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Nagore D, Candela A, Bürge M, Tamayo E, Murie-Fernández M, Vives M, Monedero P, Álvarez J, Mendez E, Pasqualetto A, Mon T, Pita R, Varela MA, Esteva C, Pereira MA, Sanchez J, Rodriguez MA, Garcia A, Carmona P, López M, Pajares A, Vicente R, Aparicio R, Gragera I, Calderón E, Marcos JM, Gómez L, Rodríguez JM, Matilla A, Medina A, Hernández A, Morales L, Santana L, Garcia E, Montesinos S, Muñoz P, Bravo B, Blanco V. Uric acid and acute kidney injury in high-risk patients for developing acute kidney injury undergoing cardiac surgery: A prospective multicenter study. Rev Esp Anestesiol Reanim (Engl Ed) 2024:S2341-1929(24)00094-5. [PMID: 38704092 DOI: 10.1016/j.redare.2024.04.019] [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] [Received: 06/17/2023] [Revised: 09/06/2023] [Accepted: 09/20/2023] [Indexed: 05/06/2024]
Abstract
PURPOSE It is unclear whether preoperative serum uric acid (SUA) elevation may play a role in the development of acute kidney injury (AKI) associated with cardiac surgery (CSA-AKI). We conducted a cohort study to evaluate the influence of preoperative hyperuricemia on AKI in patients at high risk for developing SC-AKI. DESIGN Multicenter prospective international cohort study. SETTING Fourteen university hospitals in Spain and the United Kingdom. PARTICIPANTS We studied 261 consecutive patients at high risk of developing CSA-AKI, according to a Cleveland score ≥ 4 points, from July to December 2017. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS AKIN criteria were used for the definition of AKI. Multivariable logistic regression models and propensity score-matched pairwise analysis were used to determine the adjusted association between preoperative hyperuricemia (≥7 mg/dL) and AKI. Elevated preoperative AUS (≥7 mg/dL) was present in 190 patients (72.8%), whereas CSA-AKI occurred in 145 patients (55.5%). In multivariable logistic regression models, hyperuricemia was not associated with a significantly increased risk of AKI (adjusted Odds Ratio [OR]: 1.58; 95% confidence interval [CI]: 0.81-3; P = .17). In propensity score-matched analysis of 140 patients, the hyperuricemia group experienced similar adjusted odds of AKI (OR 1.05, 95%CI 0.93-1.19, P = .37). CONCLUSIONS Hyperuricemia was not associated with an increased risk of AKI in this cohort of patients undergoing cardiac surgery at high risk of developing CSA-AKI.
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Affiliation(s)
- D Nagore
- Departamento de Anestesia y Medicina Perioperatoria, Grupo Quirón - Policlínica Guipúzcoa, San Sebastián, Spain; Departamento de Anestesiología y Medicina Perioperatoria, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - A Candela
- Departamento de Anestesia y Medicina Perioperatoria, Grupo Quirón - Policlínica Guipúzcoa, San Sebastián, Spain; Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - M Bürge
- Departamento de Anestesia y Medicina Perioperatoria, Barts Heart Centre, St Bartholomew's Hospital, Londres, UK
| | - E Tamayo
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - M Vives
- Departamento de Anestesiología & Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, Spain; Departamento de Anestesiología y Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, Spain.
| | - P Monedero
- Departamento de Anestesiología & Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, Spain
| | - J Álvarez
- Departamento de Anestesiología y Medicina Perioperatoria, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Departamento de Anestesiología y Medicina Perioperatoria, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | - E Mendez
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Pasqualetto
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - T Mon
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - R Pita
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Alvaro Cunqueiro Vigo, Vigo, Spain
| | - M A Varela
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Alvaro Cunqueiro Vigo, Vigo, Spain
| | - C Esteva
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Alvaro Cunqueiro Vigo, Vigo, Spain
| | - M A Pereira
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Alvaro Cunqueiro Vigo, Vigo, Spain
| | - J Sanchez
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - M A Rodriguez
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - A Garcia
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - P Carmona
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - M López
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - A Pajares
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - R Vicente
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - R Aparicio
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - I Gragera
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Infanta Cristina, Badajoz, Spain
| | - E Calderón
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario Puerta de Mar, Cádiz, Spain
| | - J M Marcos
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario de León, León, Spain
| | - L Gómez
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - J M Rodríguez
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario de Salamanca, Salamanca, Spain
| | - A Matilla
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario de Salamanca, Salamanca, Spain
| | - A Medina
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario de Málaga, Málaga, Spain
| | - A Hernández
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Policlínica Ibiza, Ibiza, Spain
| | - L Morales
- Servicio de Anestesiología y Medicina Perioperatoria, Hospital Universitario Dr, Negrín, Las Palmas de Gran Canaria, Spain
| | - L Santana
- Servicio de Anestesiología y Medicina Perioperatoria, Hospital Universitario Dr, Negrín, Las Palmas de Gran Canaria, Spain
| | - E Garcia
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - S Montesinos
- Departamento de Anestesiología y Medicina Perioperatoria, Centro Médico Teknon Barcelona, Barcelona, Spain
| | - P Muñoz
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital 12 de octubre, Madrid, Spain
| | - B Bravo
- Servicio de Anestesiología y Medicina Perioperatoria, Hospital de Cruces de Bizkaia, Bilbao, Spain
| | - V Blanco
- Departamento de Anestesiología y Medicina Perioperatoria, Hospital Universitario Virgen de la Macarena, Sevilla, Spain
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Gine C, Maiz N, Arévalo S, Rodó C, López M, Carreras E. Ruptured saccular limited dorsal myeloschisis: good indication for fetal repair. Ultrasound Obstet Gynecol 2024; 63:113-115. [PMID: 37606294 DOI: 10.1002/uog.27457] [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] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/27/2023] [Accepted: 08/04/2023] [Indexed: 08/23/2023]
Affiliation(s)
- C Gine
- Pediatric Surgery Department, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - N Maiz
- Maternal-Fetal Medicine Department, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - S Arévalo
- Maternal-Fetal Medicine Department, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - C Rodó
- Maternal-Fetal Medicine Department, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - M López
- Pediatric Surgery Department, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - E Carreras
- Maternal-Fetal Medicine Department, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
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Hernando-Requejo O, Chen X, López M, Sánchez E, García J, García P, Alonso R, Montero A, Ciervide R, Álvarez B, Zucca D, García Aranda M, Valero J, Fernández Letón P, Rubio C. Real-world effectiveness and safety of stereotactic body radiotherapy for liver metastases with different respiratory motion management techniques. Strahlenther Onkol 2023; 199:1000-1010. [PMID: 37728734 DOI: 10.1007/s00066-023-02147-w] [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: 03/03/2023] [Accepted: 08/13/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE Stereotactic body radiotherapy (SBRT) has been firmly established as a treatment choice for patients with oligometastases, as it has demonstrated both safety and efficacy by consistently achieving high rates of local control. Moreover, it offers potential survival benefits for carefully selected patients in real-world clinical settings. METHODS Between January 2008 and May 2020, a total of 149 patients (with 414 liver metastases) received treatment. The Active Breathing Coordinator device was used for 68 patients, while respiratory gating was used for 65 and abdominal compression was used for 16 patients. The most common histological finding was colorectal adenocarcinoma, with 37.6% of patients having three or more metastases, and 18% having two metastases. The prescribed dose ranged from 36 to 60 Gy, delivered in 3-5 fractions. RESULTS Local control rates at 2 and 3 years were 76.1% and 61.2%, respectively, with no instances of local recurrence after 3 years. Factors negatively impacting local control included colorectal histology, lower prescribed dose, and the occurrence of new liver metastases. The median overall survival from SBRT was 32 months, with the presence of metastases outside the liver and the development of new liver metastases after SBRT affecting survival. The median disease-free survival was 10 months. No substantial differences in both local control and survival were observed between the respiratory motion control techniques employed. Treatment tolerance was excellent, with only one patient experiencing acute grade IV thrombocytopenia and two patients suffering from ≥ grade II chronic toxicity. CONCLUSION For radical management of single or multiple liver metastases, SBRT is an effective and well-tolerated treatment option. Regardless of the technology employed, experienced physicians can achieve similarly positive outcomes. However, additional studies are required to elucidate prognostic factors that can facilitate improved patient selection.
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Affiliation(s)
- O Hernando-Requejo
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain.
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain.
| | - X Chen
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - M López
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - E Sánchez
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - J García
- Radiation Physics Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - P García
- Radiation Physics Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - R Alonso
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - A Montero
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - R Ciervide
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - B Álvarez
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - D Zucca
- Radiation Physics Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - M García Aranda
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - J Valero
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - P Fernández Letón
- Radiation Physics Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - C Rubio
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
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Maiz N, Arévalo S, García-Manau P, Meléndez M, Giné C, Rodó C, López M, Carreras E. Presurgery motor level assessment for prediction of motor level at birth in fetuses undergoing prenatal repair of open spina bifida: time to abandon anatomical level in counseling. Ultrasound Obstet Gynecol 2023; 61:728-733. [PMID: 36807360 DOI: 10.1002/uog.26180] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/30/2023] [Accepted: 02/03/2023] [Indexed: 05/14/2023]
Abstract
OBJECTIVES First, to investigate the correlation between prenatal presurgery anatomical and motor levels of the lesion with motor level at birth in cases undergoing prenatal repair of open spina bifida and, second, to identify factors leading to a loss of two or more motor levels between the presurgery and postnatal assessments. METHODS This was an observational study of singleton pregnancies undergoing prenatal repair of open spina bifida, conducted between March 2011 and May 2022. All fetuses underwent an ultrasound assessment at 20-24 weeks of gestation to determine the motor and anatomical levels of the lesion before surgery. The anatomical level of the lesion was defined as the highest open posterior vertebral arch. The motor level was determined by systematic observation of the lower limb movements and was defined as the most distal active muscle present. Prenatal repair was performed at 23-26 weeks. At birth, motor level was assessed by a rehabilitation specialist by physical examination. Cases of intrauterine death or termination of pregnancy and those delivered at other sites were excluded from the neonatal assessment. The agreement between presurgery motor level and motor level at birth, and between presurgery anatomical level and motor level at birth, was assessed using the weighted kappa index (wκ). Logistic regression analysis was used to assess factors leading to a loss of two or more motor levels between the presurgery and postnatal assessments. RESULTS Presurgery motor and anatomical levels were assessed in 61 fetuses at a median gestational age of 22.7 (interquartile range (IQR), 21.6-24.4) weeks. Prenatal repair was performed at a median gestational age of 24.6 (IQR, 23.7-25.7) weeks. Motor level at birth was assessed in 52 neonates after exclusion of nine fetuses due to loss to follow-up or fetal loss. There was moderate agreement between presurgery motor level and motor level at birth (wκ = 0.42; 95% CI, 0.21-0.63), with a median difference of 0 (IQR, -2 to 9) levels. Factors leading to a loss of two or more motor levels between the presurgery ultrasound assessment and postnatal examination were higher presurgery anatomical level (odds ratio (OR), 0.59 (95% CI, 0.35-0.98); P = 0.04) and larger difference between the anatomical and motor levels before surgery (OR, 1.85 (95% CI, 1.12-3.06); P = 0.017). None of the other ultrasound, surgery-related or neonatal variables assessed was associated significantly with a loss of two or more motor levels. There was slight agreement between the presurgery anatomical level of the lesion and motor level at birth (wκ = 0.07; 95% CI, -0.02 to 0.15). CONCLUSIONS There is moderate agreement between fetal motor level of the lesion before prenatal repair of open spina bifida and motor level at birth, as opposed to only slight agreement between presurgery anatomical level and motor level at birth. A loss of two or more motor levels between the presurgery and postnatal assessments is associated with a higher presurgery anatomical level and with a larger difference between the presurgery anatomical and motor levels. Consequently, motor level, rather than the anatomical level, should be used for prenatal counseling. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- N Maiz
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Arévalo
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - P García-Manau
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Meléndez
- Physical Medicine and Rehabilitation, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Giné
- Paediatric Surgery Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Rodó
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M López
- Paediatric Surgery Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - E Carreras
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain
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Fanlo P, Garralda A, Gómez-Cerezo JF, Echeverria M, López M, Heras H, Riera-Mestre A. Results of the screening program for Fabry disease in patients with cornea verticillata at the University Hospital of Navarre. Rev Clin Esp 2023; 223:25-31. [PMID: 36528303 DOI: 10.1016/j.rceng.2022.10.005] [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: 07/25/2022] [Accepted: 10/18/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Cornea verticillata (CV) or vortex keratopathy is characterized by the presence of spiral-shaped deposits in the corneal epithelium. The most frequent causes are antimalarial drugs and amiodarone and, among systemic causes, Fabry disease (FD). MATERIAL AND METHODS A multidisciplinary, prospective, descriptive study was conducted in a tertiary reference center in Spain's Autonomous Community of Navarre after the implementation of a FD screening program for patients attended to in the Ophthalmology Department. The study analyzed those diagnosed with CV, who were subsequently referred to the rare disease clinic of the University Hospital of Navarre's Internal Medicine Department for an FD study. RESULTS Two women and four men with a mean age of 76.8 years were diagnosed with CV out of a total of 17,280 patients evaluated in outpatient consultations by three ophthalmology specialists during the period from April 2018 to April 2020. One patient died before performing the screening study and no patients were diagnosed with FD. CONCLUSIONS Despite the fact that the University Hospital of Navarre's FD screening program for patients with CV did not confirm any cases of FD, ophthalmology specialists should consider the possible diagnosis of FD in patients with CV in their routine consultations.
