, there was a mean difference of -Є1,437.20 in the costs of Group II, P < 0.0001. Unadjusted mean hospital stay was significantly longer in Group I (5.6 days) than in Group II (3.5 days). CONCLUSIONS The results suggest that indicating surgical resection of lung cancer based on Multidisciplinary Cancer Committee criteria, rather than performing CT-guided percutaneous lung biopsy, may result in a significant decrease in cost and length of hospital stay.
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Affiliation(s)
- Rudith Guzmán
- Respiratory Institute, Hospital Clínic de Barcelona, Spain.
| | - Angela Guirao
- Respiratory Institute, Hospital Clínic de Barcelona, Spain; University of Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Leandro Grando
- Respiratory Institute, Hospital Clínic de Barcelona, Spain
| | - Marc Boada
- Respiratory Institute, Hospital Clínic de Barcelona, Spain; University of Barcelona, Spain
| | - David Sanchez
- Respiratory Institute, Hospital Clínic de Barcelona, Spain; University of Barcelona, Spain
| | - Nestor Quiroga
- Respiratory Institute, Hospital Clínic de Barcelona, Spain
| | | | - Laureano Molins
- Respiratory Institute, Hospital Clínic de Barcelona, Spain; University of Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Lucena CM, Martin-Deleon R, Boada M, Marrades RM, Sánchez D, Sánchez M, Vollmer I, Martínez D, Fontana A, Reguart N, Molins L, Agustí C. Integral mediastinal staging in patients with NON-SMALL cell lung cancer and risk factors for occult N2 disease. Respir Med 2023; 208:107132. [PMID: 36720323 DOI: 10.1016/j.rmed.2023.107132] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND In patients with non-small cell lung cancer (NSCLC), the presence of abnormal hiliar lymph nodes (clinical N1; cN1), central tumor location and/or tumor size (diameter >3 cm) increases the risk of occult mediastinal metastasis (OMM). This study investigates prospectively the diagnostic value of an integral mediastinal staging (IMS) strategy that combines EndoBronchial Ultrasound-TransBronchial Needle Aspiration (EBUS-TBNA) and Video-Assisted Mediastinoscopy (VAM) in patients with NSCLC at risk of OMM. METHODS Patients with NSCLC and radiologically normal mediastinum assessed non-invasively by positron emission tomography and computed tomography of the chest (PET-CT), and OMM risk factors (cN1, central tumor and/or >3 cm) underwent EBUS-TBNA followed by VAM if the former was negative. Those with negative IMS underwent resection surgery of the tumor. RESULTS EBUS-TBNA identified OMM in 2 out of the 49 patients evaluated (4%) and VAM in 1 of the 47 patients with negative EBUS (2%). Two patients with a negative IMS had OMM at surgery. Overall, the prevalence of OMM was 10%. EBUS-TBNA has a sensitivity of 40%, a negative predictive value (NPV) of 93.6%, and negative likelihood ratio of 0.60 (95%CI:0.30-1.16). The risk of not diagnosing OMM after EBUS was 6% and after IMS was 4.4%. CONCLUSION Integral mediastinal staging in patients with NSCLC and clinical risk factors for OMM, does not seem to provide added diagnostic value to that of EBUS-TBNA, except perhaps in patients with cN1 disease who deserve further research.
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Affiliation(s)
- Carmen M Lucena
- Pulmonary Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | | | - Marc Boada
- Thoracic Surgery Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - Ramon M Marrades
- Pulmonary Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - David Sánchez
- Thoracic Surgery Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - Marcelo Sánchez
- Radiology Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - Ivan Vollmer
- Radiology Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - Daniel Martínez
- Pathology Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - Ainhoa Fontana
- Pulmonary Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - Noemi Reguart
- Medical Oncology Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain
| | - Laureano Molins
- Thoracic Surgery Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain
| | - Carlos Agustí
- Pulmonary Service, Thoracic Oncology Unit, Hospital Clínic, Barcelona, Spain.
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Costa M, Boada M. Letter to the Editor: AMBAR: A Therapeutical Approach for Alzheimer's Disease Patients Regardless of Amyloid Status. J Prev Alzheimers Dis 2023; 10:148-149. [PMID: 36641621 DOI: 10.14283/jpad.2022.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- M Costa
- Montserrat Costa, Ph.D., Grifols Scientific Innovation Office, Carrer Palou, 3, 08150 Parets del Vallès, Barcelona, Spain, Tel: (+34) 935710853; Fax: (+34) 935710855, E-mail:
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Parra C, Boada M, Rojas A, Pallache A, Trenchs V, Luaces C. Patient experience among adolescents in a Spanish paediatric emergency department. J Healthc Qual Res 2022:S2603-6479(22)00100-2. [PMID: 36543622 DOI: 10.1016/j.jhqr.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/03/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Affiliation(s)
- C Parra
- Paediatric Emergency Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain; Influencia del entorno en el bienestar del niño y del adolescente [Influence of the Environment on the Well-being of Children and Adolescents], Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.
| | - M Boada
- Paediatric Emergency Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - A Rojas
- Paediatric Emergency Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - A Pallache
- Paediatric Emergency Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - V Trenchs
- Paediatric Emergency Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain; Influencia del entorno en el bienestar del niño y del adolescente [Influence of the Environment on the Well-being of Children and Adolescents], Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Universitat de Barcelona, Barcelona, Spain
| | - C Luaces
- Paediatric Emergency Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain; Influencia del entorno en el bienestar del niño y del adolescente [Influence of the Environment on the Well-being of Children and Adolescents], Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Universitat de Barcelona, Barcelona, Spain
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Ojosnegros S, Godeau A, Aroca E, Solé M, Parriego M, Boada M, Veiga A, Lesman A, Tchaicheeyan O, Goren S, Seriola A. P-412 3D live-imaging reconstruction of the human embryo implantation ex vivo. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.389] [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: 11/13/2022] Open
Abstract
Abstract
Study question
How do human embryos implant in physiological conditions and develop beyond blastocyst stage?
Summary answer
Human embryos apply forces during invasion of the matrix, the mural trophectoderm undergoes a quick compaction leading to a fast radial expansion of polar side
What is known already
Human embryos can be cultured beyond blastocyst stage using supplements of animal origin, such as fetal bovine serum. However, two main issues limit our understanding of the implantation of the human embryo. First, human embryos do not express fluorescent proteins, severely limiting the access to advanced live-imaging tools. Second, the animal serums may not represent the physiological peri-implantation conditions of the human embryo, thus limiting the reproducibility of the in vitro experiments. Here we combine label-free multiphoton imaging with media formulations including clinical-grade protein supplements from human plasma unlocking the observation of the human embryo in 3D and physiological conditions
Study design, size, duration
We have cultured 150 human embryos from D3 until blastocyst stage and also more than 600 mouse embryos from zygote until blastocyst stage and then transferred them into a 3D implantation platform. All embryos were supplemented with clinical-grade human-derived serum, which is rich in globulins and growth factors, and commercial basal media. The implantation was monitored for 3-to-5 days up until day 11. Traction-force microscopy and molecular imaging was employed to quantify implantation markers.
Participants/materials, setting, methods
Implantation was measured using our novel version of traction-force microscopy, which reveals the force applied by entire embryos during live-imaging experiments. Multiphoton illumination of autofluorescent molecules allows to reconstruct images of live human embryos on 3D at unprecedented resolution. Key molecular markers for the formation of the epiblast rosette (OCT4), extra-embryonic visceral endoderm (GATA4), extra-embryonic ectoderm and trophoblast (CDX2) and primary yolk sac and pre-amniotic cavity were reconstructed in 3D using high resolution confocal imaging.
Main results and the role of chance
The implantation of human embryos was visualized in 3D movies at high resolution, during time-resolved experiments and compared to implantation in mouse embryos. Human embryos undergo a remarkable compaction upon attachment of the polar trophectoderm and thereafter they implant by engaging the matrix through many different points (>8). The post-implantation compaction leads to a strong invasion of the polar trophectoderm, digging large holes in the matrix and expanding radially. Some trophoblast cells escape the embryo colonizing the matrix. Human embryos expressed the correct pattern of molecular markers by day 11 of culture. Actin staining and OCT4 expression revealed the formation of a central rosette defining the pre-amniotic cavity. GATA6 expression defined the visceral endoderm and the formation of a primordial yolk sac. Mouse embryos conversely, compact upon implantation of the mural trophectoderm and are less invasive, typically anchoring to the matrix through 2-to-3 points. Post-implantation culture of mouse embryos starting at zygote was possible until the formation and large expansion of the amniotic cavity, which constituted 2/3 of the whole embryo size, corresponding with the initial steps of gastrulation, longer than any previous protocol Transfer of mouse blastocysts back to receptive mothers resulted in birth of viable litter.
Limitations, reasons for caution
This study has been performed with human embryos ex vivo using bioengineering technology to implant embryos outside the mother uterus. The bio-compatibility of our serum supplements was validated by live birth of transferred embryos in animal models, but would require further evaluation in clinical trials.
Wider implications of the findings
Our work stresses the safety and efficiency of supplementing embryo culture and particularly embryo transfer, with human plasma-derived serums of clinical-grade. The correct expression of main molecular markers indicates that this type of supplementation promotes implantation physiologically, which opens the possibility to employ these serums in the IVF laboratory.
Trial registration number
Not applicable
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Affiliation(s)
- S Ojosnegros
- Institute for BioEngineering of Catalonia IBEC, Bioengineering in Reproductive Health , Barcelona, Spain
| | - A Godeau
- Institute for BioEngineering of Catalonia IBEC, Bioengineering in Reproductive Health , Barcelona, Spain
| | - E Aroca
- Institute for BioEngineering of Catalonia IBEC, Bioengineering in Reproductive Health , Barcelona, Spain
| | - M Solé
- Hospital Universitari Dexeus, Dexeus Mujer , Barcelona, Spain
| | - M Parriego
- Hospital Universitari Dexeus, Dexeus Mujer , Barcelona, Spain
| | - M Boada
- Hospital Universitari Dexeus, Dexeus Mujer , Barcelona, Spain
| | - A Veiga
- Institut d'Investigació Biomèdica de Bellvitge. IDIBELL, Barcelona Stem Cell Bank Regenerative Medicine Programme , Barcelona, Spain
| | - A Lesman
- Tel Aviv University, School of Mechanical Engineering- Faculty of Engineering , Tel Aviv, Israel
| | - O Tchaicheeyan
- Tel Aviv University, School of Mechanical Engineering- Faculty of Engineering , Tel Aviv, Israel
| | - S Goren
- Tel Aviv University, School of Mechanical Engineering- Faculty of Engineering , Tel Aviv, Israel
| | - A Seriola
- Institute for BioEngineering of Catalonia IBEC, Bioengineering in Reproductive Health , Barcelona, Spain
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Boada M, Perez-Poch A, Ballester M, Tresanchez M, Sánchez E, Martínez G, González D, García S, Jordi T, Polyzos N. P-008 Microgravity exposure significantly decreases sperm motility and vitality. Can we consider human reproduction outside the Earth? Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Are fresh human sperm samples affected by different gravitational conditions than on Earth?
Summary answer
Motility and vitality of fresh human sperm samples are significantly decreased under microgravity conditions obtained by parabolic flight.
What is known already
Microgravity effects on the male reproductive system have mainly been studied in the animal model with diverse results and discouraging extrapolation in humans. While an increased motility was reported in bulls, mice models showed a decrease. Although preliminary data from the Micro-11 experiment presented by NASA reported human sperm alterations after microgravity exposure, our first study failed to show any significant effect of microgravity on “frozen” samples, suggesting that human sperm could be safely shipped outside the earth if important aspects related with cryopreservation were solved.
Study design, size, duration
Prospective study carried out in collaboration between the ART centre, a Technical University, and an Aviation Club specializing in parabolic flights.Two parabolic flights were conducted between 2020-2021, each consisting of 20 parabolic maneuvers, which means 160 seconds of microgravity exposure per sample. Fifteen sperm samples obtained from healthy men were included in the study in order to analyse the effects of microgravity and compare the results with those obtained in Earth gravity.
Participants/materials, setting, methods
Fresh sperm samples were checked pre-flight to evaluate vitality, concentration, motility and morphology. Samples were split into two to compare the effects of different gravity exposure: microgravity (flight) and Earth gravity (ground). After the flight, the same analysis were repeated, plus kinematics, DNA fragmentation by sperm chromatin dispersion, apoptosis by magnetic activated cell sorting, and oxidative stress by colorimetric test (Halosperm-Halotech). Computer Aided Semen Analysis (SCA-Scope) was used for cell counting.
Main results and the role of chance
On comparison of the mean values between fresh samples exposed to microgravity and those maintained on Earth gravity, statistical significant differences (p < 0,05) were found in the following parameters: vitality (69,7 ± 9,9 vs 72,4 ± 9,7 %), motile sperm concentration (23,7 ± 15,3 M/ml vs 31,5 ± 25,1 M/ml), grade “a” sperm concentration (8,7 ± 6,5 vs 11,7 ± 9,9 M/ml), percentage of spermatozoa with progressive motility (30 ± 12,9 vs 36 ± 14,3 %), curvilinear motility-VCL (45,7 ± 12,8 vs 47,7 ± 13,3 μm/s). Under the study conditions, non-statistically significant differences were observed in the other kinematic parameters: Lineal Velocity (VSL), Average Path Velocity (VAP), Straightness (STR), Amplitude of Lateral Head displacement (ALH), Linearity (LIN), Wobble (WOB), Beat-Cross Frequency (BCF), total sperm concentration (81,7 ± 112,1 vs 79,7 ± 89,8 M/ml), morphology (11,3 ± 6,3 vs 10,6 ± 5,3%), DNA fragmentation (14,6 ± 9,6 vs 15,7 ± 9,4), apoptosis (2,8 ± 2,8 vs 3,8 ± 4,4) and oxidative stress, since all samples maintained the same stress level in both splits.
Limitations, reasons for caution
Parabolic flight is an accepted ground-based method for obtaining microgravity conditions, but provides a short period of elapsed exposure to microgravity. Therefore, the results obtained need to be confirmed by using other platforms that provide a much longer time of exposure. More cases must be analysed to confirm the results.
Wider implications of the findings
Short exposure to microgravity significantly decreases sperm motility and vitality. Such an effect is likely to be stronger with longer exposure. These findings should be taken into account since this may eventually affect sperm fertilizing capacity and therefore natural conception or ART with fresh/frozen sperm, outside of the Earth.