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Affiliation(s)
- P Fanlo
- Unidad de Enfermedades Autoinmunes Sistémicas, Consulta de Enfermedades Minoritarias, Servicio de Medicina Interna, Hospital Universitario de Navarra, Pamplona, Spain.
| | - A Garralda
- Servicio de Oftalmología, Hospital Universitario de Navarra, Pamplona, Spain
| | - J F Gómez-Cerezo
- Servicio de Medicina Interna, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain; Docencia titular de Medicina, Universidad Europea de Madrid, Madrid, Spain
| | - M Echeverria
- Servicio de Oftalmología, Hospital Universitario de Navarra, Pamplona, Spain
| | - M López
- Unidad de Enfermedades Sistémicas Autoinmunes y Minoritarias, Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - H Heras
- Servicio de Oftalmología, Hospital Universitario de Navarra, Pamplona, Spain
| | - A Riera-Mestre
- Servicio de Medicina Interna, Hospital Universitari de Bellvitge, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Departamento de Ciencias Clínicas, Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona, Barcelona, Spain
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Molino J, Guillén G, Rocha O, Oliver B, López Fernández S, Khan H, de Mir I, Iglesias I, López M. Analysis of perceived risk and satisfaction with telematic follow-up in patients and families of congenital diaphragmatic hernia patients during SARS-CoV-2 pandemia. J Healthc Qual Res 2023; 38:20-25. [PMID: 35835633 PMCID: PMC9221794 DOI: 10.1016/j.jhqr.2022.05.009] [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] [Received: 04/29/2022] [Accepted: 05/23/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND The impact of COVID-19 in families and patients with congenital diaphragmatic hernia (CDH) is unknown, this situation has generated uncertainty not only in family members but also in the optimal outpatient follow-up. Telehealth has become a fundamental tool for the follow-up during the pandemic. The objective of this survey is to evaluated the impact of SARS-CoV-2 in families and patients with CDH and the satisfaction with telematic follow-up. METHODS Telephone survey of patient's caregivers with CHD, aged 1-16 years, followed in neonatal surgery outpatients, from January 31, 2020 to November 15, 2020. The ethical clearance for this study was taken from the Clinical Research Ethics Committee of our Research Institute vide letter number VHIR/239283/01.01.2021. RESULTS 81 surveys of 100 patients with active follow-up were carried out. There were no refusals in any contacted parents. There were 30 contacts (37%), 44.8% at school and 27.6% from cohabiting family members. Four infections (4.9%) were diagnosed, half symptomatic. In 40 patients (49.4%) the follow-up was telematic, with a mean score of 3.1±1.3 out of 5. For future controls, 65% prefer presential follow-up, 25% alternate and 10% telematics. 50.6% reported greater anxiety and 34.6% (28/81) extreme measures of isolation, being more accentuated in the group of 3-6 years (p<0.05). CONCLUSION The impact of COVID19 in patients with CHD is not greater than in the general pediatric population. Although the incorporation of the telehealth was well valued, most of the caregivers prefer the face-to-face outpatient follow-up.
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Affiliation(s)
- J.A. Molino
- Pediatric Surgery and Urology Department, Neonatal Surgery Unit, Universitat Autónoma de Barcelona, Vall d’Hebron Hospital Campus, Barcelona, Spain,Corresponding author
| | - G. Guillén
- Pediatric Surgery and Urology Department, Neonatal Surgery Unit, Universitat Autónoma de Barcelona, Vall d’Hebron Hospital Campus, Barcelona, Spain
| | - O. Rocha
- Pediatric Surgery and Urology Department, Universitat Autónoma de Barcelona, Vall d’Hebron Hospital Campus, Barcelona, Spain
| | - B. Oliver
- Pediatric Surgery and Urology Department, Universitat Autónoma de Barcelona, Vall d’Hebron Hospital Campus, Barcelona, Spain
| | - S. López Fernández
- Pediatric Surgery and Urology Department, Neonatal Surgery Unit, Universitat Autónoma de Barcelona, Vall d’Hebron Hospital Campus, Barcelona, Spain
| | - H.A. Khan
- Pediatric Surgery and Urology Department, Universitat Autónoma de Barcelona, Vall d’Hebron Hospital Campus, Barcelona, Spain
| | - I. de Mir
- Pediatric Pulmonolocy Department, Universitat Autónoma de Barcelona, Vall d’Hebron Hospital Campus, Barcelona, Spain
| | - I. Iglesias
- Pediatric Pulmonolocy Department, Universitat Autónoma de Barcelona, Vall d’Hebron Hospital Campus, Barcelona, Spain
| | - M. López
- Pediatric Surgery and Urology Department, Universitat Autónoma de Barcelona, Vall d’Hebron Hospital Campus, Barcelona, Spain
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7
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Torres MI, Farelo H, Otero P, Di Cugno M, Kozak A, Ruibal G, Rodriguez P, Fenili C, Sequera A, Álvarez G, Anselmo C, Araque S, Barrios V, Belloni J, Blanco C, Burakowski D, Cabral F, Cãceres L, Castillo MS, Cateura M, Cepero MI, Corbatta C, De La Colina A, De Miguel L, Delgado V, Dominguez C, Dragani V, Fillipini S, Foglino E, Gasparin A, Gerosa P, Golinelli B, Herrero D, Isaack K, Laguarde M, Lalosa L, López M, Lucero V, Mallo MV, Marina C, Minotti F, Mora ME, Palacios M, Paz Pacheco J, Perez Bonetti L, Podadas Gaspa S, Rios E, Rossi O, Sanhueza N, Sosa S, Surbando L, Vargas R. ODP109 PARATHYROID HORMONE AND 25 OH VITAMINA D IN PREGNANCY: DATA FROM AN ARGENTINEAN COHORT SUPPORTING SUPPLEMENTATION. J Endocr Soc 2022. [PMCID: PMC9625022 DOI: 10.1210/jendso/bvac150.352] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Vitamin D (Vit D) deficiency has become a global health care issue, as it affects a great number of women during pregnancy and lactation. Vit D levels are critical during pregnancy, being the mother the only source of them for the developing fetus; an enzymatic system for conversion of 25OH VitD into 1-25(OH) 2 VitD is present in the placenta, thus reinforcing the importance of VitD during gestation. VitD deficiency has been associated with obstetric complications and adverse outcomes in offspring, affecting skeletal, immunological and respiratory systems. It is known that prenatal supplements available do not contain enough VitD to fulfil requirements. It is generally accepted that elevated PTH is an indicator of VitD deficiency, and Hysaj O et al (2021) showed that 25OH VitD is a statistically significant determinant of PTH levels in early and late pregnancy. Aim To evaluateVitD status and its relationship to parathyroid hormone (PTH) in a cohort of pregnant women representative of multiple Argentinian regions. Subjects and Methods Data from samples of 423 pregnant women in 1st and 2nd trimester were collected between 2016 and 2021. VitD was measured in different platforms: DiaSorin Liaison CLIA (n=184), Roche COBAS ECLIA (n=166), Abbott ARCHITECT CMIA (n=33), Biomérieux VIDAS ELFA (n=18) and Siemens CENTAUR CLIA (n=16). PTH (ng/L) was measured in 162 samples by SIEMENS IMMULITE CLIA and Roche COBAS ECLIA. As VitD is light-exposure dependent, we considered warm and high light-exposure season period from December to March and cold and low light season from April to September. VITD (ng/L) levels were classified as Deficient (<20), Insufficient (between 21 and 29) and Sufficient (>30) (Endocrine Society, 2014). Results From 423 data collected, 102 were excluded because of lacking information on VitD supplementation. From the remaining non supplemented 321 samples, 48% resulted insufficient, 30% deficient and 22% sufficient for VitD (groups comparison: p< 0. 05, Kruskal Wallis-Dunn test). The seasonal period and pregnancy trimester distributions didn't show significant differences. Similar results of VitD insufficiency were found in the major used platforms, regardless the seasonal period considered. PTH results expressed as median and interquartile range were (ng/L): 32. 0 (13.7-169. 0) in Deficient pregnancies (N=92), 23.7(13.3-88. 0) in Insufficient (n=50) and 18.7 (9.8-55.7) in Sufficient (n=20). Conclusions This study shows VitD inadequate levels in 78% in non-supplemented pregnancies, regardless season or measurement platform. Relative elevated levels of PTH were associated to pregnancies with VitD deficiency, evidenciating a regulatory role according to published data. To improve VitD status during pregnancy it would be advisable to pose new strategies for prenatal supplements developed by a multidisciplinary professional team. Presentation: No date and time listed
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Fanlo P, Garralda A, Gómez-Cerezo J, Echeverria M, López M, Heras H, Riera-Mestre A. Resultados del programa de cribado de enfermedad de Fabry en pacientes con córnea verticillata en el Hospital Universitario de Navarra. Rev Clin Esp 2022. [DOI: 10.1016/j.rce.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Rubio A, López M, Rodrigues T, Campo-Deaño L, Vega EJ. A particulate blood analogue based on artificial viscoelastic blood plasma and RBC-like microparticles at a concentration matching the human haematocrit. Soft Matter 2022; 18:7510-7523. [PMID: 36148801 DOI: 10.1039/d2sm00947a] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
There has been enormous interest in the production of fluids with rheological properties similar to those of real blood over the last few years. Application fields range from biomicrofluidics (microscale) to forensic science (macroscale). The inclusion of flexible microparticles in blood analogue fluids has been demonstrated to be essential in order to reproduce the behaviour of blood flow in these fields. Here, we describe a protocol to produce a whole human blood analogue composed of a proposed plasma analogue and flexible spherical microparticles that mimic the key structural attributes of RBCs (size and mechanical properties), at a concentration matching the human haematocrit (∼42% by volume). Polydimethylsiloxane (PDMS) flexible microparticles were used to mimic RBCs, whose capability to deform is tunable by means of the mixing ratio of the PDMS precursor. Their flow through glass micronozzles allowed us to find the appropriate mixing ratio of PDMS to have approximately the same Young's modulus (E) as that exhibited by real RBCs. Shear and extensional rheology and microrheology techniques were used to match the properties exhibited by human plasma and whole blood at body temperature (37 °C). Finally, we study the flow of our proposed fluid through a microfluidic channel, showing the in vitro reproduction of the multiphase flow effects taking place in the human microcirculatory system, such as the cell-free layer (CFL) and the Fåhræus-Lindqvist effect. A macroscale application in the field of forensic science is also presented, concerning the impact of our blood analogue droplets on a solid surface for bloodstain pattern analysis.