Trial registration number
NCT03760783
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Affiliation(s)
- M Boada
- Women's Health Dexeus, Department of Obstetrics- Gynecology and Reproduction , Barcelona, Spain
| | - A Perez-Poch
- UPC Universitat Politècnica de Catalunya., Institute of Education Sciences. Department of Computer Science , Barcelona, Spain
| | - M Ballester
- Women's Health Dexeus, Department of Obstetrics- Gynecology and Reproduction , Barcelona, Spain
| | - M Tresanchez
- Women's Health Dexeus, Department of Obstetrics- Gynecology and Reproduction , Barcelona, Spain
| | - E Sánchez
- Microptic SL, Computer Engineering and Biology , Barcelona, Spain
| | - G Martínez
- Microptic SL, Computer Engineering and Biology , Barcelona, Spain
| | - D.V González
- Sabadell Airport, Aviation Club , Sabadell, Spain
| | - S García
- Women's Health Dexeus, Department of Obstetrics- Gynecology and Reproduction , Barcelona, Spain
| | - T Jordi
- UPC Universitat Politècnica de Catalunya., Institute of Education Sciences. Department of Computer Science , Barcelona, Spain
| | - N.P Polyzos
- Women's Health Dexeus, Department of Obstetrics- Gynecology and Reproduction , Barcelona, Spain
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Han B, Molins L, He Y, Viñolas N, Sánchez-Lorente D, Boada M, Guirao A, Díaz T, Martinez D, Ramirez J, Moisés J, Acosta-Plasencia M, Monzo M, Marrades RM, Navarro A. Characterization of the MicroRNA Cargo of Extracellular Vesicles Isolated from a Pulmonary Tumor-Draining Vein Identifies miR-203a-3p as a Relapse Biomarker for Resected Non-Small Cell Lung Cancer. Int J Mol Sci 2022; 23:ijms23137138. [PMID: 35806142 PMCID: PMC9266391 DOI: 10.3390/ijms23137138] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 02/05/2023] Open
Abstract
In resected non-small cell lung cancer (NSCLC), post-surgical recurrence occurs in around 40% of patients, highlighting the necessity to identify relapse biomarkers. An analysis of the extracellular vesicle (EV) cargo from a pulmonary tumor-draining vein (TDV) can grant biomarker identification. We studied the pulmonary TDV EV-miRNAome to identify relapse biomarkers in a two-phase study (screening and validation). In the screening phase, a 17-miRNA relapse signature was identified in 18 selected patients by small RNAseq. The most expressed miRNA from the signature (EV-miR-203a-3p) was chosen for further validation. Pulmonary TDV EV-miR-203a-3p was studied by qRT-PCR in a validation cohort of 70 patients, where it was found to be upregulated in relapsed patients (p = 0.0194) and in patients with cancer spread to nearby lymph nodes (N+ patients) (p = 0.0396). The ROC curve analysis showed that TDV EV-miR-203a-3p was able to predict relapses with a sensitivity of 88% (AUC: 0.67; p = 0.022). Moreover, patients with high TDV EV-miR-203a-3p had a shorter time to relapse than patients with low levels (43.6 vs. 97.6 months; p = 0.00703). The multivariate analysis showed that EV-miR-203a-3p was an independent, predictive and prognostic post-surgical relapse biomarker. In conclusion, pulmonary TDV EV-miR-203a-3p is a promising new relapse biomarker for resected NSCLC patients.
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Affiliation(s)
- Bing Han
- Molecular Oncology and Embryology Laboratory, Department of Surgery and Medical Specializations, Human Anatomy Unit, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), c. Casanova 143, 08036 Barcelona, Spain; (B.H.); (Y.H.); (T.D.); (M.A.-P.); (M.M.)
| | - Laureano Molins
- Department of Thoracic Surgery, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain; (L.M.); (D.S.-L.); (M.B.); (A.G.)
- Thoracic Oncology Unit, Hospital Clinic, 08036 Barcelona, Spain; (N.V.); (D.M.); (J.R.); (R.M.M.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain;
| | - Yangyi He
- Molecular Oncology and Embryology Laboratory, Department of Surgery and Medical Specializations, Human Anatomy Unit, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), c. Casanova 143, 08036 Barcelona, Spain; (B.H.); (Y.H.); (T.D.); (M.A.-P.); (M.M.)
- School of Basic Medical Sciences, Chengdu University, Chengdu 610106, China
| | - Nuria Viñolas
- Thoracic Oncology Unit, Hospital Clinic, 08036 Barcelona, Spain; (N.V.); (D.M.); (J.R.); (R.M.M.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain;
- Department of Medical Oncology, Institut Clínic de Malalties Hemato-Oncològiques (ICMHO), Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - David Sánchez-Lorente
- Department of Thoracic Surgery, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain; (L.M.); (D.S.-L.); (M.B.); (A.G.)
- Thoracic Oncology Unit, Hospital Clinic, 08036 Barcelona, Spain; (N.V.); (D.M.); (J.R.); (R.M.M.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain;
| | - Marc Boada
- Department of Thoracic Surgery, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain; (L.M.); (D.S.-L.); (M.B.); (A.G.)
- Thoracic Oncology Unit, Hospital Clinic, 08036 Barcelona, Spain; (N.V.); (D.M.); (J.R.); (R.M.M.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain;
| | - Angela Guirao
- Department of Thoracic Surgery, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain; (L.M.); (D.S.-L.); (M.B.); (A.G.)
- Thoracic Oncology Unit, Hospital Clinic, 08036 Barcelona, Spain; (N.V.); (D.M.); (J.R.); (R.M.M.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain;
| | - Tania Díaz
- Molecular Oncology and Embryology Laboratory, Department of Surgery and Medical Specializations, Human Anatomy Unit, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), c. Casanova 143, 08036 Barcelona, Spain; (B.H.); (Y.H.); (T.D.); (M.A.-P.); (M.M.)
| | - Daniel Martinez
- Thoracic Oncology Unit, Hospital Clinic, 08036 Barcelona, Spain; (N.V.); (D.M.); (J.R.); (R.M.M.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain;
- Department of Pathology, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - Jose Ramirez
- Thoracic Oncology Unit, Hospital Clinic, 08036 Barcelona, Spain; (N.V.); (D.M.); (J.R.); (R.M.M.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain;
- Department of Pathology, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Jorge Moisés
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Melissa Acosta-Plasencia
- Molecular Oncology and Embryology Laboratory, Department of Surgery and Medical Specializations, Human Anatomy Unit, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), c. Casanova 143, 08036 Barcelona, Spain; (B.H.); (Y.H.); (T.D.); (M.A.-P.); (M.M.)
| | - Mariano Monzo
- Molecular Oncology and Embryology Laboratory, Department of Surgery and Medical Specializations, Human Anatomy Unit, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), c. Casanova 143, 08036 Barcelona, Spain; (B.H.); (Y.H.); (T.D.); (M.A.-P.); (M.M.)
- Thoracic Oncology Unit, Hospital Clinic, 08036 Barcelona, Spain; (N.V.); (D.M.); (J.R.); (R.M.M.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain;
| | - Ramón M. Marrades
- Thoracic Oncology Unit, Hospital Clinic, 08036 Barcelona, Spain; (N.V.); (D.M.); (J.R.); (R.M.M.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Pneumology, Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - Alfons Navarro
- Molecular Oncology and Embryology Laboratory, Department of Surgery and Medical Specializations, Human Anatomy Unit, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), c. Casanova 143, 08036 Barcelona, Spain; (B.H.); (Y.H.); (T.D.); (M.A.-P.); (M.M.)
- Thoracic Oncology Unit, Hospital Clinic, 08036 Barcelona, Spain; (N.V.); (D.M.); (J.R.); (R.M.M.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain;
- Correspondence: ; Tel.: +34-93-4021903
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9
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Lopez I, Aguinagalde B, Urreta I, Royo I, Bolufer S, Sanchez L, Zabaleta J, Fernández-Monge A, Recuero JL, Sesma J, Amor S, Moradiellos FJ, Arrarás MJ, Blanco AI, Boada M, Sanchez D, Cabañero A, Moreno N, Cal I, Moreno R, Cilleruelo Á, Crowley S, Gómez D, Fernández E, Hernando F, García S, López C, García MD, García JM, Rivo JE, Garcia JA, Gelbenzu JJ, Ramírez ME, Giraldo CF, Mongil R, Gómez MT, Jiménez M, Henández J, Fibla JJ, Illana JD, Jauregui A, Jiménez U, Rojo R, Martínez NJ, Martínez E, Trujillo JC, Milla L, Moreno SB, Congregado M, Obiols C, Call S, Quero F, Ramos R, Rodríguez A, Simón CM, Embun R. Results in mediastinal lymph node staging of surgical lung cancer: Data from the prospective cohort of the Spanish Video-Assisted Thoracic Surgery Group. Cir Esp 2022:S2173-5077(22)00157-0. [PMID: 35671974 DOI: 10.1016/j.cireng.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/04/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The objective of this study was to assess the diagnostic performance of combined computerised tomography (CT) and positron emission tomography (PET) in mediastinal staging of surgical lung cancer based on data obtained from the prospective cohort of the Spanish Group for Video-Assisted Thoracic Surgery (GEVATS). METHODS A total of 2782 patients underwent surgery for primary lung carcinoma. We analysed diagnostic success in mediastinal lymph node staging (cN2) using CT and PET. Bivariate and multivariate analyses were performed of the factors involved in this success. The risk of unexpected pN2 disease was analysed for cases in which an invasive testing is recommended: cN1, the tumour centrally located or the tumour diameter >3 cm. RESULTS The overall success of CT together with PET was 82.9% with a positive predictive value of 0.21 and negative predictive value of 0.93. If the tumour was larger than 3 cm and for each unit increase in mediastinal SUVmax, the probability of success was lower with OR 0.59 (0.44-0.79) and 0.71 (0.66-0.75), respectively. In the video-assisted thoracic surgery (VATS) approach, the probability of success was higher with OR 2.04 (1.52-2.73). The risk of unexpected pN2 increased with the risk factors cN1, the tumour centrally located or the tumour diameter >3 cm: from 4.5% (0 factors) to 18.8% (3 factors) but did not differ significantly as a function of whether invasive testing was performed. CONCLUSIONS CT and PET together have a high negative predictive value. The overall success of the staging is lower in the case of tumours >3 cm and high mediastinal SUVmax, and it is higher when VATS is performed. The risk of unexpected pN2 is higher if the disease is cN1, the tumour centrally located or the tumour diameter >3 cm but does not vary significantly as a function of whether patients have undergone invasive testing.
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Affiliation(s)
- Iker Lopez
- Servicio de Cirugía Torácica, Hospital Universitario Donostia, Instituto de Investigación Sanitaria Biodonostia, San Sebastián-Donostia, Spain.
| | - Borja Aguinagalde
- Servicio de Cirugía Torácica, Hospital Universitario Donostia, Instituto de Investigación Sanitaria Biodonostia, San Sebastián-Donostia, Spain
| | - Iratxe Urreta
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Epidemiología Clínica, Servicio Vasco de Salud Osakidetza, Hospital Universitario Donostia, Unidad de Epidemiología Clínica, San Sebastián-Donostia, Spain
| | - Iñigo Royo
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
| | - Sergio Bolufer
- Servicio de Cirugía Torácica, Hospital Universitario General de Alicante, Alicante, Spain
| | - Laura Sanchez
- Servicio de Cirugía Torácica, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Jon Zabaleta
- Servicio de Cirugía Torácica, Hospital Universitario Donostia, Instituto de Investigación Sanitaria Biodonostia, San Sebastián-Donostia, Spain
| | - Arantza Fernández-Monge
- Servicio de Cirugía Torácica, Hospital Universitario Donostia, Instituto de Investigación Sanitaria Biodonostia, San Sebastián-Donostia, Spain
| | - José Luis Recuero
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
| | - Julio Sesma
- Servicio de Cirugía Torácica, Hospital Universitario General de Alicante, Alicante, Spain
| | - Sergio Amor
- Servicio de Cirugía Torácica, Hospital Universitario Quironsalud Madrid, Madrid, Spain
| | | | - Miguel Jesús Arrarás
- Servicio de Cirugía Torácica, Instituto Valenciano de Oncología, Valencia, Spain
| | - Ana Isabel Blanco
- Servicio de Cirugía Torácica, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Marc Boada
- Servicio de Cirugía Torácica, Hospital Clinic de Barcelona, Barcelona, Spain
| | - David Sanchez
- Servicio de Cirugía Torácica, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Alberto Cabañero
- Servicio de Cirugía Torácica, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Nicolás Moreno
- Servicio de Cirugía Torácica, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Isabel Cal
- Servicio de Cirugía Torácica, Hospital Universitario de la Princesa, Madrid, Spain
| | - Ramón Moreno
- Servicio de Cirugía Torácica, Hospital Universitario de la Princesa, Madrid, Spain
| | - Ángel Cilleruelo
- Servicio de Cirugía Torácica, Hospital Universitario Clínico de Valladolid, Valladolid, Spain
| | - Silvana Crowley
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - David Gómez
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Elena Fernández
- Servicio de Cirugía Torácica, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Santiago García
- Servicio de Cirugía Torácica, Hospital Universitario de Badajoz, Badajoz, Spain
| | - Cipriano López
- Servicio de Cirugía Torácica, Hospital Universitario de Badajoz, Badajoz, Spain
| | - María Dolores García
- Servicio de Cirugía Torácica, Hospital Universitario de Albacete, Albacete, Spain
| | - Jose María García
- Servicio de Cirugía Torácica, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - José Eduardo Rivo
- Servicio de Cirugía Torácica, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Jose Alberto Garcia
- Servicio de Cirugía Torácica, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Juan José Gelbenzu
- Servicio de Cirugía Torácica, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - María Elena Ramírez
- Servicio de Cirugía Torácica, Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | - Roberto Mongil
- Servicio de Cirugía Torácica, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - María Teresa Gómez
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain
| | - Marcelo Jiménez
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain
| | - Jorge Henández
- Servicio de Cirugía Torácica, Hospital Universitario Sagrat Cor, Barcelona, Spain
| | - Juan José Fibla
- Servicio de Cirugía Torácica, Hospital Universitario Sagrat Cor, Barcelona, Spain
| | | | - Alberto Jauregui
- Servicio de Cirugía Torácica, Hospital Universitario Vall d́Hebron, Barcelona, Spain
| | - Unai Jiménez
- Servicio de Cirugía Torácica, Hospital Universitario de Cruces, Bilbao, Spain
| | - Rafael Rojo
- Servicio de Cirugía Torácica, Hospital Universitario de Cruces, Bilbao, Spain
| | - Néstor J Martínez
- Servicio de Cirugía Torácica, Hospital Universitario La Ribera, Alcira, Valencia, Spain
| | - Elisabeth Martínez
- Servicio de Cirugía Torácica, Hospital Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Juan Carlos Trujillo
- Servicio de Cirugía Torácica, Hospital Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Lucía Milla
- Servicio de Cirugía Torácica, Hospital Arnau de Vilanova, Lleida, Spain
| | - Sergio B Moreno
- Servicio de Cirugía Torácica, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Miguel Congregado
- Servicio de Cirugía Torácica, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Carme Obiols
- Servicio de Cirugía Torácica, Hospital Universitario MútuaTerrasa, Universidad de Barcelona, Terrasa, Barcelona, Spain
| | - Sergi Call
- Servicio de Cirugía Torácica, Hospital Universitario MútuaTerrasa, Universidad de Barcelona, Terrasa, Barcelona, Spain
| | - Florencio Quero
- Servicio de Cirugía Torácica, Hospital Virgen de las Nieves, Granada, Spain
| | - Ricard Ramos
- Servicio de Cirugía Torácica, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Alberto Rodríguez
- Servicio de Cirugía Torácica, Hospital del Mar, Instituto de Investigación Médica Hospital del Mar, Barcelona, Spain
| | - Carlos María Simón
- Servicio de Cirugía Torácica, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Raul Embun
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
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10
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Sellarés J, Guerrero C, Martínez D, Benegas M, Cuerpo S, Hernández-González F, Libreros A, Guzman R, Guirao Á, Boada M, Sánchez-Lorente D, Albacar N, Grando L, Paglialunga P, García FJ, Faner R, Agusti A, Sibila O, Sanchez M, Molins L, Ramírez J. [Histology Study of Postmortem Lung Biopsies in Patients with Covid-19 Pneumonia]. Arch Bronconeumol 2022; 58:444-447. [PMID: 34629614 PMCID: PMC8487655 DOI: 10.1016/j.arbres.2021.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Jacobo Sellarés
- Servicio de Neumología, Hospital Clínic de Barcelona, Universitat de Barcelona, Universitat de Vic (UVIC), Barcelona, España,IDIBAPS-Hospital Clínic de Barcelona, Barcelona, España,Autor para correspondencia
| | - Carlos Guerrero
- Servicio de Cirugía Torácica, Hospital Clínic de Barcelona, Barcelona, España
| | - Daniel Martínez
- Servicio de Anatomía Patológica, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España,IDIBAPS-Hospital Clínic de Barcelona, Barcelona, España
| | - Mariana Benegas
- Servicio de Radiología, Hospital Clínic de Barcelona, Barcelona, España
| | - Sandra Cuerpo
- Servicio de Neumología, Hospital Clínic de Barcelona, Universitat de Barcelona, Universitat de Vic (UVIC), Barcelona, España
| | - Fernanda Hernández-González
- Servicio de Neumología, Hospital Clínic de Barcelona, Universitat de Barcelona, Universitat de Vic (UVIC), Barcelona, España
| | - Alejandra Libreros
- Servicio de Cirugía Torácica, Hospital Clínic de Barcelona, Barcelona, España
| | - Rudith Guzman
- Servicio de Cirugía Torácica, Hospital Clínic de Barcelona, Barcelona, España
| | - Ángela Guirao
- Servicio de Cirugía Torácica, Hospital Clínic de Barcelona, Barcelona, España
| | - Marc Boada
- Servicio de Cirugía Torácica, Hospital Clínic de Barcelona, Barcelona, España
| | | | - Núria Albacar
- Servicio de Neumología, Hospital Clínic de Barcelona, Universitat de Barcelona, Universitat de Vic (UVIC), Barcelona, España
| | - Leandro Grando
- Servicio de Cirugía Torácica, Hospital Clínic de Barcelona, Barcelona, España
| | - Pablo Paglialunga
- Servicio de Cirugía Torácica, Hospital Clínic de Barcelona, Barcelona, España
| | - Francisco Javier García
- Sección de Donación y Coordinación de Trasplantes, Hospital Clínic de Barcelona, Barcelona, España
| | - Rosa Faner
- IDIBAPS-Hospital Clínic de Barcelona, Barcelona, España
| | - Alvar Agusti
- Servicio de Neumología, Hospital Clínic de Barcelona, Universitat de Barcelona, Universitat de Vic (UVIC), Barcelona, España,IDIBAPS-Hospital Clínic de Barcelona, Barcelona, España
| | - Oriol Sibila
- Servicio de Neumología, Hospital Clínic de Barcelona, Universitat de Barcelona, Universitat de Vic (UVIC), Barcelona, España,IDIBAPS-Hospital Clínic de Barcelona, Barcelona, España
| | - Marcelo Sanchez
- Servicio de Radiología, Hospital Clínic de Barcelona, Barcelona, España
| | - Laureano Molins
- Servicio de Cirugía Torácica, Hospital Clínic de Barcelona, Barcelona, España
| | - José Ramírez
- Servicio de Anatomía Patológica, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
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11
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Gómez de Antonio D, Crowley Carrasco S, Romero Román A, Royuela A, Calle ÁS, Obiols Fornell C, Call Caja S, Embún R, Royo Í, Recuero JL, Cabañero A, Moreno N, Bolufer S, Congregado M, Jimenez MF, Aguinagalde B, Amor-Alonso S, Arrarás MJ, Blanco Orozco AI, Boada M, Cal I, Cilleruelo Ramos Á, Fernández-Martín E, García-Barajas S, García-Jiménez MD, García-Prim JM, Garcia-Salcedo JA, Gelbenzu-Zazpe JJ, Giraldo-Ospina CF, Gómez Hernández MT, Hernández J, Wolf JDI, Jáuregui Abularach A, Jiménez U, López Sanz I, Martínez-Hernández NJ, Martínez-Téllez E, Milla Collado L, Mongil Poce R, Moradiellos-Díez FJ, Moreno-Basalobre R, Moreno Merino SB, Quero-Valenzuela F, Ramírez-Gil ME, Ramos-Izquierdo R, Rivo E, Rodríguez-Fuster A, Rojo-Marcos R, Sanchez-Lorente D, Sánchez Moreno L, Simón C, Trujillo-Reyes JC, López García C, Fibla Alfara JJ, Sesma Romero J, Hernando Trancho F. [Translated article] Surgical Risk Following Anatomic Lung Resection in Thoracic Surgery: A Prediction Model Derived From a Spanish Multicenter Database. Arch Bronconeumol 2022. [DOI: 10.1016/j.arbres.2021.01.039] [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: 11/02/2022]
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12
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Quiroga N, Boada M, Guzman R, Paglialunga P, Grando L, Molins L. Tunnel technique for robotic-assisted left upper lobectomy. Multimed Man Cardiothorac Surg 2022; 2022. [PMID: 35224897 DOI: 10.1510/mmcts.2022.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Robotic-assisted thoracoscopy is a procedure that allows certain improvements over the traditionally used thoracoscopic procedures but still has disadvantages. Its association with dissection techniques such as the tunnel technique allows an approach to lungs with incomplete or fused fissures. We present the case of a 65-year-old female smoker with a 33-mm mass with a 13.7 SUVmax on positron emission tomography-computed tomography scans accompanied by biopsies that confirmed the diagnosis of small-cell lung cancer. After confirming that it was stage N0 and M0, surgical treatment was chosen. We performed a left upper lobectomy and thoracoscopic lymphadenectomy with robotic assistance; due to the presence of incomplete fissures, we used the fissure tunneling technique. This procedure ensured a safe dissection technique with the correct identification of the vascular and bronchial structures and reduced the risk of air leakage.
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Affiliation(s)
- Nestor Quiroga
- Clinical Respiratory Institute - Thoracic Surgery - Hospital Clinic i Provincial Barcelona
| | | | - Rudith Guzman
- Clinical Respiratory Institute - Thoracic Surgery - Hospital Clinic i Provincial Barcelona
| | - Pablo Paglialunga
- Clinical Respiratory Institute - Thoracic Surgery - Hospital Clinic i Provincial Barcelona
| | - Leandro Grando
- Clinical Respiratory Institute - Thoracic Surgery - Hospital Clinic i Provincial Barcelona
| | - Laureano Molins
- Thoracic Surgery Hospital Sagrat Cor Barcelona University Viladomat 288 08029 Barcelona Spain
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13
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Vollmer I, Páez-Carpio A, Sánchez-Lorente D, Boada M, Martínez D, Sánchez M, Sánchez-Izquierdo N, Tormo-Ratera M, Ribera-Perianes J, Vidal-Sicart S, Carrero-Cardenal E, Paredes P. Preoperative localization of lung nodules: a comparative analysis of hookwire and radio-guided procedures. J Thorac Dis 2022; 14:4329-4340. [PMID: 36524098 PMCID: PMC9745529 DOI: 10.21037/jtd-22-552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 10/09/2022] [Indexed: 11/29/2022]
Abstract
Background Histological diagnosis of pulmonary nodules requires surgical resection on many occasions. There are multiple localization strategies each with their own benefits and complications. The objective of this study is to compare preoperative lung nodule localization with hookwire and radiotracer injection (radioguided occult lesion localization, ROLL). To compare results, complications, and volume of the sample resected with both techniques. Methods Patients undergoing resection of pulmonary nodules with video-assisted thoracoscopy and pre-surgical localization with hookwire or ROLL were studied. Eighty-eight pulmonary nodules were resected in 76 patients: 52 with a hook wire and 36 with a radiotracer. The localization rate, the shortest distance between the nodule and the pleura, the intrapulmonary distance of the locator, the complications, the volume of the resection piece, and the histological result were all assessed. In addition, the factors that influence the volume of the surgical piece were analyzed. Results All the nodules were resected with both techniques. The intrapulmonary path of the locator is longer for the ROLL group (23.91 vs. 16.28 mm; P=0.04), with no differences in the distance from the nodule to the pleura. The rate of pneumothorax was significantly higher after the placement of a hook wire (69.2% vs. 24.2%; P<0.0001), while there were no differences in the presence of hemorrhage. The volume of the pieces resected using ROLL was more minor than with hookwire, although not statistically significant (20.19 vs. 34.26 cc; P=0.07). Conclusions Preoperative localization with the ROLL technique is safer than the placement of hookwire. In addition, the ROLL technique shows a tendency to obtain a smaller volume of resected tissue since the marking is not affected by the intrapulmonary route used during marker placement. ROLL technique allows to locate lung nodules with fewer complications than hookwire and probably gets smaller resection samples.
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14
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Ruiz A, Sánchez D, Lafuente A, Ortega G, Buendía M, Papasey J, Jimeno SY, Badia FP, Palacio ME, Abdelnour C, Ramírez-Toraño F, Maestú F, Sáez ME, Tárraga L, Dagnelie PC, Boada M. Evaluation of the Feasibility, Safety and Efficacy of the Use of Intravenous Infusions of Adenosine Triphosphate (ATP) in People Affected by Moderate to Severe Alzheimer's Disease: A Double-Blind Masked Clinical Trial for Dose Finding. J Prev Alzheimers Dis 2022; 9:425-434. [PMID: 35841243 DOI: 10.14283/jpad.2022.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND There are currently no drug therapies modifying the natural history of patients suffering Alzheimer's disease (AD). Most recent clinical trials in the field include only subjects in early stage of the disease, while patients with advanced AD are usually not represented. OBJECTIVES To evaluate the feasibility, safety and efficacy of systemic infusions of adenosine triphosphate (ATP) in patients with moderate to severe AD, and to select the minimum effective dose of infusion. DESIGN A phase IIb, randomized, double-blind, placebo-controlled clinical trial investigates. PARTICIPANTS A total of 20 subjects with moderate or severe AD were included, 16 in the treatment group and 4 in the placebo group (4:1 randomization) at two dosage regimens, 6-hour or 24-hour infusions. RESULTS The proof-of-concept study was successfully conducted, with no significant deviations from the study protocol and no serious adverse events reported. Regarding efficacy, only marginal differences were observed between ATP and placebo arms for H-MRS and MMSE variables. CONCLUSIONS Our study demonstrates that the use of ATP infusion as therapy is feasible and safe. Larger studies are however needed to assess the efficacy of ATP in moderate to severe AD.
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Affiliation(s)
- A Ruiz
- Dr. Agustín Ruiz, Research Center and Memory Clinic, Fundació ACE, Barcelona Alzheimer Treatment and Research Centre, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya (UIC) - Barcelona, Spain, ,
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15
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Muñoz-Guglielmetti D, Sanchez-Lorente D, Reyes R, Martinez D, Lucena C, Boada M, Paredes P, Parera-Roig M, Vollmer I, Mases J, Martin-Deleon R, Castillo S, Benegas M, Muñoz S, Mayoral M, Cases C, Mollà M, Casas F. Pathological response to neoadjuvant therapy with chemotherapy vs chemoradiotherapy in stage III NSCLC-contribution of IASLC recommendations. World J Clin Oncol 2021; 12:1047-1063. [PMID: 34909399 PMCID: PMC8641007 DOI: 10.5306/wjco.v12.i11.1047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/22/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Neoadjuvant treatment (NT) with chemotherapy (Ch) is a standard option for resectable stage III (N2) NSCLC. Several studies have suggested benefits with the addition of radiotherapy (RT) to NT Ch. The International Association for the Study of Lung Cancer (IASLC) published recommendations for the pathological response (PHR) of NSCLC resection specimens after NT.
AIM To contribute to the IASLC recommendations showing our results of PHR to NT Ch vs NT chemoradiotherapy (ChRT).
METHODS We analyzed 67 consecutive patients with resectable stage III NSCLC with positive mediastinal nodes treated with surgery after NT Ch or NT ChRT between 2013 and 2020. After NT, all patients were evaluated for radiological response (RR) according to Response Evaluation Criteria in Solid Tumours criteria and evaluated for surgery by a specialized group of thoracic surgeons. All histological samples were examined by the same two pathologists. PHR was evaluated by the percentage of viable cells in the tumor and the resected lymph nodes.
RESULTS Forty patients underwent NT ChRT and 27 NT Ch. Fifty-six (83.6%) patients underwent surgery (35 ChRT and 21 Ch). The median time from ChRT to surgery was 6 wk (3-19) and 8 wk (3-21) for Ch patients. We observed significant differences in RR, with disease progression in 2.5% and 14.8% of patients with ChRT and Ch, respectively, and partial response in 62.5% ChRT vs 29.6% Ch (P = 0.025). In PHR we observed ≤ 10% viable cells in the tumor in 19 (54.4%) and 2 cases (9.5%), and in the resected lymph nodes (RLN) 30 (85.7%) and 7 (33.3%) in ChRT and Ch, respectively (P = 0.001). Downstaging was greater in the ChRT compared to the Ch group (80% vs 33.3%; P = 0.002). In the univariate analysis, NT ChRT had a significant impact on partial RR [odds ratio (OR) 12.5; 95% confidence interval (CI): 1.21 - 128.61; P = 0.034], a decreased risk of persistence of cancer cells in the tumor and RLN and an 87.5% increased probability for achieving downstaging (OR 8; 95%CI: 2.34-27.32; P = 0.001).
CONCLUSION We found significant benefits in RR and PHR by adding RT to Ch as NT. A longer follow-up is necessary to assess the impact on clinical outcomes.
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Affiliation(s)
| | - David Sanchez-Lorente
- Thoracic Surgery Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Roxana Reyes
- Medical Oncology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Daniel Martinez
- Pathology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Carmen Lucena
- Pneumology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Marc Boada
- Thoracic Surgery Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Pilar Paredes
- Nuclear Medicine Department, Faculty of Medicine of University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona 08036, Cataluña, Spain
| | - Marta Parera-Roig
- Medical Oncology Department, Hospital Comarcal de Vic, Vic 08500, Cataluña, Spain
| | - Ivan Vollmer
- Radiology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Joel Mases
- Radiation Oncology Department, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Roberto Martin-Deleon
- Pneumology Department, Hospital Universitario Reina Sofia, Córdoba 14004, Andalucía, Spain
| | - Sergi Castillo
- Medical Oncology Department, Hospital de Mollet, Mollet 08100, Cataluña, Spain
| | - Mariana Benegas
- Radiology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Silvia Muñoz
- Medical Oncology Department, Hospital General de Granollers, Granollers 08402, Cataluña, Spain
| | - Maria Mayoral
- Nuclear Medicine Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Carla Cases
- Radiation Oncology Department, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Meritxell Mollà
- Radiation Oncology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
| | - Francesc Casas
- Radiation Oncology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
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Ortega G, Espinosa A, Alegret M, Monté-Rubio GC, Sotolongo-Grau O, Sanabria A, Tartari JP, Rodríguez-Gómez O, Marquié M, Vivas A, Gómez-Chiari M, Alarcón-Martín E, Pérez-Cordón A, Roberto N, Hernández I, Rosende-Roca M, Vargas L, Mauleón A, Abdelnour C, Esteban De Antonio E, López-Cuevas R, Alonso-Lana S, Moreno-Grau S, de Rojas I, Orellana A, Montrreal L, Tárraga L, Ruiz A, Boada M, Valero S. Combination of white matter hyperintensities and Aβ burden is related to cognitive composites domain scores in subjective cognitive decline: the FACEHBI cohort. Alzheimers Res Ther 2021; 13:141. [PMID: 34404456 PMCID: PMC8371791 DOI: 10.1186/s13195-021-00877-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/13/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND To explore whether the combination of white matter hyperintensities (WMHs) and amyloid-beta (Aβ) deposition is associated with worse cognitive performance on cognitive composites (CCs) domain scores in individuals with subjective cognitive decline (SCD). METHODS Two hundred participants from the FACEHBI cohort underwent structural magnetic resonance imaging (MRI), 18F-florbetaben positron emission tomography (FBB-PET), and neuropsychological assessment. WMHs were addressed through the Fazekas scale, the Age-Related White Matter Changes (ARWMC) scale, and the FreeSurfer pipeline. Eight CCs domain scores were created using the principal component analysis (PCA). Age, sex, education, and apolipoprotein E (APOE) were used as adjusting variables. RESULTS Adjusted multiple linear regression models showed that FreeSurfer (B - .245; 95% CI - .1.676, - .393, p = .016) and β burden (SUVR) (B - .180; 95% CI - 2.140, - .292; p = .070) were associated with face-name associative memory CCs domain score, although the latest one was not statistically significant after correction for multiple testing (p = .070). There was non-significant interaction of these two factors on this same CCs domain score (p = .54). However, its cumulative effects on face-name associative performance indicated that those individuals with either higher WMH load or higher Aβ burden showed the worst performance on the face-name associative memory CCs domain score. CONCLUSIONS Our results suggest that increased WMH load and increased Aβ are independently associated with poorer episodic memory performance in SCD individuals, indicating a cumulative effect of the combination of these two pathological conditions in promoting lower cognitive performance, an aspect that could help in terms of treatment and prevention.