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Affiliation(s)
- A Rubio
- Depto. de Ingeniería Mecánica, Energética y de los Materiales and Instituto de Computación Científica Avanzada (ICCAEx), Universidad de Extremadura, E-06006, Badajoz, Spain. ejvega@unex
| | - M López
- Depto. de Ingeniería Mecánica, Energética y de los Materiales and Instituto de Computación Científica Avanzada (ICCAEx), Universidad de Extremadura, E-06006, Badajoz, Spain. ejvega@unex
| | - T Rodrigues
- CEFT, Depto. de Engenharia Mecânica, Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal
- ALiCE, Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal
| | - L Campo-Deaño
- CEFT, Depto. de Engenharia Mecânica, Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal
- ALiCE, Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal
| | - E J Vega
- Depto. de Ingeniería Mecánica, Energética y de los Materiales and Instituto de Computación Científica Avanzada (ICCAEx), Universidad de Extremadura, E-06006, Badajoz, Spain. ejvega@unex
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López M, Reche C, Pérez-Albaladejo E, Porte C, Balasch A, Monfort E, Eljarrat E, Viana M. E-waste dismantling as a source of personal exposure and environmental release of fine and ultrafine particles. Sci Total Environ 2022; 833:154871. [PMID: 35364180 DOI: 10.1016/j.scitotenv.2022.154871] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/01/2022] [Accepted: 03/23/2022] [Indexed: 06/14/2023]
Abstract
Electronic waste (WEEE; from TV screens to electric toothbrushes) is one of the fastest growing waste streams in the world. Prior to recycling, e-waste components (metals, wood, glass, etc.) are processed by shredding, grinding and chainsaw cutting. These activities generate fine and ultrafine particle emissions, containing metals as well as organics (e.g., flame retardants), which have high potential for human health impacts as well as for environmental release. In this work, release of fine and ultrafine particles, and their exposure impacts, was assessed in an e-waste recycling facility under real-world operating conditions. Parameters monitored were black carbon, particle mass concentrations, ultrafine particles, and aerosol morphology and chemical composition. Potential health impacts were assessed in terms of cytotoxicity (cell viability) and oxidative stress (ROS) on <2 μm particles collected in liquid suspension. Environmental release of WEEE aerosols was evidenced by the higher particle concentrations monitored outside the facility when compared to the urban background (43 vs.11 μgPM2.5/m3, respectively, or 2.4 vs. 0.2 μgCa/m3). Inside the facility, concentrations were higher in the top than on the ground floor (PM2.5 = 147 vs. 78 μg/m3, N = 15.4 ∗ 104 vs. 8.7 ∗ 104/cm3, BC = 12.4 vs. 7.2 μg/m3). Ventilation was a key driver of human exposure, in combination with particle emissions. Key chemical tracers were Ca (from plastic fillers) and Fe (from wiring and other metal components). Y, Zr, Cd, Pb, P and Bi were markers of cathode TV recycling, and Li and Cr of grinding activities. While aerosols did not evidence cytotoxic effects, ROS generation was detected in 4 out of the 12 samples collected, associated to the ultrafine fraction. We conclude on the need for studies on aerosol emissions from WEEE facilities, especially in Europe, due to their demonstrable environmental and human health impacts and the rapidly growing generation of this type of waste.
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Affiliation(s)
- M López
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), C/ Jordi Girona 18, 08034 Barcelona, Spain; Barcelona University, Chemistry Faculty, C/ de Martí i Franquès, 1-11, 08028 Barcelona, Spain.
| | - C Reche
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), C/ Jordi Girona 18, 08034 Barcelona, Spain
| | - E Pérez-Albaladejo
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), C/ Jordi Girona 18, 08034 Barcelona, Spain
| | - C Porte
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), C/ Jordi Girona 18, 08034 Barcelona, Spain
| | - A Balasch
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), C/ Jordi Girona 18, 08034 Barcelona, Spain; Barcelona University, Chemistry Faculty, C/ de Martí i Franquès, 1-11, 08028 Barcelona, Spain
| | - E Monfort
- Institute of Ceramic Technology (ITC)-AICE - Universitat Jaume I, Campus Universitario Riu Sec, Av. Vicent Sos Baynat s/n, 12006 Castellón, Spain
| | - E Eljarrat
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), C/ Jordi Girona 18, 08034 Barcelona, Spain
| | - M Viana
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), C/ Jordi Girona 18, 08034 Barcelona, Spain
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Álvarez B, Montero Á, Alonso R, Valero J, Ciérvide R, López M, Alonso L, Sánchez E, García-Aranda M, Chen X, Hernando O, Rubio C. PO-1442 Low-dose RT for benign musculoeskeletal disorders:clap your hands, stomp your feet,return to be fit! Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03406-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Balasch A, López M, Reche C, Viana M, Moreno T, Eljarrat E. Exposure of e-waste dismantlers from a formal recycling facility in Spain to inhalable organophosphate and halogenated flame retardants. Chemosphere 2022; 294:133775. [PMID: 35104541 DOI: 10.1016/j.chemosphere.2022.133775] [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] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
Concentration levels of 16 organophosphate esters (OPEs) and 18 halogenated flame retardants (HFRs) were measured in airborne fine particulate matter (PM2.5) from an e-waste dismantling facility in Catalonia (Spain) to assess their occurrence, profiles and potential health risks. Three different areas from the facility were studied, including an area for cathodic ray-tube (CRT) TV dismantling, a grinding area, and the outdoor background. OPEs and HFRs were detected in all samples, with concentrations between 10.4 and 110 ng/m3 for OPEs and from 0.72 to 2213 ng/m3 for HFRs. The compounds with highest concentrations in both working areas were triphenyl phosphate (TPHP) and tris(2-chloroisopropyl) phosphate (TCIPP) for OPEs and decabromodiphenyl ether (BDE-209) for HFRs. Higher concentration levels were found in the CRT area compared to the grinding one, probably due to the lower ventilation and different types of e-waste being processed. OPEs were also detected in the solid e-waste from the facility, highlighting the need to evaluate pollutant levels in e-waste before proceeding to its re-use. Estimated daily intakes via inhalation during workday were calculated, as well as carcinogenic and non-carcinogenic health risks, these being 25 and 50 times lower than threshold risk values in the worst cases, respectively. However, this calculated risk only considers the workday exposure via inhalation, while other routes of exposure (e.g., ingestion, dermal) could bring these values closer to threshold values.
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Affiliation(s)
- A Balasch
- Institute of Environmental Assessment and Water Research (IDAEA)-CSIC, Jordi Girona 18-26, 08034, Barcelona, Spain
| | - M López
- Institute of Environmental Assessment and Water Research (IDAEA)-CSIC, Jordi Girona 18-26, 08034, Barcelona, Spain
| | - C Reche
- Institute of Environmental Assessment and Water Research (IDAEA)-CSIC, Jordi Girona 18-26, 08034, Barcelona, Spain
| | - M Viana
- Institute of Environmental Assessment and Water Research (IDAEA)-CSIC, Jordi Girona 18-26, 08034, Barcelona, Spain
| | - T Moreno
- Institute of Environmental Assessment and Water Research (IDAEA)-CSIC, Jordi Girona 18-26, 08034, Barcelona, Spain
| | - E Eljarrat
- Institute of Environmental Assessment and Water Research (IDAEA)-CSIC, Jordi Girona 18-26, 08034, Barcelona, Spain.
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Gander R, Asensio M, Royo GF, Molino JA, López M, Coma A, Muñoz M, Cruz A, Ríos H, Ariceta G. Page kidney after pediatric kidney transplantation: a case report. Cir Pediatr 2022; 35:94-98. [PMID: 35485759 DOI: 10.54847/cp.2022.02.19] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Page kidney (PK) is a rare condition caused by parenchymal compression due to a subcapsular hematoma. Irreversible damage of the graft may occur if this condition is not recognized and treated properly. CLINICAL CASE We describe the case of a 16-year-old man with chronic renal failure secondary to corticosteroid-resistant nephrotic syndrome (CRNS) caused by NPHS2 mutations. The patient underwent a 5th fifth living-related KT. The graft was placed intraperitoneally and reperfused well without complications. On the 4th postoperative day his labs demonstrated raising creatinine associated with refractory hypertension, gross hematuria and anemia. Urgent ultrasound revealed a subcapsular hematoma with signs of parenchymal compression. PK phenomenon was suspected and urgent surgical intervention decided. COMMENTS PK is a rare but an emergence potentially treatable and reversible complication after pediatric KT. Early diagnosis based on clinical suspicion and suggestive imaging are the key points for a favorable outcome.