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Affiliation(s)
- G Ortega
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain.
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain.
| | - A Espinosa
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Alegret
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - G C Monté-Rubio
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - O Sotolongo-Grau
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - A Sanabria
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - J P Tartari
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - O Rodríguez-Gómez
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Marquié
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - A Vivas
- Departament de Diagnòstic Per La Imatge, Clínica Corachan, Barcelona, Spain
| | - M Gómez-Chiari
- Departament de Diagnòstic Per La Imatge, Clínica Corachan, Barcelona, Spain
| | - E Alarcón-Martín
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - A Pérez-Cordón
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - N Roberto
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - I Hernández
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Rosende-Roca
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - L Vargas
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - A Mauleón
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - C Abdelnour
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - E Esteban De Antonio
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - R López-Cuevas
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - S Alonso-Lana
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - S Moreno-Grau
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - I de Rojas
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - A Orellana
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - L Montrreal
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - L Tárraga
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - A Ruiz
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Boada
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - S Valero
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
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Carrasc. Canal B, Pons MC, Parriego M, Boada M, García S, Polyzos NP, Veiga A. P–561 Male and female blastocyst: any difference other than the sex? Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.560] [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: 11/12/2022] Open
Abstract
Abstract
Study question
Is there any imbalance in the sex ratio (SR) and in the aneuploidy rate of male and female human blastocysts from a PGT-A programme?
Summary answer
Although SR in human blastocysts is significantly male-biased, more aneuploidies are observed among male blastocysts, resulting in comparable euploid male and female embryos available.
What is known already
More boys than girls are born worldwide, meaning that the SR at birth is biased towards males. Differences in the SR of children born after ART have been also reported. Factors such as the insemination technique or the day of embryo transfer have been shown to be related to the SR at birth, but whether the SR is shifted during the preimplantation and/or postimplantation development remains unknown. Study design, size, duration: Embryos from patients undergoing 921 PGT-A cycles from September 2017 to February 2020 were included in the study. Data from the chromosomal constitution of 2637 biopsied blastocysts was retrospectively analysed.
Participants/materials, setting, methods
Embryos were cultured in time-lapse incubators with low oxygen tension (5%) (Embryoscope®; Geri®) using single-step medium (Global®, LifeGlobal®; GTL™, Vitrolife). Blastocyst biopsy was performed between D5-D7 followed by immediate vitrification (Cryotop®, Kitazato). Trophectoderm samples were analysed by NGS. Embryos were categorized as euploid, aneuploid or mosaic. Embryos were called as mosaic when the deviation from the normal copy number was ≥30% and <70%.
Main results and the role of chance
Overall biopsies from 2637 blastocysts were analysed, 1320 on day 5 (50.1%), 1169 on day 6 (44.3%) and 148 on day 7 (5.6%). Sex distribution among the embryos analysed was skewed in favor of male sex with 1401 diagnosed as male (53.1%) and 1236 were female (46.9%), [OR (95%CI):1.13(1.05–1.22)]. As a consequence of this biased SR, more male embryos reached the blastocyst stage and were biopsied both on day 5/6 (708/1320, 53.6% on day 5 and 619/1169, 53% on day 6). Embryos biopsied on day 7 were balanced between sexes with 50% being male and 50% being female. Following biopsy and PGT-A, 1086 (41.2%) of the embryos were classified as euploid, 1349 (51.16%) as aneuploid, and 202 (7.7%) as mosaic embryos. More chromosomal anomalies were observed among male blastocysts when compared to the female ones, 738 (52.7%) vs 611 (49.4%). Similarly, mosaicism was more frequents in male as compared with female blastocysts, 123 (8.8%) vs 79 (6.4%). (P = 0.000). As more aneuploidies are observed among male blastocysts, the final number of available euploid blastocysts for embryo transfer was comparable between sexes (540 male/546 female), [OR (95%CI): 0.99 (0.87–1.11)].
Limitations, reasons for caution
This is a retrospective study. Only embryos at the blastocyst stage have been analyzed. Potential confounding factors such as sperm quality or the female age have not been analyzed. No data regarding the SR at birth have been analyzed in these study.
Wider implications of the findings: In our study, more male embryos develop to the blastocyst when compared to female ones. It can be hypothesized that female embryos can be more affected by an early arrest at cleavage stages. SR at birth would be expected to be similar as more aneuploidy is observed in male embryos.
Trial registration number
Not applicable
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Affiliation(s)
- B Carrasc. Canal
- Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproduction, Barcelona, Spain
| | - M C Pons
- Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproduction, Barcelona, Spain
| | - M Parriego
- Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproduction, Barcelona, Spain
| | - M Boada
- Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproduction, Barcelona, Spain
| | - S García
- Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproduction, Barcelona, Spain
| | - N P Polyzos
- Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproduction, Barcelona, Spain
| | - A Veiga
- Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproduction, Barcelona, Spain
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Muñoz Guglielmetti D, Sánchez D, Reyes R, Boada M, Mases J, Mollà M, Casas F. PO-1184 Pathological response after neoadjuvant chemotherapy versus chemoradiotherapy in stage III NSCLC. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07635-0] [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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19
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Vollmer I, Sánchez-Izquierdo N, Martínez D, Sánchez-Lorente D, Casanueva-Eliceiry S, Boada M, Guirao Á, Romero-Zayas I, Vidal-Sicart S, Paredes P. Role of a portable gamma-camera with optical view for margins assessment of pulmonary nodules resected by radioguided surgery. Eur J Nucl Med Mol Imaging 2021; 49:361-370. [PMID: 34185137 DOI: 10.1007/s00259-021-05466-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/16/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Radioguided occult lesion localization (ROLL) of pulmonary nodules is an alternative to hook-wire. Both required of a histological margin assessment. The activity emerging from the radiotracer allows to obtain an intraoperative scintigraphic image of the surgical specimen by a portable gamma-camera (PGC) fitted with an optical view, which provides information about the localization of the nodule in relation to the margins. The aim of this study was to evaluate the intraoperative use of a PGC for margin assessment of pulmonary nodules. METHODS ROLL technique was used in 38 nodules (36 pulmonary, 1 chest wall, and 1 pleural nodules). A PGC intraoperative image of the surgical specimen was obtained in 32. Scintigraphic results were compared to the histological assessment. Other factors, such as nodule size, distance from the pleural surface, or distance covered by the needle, were considered as possible factors for non-centered lesions. RESULTS PGC images showed that the lesion was in contact with the margins in 8/32 cases and centered in 24. In all cases in which the lesion was considered as centered by the PGC, the margins were free of involvement (NPV 100%), although the PPV is low. CONCLUSIONS The use of a PGC for margin assessment after pulmonary nodule resection is feasible and provides a high NPV in our series. In addition, the short intraoperative time required for its use makes the PGC a useful tool for providing supplementary information to histopathologic results. Further studies from different surgical teams are required for an external validation.
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Affiliation(s)
- Ivan Vollmer
- Radiology Department, Hospital Clínic Barcelona, Barcelona, Spain
- Faculty of Medicine, University of Barcelona (UB), Barcelona, Spain
| | | | - Daniel Martínez
- Faculty of Medicine, University of Barcelona (UB), Barcelona, Spain
- Pathology Department, Hospital Clínic Barcelona, Barcelona, Spain
| | - David Sánchez-Lorente
- Faculty of Medicine, University of Barcelona (UB), Barcelona, Spain
- Thoracic Surgery Department, Hospital Clínic Barcelona, Barcelona, Spain
| | | | - Marc Boada
- Thoracic Surgery Department, Hospital Clínic Barcelona, Barcelona, Spain
| | - Ángela Guirao
- Thoracic Surgery Department, Hospital Clínic Barcelona, Barcelona, Spain
| | | | - Sergi Vidal-Sicart
- Nuclear Medicine Department, Hospital Clínic Barcelona, Barcelona, Spain
- Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Villarroel 170, 08036, Barcelona, Spain
| | - Pilar Paredes
- Faculty of Medicine, University of Barcelona (UB), Barcelona, Spain.
- Nuclear Medicine Department, Hospital Clínic Barcelona, Barcelona, Spain.
- Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Villarroel 170, 08036, Barcelona, Spain.
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Han B, Marrades RM, Viñolas N, He Y, Canals J, Díaz T, Molins L, Martinez D, Moisés J, Sánchez D, Boada M, Acosta-Plasencia M, Cros-Font C, Monzo M, Navarro A. Monitoring HOTTIP levels on extracellular vesicles for predicting recurrence in surgical non-small cell lung cancer patients. Transl Oncol 2021; 14:101144. [PMID: 34111710 PMCID: PMC8192731 DOI: 10.1016/j.tranon.2021.101144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/18/2021] [Accepted: 05/29/2021] [Indexed: 12/11/2022] Open
Abstract
EV HOTTIP analysis during post-surgical follow-up allows early recurrence detection. Detection of an increment of EV HOTTIP level in first post-surgical sample predicts recurrence with a sensitivity of 87.5% and specificity of 90.9%. Detection of an increment of EV HOTTIP level in first post-surgical sample predicts worse patient outcome. EV HOTTIP could be considered as a follow-up biomarker for monitoring recurrence in NSCLC.
In resected non-small cell lung cancer (NSCLC), postsurgical recurrence is the major factor affecting long-term survival. The identification of biomarkers in extracellular vesicles (EV) obtained from serial blood samples after surgery could enhance early detection of relapse and improve NSCLC outcome. Since EV cargo contains long non-coding RNAs (lncRNAs), we aimed to analyze whether the oncogenic lncRNA HOTTIP, which higher expression in tumor tissue was related to worse outcome in NSCLC, could be detected in EV from NSCLC patients and serve as recurrence biomarker. After purification of EVs by ultracentrifugation in 52 serial samples from 18 NSCLC patients, RNA was isolated and HOTTIP was quantified by Real time PCR. We observed that patients that relapsed after surgery displayed increased postsurgical EV HOTTIP levels in comparison with presurgical levels. In the relapsed patients with several samples available between surgery and relapse, we observed an increment in the EV HOTTIP levels when approaching to relapse, which indicated its potential utility for monitoring disease recurrence. When we focused in EV HOTTIP levels in the first post-surgical sample, we observed that the detection of an increment of the expression levels in comparison to presurgical sample, predicted recurrence with high sensitivity (85.7%) and specificity (90.9%) and that patients had shorter time to relapse and shorter overall survival. In conclusion, our pilot study showed that EV HOTTIP is a potential biomarker for monitoring disease recurrence after surgery in NSCLC.
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Affiliation(s)
- Bing Han
- Molecular Oncology and Embryology Laboratory, Human Anatomy Unit, Faculty of Medicine and Health Sciences, University of Barcelona, IDIBAPS, Casanova 143, 08036 Barcelona, Spain.
| | - Ramón María Marrades
- Thoracic Oncology Unit, Hospital Clinic, Barcelona; Department of Pneumology, Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, University of Barcelona, IDIBAPS, CIBER Enfermedades Respiratorias (CIBERES), 08036 Barcelona, Spain.
| | - Nuria Viñolas
- Thoracic Oncology Unit, Hospital Clinic, Barcelona; Department of Medical Oncology, Institut Clínic de Malalties Hemato-Oncològiques (ICMHO). Hospital Clínic de Barcelona, University of Barcelona, IDIBAPS, 08036 Barcelona, Spain.
| | - Yangyi He
- Molecular Oncology and Embryology Laboratory, Human Anatomy Unit, Faculty of Medicine and Health Sciences, University of Barcelona, IDIBAPS, Casanova 143, 08036 Barcelona, Spain; School of Basic Medical Sciences, Chengdu University, 610106 Chengdu, China.
| | - Jordi Canals
- Molecular Oncology and Embryology Laboratory, Human Anatomy Unit, Faculty of Medicine and Health Sciences, University of Barcelona, IDIBAPS, Casanova 143, 08036 Barcelona, Spain.
| | - Tania Díaz
- Molecular Oncology and Embryology Laboratory, Human Anatomy Unit, Faculty of Medicine and Health Sciences, University of Barcelona, IDIBAPS, Casanova 143, 08036 Barcelona, Spain.
| | - Laureano Molins
- Thoracic Oncology Unit, Hospital Clinic, Barcelona; Department of Thoracic Surgery, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain.
| | - Daniel Martinez
- Thoracic Oncology Unit, Hospital Clinic, Barcelona; Department of Pathology, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain.
| | - Jorge Moisés
- Department of Pneumology, Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, University of Barcelona, IDIBAPS, CIBER Enfermedades Respiratorias (CIBERES), 08036 Barcelona, Spain.
| | - David Sánchez
- Thoracic Oncology Unit, Hospital Clinic, Barcelona; Department of Thoracic Surgery, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain.
| | - Marc Boada
- Thoracic Oncology Unit, Hospital Clinic, Barcelona; Department of Thoracic Surgery, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain.
| | - Melissa Acosta-Plasencia
- Molecular Oncology and Embryology Laboratory, Human Anatomy Unit, Faculty of Medicine and Health Sciences, University of Barcelona, IDIBAPS, Casanova 143, 08036 Barcelona, Spain.
| | - Coralí Cros-Font
- Molecular Oncology and Embryology Laboratory, Human Anatomy Unit, Faculty of Medicine and Health Sciences, University of Barcelona, IDIBAPS, Casanova 143, 08036 Barcelona, Spain.
| | - Mariano Monzo
- Molecular Oncology and Embryology Laboratory, Human Anatomy Unit, Faculty of Medicine and Health Sciences, University of Barcelona, IDIBAPS, Casanova 143, 08036 Barcelona, Spain; Thoracic Oncology Unit, Hospital Clinic, Barcelona.
| | - Alfons Navarro
- Molecular Oncology and Embryology Laboratory, Human Anatomy Unit, Faculty of Medicine and Health Sciences, University of Barcelona, IDIBAPS, Casanova 143, 08036 Barcelona, Spain; Thoracic Oncology Unit, Hospital Clinic, Barcelona.