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Affiliation(s)
- R Gander
- Pediatric Surgery Department, Pediatric Urology and Renal Transplant Unit. Vall d'Hebron Hospital. Barcelona (Spain)
| | - M Asensio
- Pediatric Surgery Department, Pediatric Urology and Renal Transplant Unit. Vall d'Hebron Hospital. Barcelona (Spain)
| | - G F Royo
- Pediatric Surgery Department, Pediatric Urology and Renal Transplant Unit. Vall d'Hebron Hospital. Barcelona (Spain)
| | - J A Molino
- Pediatric Surgery Department, Pediatric Urology and Renal Transplant Unit. Vall d'Hebron Hospital. Barcelona (Spain)
| | - M López
- Pediatric Surgery Department. Vall d'Hebron Hospital. Barcelona (Spain)
| | - A Coma
- Pediatric Radiology Department. Vall d'Hebron Hospital. Barcelona (Spain)
| | - M Muñoz
- Pediatric Nephrology Department. Vall d'Hebron Hospital. Barcelona (Spain)
| | - A Cruz
- Pediatric Nephrology Department. Vall d'Hebron Hospital. Barcelona (Spain)
| | - H Ríos
- Pediatric Nephrology Department. Vall d'Hebron Hospital. Barcelona (Spain)
| | - G Ariceta
- Pediatric Nephrology Departmenta. Vall d'Hebron Hospital. Barcelona (Spain)
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López M, López Lilao A, Ribalta C, Martínez Y, Piña N, Ballesteros A, Fito C, Koehler K, Newton A, Monfort E, Viana M. Particle release from refit operations in shipyards: Exposure, toxicity and environmental implications. Sci Total Environ 2022; 804:150216. [PMID: 34520930 DOI: 10.1016/j.scitotenv.2021.150216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/22/2021] [Accepted: 09/04/2021] [Indexed: 06/13/2023]
Abstract
European harbours are known to contribute to air quality degradation. While most of the literature focuses on emissions from stacks or logistics operations, ship refit and repair activities are also relevant aerosol sources in EU harbour areas. Main activities include abrasive removal of filler and spray painting with antifouling coatings/primers/topcoats. This work aimed to assess ultrafine particle (UFP) emissions from ship maintenance activities and their links with exposure, toxicity and health risks for humans and the aquatic environment. Aerosol emissions were monitored during mechanical abrasion of surface coatings under real-world operating conditions in two scenarios in the Mallorca harbour (Spain). Different types of UFPs were observed: (1) highly regular (triangular, hexagonal) engineered nanoparticles (Ti-, Zr-, Fe-based), embedded as nano-additives in the coatings, and (2) irregular, incidental particles emitted directly or formed during abrasion. Particle number concentrations monitored were in the range of industrial activities such as drilling or welding (up to 5 ∗ 105/cm3, mean diameters <30 nm). The chemical composition of PM4 aerosols was dominated by metallic tracers in the coatings (Ti, Al, Ba, Zn). In vitro toxicity of PM2 aerosols evidenced reduced cell viability and a moderate potential for cytotoxic effects. While best practices (exhaust ventilation, personal protective equipment, dust removal) were in place, it is unlikely that exposures and environmental release can be fully avoided at all times. Thus, it is advisable that health and safety protocols should be comprehensive to minimise exposures in all types of locations (near- and far-field) and periods (activity and non-activity). Potential release to coastal surface waters of metallic engineered and incidental nanomaterials, as well as fine and coarse particles (in the case of settled dust), should be assessed and avoided.
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Affiliation(s)
- M López
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), C/ Jordi Girona 18, 08034 Barcelona, Spain; Barcelona University, Chemistry Faculty, C/ de Martí i Franquès, 1-11, 08028 Barcelona, Spain.
| | - A López Lilao
- Institute of Ceramic Technology (ITC)- AICE - Universitat Jaume I, Campus Universitario Riu Sec, Av. Vicent Sos Baynat s/n, 12006 Castellón, Spain
| | - C Ribalta
- The National Research Center for Work Environment (NRCWE), Lersø Parkallé 105, 2100 København, Denmark
| | - Y Martínez
- Baleari Island University (UIB), Carretera de Valldemossa, km 7.5, 07122 Palma, Illes Balears, Spain
| | - N Piña
- Baleari Island University (UIB), Carretera de Valldemossa, km 7.5, 07122 Palma, Illes Balears, Spain
| | - A Ballesteros
- Technological Institute of Packaging, Transportation and Logistics (ITENE), C/ Albert Einstein, 1, 46980 Paterna, Valencia, Spain
| | - C Fito
- Technological Institute of Packaging, Transportation and Logistics (ITENE), C/ Albert Einstein, 1, 46980 Paterna, Valencia, Spain
| | - K Koehler
- Johns Hopkins University (JHU), Baltimore, MD 21218, USA
| | - A Newton
- Johns Hopkins University (JHU), Baltimore, MD 21218, USA
| | - E Monfort
- Institute of Ceramic Technology (ITC)- AICE - Universitat Jaume I, Campus Universitario Riu Sec, Av. Vicent Sos Baynat s/n, 12006 Castellón, Spain
| | - M Viana
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), C/ Jordi Girona 18, 08034 Barcelona, Spain
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Molino Gahete JA, López Fernández S, Oliver B, Boix H, Rocha O, López M, Guillén G. Duodenal atresia with apple peel associated with congenital diaphragmatic hernia: an exceptional case and a literature review. Cir Pediatr 2022; 35:31-35. [PMID: 35037438 DOI: 10.54847/cp.2022.01.16] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Duodenal atresia associated with apple peel is extremely rare. Duodenal atresia occurs as a result of absence of recanalization at an early stage, whereas intestinal atresia is seemingly due to vascular causes at later stages. The presence of abnormalities associated with diaphragmatic hernia is frequent, but association with duodenal atresia has been little explored. CASE REPORT This is the case of a female neonate born at gestational week 31, with duodenal atresia and apple peel, associated with left diaphragmatic hernia and major heart disease. An abdominal muscle flap was performed for diaphragmatic defect closure purposes, and duodenojejunal anastomosis was carried out following resection of part of the non-viable apple peel. DISCUSSION To our knowledge, this is the first case described with this rare association. The combination of duodenal atresia and apple peel had been previously described 11 times. However, the association of both with congenital diaphragmatic hernia had not been reported yet.
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Affiliation(s)
- J A Molino Gahete
- Oncological and Neonatal Surgery Unit. Pediatric Surgery Department. Vall d'Hebrón University Hospital. Barcelona (Spain)
| | - S López Fernández
- Oncological and Neonatal Surgery Unit. Pediatric Surgery Department. Vall d'Hebrón University Hospital. Barcelona (Spain)
| | - B Oliver
- Oncological and Neonatal Surgery Unit. Pediatric Surgery Department. Vall d'Hebrón University Hospital. Barcelona (Spain)
| | - H Boix
- Oncological and Neonatal Surgery Unit. Pediatric Surgery Department. Vall d'Hebrón University Hospital. Barcelona (Spain)
| | - O Rocha
- Oncological and Neonatal Surgery Unit. Pediatric Surgery Department. Vall d'Hebrón University Hospital. Barcelona (Spain)
| | - M López
- Oncological and Neonatal Surgery Unit. Pediatric Surgery Department. Vall d'Hebrón University Hospital. Barcelona (Spain)
| | - G Guillén
- Oncological and Neonatal Surgery Unit. Pediatric Surgery Department. Vall d'Hebrón University Hospital. Barcelona (Spain)
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Martos M, Cano P, Molino JA, López-Fernández S, Hladun R, López M, Guillén G. Minimally invasive surgery for pediatric dumbbell neuroblastoma: systematic literature review and report of a single-stage neurosurgical and thoracoscopic approach. Clin Transl Oncol 2021; 24:950-957. [PMID: 34718957 DOI: 10.1007/s12094-021-02724-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/13/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Traditional surgical strategies for dumbbell neuroblastoma entail, among others, high risk of spinal deformity. Less invasive procedures might reduce these sequelae, however, there is small evidence comparing different strategies. Indications of minimally invasive surgery in neuroblastoma are still developing. Our aim is to identify and analyze different surgical approaches described in the recent literature and to suggest a minimally invasive option. METHODS A systematic review of the literature was conducted in PubMed (Jan 2000-Dec 2021) to identify reports describing surgical resection of dumbbell neuroblastoma in children, according to the PRISMA guidelines. Only full-text articles were included. RESULTS 7 articles met the inclusion criteria which, added to the present case, represent a total of 43 patients. All were retrospective studies, most of them small series. Tumor location was mostly thoracic. Most of combined approaches were performed in two stages. Spinal deformity after surgery was reported in 3 patients. Minimally invasive approach was described in only one paper, with no reported cases of its use in a single-stage combined surgery. We also report, to our knowledge, the first single-stage posterior neurosurgical approach combined with thoracoscopy for resection of a dumbbell neuroblastoma in an infant. CONCLUSION Surgical resection of dumbbell neuroblastomas is challenging. There is no consensus on best surgical approach. Dumbbell tumors should not be considered a contraindication for minimally invasive surgery. A single stage and minimally invasive strategy is proposed.
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Affiliation(s)
- M Martos
- Pediatric Surgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - P Cano
- Neurosurgery Department, Hospital Infantil Vall d'Hebron, Barcelona, Spain
| | - J A Molino
- Pediatric Surgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - S López-Fernández
- Pediatric Surgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - R Hladun
- Pediatric Oncohematology Department, Hospital Infantil Vall d'Hebron, Barcelona, Spain
| | - M López
- Pediatric Surgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Surgery Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - G Guillén
- Pediatric Surgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain. .,Surgery Department, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Álvarez B, Montero A, Alonso R, Valero J, López M, Ciérvide R, Sánchez E, Hernando O, García-Aranda M, Martí J, Prado A, Chen-Zhao X, Rubio C. Low-dose radiation therapy for hand osteoarthritis: shaking hands again? Clin Transl Oncol 2021; 24:532-539. [PMID: 34585316 DOI: 10.1007/s12094-021-02710-w] [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: 07/02/2021] [Accepted: 09/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hand osteoarthritis (HOA) is one of the most common causes of pain and functional disability in western countries and there is still no definitive cure. Low-dose radiation therapy (LDRT) has anti-inflammatory properties that have shown to be effective in the symptomatic relief of various degenerative musculoskeletal disorders. We designed a clinical protocol using LDRT for symptomatic HOA and present results and tolerance in the first 100 patients included. MATERIALS AND METHODS Between April 2015 and March 2021, 100 patients with a median age of 60 were treated. Fifty-seven patients suffering from proximal/distal interphalangeal joint pain, 40 patients with thumb arthritis, 2 patients with radiocarpal joint affection and 1 patient with metacarpophalangeal joint pain were enrolled. LDRT comprised of 6 fractions of 0.5-1 Gy on every other day up to a total dose of 3-6 Gy. Clinical response was evaluated according to the visual analog scale (VAS) for pain level and the von Pannewitz score (VPS) for joint functionality. Any patients not achieving subjective adequate pain relief after 8 weeks of treatment were offered a second identical LDRT course. RESULTS With a median follow-up of 10.5 months (range 7.55-12.45), 94% reported an improvement in the pain, with a significant reduction in the VAS level after 3, 6 and 12 months (p < 0.001). Sixty-three patients needed a second course of treatment at a median time interval of 12 weeks (range 9-14). The mean VAS score before treatment was 8 (range 3-10). After treatment, it was 5 (range 1-10). After 3, 6 and 12 months, the mean VAS scores were 4 (range 0-9), 3 (range 0-9) and 3.5 (range 0-9), respectively. Seventy patients reported functionality improvements after LDRT according to the von Pannewitz score. No acute or late complications were observed. CONCLUSION LDRT appears to be safe and useful for HOA and is associated with good rates of pain relief and functionality improvements. However, further studies are necessary to confirm these promising results.