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Gorría T, Fernández-Mañas L, Auclin E, Reyes R, Castro RL, De Herreros MG, Cruz C, Viladot M, Ghiglione L, Seguí E, Ramírez J, Teixidó C, Sánchez M, Agustí C, Boada M, Antelo M, Castro P, Prat A, Viñolas N, Reguart N, Mezquita L. P09.28 Access to Intermediate and Intensive Care for Patients With Lung Cancer During the COVID-19 Period. J Thorac Oncol 2021. [PMCID: PMC7976939 DOI: 10.1016/j.jtho.2021.01.456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Gómez de Antonio D, Crowley Carrasco S, Romero Román A, Royuela A, Sánchez Calle Á, Obiols Fornell C, Call Caja S, Embún R, Royo Í, Recuero JL, Cabañero A, Moreno N, Bolufer S, Congregado M, Jimenez MF, Aguinagalde B, Amor-Alonso S, Arrarás MJ, Blanco Orozco AI, Boada M, Cal I, Cilleruelo Ramos Á, Fernández-Martín E, García-Barajas S, García-Jiménez MD, García-Prim JM, Garcia-Salcedo JA, Gelbenzu-Zazpe JJ, Giraldo-Ospina CF, Gómez Hernández MT, Hernández J, Illana Wolf JD, Jáuregui Abularach A, Jiménez U, López Sanz I, Martínez-Hernández NJ, Martínez-Téllez E, Milla Collado L, Mongil Poce R, Moradiellos-Díez FJ, Moreno-Basalobre R, Moreno Merino SB, Quero-Valenzuela F, Ramírez-Gil ME, Ramos-Izquierdo R, Rivo E, Rodríguez-Fuster A, Rojo-Marcos R, Sanchez-Lorente D, Moreno LS, Simón C, Trujillo-Reyes JC, López García C, Fibla Alfara JJ, Sesma Romero J, Hernando Trancho F. Surgical Risk Following Anatomic Lung Resection in Thoracic Surgery: A Prediction Model Derived from a Spanish Multicenter Database. Arch Bronconeumol 2021; 58:398-405. [PMID: 33752924 DOI: 10.1016/j.arbres.2021.01.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 11/02/2022]
Abstract
INTRODUCTION The aim of this study was to develop a surgical risk prediction model in patients undergoing anatomic lung resections from the registry of the Spanish Video-Assisted Thoracic Surgery Group (GEVATS). METHODS Data were collected from 3,533 patients undergoing anatomic lung resection for any diagnosis between December 20, 2016 and March 20, 2018. We defined a combined outcome variable: death or Clavien Dindo grade IV complication at 90 days after surgery. Univariate and multivariate analyses were performed by logistic regression. Internal validation of the model was performed using resampling techniques. RESULTS The incidence of the outcome variable was 4.29% (95% CI 3.6-4.9). The variables remaining in the final logistic model were: age, sex, previous lung cancer resection, dyspnea (mMRC), right pneumonectomy, and ppo DLCO. The performance parameters of the model adjusted by resampling were: C-statistic 0.712 (95% CI 0.648-0.750), Brier score 0.042 and bootstrap shrinkage 0.854. CONCLUSIONS The risk prediction model obtained from the GEVATS database is a simple, valid, and reliable model that is a useful tool for establishing the risk of a patient undergoing anatomic lung resection.
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Affiliation(s)
- David Gómez de Antonio
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda. Madrid, España.
| | - Silvana Crowley Carrasco
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda. Madrid, España
| | - Alejandra Romero Román
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda. Madrid, España
| | - Ana Royuela
- Unidad de Bioestadística, Instituto de Investigación Biomédica Puerta de Hierro (IDIPHISA); CIBERESP. Madrid, España
| | - Álvaro Sánchez Calle
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda. Madrid, España
| | - Carme Obiols Fornell
- Servicio de Cirugía Torácica, Hospital Universitari Mútua Terrassa, Universidad de Barcelona, Terrassa, Barcelona, España
| | - Sergi Call Caja
- Servicio de Cirugía Torácica, Hospital Universitari Mútua Terrassa, Universidad de Barcelona, Terrassa, Barcelona, España
| | - Raúl Embún
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, España
| | - Íñigo Royo
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, España
| | - José Luis Recuero
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, España
| | - Alberto Cabañero
- Servicio de Cirugía Torácica, Hospital Universitario Ramón y Cajal. Madrid, España
| | - Nicolás Moreno
- Servicio de Cirugía Torácica, Hospital Universitario Ramón y Cajal. Madrid, España
| | - Sergio Bolufer
- Servicio de Cirugía Torácica, Hospital General Universitario de Alicante, Alicante, España
| | - Miguel Congregado
- Servicio de Cirugía Torácica, Hospital Universitario Virgen Macarena, Sevilla, España
| | - Marcelo F Jimenez
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Universidad de Salamanca, IBSAL, Salamanca, España
| | - Borja Aguinagalde
- Servicio de Cirugía Torácica, Hospital Universitario de Donostia, San Sebastián-Donostia, España
| | - Sergio Amor-Alonso
- Servicio de Cirugía Torácica, Hospital Universitario Quironsalud Madrid, Madrid, España
| | - Miguel Jesús Arrarás
- Servicio de Cirugía Torácica, Fundación Instituto Valenciano de Oncología, Valencia, España
| | | | - Marc Boada
- Servicio de Cirugía Torácica, Hospital Clinic de Barcelona, Instituto Respiratorio, Universidad de Barcelona, Barcelona, España
| | - Isabel Cal
- Servicio de Cirugía Torácica, Hospital Universitario La Princesa, Madrid, España
| | | | | | | | | | - Jose María García-Prim
- Servicio de Cirugía Torácica, Hospital Universitario Santiago de Compostela , Santiago de Compostela, España
| | | | | | | | - María Teresa Gómez Hernández
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Universidad de Salamanca, IBSAL, Salamanca, España
| | - Jorge Hernández
- Servicio de Cirugía Torácica, Hospital Universitario Sagrat Cor, Barcelona, España
| | | | | | - Unai Jiménez
- Servicio de Cirugía Torácica, Hospital Universitario Cruces, Bilbao, España
| | - Iker López Sanz
- Servicio de Cirugía Torácica, Hospital Universitario de Donostia, San Sebastián-Donostia, España
| | | | - Elisabeth Martínez-Téllez
- Servicio de Cirugía Torácica, Hospital Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España
| | | | - Roberto Mongil Poce
- Servicio de Cirugía Torácica, Hospital Regional Universitario, Málaga, España
| | | | | | | | | | | | - Ricard Ramos-Izquierdo
- Servicio de Cirugía Torácica, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - Eduardo Rivo
- Servicio de Cirugía Torácica, Hospital Universitario Santiago de Compostela , Santiago de Compostela, España
| | - Alberto Rodríguez-Fuster
- Servicio de Cirugía Torácica, Hospital del Mar, IMIM (Instituto de Investigación Médica Hospital del Mar), Barcelona, España
| | - Rafael Rojo-Marcos
- Servicio de Cirugía Torácica, Hospital Universitario Cruces, Bilbao, España
| | - David Sanchez-Lorente
- Servicio de Cirugía Torácica, Hospital Clinic de Barcelona, Instituto Respiratorio, Universidad de Barcelona, Barcelona, España
| | - Laura Sánchez Moreno
- Servicio de Cirugía Torácica, Hospital Universitario Marqués de Valdecilla, Santader, España
| | - Carlos Simón
- Servicio de Cirugía Torácica, Hospital Universitario Gregorio Marañón, Madrid, España
| | - Juan Carlos Trujillo-Reyes
- Servicio de Cirugía Torácica, Hospital Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España
| | | | | | - Julio Sesma Romero
- Servicio de Cirugía Torácica, Hospital General Universitario de Alicante, Alicante, España
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McDougall F, Edgar C, Mertes M, Delmar P, Fontoura P, Abi-Saab D, Lansdall CJ, Boada M, Doody R. Psychometric Properties of the Clinical Dementia Rating - Sum of Boxes and Other Cognitive and Functional Outcomes in a Prodromal Alzheimer's Disease Population. J Prev Alzheimers Dis 2021; 8:151-160. [PMID: 33569561 DOI: 10.14283/jpad.2020.73] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The Clinical Dementia Rating-Sum of Boxes (CDR-SB) has been proposed as a primary outcome for use in prodromal AD trials. However, the psychometric properties of this, and of other commonly used measures, have not been well-established in this patient population. OBJECTIVE To describe the psychometric properties of commonly used efficacy measures in a clinical trial of prodromal AD. SETTING Data were gathered as part of a two-year clinical trial. PARTICIPANTS Patients had biomarker confirmed prodromal AD. MEASUREMENTS Clinical Dementia Rating (CDR), Functional Activities Questionnaire (FAQ), Alzheimer's Disease Assessment Scale - Cognition Subscale 11 and 13 (ADAS-Cog), Mini Mental State Exam (MMSE), and Free and Cued Selective Reminding Test (FCSRT-IR [words]). Assessments were conducted at least every 24 weeks. RESULTS For the CDR-SB, test-retest reliability was good (intra-class correlation coefficient [ICC]=0.83); internal consistency was 0.65 at baseline but above 0.8 at later assessments. Relationships between the CDR-SB and other measures were as expected (higher correlations with more closely related constructs), and the CDR-SB differentiated between patients with different severities of dementia (-2.9 points difference between CDR-Global Score 0.5 and 1, P<.0001). Floor and ceiling effects on the CDR-SB total score were minimal; however, at baseline there were ceiling effects in the personal care domain. Further detail is provided on the psychometric properties of ADAS-Cog, MMSE, FCSRT-IR and FAQ in this population. CONCLUSION The psychometric properties of the CDR-SB are adequate in prodromal AD and continued use is warranted in clinical trials. However, there remains scope for improvement in the assessment of functional constructs and development of novel measures should continue.
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Affiliation(s)
- F McDougall
- Fiona McDougall, Genentech 620 E Grand Ave, South San Francisco, CA 94080, USA,
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Embun R, Royo-Crespo I, Recuero Díaz JL, Bolufer S, Call S, Congregado M, Gómez-de Antonio D, Jimenez MF, Moreno-Mata N, Aguinagalde B, Amor-Alonso S, Arrarás MJ, Blanco Orozco AI, Boada M, Cabañero Sánchez A, Cal Vázquez I, Cilleruelo Ramos Á, Crowley Carrasco S, Fernández-Martín E, García-Barajas S, García-Jiménez MD, García-Prim JM, Garcia-Salcedo JA, Gelbenzu-Zazpe JJ, Giraldo-Ospina CF, Gómez Hernández MT, Hernández J, Wolf JDI, Jauregui Abularach A, Jiménez U, López Sanz I, Martínez-Hernández NJ, Martínez-Téllez E, Milla Collado L, Mongil Poce R, Moradiellos-Díez FJ, Moreno-Balsalobre R, Moreno Merino SB, Obiols C, Quero-Valenzuela F, Ramírez-Gil ME, Ramos-Izquierdo R, Rivo E, Rodríguez-Fuster A, Rojo-Marcos R, Sanchez-Lorente D, Sanchez Moreno L, Simón C, Trujillo-Reyes JC, Hernando Trancho F. Spanish Video-Assisted Thoracic Surgery Group: Method, Auditing, and Initial Results From a National Prospective Cohort of Patients Receiving Anatomical Lung Resections. Arch Bronconeumol 2020; 56:718-724. [PMID: 35579917 DOI: 10.1016/j.arbr.2020.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/05/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Our study sought to know the current implementation of video-assisted thoracoscopic surgery (VATS) for anatomical lung resections in Spain. We present our initial results and describe the auditing systems developed by the Spanish VATS Group (GEVATS). METHODS We conducted a prospective multicentre cohort study that included patients receiving anatomical lung resections between 12/20/2016 and 03/20/2018. The main quality controls consisted of determining the recruitment rate of each centre and the accuracy of the perioperative data collected based on six key variables. The implications of a low recruitment rate were analysed for "90-day mortality" and "Grade IIIb-V complications". RESULTS The series was composed of 3533 cases (1917 VATS; 54.3%) across 33 departments. The centres' median recruitment rate was 99% (25-75th:76-100%), with an overall recruitment rate of 83% and a data accuracy of 98%. We were unable to demonstrate a significant association between the recruitment rate and the risk of morbidity/mortality, but a trend was found in the unadjusted analysis for those centres with recruitment rates lower than 80% (centres with 95-100% rates as reference): grade IIIb-V OR=0.61 (p=0.081), 90-day mortality OR=0.46 (p=0.051). CONCLUSIONS More than half of the anatomical lung resections in Spain are performed via VATS. According to our results, the centre's recruitment rate and its potential implications due to selection bias, should deserve further attention by the main voluntary multicentre studies of our speciality. The high representativeness as well as the reliability of the GEVATS data constitute a fundamental point of departure for this nationwide cohort.
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Affiliation(s)
- Raul Embun
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain.