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Affiliation(s)
- B Álvarez
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - A Montero
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain.
| | - R Alonso
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - J Valero
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - M López
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - R Ciérvide
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - E Sánchez
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - O Hernando
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - M García-Aranda
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - J Martí
- Department of Medical Physics, HM Hospitales, Madrid, Spain
| | - A Prado
- Department of Medical Physics, HM Hospitales, Madrid, Spain
| | - X Chen-Zhao
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
| | - C Rubio
- Department of Radiation Oncology, HM Hospitales, Calle Oña 10, 28050, Madrid, Spain
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Chen-Zhao X, Montero Á, de las Heras J, Álvarez B, Barrientos I, Prado A, Ciérvide R, López M, García-Aranda M, Ortiz E, Gutiérrez M, Sánchez E, Hernando O, De la Casa M, Valero J, Alonso R, Fernández-Letón P, Rubio C. PO-1422 Perioperative HDR brachytherapy and EBRT: a winning combo for soft tissue sarcomas. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07873-7] [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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Rubio Rodríguez M, Arias F, Chen-Zhao X, Flamarique S, Fernández-Letón P, Campo M, López M, Rodríguez M, Zucca D, Martínez D, Sánchez-Saugar E, Mañeru F, García Ruiz-Zorrilla J, García de Acilu P, Valero J, Montero A, Ciérvide R, Alvarez B, García-Aranda M, Alonso R, de la Casa M, Alonso L, Nuñez M, Martí J, Hernando O. OC-0416 Results of SBRT-SG-01, a prospective multicentric-study of SBRT for liver metastases. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06903-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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García I, Suárez E, Maiz N, Pascual M, Perera R, Arévalo S, Giné C, Molino JA, López M, Carreras E, Manrique S. Fetal heart rate monitoring during fetoscopic repair of open spinal neural tube defects: a single-centre observational cohort study. Int J Obstet Anesth 2021; 48:103195. [PMID: 34175576 DOI: 10.1016/j.ijoa.2021.103195] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 04/23/2021] [Accepted: 05/31/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND During fetal surgery, the haemodynamic stability of the fetus depends on the haemodynamic stability of the mother. The primary objective of this study was to assess changes in fetal heart rate (FHR) throughout the different stages of surgery. The secondary objective was to assess potential changes in maternal physiological parameters and their association with FHR. METHODS This was a single-center observational cohort study conducted between 2015 and 2019 in 26 women undergoing intra-uterine fetoscopic repair of open spina bifida. The primary outcome was FHR. Maternal physiologic parameters were measured at the beginning, during and after surgery. The linear mixed-effects model fitted by maximum likelihood was used to assess changes in each variable at specific times throughout the surgery, and the repeated measures correlation coefficient was used to study the association between FHR and maternal physiological parameters. RESULTS One (3.8%) case of fetal bradycardia (FHR <110 beats per minute) required the administration of intramuscular atropine. No other significant FHR changes were observed during surgery. Maternal oesophageal temperature (P <0.001), lactate levels (P=0.002), and mean arterial pressure (P=0.016) changed significantly during surgery, although none of these changes was clinically relevant. The FHR showed a significant association with maternal carbon dioxide tension (r=0.285, 95% CI 0.001 to 0.526) and maternal heart rate (r=0.302, 95% CI 0.025 to 0.535). CONCLUSION The FHR remained stable during intra-uterine fetoscopic repair of open spina bifida. Maternal carbon dioxide tension and heart rate may have a mild influence on FHR.
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Affiliation(s)
- I García
- Anaesthesiology and Intensive Care Department. Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - E Suárez
- Anaesthesiology and Intensive Care Department. Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - N Maiz
- Universitat Autònoma de Barcelona, Bellaterra, Spain; Obstetrics Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
| | - M Pascual
- Anaesthesiology and Intensive Care Department. Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - R Perera
- Anaesthesiology and Intensive Care Department. Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - S Arévalo
- Universitat Autònoma de Barcelona, Bellaterra, Spain; Obstetrics Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - C Giné
- Universitat Autònoma de Barcelona, Bellaterra, Spain; Paediatric Surgery Department. Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus. Barcelona, Spain
| | - J A Molino
- Universitat Autònoma de Barcelona, Bellaterra, Spain; Paediatric Surgery Department. Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus. Barcelona, Spain
| | - M López
- Universitat Autònoma de Barcelona, Bellaterra, Spain; Paediatric Surgery Department. Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus. Barcelona, Spain
| | - E Carreras
- Universitat Autònoma de Barcelona, Bellaterra, Spain; Obstetrics Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - S Manrique
- Anaesthesiology and Intensive Care Department. Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain
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Ciérvide R, Montero Á, Potdevin G, García J, Aranda MG, Álvarez B, Rossi K, López M, Hernando O, Valero J, Sánchez E, Chen X, Alonso R, Letón PF, Rubio C. 5-year results of accelerated partial breast irradiation (APBI) with SBRT (stereotactic body radiation therapy) and exactrac adaptive gating (Novalis ®) for very early breast cancer patients: was it all worth it? Clin Transl Oncol 2021; 23:2358-2367. [PMID: 34043153 DOI: 10.1007/s12094-021-02636-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/05/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE To explore the feasibility of image-guided and respiratory-gated Stereotactic Body Radiation Therapy (SBRT) for Accelerated Partial Breast Irradiation (APBI) in patients with very early breast cancer. MATERIAL AND METHODS Selected patients with early breast carcinoma after breast-conserving surgery were enrolled in this phase II trial. A fiducial marker was percutaneously placed close to surgical bed and five external fiducials were set on the skin. A CT scan for planning was acquired at free breathing. The treatment was planned and DVH were assessed according to international recommendations. Prescription dose was 30 Gy in five consecutive fractions of 6 Gy. A 6MV monoenergetic LINAC (linear accelerator) that combines stereoscopic X-ray imaging system and ExacTrac Adaptive Gating technique was used. PTV (planning target volume) intrafraction motion was controlled and PTV was irradiated in a selected gated area of the respiratory cycle. Shifts for a correct, gated set-up were calculated and automatically applied. RESULTS Between April 2013 and October 2015, a total of 23 patients were included. The median tumor size was 12 mm. The mean PTV volume was 114 cc. The mean ipsilateral lung V9 Gy was 2.2% and for left-sided breast cancers, the volume of the heart receiving 1.5 Gy was 11.5%. Maximum skin dose was 30.8 Gy. Acute toxicity was grade1 in all the patients and 100% experienced excellent/good breast cosmesis outcomes. With a median follow-up of 66 months (range 8-99 months) local-relapse-free-survival reaches 100%. One patient developed a second breast cancer outside the treated quadrant after 25.1 months. CONCLUSION APBI with SBRT and ExacTrac Adaptive Gating System was feasible. The acute and late toxicities were almost null and cosmesis was excellent. We also found that the margins of 5 mm applied from CTV to PTV were sufficient to compensate for geometric uncertainties.
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MESH Headings
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Breast Neoplasms/radiotherapy
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Ductal, Breast/surgery
- Disease-Free Survival
- Dose Fractionation, Radiation
- Feasibility Studies
- Female
- Fiducial Markers
- Heart/radiation effects
- Humans
- Lung/radiation effects
- Mastectomy, Segmental
- Middle Aged
- Organ Motion
- Organs at Risk/radiation effects
- Postoperative Care/methods
- Prospective Studies
- Radiosurgery/instrumentation
- Radiosurgery/methods
- Respiration
- Skin/radiation effects
- Time Factors
- Tomography, X-Ray Computed
- Tumor Burden
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Affiliation(s)
- R Ciérvide
- Department of Radiation Oncology, U.H. Sanchinarro. HM Hospitales, Calle Oña, 10, 28050, Madrid, Spain.
| | - Á Montero
- Department of Radiation Oncology, U.H. Sanchinarro. HM Hospitales, Calle Oña, 10, 28050, Madrid, Spain
| | - G Potdevin
- Department of Radiation Oncology, Fundación Valle del Lili, Cali, Colombia
| | - J García
- Department of Radiation Oncology, U.H. Puerta del Sur. HM Hospitales, Madrid, Spain
| | - M G Aranda
- Department of Radiation Oncology, U.H. Sanchinarro. HM Hospitales, Calle Oña, 10, 28050, Madrid, Spain
| | - B Álvarez
- Department of Radiation Oncology, U.H. Sanchinarro. HM Hospitales, Calle Oña, 10, 28050, Madrid, Spain
| | - K Rossi
- Department of Radiation Oncology, U.H. Sanchinarro. HM Hospitales, Calle Oña, 10, 28050, Madrid, Spain
| | - M López
- Department of Radiation Oncology, U.H. Sanchinarro. HM Hospitales, Calle Oña, 10, 28050, Madrid, Spain
| | - O Hernando
- Department of Radiation Oncology, U.H. Puerta del Sur. HM Hospitales, Madrid, Spain
| | - J Valero
- Department of Radiation Oncology, U.H. Sanchinarro. HM Hospitales, Calle Oña, 10, 28050, Madrid, Spain
| | - E Sánchez
- Department of Radiation Oncology, U.H. Sanchinarro. HM Hospitales, Calle Oña, 10, 28050, Madrid, Spain
| | - X Chen
- Department of Radiation Oncology, U.H. Puerta del Sur. HM Hospitales, Madrid, Spain
| | - R Alonso
- Department of Radiation Oncology, U.H. Puerta del Sur. HM Hospitales, Madrid, Spain
| | - P F Letón
- Department of Radiation Oncology, U.H. Sanchinarro. HM Hospitales, Calle Oña, 10, 28050, Madrid, Spain
- Department of Radiation Oncology, U.H. Puerta del Sur. HM Hospitales, Madrid, Spain
| | - C Rubio
- Department of Radiation Oncology, U.H. Sanchinarro. HM Hospitales, Calle Oña, 10, 28050, Madrid, Spain
- Department of Radiation Oncology, U.H. Puerta del Sur. HM Hospitales, Madrid, Spain
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Engel O, Córdoba S, Arroyo M, Rodriguez N, Fernando J, de la Fuente C, Zapata I, Velasco J, Gil B, López M, Benlloch R, Hernandez M. PO-0189 The second planning-CT in a two daily fractions implant can be omitted in cervical cancer IGABT. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06348-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Torrijo I, Balciscueta Z, Tabet J, Martín MC, López M, Uribe N. Prospective study of urinary function and analysis of risk factors after rectal cancer surgery. Tech Coloproctol 2021; 25:727-737. [PMID: 33811298 DOI: 10.1007/s10151-021-02445-4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/27/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Alterations in urinary function are complications of rectal cancer surgery. The aim of this study was to prospectively analyze the changes in urinary function in patients operated on for rectal cancer, and to identify risk factors that may have an impact on the deterioration of postoperative urinary function. METHODS A prospective study of urinary function in rectal cancer patients who had elective oncological resection with curative intention at the Arnau de Vilanova Hospital in Valencia, Spain, from January 2017 to March 2019. The evaluation of urinary function was performed using the International Prostate Symptom Score (IPSS) preoperatively, at 6 and 12 months after surgery. Predictive factors of urinary dysfunction were identified by univariate and multivariate analysis. RESULTS Ninety-four patients were enrolled in the study. Eighty-seven of them completed all the follow-up assessments (48 men and 39 women, mean age 65.74 ± 10.95 years,). The mean IPSS was 7.96 ± 7.59 preoperatively, 9.01 ± 6.81 at 6 months, and 8.63 ± 5.59 at 12 months, without statistically significant differences. There were no differences in IPSS between males and females. Preoperative urinary dysfunction was 39% and at 12 months, a deterioration occurred in 23 patients (26.4%). IPSS analysis of symptoms showed a statistically significant worsening of nocturia at 6 months (p = 0.002) and 1 year after surgery (p = 0.037) in women. American Society of Anesthesiologists (ASA) class (OR: 11, [95% CI2.4-53]; p = 0.010), surgical difficulty (OR: 4.5, [95% CI 1-19]; p = 0.027) and anastomotic leakage (OR: 14, [95% CI 1.6-117]; p = 0.010), were identified as independent risk factors for deterioration of urinary function after surgery. CONCLUSIONS Our study showed worsening urinary dysfunction after rectal cancer surgery in 26.4% of the patients. However, there were no statistically significant differences in mean IPSS scores at the three assessment times (preoperatively, 6 months, 12 months). ASA class, surgical difficulty, and anastomotic leakage may predict postoperative deterioration.
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Affiliation(s)
- I Torrijo
- Department of General and Digestive Surgery, Colorectal Unit, Arnau de Vilanova Hospital, C/San Clemente no. 12, 46015, Valencia, Spain.
| | - Z Balciscueta
- Department of General and Digestive Surgery, Colorectal Unit, Arnau de Vilanova Hospital, C/San Clemente no. 12, 46015, Valencia, Spain
| | - J Tabet
- Department of General and Digestive Surgery, Colorectal Unit, Arnau de Vilanova Hospital, C/San Clemente no. 12, 46015, Valencia, Spain
| | - M C Martín
- Department of General and Digestive Surgery, Colorectal Unit, Arnau de Vilanova Hospital, C/San Clemente no. 12, 46015, Valencia, Spain
| | - M López
- Department of General and Digestive Surgery, Colorectal Unit, Arnau de Vilanova Hospital, C/San Clemente no. 12, 46015, Valencia, Spain
| | - N Uribe
- Department of General and Digestive Surgery, Colorectal Unit, Arnau de Vilanova Hospital, C/San Clemente no. 12, 46015, Valencia, Spain
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Aragón S, Oliver R, Tabuenca M, López M, Ciruelos E. Is number of sentinel nodes enougth after neoadjuvant chemotherapy? Breast 2021. [DOI: 10.1016/s0960-9776(21)00230-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Abstract
La leche de pastoreo es una certificación privada que se están implantando en el mercado europeo, principalmente para leche fresca y queso de vaca, debido a su asociación con atributos de salud, calidad y sostenibilidad. La leche de cabra de pastoreo, por sus particularidades productivas y ecosistémicas, puede ser una alternativa de mercado. En el presente estudio, se diseñó una encuesta online para una muestra representativa de consumidores (n=423), y mediante un estudio de clúster se segmentó en base a: i) ocho afirmaciones de hábitos de compra y ii) siete afirmaciones sobre la leche de pastoreo de cabra. Los consumidores se clasificaron en tres clusters: i) COMPROMETIDOS CALIDAD Y PASTOREO (n=210), ii) PASTORALES (n=139) y iii) COMPROMETIDOS PERO INDECISOS (n=70). Posteriormente, se realizó un análisis mixto de texto, usando tres palabras de asociación por consumidor con respecto a la leche de cabra de pastoreo (n=1072). Los resultados indican que los consumidores valoran positivamente la leche de pastoreo de cabra, especialmente aquellos en el clúster A: son de mayor edad, y tendrían una mayor disposición a pagar este producto, asociándola a ideas como la salud, la protección del medioambiente y la calidad sensorial. Este estudio pretende sondear las posibilidades de la leche de cabra y sus productos para crear herramientas que optimicen su futura comercialización.
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Valero J, Montero A, Hernando O, Izquierdo M, Sánchez E, García-Aranda M, López M, Ciérvide R, Martí J, Álvarez B, Alonso R, Chen-Zhao X, Fernández-Letón P, Rubio C. Moderate hypofractionated post-prostatectomy radiation therapy is feasible and well tolerated: experience from a single tertiary cancer centre. Clin Transl Oncol 2021; 23:1452-1462. [PMID: 33433839 DOI: 10.1007/s12094-020-02543-z] [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: 10/30/2020] [Accepted: 12/14/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Conventional post-prostatectomy radiation therapy comprises 6.5-8 weeks of treatment, therefore, hypofractionated and shortened schemes arouse increasing interest. We describe our experience regarding feasibility and clinical outcome of a post-prostatectomy moderate hypofractionated image-guided radiotherapy schedule MATERIALS AND METHODS: From Oct 2015-Mar 2020, 113 patients, median age of 62 years-old (range 45-76) and prostate adenocarcinoma of low risk (30%), intermediate risk (49%) and high risk (21%) were included for adjuvant (34%) or salvage radiation therapy (66%) after radical prostatectomy (RP). All patients underwent radiotherapy with image-guided IMRT/VMAT to a total dose of 62.5 Gy in 2.5 Gy/fraction in 25 fractions. Sixteen patients (14%) received concomitant androgen deprivation therapy. RESULTS With a median follow-up of 29 months (range 3-60 months) all patients but three are alive. Eleven patients (10%) developed exclusive biochemical relapse while 19 patients (17%) presented macroscopically visible relapse: prostatectomy bed in two patients (2%), pelvic lymph nodes in 13 patients (11.5%) and distant metastases in four patients (4%). The 3 years actuarial rates for OS, bFRS, and DMFS were 99.1, 91.1 and 91.2%, respectively. Acute and late tolerance was satisfactory. Maximal acute genitourinary (AGU) toxicity was G2 in 8% of patients; maximal acute gastrointestinal (AGI) toxicity was G2 in 3.5% of patients; maximal late genitourinary (LGU) toxicity was G3 in 1% of patients and maximal late gastrointestinal (LGI) toxicity was G2 in 2% of patients. There were no cases of severe acute or late toxicity. No relationship was found between acute or late GI/GU adverse effects and dosimetric parameters, age, presence of comorbidities or concomitant treatments. CONCLUSIONS Hypofractionated radiotherapy (62.5 Gy in 25 2.5 Gy fractions) is feasible and well tolerated with low complication rates allowing for a moderate dose-escalation that offers encouraging clinical results for biochemical control and survival in patients with prostate cancer after radical prostatectomy.
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Affiliation(s)
- J Valero
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - A Montero
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain.
| | - O Hernando
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - M Izquierdo
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - E Sánchez
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - M García-Aranda
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - M López
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - R Ciérvide
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - J Martí
- Department of Medical Physics, HM Hospitales, Madrid, Spain
| | - B Álvarez
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - R Alonso
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | - X Chen-Zhao
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
| | | | - C Rubio
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, c/Oña 10, 28050, Madrid, Spain
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Pérez-Revuelta L, Téllez de Meneses PG, López M, Briñón JG, Weruaga E, Díaz D, Alonso JR. Secretagogin expression in the mouse olfactory bulb under sensory impairments. Sci Rep 2020; 10:21533. [PMID: 33299042 PMCID: PMC7726155 DOI: 10.1038/s41598-020-78499-5] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/24/2020] [Indexed: 12/04/2022] Open
Abstract
The interneurons of the olfactory bulb (OB) are characterized by the expression of different calcium-binding proteins, whose specific functions are not fully understood. This is the case of one of the most recently discovered, the secretagogin (SCGN), which is expressed in interneurons of the glomerular and the granule cell layers, but whose function in the olfactory pathway is still unknown. To address this question, we examined the distribution, generation and activity of SCGN-positive interneurons in the OB of two complementary models of olfactory impairments: Purkinje Cell Degeneration (PCD) and olfactory-deprived mice. Our results showed a significant increase in the density of SCGN-positive cells in the inframitral layers of olfactory-deprived mice as compared to control animals. Moreover, BrdU analyses revealed that these additional SCGN-positive cells are not newly formed. Finally, the neuronal activity, estimated by c-Fos expression, increased in preexisting SCGN-positive interneurons of both deprived and PCD mice -being higher in the later- in comparison with control animals. Altogether, our results suggest that the OB possesses different compensatory mechanisms depending on the type of alteration. Particularly, the SCGN expression is dependent of olfactory stimuli and its function may be related to a compensation against a reduction in sensory inputs.
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Affiliation(s)
- L Pérez-Revuelta
- Laboratory of Neuronal Plasticity and Neurorepair, Institute for Neuroscience of Castile and Leon (INCyL), University of Salamanca, C/ Pintor Fernando Gallego, 1, 37007, Salamanca, Spain.,Institute of Biomedical Research of Salamanca, IBSAL, 37007, Salamanca, Spain
| | - P G Téllez de Meneses
- Laboratory of Neuronal Plasticity and Neurorepair, Institute for Neuroscience of Castile and Leon (INCyL), University of Salamanca, C/ Pintor Fernando Gallego, 1, 37007, Salamanca, Spain.,Institute of Biomedical Research of Salamanca, IBSAL, 37007, Salamanca, Spain
| | - M López
- Laboratory of Neuronal Plasticity and Neurorepair, Institute for Neuroscience of Castile and Leon (INCyL), University of Salamanca, C/ Pintor Fernando Gallego, 1, 37007, Salamanca, Spain.,Institute of Biomedical Research of Salamanca, IBSAL, 37007, Salamanca, Spain
| | - J G Briñón
- Laboratory of Neuronal Plasticity and Neurorepair, Institute for Neuroscience of Castile and Leon (INCyL), University of Salamanca, C/ Pintor Fernando Gallego, 1, 37007, Salamanca, Spain.,Institute of Biomedical Research of Salamanca, IBSAL, 37007, Salamanca, Spain
| | - E Weruaga
- Laboratory of Neuronal Plasticity and Neurorepair, Institute for Neuroscience of Castile and Leon (INCyL), University of Salamanca, C/ Pintor Fernando Gallego, 1, 37007, Salamanca, Spain.,Institute of Biomedical Research of Salamanca, IBSAL, 37007, Salamanca, Spain
| | - D Díaz
- Laboratory of Neuronal Plasticity and Neurorepair, Institute for Neuroscience of Castile and Leon (INCyL), University of Salamanca, C/ Pintor Fernando Gallego, 1, 37007, Salamanca, Spain. .,Institute of Biomedical Research of Salamanca, IBSAL, 37007, Salamanca, Spain.
| | - J R Alonso
- Laboratory of Neuronal Plasticity and Neurorepair, Institute for Neuroscience of Castile and Leon (INCyL), University of Salamanca, C/ Pintor Fernando Gallego, 1, 37007, Salamanca, Spain.,Institute of Biomedical Research of Salamanca, IBSAL, 37007, Salamanca, Spain
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Uribe N, Balciscueta Z, Cuneo B, Martín MC, Tabet J, Torrijo I, López M. Long-term functional and clinical outcomes following transanal advancement flap for complex anal fistula repair: are there predictors of recurrence and incontinence? Colorectal Dis 2020; 22:1649-1657. [PMID: 32654425 DOI: 10.1111/codi.15251] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/23/2020] [Indexed: 02/08/2023]
Abstract
AIM Transanal flap is an attractive technique for complex fistulas. The aim of this study was to identify factors associated with poor outcome, recurrence and incontinence. METHOD All patients who underwent an advancement flap for the treatment of a complex anal fistula between 1995 and 2019 were prospectively enrolled. The patient data obtained included age, sex, body mass index, comorbid conditions and smoking history. The fistula characteristics analysed included previous anal surgery, anatomy of the fistula according to Park's classification, horseshoe or supralevator extension and preoperative seton drainage. The postoperative data registered included complications, postoperative stay, recurrence and incontinence. Predictive factors for recurrence and incontinence were identified using univariate and multivariate analysis. RESULTS One hundred and ninety patients were included; 134 (70.5%) were men and the mean patient age was 50 years. The median length of follow-up was 44.6 months. The fistula recurred in 14 patients (7.3%). Before surgery, 20 patients (10.5%) reported incontinence symptoms. In the continent patients a Wexner postoperative score of 0 was identified in 79.4%. Wexner scores between 1 and 3 were observed in 17% and scores of 4 or more in five patients (3%). Factors associated with recurrence included age < 50 years (OR = 4.8, P = 0.02, 95% CI 1.2-19), smoking (OR = 4.1, P = 0.03, 95% CI 1-16.5) and suprasphincteric fistula (OR = 0.5, P = 0.01, 95% CI 0.2-0.8) in multivariate log regression analysis. Major incontinence was influenced by female sex and previous anal surgery (OR = 7.5, P = 0.003, 95% CI 1.6-34 and OR = 0.1, P = 0.007, 95% CI 0.1-0.7, respectively). CONCLUSION Full-thickness transanal advancement flap is a good treatment for complex anal fistula repair. This study provides relevant information on risk factors for failure of therapy and incontinence, which can help in advising patients before surgery and planning a good treatment strategy.