| | - Iñigo Royo-Crespo
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
| | - José Luis Recuero Díaz
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
| | - Sergio Bolufer
- Servicio de Cirugía Torácica, Hospital General Universitario de Alicante, Alicante, Spain
| | - Sergi Call
- Servicio de Cirugía Torácica, Hospital Universitari Mútua Terrasa, Universidad de Barcelona, Terrasa, Barcelona, Spain
| | - Miguel Congregado
- Servicio de Cirugía Torácica, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - David Gómez-de Antonio
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Marcelo F Jimenez
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Universidad de Salamanca, IBSAL, Salamanca, Spain
| | - Nicolas Moreno-Mata
- Servicio de Cirugía Torácica, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Borja Aguinagalde
- Servicio de Cirugía Torácica, Hospital Universitario de Donostia, San Sebastián-Donostia, Spain
| | - Sergio Amor-Alonso
- Servicio de Cirugía Torácica, Hospital Universitario Quironsalud Madrid, Madrid, Spain
| | - Miguel Jesús Arrarás
- Servicio de Cirugía Torácica, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | | | - Marc Boada
- Servicio de Cirugía Torácica, Hospital Clinic de Barcelona, Instituto Respiratorio, Universidad de Barcelona, Barcelona, Spain
| | | | - Isabel Cal Vázquez
- Servicio de Cirugía Torácica, Hospital Universitario La Princesa, Madrid, Spain
| | | | - Silvana Crowley Carrasco
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | | | | | | | - Jose María García-Prim
- Servicio de Cirugía Torácica, Hospital Universitario Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | - María Teresa Gómez Hernández
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Universidad de Salamanca, IBSAL, Salamanca, Spain
| | - Jorge Hernández
- Servicio de Cirugía Torácica, Hospital Universitario Sagrat Cor, Barcelona, Spain
| | | | | | - Unai Jiménez
- Servicio de Cirugía Torácica, Hospital Universitario Cruces, Bilbao, Spain
| | - Iker López Sanz
- Servicio de Cirugía Torácica, Hospital Universitario de Donostia, San Sebastián-Donostia, Spain
| | | | - Elisabeth Martínez-Téllez
- Servicio de Cirugía Torácica, Hospital Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain
| | | | - Roberto Mongil Poce
- Servicio de Cirugía Torácica, Hospital Regional Universitario, Málaga, Spain
| | | | | | | | - Carme Obiols
- Servicio de Cirugía Torácica, Hospital Universitari Mútua Terrasa, Universidad de Barcelona, Terrasa, Barcelona, Spain
| | | | | | - Ricard Ramos-Izquierdo
- Servicio de Cirugía Torácica, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Eduardo Rivo
- Servicio de Cirugía Torácica, Hospital Universitario Santiago de Compostela, Santiago de Compostela, Spain
| | - Alberto Rodríguez-Fuster
- Servicio de Cirugía Torácica, Hospital del Mar, Barcelona, Spain; IMIM (Instituto de Investigación Médica Hospital del Mar), Barcelona, Spain
| | - Rafael Rojo-Marcos
- Servicio de Cirugía Torácica, Hospital Universitario Cruces, Bilbao, Spain
| | - David Sanchez-Lorente
- Servicio de Cirugía Torácica, Hospital Clinic de Barcelona, Instituto Respiratorio, Universidad de Barcelona, Barcelona, Spain
| | - Laura Sanchez Moreno
- Servicio de Cirugía Torácica, Hospital Universitario Marqués de Valdecilla, Santader, Spain
| | - Carlos Simón
- Servicio de Cirugía Torácica, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Juan Carlos Trujillo-Reyes
- Servicio de Cirugía Torácica, Hospital Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain
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Embun R, Royo-Crespo I, Recuero Díaz JL, Bolufer S, Call S, Congregado M, Gómez-de Antonio D, Jimenez MF, Moreno-Mata N, Aguinagalde B, Amor-Alonso S, Arrarás MJ, Blanco Orozco AI, Boada M, Cabañero Sánchez A, Cal Vázquez I, Cilleruelo Ramos Á, Crowley Carrasco S, Fernández-Martín E, García-Barajas S, García-Jiménez MD, García-Prim JM, Garcia-Salcedo JA, Gelbenzu-Zazpe JJ, Giraldo-Ospina CF, Gómez Hernández MT, Hernández J, Wolf JDI, Jauregui Abularach A, Jiménez U, López Sanz I, Martínez-Hernández NJ, Martínez-Téllez E, Milla Collado L, Mongil Poce R, Moradiellos-Díez FJ, Moreno-Balsalobre R, Moreno Merino SB, Obiols C, Quero-Valenzuela F, Ramírez-Gil ME, Ramos-Izquierdo R, Rivo E, Rodríguez-Fuster A, Rojo-Marcos R, Sanchez-Lorente D, Sanchez Moreno L, Simón C, Trujillo-Reyes JC, Hernando Trancho F. Spanish Video-Assisted Thoracic Surgery Group: Method, Auditing, and Initial Results From a National Prospective Cohort of Patients Receiving Anatomical Lung Resections. Arch Bronconeumol 2020. [DOI: 10.1016/j.arbres.2020.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Boada M, Sánchez-Lorente D, Libreros A, Lucena CM, Marrades R, Sánchez M, Paredes P, Serrano M, Guirao A, Guzmán R, Viñolas N, Casas F, Agustí C, Molins L. Is invasive mediastinal staging necessary in intermediate risk patients with negative PET/CT? J Thorac Dis 2020; 12:3976-3986. [PMID: 32944309 PMCID: PMC7475585 DOI: 10.21037/jtd-20-1248] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background Tumor involvement of mediastinal lymph nodes is of high importance in non-small cell lung cancer (NSCLC). Invasive mediastinal staging is recommended in selected patients without evidence of mediastinal involvement on staging by imaging. In the present study we aimed to evaluate the effectiveness of invasive mediastinal staging in reducing pN2, its impact on survival and the risk factors for occult pN2. Methods Patients with NSCLC tumors larger than 3 cm, central tumors or cN1 cases treated in our institution between 2013 and 2018 were prospectively included in the study. Incidence of pN2 and overall survival was compared among invasively staged (IS) and non-invasively staged groups (NIS). Multivariate analysis was performed to identify risk factors of pN2. Results A total of 201 patients were included in the study, 79 (39.3%) of whom were not invasively staged (NIS group) and 122 (60.7%) were invasively staged (IS group). Incidence of cN1 and mean PET/CT uptake was different among both groups. Prevalence of pN2 was similar in both groups (7.6% in NIS vs. 12.6% in IS; P>0.05). Median survival in IS-pN2 patients was 11 months longer than in NIS-pN2 group (33.6 vs. 22.5 months; P=0.245). cN1 emerged as the only a risk factor for pN2. Conclusions Invasive staging does not reduce the incidence of pN2. However, this finding could be biased because in our series cN1 patients were more often staged and cN1 has been detected as a risk factor for pN2. In addition patient better selection after invasive staging might have an impact on overall survival. To conclude, invasive mediastinal staging in intermediate risk patients for positive mediastinal nodes is justified.
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Affiliation(s)
- Marc Boada
- Thoracic Surgery Department, Respiratory Institute, Hospital Clínic de Barcelona, Barcelona, Spain.,Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - David Sánchez-Lorente
- Thoracic Surgery Department, Respiratory Institute, Hospital Clínic de Barcelona, Barcelona, Spain.,Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Alejandra Libreros
- Thoracic Surgery Department, Respiratory Institute, Hospital Clínic de Barcelona, Barcelona, Spain.,Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Carmen M Lucena
- Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain.,Pulmonology Department, Respiratory Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ramón Marrades
- Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain.,Pulmonology Department, Respiratory Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Marcelo Sánchez
- Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain.,Radiology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Pilar Paredes
- Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain.,Nuclear Medicine Department, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Mario Serrano
- Pulmonology Department, Hospital de Mollet, Barcelona, Spain
| | - Angela Guirao
- Thoracic Surgery Department, Respiratory Institute, Hospital Clínic de Barcelona, Barcelona, Spain.,Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Rudith Guzmán
- Thoracic Surgery Department, Respiratory Institute, Hospital Clínic de Barcelona, Barcelona, Spain.,Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Núria Viñolas
- Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain.,Medical Oncology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Francesc Casas
- Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain.,Radiotherapy Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Carles Agustí
- Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain.,Pulmonology Department, Respiratory Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Laureano Molins
- Thoracic Surgery Department, Respiratory Institute, Hospital Clínic de Barcelona, Barcelona, Spain.,Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain.,Nuclear Medicine Department, Hospital Clínic de Barcelona, Barcelona, Spain
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Boada M, Perez-Poch A, Ballester M, García-Monclús S, González DV, García S, Barri PN, Veiga A. Microgravity effects on frozen human sperm samples. J Assist Reprod Genet 2020; 37:2249-2257. [PMID: 32683528 PMCID: PMC7492354 DOI: 10.1007/s10815-020-01877-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/29/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE Microgravity has severe effects on cellular and molecular structures as well as on metabolic interactions. The aim of this study is to investigate the effects of microgravity (μg) exposure on human frozen sperm samples. METHODS Sibling samples from 15 normozoospermic healthy donors were frozen using glycerol as cryoprotectant and analyzed under microgravity and ground conditions. Microgravity was obtained by parabolic flights using a CAP10B plane. The plane executed 20 parabolic maneuvers with a mean of 8.5 s of microgravity for each parabola. RESULTS Frozen sperm samples preserved in cryostraws and stored in a secure and specific nitrogen vapor cryoshipper do not suffer significant alterations after μg exposure. Comparing the study group (μg) and the control group (1 g), similar results were obtained in the main parameters studied: sperm motility (M/ml) 13.72 ± 12.57 vs 13.03 ± 12.13 (- 0.69 95% CI [- 2.9; 1.52]), progressive a + b sperm motility (%) 21.83 ± 11.69 vs 22.54 ± 12.83 (0.03 95% CI [- 0.08; 0.15]), sperm vitality (%) 46.42 ± 10.81 vs 44.62 ± 9.34 (- 0.04 95% CI [- 0.13; 0.05]), morphologically normal spermatozoa (%) 7.03 ± 2.61 vs 8.09 ± 3.61 (0.12 95% CI [0.01; 0.24]), DNA sperm fragmentation by SCD (%) 13.33 ± 5.12 vs 13.88 ± 6.14 (0.03 95% CI [- 0.09; 0.16]), and apoptotic spermatozoa by MACS (%) 15.47 ± 15.04 vs 23.80 ± 23.63 (- 0.20 95% CI [- 0.66; 1.05]). CONCLUSION The lack of differences obtained between frozen samples exposed to μg and those maintained in ground conditions provides the possibility of considering the safe transport of human male gametes to space. Nevertheless, further research is needed to validate the results and to consider the possibility of creating a human sperm bank outside the Earth. TRIAL REGISTRATION NUMBER ClinicalTrials.gov: NCT03760783.
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Affiliation(s)
- M Boada
- Women's Health Dexeus, Department of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Dexeus, Avinguda Carles III 71-75, 08028, Barcelona, Spain.
| | - A Perez-Poch
- Universitat Politècnica de Catalunya, UPC BarcelonaTech, EEBE Campus Diagonal-Besòs, C. E. Maristany 16, 08019, Barcelona, Spain
| | - M Ballester
- Women's Health Dexeus, Department of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Dexeus, Avinguda Carles III 71-75, 08028, Barcelona, Spain
| | - S García-Monclús
- Women's Health Dexeus, Department of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Dexeus, Avinguda Carles III 71-75, 08028, Barcelona, Spain
| | - D V González
- Aeroclub Barcelona-Sabadell, Sabadell Airport, Carretera de Bellaterra s/n, 08205 Sabadell, Barcelona, Spain
| | - S García
- Women's Health Dexeus, Unit of Biostatistics, Avinguda Carles III 71-75, 08028, Barcelona, Spain
| | - P N Barri
- Women's Health Dexeus, Department of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Dexeus, Avinguda Carles III 71-75, 08028, Barcelona, Spain
| | - A Veiga
- Women's Health Dexeus, Department of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Dexeus, Avinguda Carles III 71-75, 08028, Barcelona, Spain
- Barcelona Stem Cell Bank, Centre of Regenerative Medicine in Barcelona, Hospital Duran i Reynals, Gran Via de l'Hospitalet 199, 08908 Hospitalet de Llobregat, Barcelona, Spain
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Pérez-Grijalba V, Romero J, Pesini P, Sarasa L, Monleón I, San-José I, Arbizu J, Martínez-Lage P, Munuera J, Ruiz A, Tárraga L, Boada M, Sarasa M. Plasma Aβ42/40 Ratio Detects Early Stages of Alzheimer's Disease and Correlates with CSF and Neuroimaging Biomarkers in the AB255 Study. J Prev Alzheimers Dis 2020; 6:34-41. [PMID: 30569084 DOI: 10.14283/jpad.2018.41] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Easily accessible biomarkers are needed for the early identification of individuals at risk of developing Alzheimer's disease (AD) in large population screening strategies. OBJECTIVES This study evaluated the potential of plasma β-amyloid (Aβ) biomarkers in identifying early stages of AD and predicting cognitive decline over the following two years. DESIGN Total plasma Aβ42/40 ratio (TP42/40) was determined in 83 cognitively normal individuals (CN) and 145 subjects with amnestic mild cognitive impairment (a-MCI) stratified by an FDG-PET AD-risk pattern. RESULTS Significant lower TP42/40 ratio was found in a-MCI patients compared to CN. Moreover, a-MCIs with a high-risk FDG-PET pattern for AD showed even lower plasma ratio levels. Low TP42/40 at baseline increased the risk of progression to dementia by 70%. Furthermore, TP42/40 was inversely associated with neocortical amyloid deposition (measured with PiB-PET) and was concordant with the AD biomarker profile in cerebrospinal fluid (CSF). CONCLUSIONS TP42/40 demonstrated value in the identification of individuals suffering a-MCI, in the prediction of progression to dementia, and in the detection of underlying AD pathology revealed by FDG-PET, Amyloid-PET and CSF biomarkers, being, thus, consistently associated with all the well-established indicators of AD.
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Affiliation(s)
- V Pérez-Grijalba
- Pedro Pesini, PhD. Vía Hispanidad 21, 50009 Zaragoza, Spain; Telephone number: +34 976 796 562; Fax: (+34) 976 217 802;
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Boada M, Perez-Poch A, Ballester M, Gárcia S, González DV, Rodríguez I, Barri PN, Veiga A. Corrigendum to P-434 (Effect of microgravity on frozen human sperm samples. Can they be sent to space?). Hum Reprod 2020; 35:739. [PMID: 31504523 DOI: 10.1093/humrep/dez183] [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] [Received: 12/15/2017] [Revised: 04/29/2019] [Accepted: 05/20/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Boada
- Women's Health Dexeus, Department of Obstetrícs- Gynaecology and Reproduction, Barcelona, Spain
| | - A Perez-Poch
- Universitat Politècnica de Catalunya, UPC Barcelona Tech, Barcelona, Spain
| | - M Ballester
- Women's Health Dexeus, Department of Obstetrícs- Gynaecology and Reproduction, Barcelona, Spain
| | - S Gárcia
- Women's Health Dexeus, Department of Obstetrícs- Gynaecology and Reproduction, Barcelona, Spain
| | - D V González
- Aeroclub Barcelona-Sabadell, Aerobatic parabolic flights, Sabadell, Spain
| | - I Rodríguez
- Wome's Health Dexeus, Unit of Biostatistics, Barcelona, Spain
| | - P N Barri
- Women's Health Dexeus, Department of Obstetrícs- Gynaecology and Reproduction, Barcelona, Spain
| | - A Veiga
- Women's Health Dexeus, Department of Obstetrícs- Gynaecology and Reproduction, Barcelona, Spain
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Boada M, Guzmán R, Sandoval E. Long tracheal replacement or the philosopher's stone. Ann Cardiothorac Surg 2020; 9:58-59. [PMID: 32175243 DOI: 10.21037/acs.2019.11.08] [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: 11/06/2022]
Affiliation(s)
- Marc Boada
- Department of Thoracic Surgery, ICR, Hospital Clínic, Barcelona, Spain
| | - Rudith Guzmán
- Department of Thoracic Surgery, ICR, Hospital Clínic, Barcelona, Spain
| | - Elena Sandoval
- Department of Cardiovascular Surgery, ICCV, Hospital Clínic, Barcelona, Spain
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Affiliation(s)
- Elena Sandoval
- Department of Cardiovascular Surgery, ICCV. Hospital Clínic, Barcelona, Spain
| | | | - Marc Boada
- Department of Thoracic Surgery, ICR. Hospital Clínic, Barcelona, Spain
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Barberan-Garcia A, Navarro-Ripoll R, Sánchez-Lorente D, Moisés-Lafuente J, Boada M, Messaggi-Sartor M, González-Vallespí L, Montané-Muntané M, Alsina-Restoy X, Campero B, Lopez-Baamonde M, Romano-Andrioni B, Guzmán R, López A, Arguis MJ, Roca J, Martinez-Palli G. Cost-effectiveness of a technology-supported multimodal prehabilitation program in moderate-to-high risk patients undergoing lung cancer resection: randomized controlled trial protocol. BMC Health Serv Res 2020; 20:207. [PMID: 32164687 PMCID: PMC7068871 DOI: 10.1186/s12913-020-05078-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 03/06/2020] [Indexed: 12/13/2022] Open
Abstract
Background Multimodal prehabilitation is a preoperative intervention with the objective to enhance cancer patients’ functional status which has been showed to reduce both postoperative morbidity and hospital length of stay in digestive oncologic surgery. However, in lung cancer surgery patients further studies with higher methodological quality are needed to clarify the benefits of prehabilitation. The main aim of the current protocol is to evaluate the cost-effectiveness of a multimodal prehabilitation program supported by information and communication technologies in moderate-to-high risk lung cancer patients undergoing thoracic surgery. Methods A Quadruple Aim approach will be adopted, assessing the prehabilitation program at the following levels: i) Patients’ and professionals’ experience outcomes (by means of standardized questionnaires, focus groups and structured interviews); ii) Population health-based outcomes (e.g. hospital length of stay, number and severity of postoperative complications, peak oxygen uptake and levels of systemic inflammation); and, iii) Healthcare costs. Discussion This study protocol should contribute not only to increase the scientific basis on prehabilitation but also to detect the main factors modulating service adoption. Trial registration NCT04052100 (August 9, 2019).