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Affiliation(s)
- N Uribe
- Colorectal Unit, Department of General and Digestive Surgery, Arnau de Vilanova Hospital, Valencia, Spain
| | - Z Balciscueta
- Colorectal Unit, Department of General and Digestive Surgery, Arnau de Vilanova Hospital, Valencia, Spain
| | - B Cuneo
- Colorectal Unit, Department of General and Digestive Surgery, Arnau de Vilanova Hospital, Valencia, Spain
| | - M C Martín
- Colorectal Unit, Department of General and Digestive Surgery, Arnau de Vilanova Hospital, Valencia, Spain
| | - J Tabet
- Colorectal Unit, Department of General and Digestive Surgery, Arnau de Vilanova Hospital, Valencia, Spain
| | - I Torrijo
- Colorectal Unit, Department of General and Digestive Surgery, Arnau de Vilanova Hospital, Valencia, Spain
| | - M López
- Colorectal Unit, Department of General and Digestive Surgery, Arnau de Vilanova Hospital, Valencia, Spain
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30
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Balciscueta Z, Uribe N, Caubet L, López M, Torrijo I, Tabet J, Martín MC. Impact of the number of stapler firings on anastomotic leakage in laparoscopic rectal surgery: a systematic review and meta-analysis. Tech Coloproctol 2020; 24:919-925. [PMID: 32451807 DOI: 10.1007/s10151-020-02240-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/13/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Several univariate and multivariate studies have already identified the number of stapler firings for laparoscopic rectal transection for rectal cancer as an independent risk factor for anastomotic leakage. The aim of this study was to perform a systematic review and meta-analysis of the anastomotic leakage rate in laparoscopic rectal surgery according to the need of using one or two stapler firings for rectal transection. METHODS PubMed, Ovid, the Cochrane Library database and ClinicalTrials.gov were searched. All of the statistical analyses were performed using Revman software. RESULTS Five studies were included (1267 patients). The overall anastomotic leakage rate was 5.5% [0.7-8.4%]. Anastomotic leak occurred in 3.5% (17/491) of the cases where 1 stapler firing was used versus 6.7% (50/786) of the cases in which 2 firings were needed (50/786). Two stapler firings were significantly associated with an increased risk of anastomotic leakage (OR 2.44, 95% CI 1.34-4.42, p = 0.003, I2 = 1%). CONCLUSIONS Our systematic review and meta-analysis suggest that two firings imply a higher rate of anastomotic leak than a single firing after laparoscopic rectal surgery with a double stapling technique. Coloproctologists should strive to reduce the number of linear stapler firings and try to transect the rectum with a single firing.
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Affiliation(s)
- Z Balciscueta
- Department of General and Digestive Surgery, Colorectal Unit, Arnau de Vilanova Hospital, C/San Clemente no. 12, 46015, Valencia, Spain.
| | - N Uribe
- Department of General and Digestive Surgery, Colorectal Unit, Arnau de Vilanova Hospital, C/San Clemente no. 12, 46015, Valencia, Spain
| | - L Caubet
- Department of General and Digestive Surgery, Colorectal Unit, Arnau de Vilanova Hospital, C/San Clemente no. 12, 46015, Valencia, Spain
| | - M López
- Department of General and Digestive Surgery, Colorectal Unit, Arnau de Vilanova Hospital, C/San Clemente no. 12, 46015, Valencia, Spain
| | - I Torrijo
- Department of General and Digestive Surgery, Colorectal Unit, Arnau de Vilanova Hospital, C/San Clemente no. 12, 46015, Valencia, Spain
| | - J Tabet
- Department of General and Digestive Surgery, Colorectal Unit, Arnau de Vilanova Hospital, C/San Clemente no. 12, 46015, Valencia, Spain
| | - M C Martín
- Department of General and Digestive Surgery, Colorectal Unit, Arnau de Vilanova Hospital, C/San Clemente no. 12, 46015, Valencia, Spain
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31
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Acciari VA, Ansoldi S, Antonelli LA, Arbet Engels A, Baack D, Babić A, Banerjee B, Barres de Almeida U, Barrio JA, Becerra González J, Bednarek W, Bellizzi L, Bernardini E, Berti A, Besenrieder J, Bhattacharyya W, Bigongiari C, Biland A, Blanch O, Bonnoli G, Bošnjak Ž, Busetto G, Carosi R, Ceribella G, Cerruti M, Chai Y, Chilingarian A, Cikota S, Colak SM, Colin U, Colombo E, Contreras JL, Cortina J, Covino S, D'Amico G, D'Elia V, Da Vela P, Dazzi F, De Angelis A, De Lotto B, Delfino M, Delgado J, Depaoli D, Di Pierro F, Di Venere L, Do Souto Espiñeira E, Dominis Prester D, Donini A, Dorner D, Doro M, Elsaesser D, Fallah Ramazani V, Fattorini A, Ferrara G, Foffano L, Fonseca MV, Font L, Fruck C, Fukami S, García López RJ, Garczarczyk M, Gasparyan S, Gaug M, Giglietto N, Giordano F, Gliwny P, Godinović N, Green D, Hadasch D, Hahn A, Herrera J, Hoang J, Hrupec D, Hütten M, Inada T, Inoue S, Ishio K, Iwamura Y, Jouvin L, Kajiwara Y, Karjalainen M, Kerszberg D, Kobayashi Y, Kubo H, Kushida J, Lamastra A, Lelas D, Leone F, Lindfors E, Lombardi S, Longo F, López M, López-Coto R, López-Oramas A, Loporchio S, Machado de Oliveira Fraga B, Maggio C, Majumdar P, Makariev M, Mallamaci M, Maneva G, Manganaro M, Mannheim K, Maraschi L, Mariotti M, Martínez M, Mazin D, Mender S, Mićanović S, Miceli D, Miener T, Minev M, Miranda JM, Mirzoyan R, Molina E, Moralejo A, Morcuende D, Moreno V, Moretti E, Munar-Adrover P, Neustroev V, Nigro C, Nilsson K, Ninci D, Nishijima K, Noda K, Nogués L, Nozaki S, Ohtani Y, Oka T, Otero-Santos J, Palatiello M, Paneque D, Paoletti R, Paredes JM, Pavletić L, Peñil P, Perennes C, Peresano M, Persic M, Prada Moroni PG, Prandini E, Puljak I, Rhode W, Ribó M, Rico J, Righi C, Rugliancich A, Saha L, Sahakyan N, Saito T, Sakurai S, Satalecka K, Schleicher B, Schmidt K, Schweizer T, Sitarek J, Šnidarić I, Sobczynska D, Spolon A, Stamerra A, Strom D, Strzys M, Suda Y, Surić T, Takahashi M, Tavecchio F, Temnikov P, Terzić T, Teshima M, Torres-Albà N, Tosti L, van Scherpenberg J, Vanzo G, Vazquez Acosta M, Ventura S, Verguilov V, Vigorito CF, Vitale V, Vovk I, Will M, Zarić D, Nava L. Bounds on Lorentz Invariance Violation from MAGIC Observation of GRB 190114C. Phys Rev Lett 2020; 125:021301. [PMID: 32701326 DOI: 10.1103/physrevlett.125.021301] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/20/2020] [Accepted: 06/04/2020] [Indexed: 06/11/2023]
Abstract
On January 14, 2019, the Major Atmospheric Gamma Imaging Cherenkov telescopes detected GRB 190114C above 0.2 TeV, recording the most energetic photons ever observed from a gamma-ray burst. We use this unique observation to probe an energy dependence of the speed of light in vacuo for photons as predicted by several quantum gravity models. Based on a set of assumptions on the possible intrinsic spectral and temporal evolution, we obtain competitive lower limits on the quadratic leading order of speed of light modification.