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Affiliation(s)
- Anael Barberan-Garcia
- Respiratory Medicine Department, Hospital Clínic de Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain. .,August Pi i Sunyer Biomedical Research Institute - IDIBAPS, University of Barcelona (UB), Barcelona, Spain. .,Biomedical Networking Research Centre on Respiratory Diseases (CIBERES), Barcelona, Spain.
| | - Ricard Navarro-Ripoll
- Anaesthesia and Intensive Care Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Jorge Moisés-Lafuente
- Respiratory Medicine Department, Hospital Clínic de Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain
| | - Marc Boada
- Thoracic Surgery Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Monique Messaggi-Sartor
- Respiratory Medicine Department, Hospital Clínic de Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain.,August Pi i Sunyer Biomedical Research Institute - IDIBAPS, University of Barcelona (UB), Barcelona, Spain
| | | | - Mar Montané-Muntané
- Anaesthesia and Intensive Care Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Xavier Alsina-Restoy
- Respiratory Medicine Department, Hospital Clínic de Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain
| | - Betina Campero
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Manuel Lopez-Baamonde
- Anaesthesia and Intensive Care Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Rudith Guzmán
- Thoracic Surgery Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Antonio López
- Anaesthesia and Intensive Care Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Maria Jose Arguis
- Anaesthesia and Intensive Care Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Josep Roca
- Respiratory Medicine Department, Hospital Clínic de Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain.,August Pi i Sunyer Biomedical Research Institute - IDIBAPS, University of Barcelona (UB), Barcelona, Spain.,Biomedical Networking Research Centre on Respiratory Diseases (CIBERES), Barcelona, Spain
| | - Graciela Martinez-Palli
- August Pi i Sunyer Biomedical Research Institute - IDIBAPS, University of Barcelona (UB), Barcelona, Spain.,Anaesthesia and Intensive Care Department, Hospital Clínic de Barcelona, Barcelona, Spain
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Sabbagh MN, Boada M, Borson S, Chilukuri M, Dubois B, Ingram J, Iwata A, Porsteinsson AP, Possin KL, Rabinovici GD, Vellas B, Chao S, Vergallo A, Hampel H. Early Detection of Mild Cognitive Impairment (MCI) in Primary Care. J Prev Alzheimers Dis 2020; 7:165-170. [PMID: 32463069 DOI: 10.14283/jpad.2020.21] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
Mild cognitive impairment (MCI) is significantly misdiagnosed in the primary care setting due to multi-dimensional frictions and barriers associated with evaluating individuals' cognitive performance. To move toward large-scale cognitive screening, a global panel of clinicians and cognitive neuroscientists convened to elaborate on current challenges that hamper widespread cognitive performance assessment. This report summarizes a conceptual framework and provides guidance to clinical researchers and test developers and suppliers to inform ongoing refinement of cognitive evaluation. This perspective builds upon a previous article in this series, which outlined the rationale for and potentially against efforts to promote widespread detection of MCI. This working group acknowledges that cognitive screening by default is not recommended and proposes large-scale evaluation of individuals with a concern or interest in their cognitive performance. Such a strategy can increase the likelihood to timely and effective identification and management of MCI. The rising global incidence of AD demands innovation that will help alleviate the burden to healthcare systems when coupled with the potentially near-term approval of disease-modifying therapies. Additionally, we argue that adequate infrastructure, equipment, and resources urgently should be integrated in the primary care setting to optimize the patient journey and accommodate widespread cognitive evaluation.
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Affiliation(s)
- M N Sabbagh
- Marwan N. Sabbagh, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA, ; Tel.: (702) 483-6029; Fax: (702) 722-6584
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Sabbagh MN, Boada M, Borson S, Doraiswamy PM, Dubois B, Ingram J, Iwata A, Porsteinsson AP, Possin KL, Rabinovici GD, Vellas B, Chao S, Vergallo A, Hampel H. Early Detection of Mild Cognitive Impairment (MCI) in an At-Home Setting. J Prev Alzheimers Dis 2020; 7:171-178. [PMID: 32463070 DOI: 10.14283/jpad.2020.22] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Emerging digital tools have the potential to enable a new generation of qualitative and quantitative assessment of cognitive performance. Moreover, the ubiquity of consumer electronics, such as smartphones and tablets, can be harnessed to support large-scale self-assessed cognitive screening with benefit to healthcare systems and consumers. A wide variety of apps, wearables, and new digital technologies are either available or in development for the detection of mild cognitive impairment (MCI), a risk factor for dementia. Two categories of novel methodologies may be considered: passive technologies (which monitor a user's behavior without active user input) and interactive assessments (which require active user input). Such examinations can be self-administered, supervised by a caregiver, or conducted by an informant at home or outside of a clinical setting. These direct-to-consumer tools have the potential to sidestep barriers associated with cognitive evaluation in primary care, thus improving access to cognitive assessments. Although direct-to-consumer cognitive assessment is associated with its own barriers, including test validation, user experience, and technological concerns, it is conceivable that these issues can be addressed so that a large-scale, self-assessed cognitive evaluation that would represent an initial cognitive screen may be feasible in the future.
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Affiliation(s)
- M N Sabbagh
- Marwan N. Sabbagh, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA, ; Tel.: (702) 483-6029; Fax: (702) 722-6584
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35
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Sabbagh MN, Boada M, Borson S, Chilukuri M, Doraiswamy PM, Dubois B, Ingram J, Iwata A, Porsteinsson AP, Possin KL, Rabinovici GD, Vellas B, Chao S, Vergallo A, Hampel H. Rationale for Early Diagnosis of Mild Cognitive Impairment (MCI) Supported by Emerging Digital Technologies. J Prev Alzheimers Dis 2020; 7:158-164. [PMID: 32463068 DOI: 10.14283/jpad.2020.19] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Disease-modifying pharmacotherapies for Alzheimer's Disease (AD) are currently in late-stage clinical development; once approved, new healthcare infrastructures and services, including primary healthcare, will be necessary to accommodate a huge demand for early and large-scale detection of AD. The increasing global accessibility of digital consumer electronics has opened up new prospects for early diagnosis and management of mild cognitive impairment (MCI) with particular regard to AD. This new wave of innovation has spurred research in both academia and industry, aimed at developing and validating a new "digital generation" of tools for the assessment of the cognitive performance. In light of this paradigm shift, an international working group (the Global Advisory Group on Future MCI Care Pathways) convened to elaborate on how digital tools may be optimally integrated in screening-diagnostic pathways of AD The working group developed consensus perspectives on new algorithms for large-scale screening, detection, and diagnosis of individuals with MCI within primary medical care delivery. In addition, the expert panel addressed operational aspects concerning the implementation of unsupervised at-home testing of cognitive performance. The ultimate intent of the working group's consensus perspectives is to provide guidance to developers of cognitive tests and tools to facilitate the transition toward globally accessible cognitive screening aimed at the early detection, diagnosis, and management of MCI due to AD.
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Affiliation(s)
- M N Sabbagh
- Marwan N. Sabbagh, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA, ; Tel.: (702) 483-6029; Fax: (702) 722-6584
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Tamburini N, Carriel N, Cavallesco G, Molins L, Galeotti R, Guzmán R, Salviato E, Sánchez-Lorente D, Maietti E, Maniscalco P, Boada M. Technical results, clinical efficacy and predictors of outcome of intercostal arteries embolization for hemothorax: a two-institutions' experience. J Thorac Dis 2019; 11:4693-4699. [PMID: 31903258 DOI: 10.21037/jtd.2019.10.27] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background To evaluate the clinical efficacy and identify the predictors of outcome of intercostal arterial embolization for hemothorax caused by intercostal artery (ICA) injuries. Methods A retrospective multi-institutional study was conducted. Outcomes were analyzed in 30 consecutive patients presenting with hemothorax caused by active ICA hemorrhage undergoing transcatheter arterial embolization (TAE). Clinical and procedural parameters were compared between outcomes groups. Results Overall technical success rate was 87% (n=26). Among the 4 failed cases, 2 underwent repeated TAE and 2 underwent additional surgery. Overall 30-day mortality rate was 23%. Low haemoglobin levels and haematocrit, hepatic comorbidities and more than one artery undergoing embolization increased technical failure rate significantly. Survival was poorer in patients with massive bleeding. Conclusions ICA embolization was found to be a safe and effective method in treating hemothorax caused by active ICA haemorrhage. Careful pre-embolization evaluation may be required for patient with low haemoglobin levels and haematocrit, hepatic comorbidities and active haemorrhage from more than one artery.
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Affiliation(s)
- Nicola Tamburini
- Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
| | - Nicole Carriel
- General Thoracic Surgery Department, Respiratory Institute, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Giorgio Cavallesco
- Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
| | - Laureano Molins
- General Thoracic Surgery Department, Respiratory Institute, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Roberto Galeotti
- Department of Radiology, Section of Interventional Radiology, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
| | - Rudith Guzmán
- General Thoracic Surgery Department, Respiratory Institute, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Elisabetta Salviato
- Department of Radiology, Section of Interventional Radiology, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
| | - David Sánchez-Lorente
- General Thoracic Surgery Department, Respiratory Institute, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Elisa Maietti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,Center for Clinical Epidemiology, Department of Medical Science, University of Ferrara, Ferrara, Italy
| | - Pio Maniscalco
- Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
| | - Marc Boada
- General Thoracic Surgery Department, Respiratory Institute, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
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Casas F, Sánchez D, Boada M, Munoz D, Cabrera C, Martin R, Martinez D, Paredes P, Vollmer I, Cortes K, Barreto T, Oses G, Parera M, Castillo S. P2.18-19 Radiological and Pathological Response to the Induction of Surgery in the NSCLC Stage III. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Boada M, Guzmán R, Montesinos M, Libreros A, Guirao A, Sánchez-Lorente D, Gimferrer JM, Agustí A, Molins L. UPSTAGING, CENTRALITY AND SURVIVAL IN EARLY STAGE NON-SMALL CELL LUNG CANCER VIDEO-ASSISTED SURGERY. Lung Cancer 2019; 134:254-258. [DOI: 10.1016/j.lungcan.2019.06.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/28/2019] [Accepted: 06/30/2019] [Indexed: 12/11/2022]
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Boada M, Ristic S, Pross N, Abi-Saab D, Bullain S, Andjelkovic M, Peters O, Delmar P, Hofmann C, Searle A, Baudler M, Fontoura P, Doody R. P37 Trial design of the GRADUATE studies: Phase III, randomized, placebo-controlled studies evaluating gantenerumab in patients with early Alzheimer’s disease. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2019.04.690] [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: 11/29/2022]
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40
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Guirao A, Molins L, Ramón I, Sunyer G, Viñolas N, Marrades R, Sánchez D, Fibla JJ, Boada M, Hernández J, Guzmán R, Libreros A, Gómez-Caro A, Guerrero C, Agustí A. Trained dogs can identify malignant solitary pulmonary nodules in exhaled gas. Lung Cancer 2019; 135:230-233. [PMID: 31235316 DOI: 10.1016/j.lungcan.2019.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 02/23/2019] [Revised: 06/04/2019] [Accepted: 06/07/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To investigate the capacity of a trained dog to identify LC in patients with malignant SPN. METHODS We collected 90 exhaled gas samples from 30 patients with SPN (3 samples/patient). As controls we used 61 healthy volunteers and 18 COPD patients without SNP or LC, in each of whom we collected 5 exhaled gas samples (n = 395). The dog (Blat, a 4-year-old crossbreed between a Labrador Retriever and a Pitbull) and the methodology used were the same as previously reported by our group (see: https://drive.google.com/open?id=1R4mOtOtuZkTeb5iOEEv0K9r2kHKlPhWd). RESULTS Of 30 patients with SPN, Blat recognized 27 of them as positive for LC and 3 as negative for LC. These results fully matched post-surgical pathological results. Sensibility was 0.97, Specificity 0.99, Positive Predictive value 0.97 and negative predictive value 0.99. The AUC of the ROC curve was 0.985. CONCLUSIONS Trained dogs can identify accurately the malignant origin of SPN. It is now time to develop technology that can match canine olfaction and facilitate the implementation of this diagnostic approach in the clinic.
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Affiliation(s)
- A Guirao
- Institut Respiratori, Hospital Clínic, Universitat de Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - L Molins
- Institut Respiratori, Hospital Clínic, Universitat de Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Spain
| | - I Ramón
- ARGUS Detection Dogs, Barcelona, Spain
| | - G Sunyer
- CIBER Enfermedades Respiratorias (CIBERES), Spain
| | - N Viñolas
- Institut Clínic de Malalties Hematològiques i Oncològiques, Hospital Clínic, Universitat de Barcelona, Spain
| | - R Marrades
- Institut Respiratori, Hospital Clínic, Universitat de Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Spain
| | - D Sánchez
- Institut Respiratori, Hospital Clínic, Universitat de Barcelona, Spain
| | - J J Fibla
- Hospital Universitari Sagrat Cor, Barcelona, Spain
| | - M Boada
- Institut Respiratori, Hospital Clínic, Universitat de Barcelona, Spain
| | - J Hernández
- Hospital Universitari Sagrat Cor, Barcelona, Spain
| | - R Guzmán
- Institut Respiratori, Hospital Clínic, Universitat de Barcelona, Spain
| | - A Libreros
- Institut Respiratori, Hospital Clínic, Universitat de Barcelona, Spain
| | - A Gómez-Caro
- Institut Respiratori, Hospital Clínic, Universitat de Barcelona, Spain
| | - C Guerrero
- Institut Respiratori, Hospital Clínic, Universitat de Barcelona, Spain
| | - A Agustí
- Institut Respiratori, Hospital Clínic, Universitat de Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Spain
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Fibla JJ, Molins L, Quero F, Izquierdo JM, Sánchez D, Hernández J, Bayarri C, Boada M, Guirao Á, Cueto A. Perioperative outcome of lung cancer surgery in women: results from a Spanish nationwide prospective cohort study. J Thorac Dis 2019; 11:1475-1484. [PMID: 31179090 DOI: 10.21037/jtd.2019.03.30] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background To assess possible differences in the perioperative profile between men and women in lung cancer surgery. Methods A prospective cohort multicenter study was design, in which consecutive patients undergoing curative intent surgery for lung cancer in 24 Thoracic Services throughout Spain were included. Clinical features, tumor- and surgery-related data, postoperative complications, and mortality were recorded. Results There were 2,566 men and 741 women. Women were younger than men [mean (SD) age, 61.8 (10.8) vs. 66.5 (9.1) years, P<0.0001] and showed a more favorable preoperative characteristics, with significantly higher percentages of ECOG grade 0 and lower percentages of active smokers (28.4% vs. 33.9%; pack-years 18.8 vs. 26.9) and comorbidities [chronic obstructive pulmonary disease (COPD), diabetes, hypertension, cardiac disorders]. There were significant differences (P<0.001) in histological types and TNM stages with adenocarcinoma (70.1% vs. 46.4%) and IA stage (41.5% vs. 33.6%) more frequent in women. The use of VATS or thoracotomy was similar. The rate of pneumonectomy was higher in men (10.9%) than in women (5.1%) (P<0.001) but the distributions of other procedures were similar. Postoperative complications (pneumonitis, atelectasis, air leak, hemorrhage, fistula, empyema, wound dehiscence, and need of reintubation) were lower in women. Significant differences (P<0.0001) in the severity of postoperative complications (Clavien-Dindo classification) were also found, with higher percentages of grades I (51.6% vs. 43%) and II (37.5% vs. 33%) and lower percentages of grades III and IV among women. The mean length of hospital stay was 7.8 (7.1) days in men versus 6.3 (5.0) days in women, and the 30-day mortality rate 0.3% in women versus 2.9% in men (P<0.0001). The percentage of readmissions within 30 days after surgery was also higher in men (8.6% vs. 2.8%). Conclusions This multicenter nationwide study of lung cancer surgery with curative intent shows that the perioperative profile is better in women than in men.
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Affiliation(s)
- Juan J Fibla
- Department of Thoracic Surgery, Hospital Universitari del Sagrat Cor, Barcelona, Spain
| | - Laureano Molins
- Department of Thoracic Surgery, Hospital Universitari del Sagrat Cor, Barcelona, Spain.,Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain
| | - Florencio Quero
- Department of Thoracic Surgery, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - José Miguel Izquierdo
- Department of Thoracic Surgery, Hospital Universitario Donostia, San Sebastián, Spain
| | - David Sánchez
- Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain
| | - Jorge Hernández
- Department of Thoracic Surgery, Hospital Universitari del Sagrat Cor, Barcelona, Spain
| | - Clara Bayarri
- Department of Thoracic Surgery, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Marc Boada
- Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain
| | - Ángela Guirao
- Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain
| | - Antonio Cueto
- Department of Thoracic Surgery, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Costa M, Mestre A, Horrillo R, Ortiz AM, Pérez A, Ruiz A, Boada M, Grancha S. Cross-Sectional Characterization of Albumin Glycation State in Cerebrospinal Fluid and Plasma from Alzheimer's Disease Patients. J Prev Alzheimers Dis 2019; 6:139-143. [PMID: 30756121 DOI: 10.14283/jpad.2018.48] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We determined albumin post-translational modifications (PTMs) by mass spectrometry (MS) in plasma and cerebrospinal fluid (CSF) from 31 Alzheimer's disease (AD) patients (with 27 samples of paired plasma-CSF from the same patients). Results were cross-sectionally compared with healthy controls. For percentage of relative intensity of glycated isoforms, plasma albumin was globally more glycated in AD patients than in healthy controls (P<0.01). MS results in plasma were confirmed by a quantitative enzymatic assay (Lucica GA-L) for albumin early-glycation detection. In CSF there were no global glycation differences detected by MS, although a different pattern of glycated isoforms was observed. Oxidized+glycated and cysteinylated+glycated isoforms were increased in both plasma and CSF of AD patients in comparison with healthy controls (P<0.001). Furthermore, AD patients showed higher glycation in plasma than in CSF (P<0.01). Our data support the role of glycation and oxidative stress in AD.
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Affiliation(s)
- M Costa
- Dr. Montserrat Costa, Grifols, Research and Development Area, Carrer Can Guasch, 2, 08150 Parets del Vallès, Barcelona, Spain, Tel: +34 935 710 853; Fax: +34 935 710 381, E-mail:
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de Rojas I, Romero J, Rodríguez-Gomez O, Pesini P, Sanabria A, Pérez-Cordon A, Abdelnour C, Hernández I, Rosende-Roca M, Mauleón A, Vargas L, Alegret M, Espinosa A, Ortega G, Gil S, Guitart M, Gailhajanet A, Santos-Santos MA, Moreno-Grau S, Sotolongo-Grau O, Ruiz S, Montrreal L, Martín E, Pelejà E, Lomeña F, Campos F, Vivas A, Gómez-Chiari M, Tejero MA, Giménez J, Pérez-Grijalba V, Marquié GM, Monté-Rubio G, Valero S, Orellana A, Tárraga L, Sarasa M, Ruiz A, Boada M. Correlations between plasma and PET beta-amyloid levels in individuals with subjective cognitive decline: the Fundació ACE Healthy Brain Initiative (FACEHBI). Alzheimers Res Ther 2018; 10:119. [PMID: 30497535 PMCID: PMC6267075 DOI: 10.1186/s13195-018-0444-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 10/29/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND Peripheral biomarkers that identify individuals at risk of developing Alzheimer's disease (AD) or predicting high amyloid beta (Aβ) brain burden would be highly valuable. To facilitate clinical trials of disease-modifying therapies, plasma concentrations of Aβ species are good candidates for peripheral AD biomarkers, but studies to date have generated conflicting results. METHODS The Fundació ACE Healthy Brain Initiative (FACEHBI) study uses a convenience sample of 200 individuals diagnosed with subjective cognitive decline (SCD) at the Fundació ACE (Barcelona, Spain) who underwent amyloid florbetaben(18F) (FBB) positron emission tomography (PET) brain imaging. Baseline plasma samples from FACEHBI subjects (aged 65.9 ± 7.2 years) were analyzed using the ABtest (Araclon Biotech). This test directly determines the free plasma (FP) and total plasma (TP) levels of Aβ40 and Aβ42 peptides. The association between Aβ40 and Aβ42 plasma levels and FBB-PET global standardized uptake value ratio (SUVR) was determined using correlations and linear regression-based methods. The effect of the APOE genotype on plasma Aβ levels and FBB-PET was also assessed. Finally, various models including different combinations of demographics, genetics, and Aβ plasma levels were constructed using logistic regression and area under the receiver operating characteristic curve (AUROC) analyses to evaluate their ability for discriminating which subjects presented brain amyloidosis. RESULTS FBB-PET global SUVR correlated weakly but significantly with Aβ42/40 plasma ratios. For TP42/40, this observation persisted after controlling for age and APOE ε4 allele carrier status (R2 = 0.193, p = 1.01E-09). The ROC curve demonstrated that plasma Aβ measurements are not superior to APOE and age in combination in predicting brain amyloidosis. It is noteworthy that using a simple preselection tool (the TP42/40 ratio with an empirical cut-off value of 0.08) optimizes the sensitivity and reduces the number of individuals subjected to Aβ FBB-PET scanners to 52.8%. No significant dependency was observed between APOE genotype and plasma Aβ measurements (p value for interaction = 0.105). CONCLUSION Brain and plasma Aβ levels are partially correlated in individuals diagnosed with SCD. Aβ plasma measurements, particularly the TP42/40 ratio, could generate a new recruitment strategy independent of the APOE genotype that would improve identification of SCD subjects with brain amyloidosis and reduce the rate of screening failures in preclinical AD studies. Independent replication of these findings is warranted.
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Affiliation(s)
- Itziar de Rojas
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | | | - O. Rodríguez-Gomez
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | | | - A. Sanabria
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - A. Pérez-Cordon
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - C. Abdelnour
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - I. Hernández
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - M. Rosende-Roca
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - A. Mauleón
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - L. Vargas
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - M. Alegret
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - A. Espinosa
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - G. Ortega
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - S. Gil
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - M. Guitart
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - A. Gailhajanet
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - M. A. Santos-Santos
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - Sonia Moreno-Grau
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - O. Sotolongo-Grau
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - S. Ruiz
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - L. Montrreal
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - E. Martín
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - E. Pelejà
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - F. Lomeña
- Servei de Medicina Nuclear, Hospital Clínic i Provincial, Barcelona, Spain
| | - F. Campos
- Servei de Medicina Nuclear, Hospital Clínic i Provincial, Barcelona, Spain
| | - A. Vivas
- Departament de Diagnòstic per la Imatge, Clínica Corachan, Barcelona, Spain
| | - M. Gómez-Chiari
- Departament de Diagnòstic per la Imatge, Clínica Corachan, Barcelona, Spain
| | - M. A. Tejero
- Departament de Diagnòstic per la Imatge, Clínica Corachan, Barcelona, Spain
| | - J. Giménez
- Departament de Diagnòstic per la Imatge, Clínica Corachan, Barcelona, Spain
| | | | - G. M. Marquié
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - G. Monté-Rubio
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - S. Valero
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - A. Orellana
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - L. Tárraga
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | | | - A. Ruiz
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
| | - M. Boada
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya-Barcelona, C/ Marquès de Sentmenat, 57, 08029 Barcelona, Spain
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Guirao A, Molins L, Guzman R, Cleries M, Vela E, Magen D, Sanchez D, Boada M, Espinas J, Borras J, Argimon J, Agusti A. P3.11-16 Comparative Analysis of Health-Care Resources and Economic Costs of Lung Cancer Patients Treated Medically or Surgically in Catalunya. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Montesinos Encalada M, Boada M, Sanchez D, Libreros A, Guirao A, Guzman R, Gimferrer J, Molins L. P2.01-72 Bronchial Sleeve vs Pneumonectomy: Complications, Recurrences and Survival. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Guirao A, Molins L, Ramon I, Sunyer G, Vinolas N, Marrades R, Sanchez D, Fibla J, Hernandez J, Boada M, Guzman R, Libreros A, Agusti A. MA03.11 Trained Dogs Can Identify Malignant Pulmonary Nodules in Exhaled Gas. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.339] [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: 11/24/2022]
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Rodriguez-Gomez O, Sanabria A, Perez-Cordon A, Sanchez-Ruiz D, Abdelnour C, Valero S, Hernandez I, Rosende-Roca M, Mauleon A, Vargas L, Alegret M, Espinosa A, Ortega G, Guitart M, Gailhajanet A, Sotolongo-Grau O, Moreno-Grau S, Ruiz S, Tarragona M, Serra J, Martin E, Peleja E, Lomeña F, Campos F, Vivas A, Gomez-Chiari M, Tejero MA, Giménez J, Pesini P, Sarasa M, Martinez G, Ruiz A, Tarraga L, Boada M. FACEHBI: A Prospective Study of Risk Factors, Biomarkers and Cognition in a Cohort of Individuals with Subjective Cognitive Decline. Study Rationale and Research Protocols. J Prev Alzheimers Dis 2018; 4:100-108. [PMID: 29186280 DOI: 10.14283/jpad.2016.122] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Long-term longitudinal studies with multimodal biomarkers are needed to delve into the knowledge of preclinical AD. Subjective cognitive decline has been proposed as a risk factor for the development of cognitive impairment. Thus, including individuals with SCD in observational studies may be a cost-effective strategy to increase the prevalence of preclinical AD in the sample. OBJECTIVES To describe the rationale, research protocols and baseline characteristics of participants in the Fundació ACE Healthy Brain Initiative (FACEHBI). DESIGN FACEHBI is a clinical trial (EudraCT: 2014-000798-38) embedded within a long-term observational study of individuals with SCD. SETTING Participants have been recruited at the memory clinic of Fundació ACE (Barcelona) from two different sources: patients referred by a general practitioner and individuals from an Open House Initiative. PARTICIPANTS 200 individuals diagnosed with SCD with a strictly normal performance in a comprehensive neuropsychological battery. MEASUREMENTS Individuals will undergo an extensive neuropsychological protocol, risk factor assessment and a set of multimodal biomarkers including florbetaben PET, structural and functional MRI, diffusion tensor imaging, determination of amyloid species in plasma and neurophthalmologic assessment with optical coherence tomography. RESULTS Two hundred individuals have been recruited in 15 months. Mean age was 65.9 years; mean MMSE was 29.2 with a mean of 14.8 years of education. CONCLUSIONS FACEHBI is a long-term study of cognition, biomarkers and lifestyle that has been designed upon an innovative symptom-based approach using SCD as target population. It will shed light on the pathophysiology of preclinical AD and the role of SCD as a risk marker for the development of cognitive impairment.
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Affiliation(s)
- O Rodriguez-Gomez
- Octavio Rodriguez-Gomez, MD., Gran Via De Carles III, 85 BIS. CP: 08028. Barcelona. Spain, E-mail: , Fax: 0034 934193542, Telephone number: 0034 934304720
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Abstract
The correct treatment for patients with non-small-cell lung cancer and ipsilateral mediastinal involvement (N2) remains a challenge. The heterogeneity of this group of patients has been shown, as well as many different prognostic factors, that will determine a specific management to each of them. Although the standard treatment is based on a multimodality therapy consisting of chemotherapy, radiotherapy and surgery, surgery is not always indicated. The selection of patients who are going to be operated, reminds being a key point of the treatment of this disease. Recent reports on operable N2 disease have been reviewed by our group in order to discuss surgery indications and when to bring it about, with the possibility to go straight to surgery.
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Affiliation(s)
| | - Rudith Guzman
- General Thoracic Surgery, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Marc Boada
- General Thoracic Surgery, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Angela Guirao
- General Thoracic Surgery, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Nicole Carriel
- General Thoracic Surgery, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Laureano Molins
- General Thoracic Surgery, Hospital Clinic of Barcelona, Barcelona, Spain
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Abstract
Surgical resection remains the best treatment option for patients with early stage of non-small cell lung cancer (NSCLC). However, it may be responsible of postoperative complication and mortality, especially in patients with impaired pulmonary function. Enhanced recovery after surgery (ERAS) programs have been focused mainly in minimal invasive surgery approach during lung resection and respiratory rehabilitation after surgery. Preoperative exercise-based intervention (prehabilitation) has demonstrated reduction of morbi-mortality in other surgeries but in thoracic surgery continues to be under discussion. Cardio-pulmonary exercise test (CPET) is the gold standard technique to predict postoperative morbi-mortality. The implementation of a preoperative respiratory rehabilitation could optimize patient's physical capacity before surgery and improve outcomes and enhance recovery. The aim of this systematic review of the literature is to identify the effectiveness and safety of prehabilitation programs in thoracic surgery, the type of exercise and its duration, and the group of patients with best benefit. Prehabilitation is a safe intervention without side effects in patients. High-intensity interval training (HIT) with duration of 2 to 6 weeks seems to be the best exercise programme in a prehabilitation intervention but it exists heterogeneity in terms of intensity and duration. Prehabilitation increase exercise capacity and significantly enhances pulmonary function. But the reduction of postoperative complication and mortality has not been clearly demonstrated. Different criteria selection, type of intervention and small sample size, in addition to no randomization, could justify disparate results. It seems that not all patients can benefit from prehabilitation and it could be indicated only in patients with impaired lung function. Further randomized clinical trials with enough patients, correct duration of HIT (2 to 6 weeks) and focused in COPD patients are needed to clarify the suitability of prehabilitation. Meanwhile, safety of prehabilitation and good results of some studies support this intervention in high-risk patients.
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Affiliation(s)
- David Sanchez-Lorente
- General Thoracic Surgery Department, Clinical Respiratory Institute, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Ricard Navarro-Ripoll
- Department of Anesthesiology, Clinical Respiratory Institute, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Rudith Guzman
- General Thoracic Surgery Department, Clinical Respiratory Institute, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Jorge Moises
- Department of Pneumology, Clinical Respiratory Institute, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Elena Gimeno
- Department of Pneumology, Clinical Respiratory Institute, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Marc Boada
- General Thoracic Surgery Department, Clinical Respiratory Institute, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Laureano Molins
- General Thoracic Surgery Department, Clinical Respiratory Institute, Hospital Clínic of Barcelona, Barcelona, Spain
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Navarro-Ripoll R, Lopez M, Coca M, Rivera L, Jiménez M, Guzmám R, Rovira I, Matute P, Gomar C, Guillermina F, Arguis M, Carretero M, Boada M, Sánchez D. Management of hypertermic intrathoracic chemotherapy in Malignant Pleural Mesothelioma (MPM). J Cardiothorac Vasc Anesth 2018. [DOI: 10.1053/j.jvca.2018.08.176] [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: 11/11/2022]
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