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Affiliation(s)
- V A Acciari
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - S Ansoldi
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - L A Antonelli
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | | | - D Baack
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - A Babić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - B Banerjee
- Saha Institute of Nuclear Physics, HBNI, 1/AF Bidhannagar, Salt Lake, Sector-1, Kolkata 700064, India
| | - U Barres de Almeida
- Centro Brasileiro de Pesquisas Fsicas (CBPF), 22290-180 URCA, Rio de Janeiro (RJ), Brasil
| | - J A Barrio
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - J Becerra González
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - W Bednarek
- University of Lodz, Faculty of Physics and Applied Informatics, Department of Astrophysics, 90-236 Lodz, Poland
| | - L Bellizzi
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - E Bernardini
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
- Università di Padova and INFN, I-35131 Padova, Italy
| | - A Berti
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - J Besenrieder
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - W Bhattacharyya
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - C Bigongiari
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - A Biland
- ETH Zurich, CH-8093 Zurich, Switzerland
| | - O Blanch
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - G Bonnoli
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - Ž Bošnjak
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - G Busetto
- Università di Padova and INFN, I-35131 Padova, Italy
| | - R Carosi
- Università di Pisa, and INFN Pisa, I-56126 Pisa, Italy
| | - G Ceribella
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - M Cerruti
- Universitat de Barcelona, ICCUB, IEEC-UB, E-08028 Barcelona, Spain
| | - Y Chai
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - A Chilingarian
- The Armenian Consortium: ICRANet-Armenia at NAS RA, A. Alikhanyan National Laboratory
| | - S Cikota
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - S M Colak
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - U Colin
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - E Colombo
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - J L Contreras
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - J Cortina
- Centro de Investigaciones Energticas, Medioambientales y Tecnolgicas, E-28040 Madrid, Spain
| | - S Covino
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - G D'Amico
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - V D'Elia
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - P Da Vela
- Università di Pisa, and INFN Pisa, I-56126 Pisa, Italy
| | - F Dazzi
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - A De Angelis
- Università di Padova and INFN, I-35131 Padova, Italy
| | - B De Lotto
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | - M Delfino
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - J Delgado
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - D Depaoli
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - F Di Pierro
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - L Di Venere
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - E Do Souto Espiñeira
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - D Dominis Prester
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - A Donini
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | - D Dorner
- Universität Würzburg, D-97074 Würzburg, Germany
| | - M Doro
- Università di Padova and INFN, I-35131 Padova, Italy
| | - D Elsaesser
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - V Fallah Ramazani
- Finnish MAGIC Consortium: Finnish Centre of Astronomy with ESO (FINCA), University of Turku, FI-20014 Turku, Finland; Astronomy Research Unit, University of Oulu, FI-90014 Oulu, Finland
| | - A Fattorini
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - G Ferrara
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - L Foffano
- Università di Padova and INFN, I-35131 Padova, Italy
| | - M V Fonseca
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - L Font
- Departament de Física, and CERES-IEEC, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - C Fruck
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - S Fukami
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - R J García López
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - M Garczarczyk
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - S Gasparyan
- The Armenian Consortium: ICRANet-Armenia at NAS RA, A. Alikhanyan National Laboratory
| | - M Gaug
- Departament de Física, and CERES-IEEC, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - N Giglietto
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - F Giordano
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - P Gliwny
- University of Lodz, Faculty of Physics and Applied Informatics, Department of Astrophysics, 90-236 Lodz, Poland
| | - N Godinović
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - D Green
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - D Hadasch
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - A Hahn
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - J Herrera
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - J Hoang
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - D Hrupec
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - M Hütten
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - T Inada
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - S Inoue
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - K Ishio
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - Y Iwamura
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - L Jouvin
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - Y Kajiwara
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - M Karjalainen
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - D Kerszberg
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - Y Kobayashi
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - H Kubo
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - J Kushida
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - A Lamastra
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - D Lelas
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - F Leone
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - E Lindfors
- Finnish MAGIC Consortium: Finnish Centre of Astronomy with ESO (FINCA), University of Turku, FI-20014 Turku, Finland; Astronomy Research Unit, University of Oulu, FI-90014 Oulu, Finland
| | - S Lombardi
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - F Longo
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - M López
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - R López-Coto
- Università di Padova and INFN, I-35131 Padova, Italy
| | - A López-Oramas
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - S Loporchio
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | | | - C Maggio
- Departament de Física, and CERES-IEEC, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - P Majumdar
- Saha Institute of Nuclear Physics, HBNI, 1/AF Bidhannagar, Salt Lake, Sector-1, Kolkata 700064, India
| | - M Makariev
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - M Mallamaci
- Università di Padova and INFN, I-35131 Padova, Italy
| | - G Maneva
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - M Manganaro
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - K Mannheim
- Universität Würzburg, D-97074 Würzburg, Germany
| | - L Maraschi
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - M Mariotti
- Università di Padova and INFN, I-35131 Padova, Italy
| | - M Martínez
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - D Mazin
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - S Mender
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - S Mićanović
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - D Miceli
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | - T Miener
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - M Minev
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - J M Miranda
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - R Mirzoyan
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - E Molina
- Universitat de Barcelona, ICCUB, IEEC-UB, E-08028 Barcelona, Spain
| | - A Moralejo
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - D Morcuende
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - V Moreno
- Departament de Física, and CERES-IEEC, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - E Moretti
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - P Munar-Adrover
- Departament de Física, and CERES-IEEC, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - V Neustroev
- Finnish MAGIC Consortium: Finnish Centre of Astronomy with ESO (FINCA), University of Turku, FI-20014 Turku, Finland; Astronomy Research Unit, University of Oulu, FI-90014 Oulu, Finland
| | - C Nigro
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - K Nilsson
- Finnish MAGIC Consortium: Finnish Centre of Astronomy with ESO (FINCA), University of Turku, FI-20014 Turku, Finland; Astronomy Research Unit, University of Oulu, FI-90014 Oulu, Finland
| | - D Ninci
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - K Nishijima
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - K Noda
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - L Nogués
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - S Nozaki
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - Y Ohtani
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - T Oka
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - J Otero-Santos
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - M Palatiello
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | - D Paneque
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - R Paoletti
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - J M Paredes
- Universitat de Barcelona, ICCUB, IEEC-UB, E-08028 Barcelona, Spain
| | - L Pavletić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - P Peñil
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - C Perennes
- Università di Padova and INFN, I-35131 Padova, Italy
| | - M Peresano
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | - M Persic
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | | | - E Prandini
- Università di Padova and INFN, I-35131 Padova, Italy
| | - I Puljak
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - W Rhode
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - M Ribó
- Universitat de Barcelona, ICCUB, IEEC-UB, E-08028 Barcelona, Spain
| | - J Rico
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - C Righi
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - A Rugliancich
- Università di Pisa, and INFN Pisa, I-56126 Pisa, Italy
| | - L Saha
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - N Sahakyan
- The Armenian Consortium: ICRANet-Armenia at NAS RA, A. Alikhanyan National Laboratory
| | - T Saito
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - S Sakurai
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - K Satalecka
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | | | - K Schmidt
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - T Schweizer
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - J Sitarek
- University of Lodz, Faculty of Physics and Applied Informatics, Department of Astrophysics, 90-236 Lodz, Poland
| | - I Šnidarić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - D Sobczynska
- University of Lodz, Faculty of Physics and Applied Informatics, Department of Astrophysics, 90-236 Lodz, Poland
| | - A Spolon
- Università di Padova and INFN, I-35131 Padova, Italy
| | - A Stamerra
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - D Strom
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - M Strzys
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - Y Suda
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - T Surić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - M Takahashi
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - F Tavecchio
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - P Temnikov
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - T Terzić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - M Teshima
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - N Torres-Albà
- Universitat de Barcelona, ICCUB, IEEC-UB, E-08028 Barcelona, Spain
| | - L Tosti
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | | | - G Vanzo
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - M Vazquez Acosta
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - S Ventura
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - V Verguilov
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - C F Vigorito
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - V Vitale
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - I Vovk
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - M Will
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - D Zarić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - L Nava
- National Institute for Astrophysics (INAF), Osservatorio Astronomico di Brera, 23807 Merate, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, 34149 Trieste, Italy
- Institute for Fundamental Physics of the Universe (IFPU), 34151 Trieste, Italy
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Montero A, Nuñez M, Hernando O, Vicente E, Ciervide R, Zucca D, Sanchez E, López M, Quijano Y, Garcia-Aranda M, Alonso R, Valero J, Chen X, Alvarez B, Fernandez-Leton P, Rubio C. Retroperitoneal soft-tissue sarcomas: Radiotherapy experience from a tertiary cancer center and review of current evidence. Rep Pract Oncol Radiother 2020; 25:643-655. [PMID: 32565743 DOI: 10.1016/j.rpor.2020.05.006] [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: 12/16/2019] [Revised: 04/14/2020] [Accepted: 05/25/2020] [Indexed: 12/19/2022] Open
Abstract
Background Surgery remains to be the main therapeutic approach for retroperitoneal sarcomas (RPS) although evidence supports that complementary radiotherapy increases local-control and survival. We present a multidisciplinary management and experience of a tertiary cancer center in the treatment of RPS and analyze current evidence of radiotherapy efficacy. Patients and methods We retrospectively reviewed 19 patients with primary or relapsed RPS treated between November 2009 and October 2018. Multidisciplinary approach comprised complete resection in 15 patients (79%) achieving resection R0 in 11 patients (58%), R1 in 4 patients (21%) and R2 in 2 patients (10%). Seven patients (37%) underwent a preoperative radiation (PRORT), 10 patients (53%), post-operative radiation (PORT) and 2 patients (10%), received radiotherapy exclusively. Ten patients (53%) received adjuvant chemotherapy. Results With a median follow-up of 24 months (2-114 months), actuarial rates of loco-regional relapse free survival (LRFS) at 1, 2 and 3 years were 77%, 77% and 67%, respectively. Actuarial rates of distant-metastases-free survival (DMFS), disease-free survival (DFS) and overall survival (OS) at 1, 2 and 3 years were 100%, 100% and 80% for DMFS; 94%, 77% and 67% for DFS and 100%, 91% and 91% for OS, respectively. Only surgical margins (negative vs. positive) showed significance for 3y-LRFS: 100% vs. 34.3%, p = 0.018. Treatment tolerance was acceptable with no acute or late toxicity higher than grade 2. Conclusions Complementary radiotherapy appears to be useful and well tolerated for the multidisciplinary management of RPS. Presence of positive surgical margins seems to be the most relevant prognostic factor through the follow-up.
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Affiliation(s)
- A Montero
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - M Nuñez
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - O Hernando
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - E Vicente
- Department of General Surgery, University Hospital HM Sanchinarro, Madrid, Spain
| | - R Ciervide
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - D Zucca
- Department of Medical Physics, University Hospital HM Sanchinarro, Madrid, Spain
| | - E Sanchez
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - M López
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - Y Quijano
- Department of General Surgery, University Hospital HM Sanchinarro, Madrid, Spain
| | - M Garcia-Aranda
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - R Alonso
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - J Valero
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - X Chen
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - B Alvarez
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - P Fernandez-Leton
- Department of Medical Physics, University Hospital HM Sanchinarro, Madrid, Spain
| | - C Rubio
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
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33
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Rosenthal VD, Bat-Erdene I, Gupta D, Belkebir S, Rajhans P, Zand F, Myatra SN, Afeef M, Tanzi VL, Muralidharan S, Gurskis V, Al-Abdely HM, El-Kholy A, AlKhawaja SAA, Sen S, Mehta Y, Rai V, Hung NV, Sayed AF, Guerrero-Toapanta FM, Elahi N, Morfin-Otero MDR, Somabutr S, De-Carvalho BM, Magdarao MS, Velinova VA, Quesada-Mora AM, Anguseva T, Ikram A, Aguilar-de-Moros D, Duszynska W, Mejia N, Horhat FG, Belskiy V, Mioljevic V, Di-Silvestre G, Furova K, Gamar-Elanbya MO, Gupta U, Abidi K, Raka L, Guo X, Luque-Torres MT, Jayatilleke K, Ben-Jaballah N, Gikas A, Sandoval-Castillo HR, Trotter A, Valderrama-Beltrán SL, Leblebicioglu H, Riera F, López M, Maurizi D, Desse J, Pérez I, Silva G, Chaparro G, Golschmid D, Cabrera R, Montanini A, Bianchi A, Vimercati J, Rodríguez-del-Valle M, Domínguez C, Saul P, Chediack V, Piastrelini M, Cardena L, Ramasco L, Olivieri M, Gallardo P, Juarez P, Brito M, Botta P, Alvarez G, Benchetrit G, Caridi M, Stagnaro J, Bourlot I, García M, Arregui N, Saeed N, Abdul-Aziz S, ALSayegh S, Humood M, Mohamed-Ali K, Swar S, Magray T, Aguiar-Portela T, Sugette-de-Aguiar T, Serpa-Maia F, Fernandes-Alves-de-Lima L, Teixeira-Josino L, Sampaio-Bezerra M, Furtado-Maia R, Romário-Mendes A, Alves-De-Oliveira A, Vasconcelos-Carneiro A, Anjos-Lima JD, Pinto-Coelho K, Maciel-Canuto M, Rocha-Batista M, Moreira T, Rodrigues-Amarilo N, Lima-de-Barros T, Guimarães KA, Batista C, Santos C, de-Lima-Silva F, Santos-Mota E, Karla L, Ferreira-de-Souza M, Luzia N, de-Oliveira S, Takeda C, Azevedo-Ferreira-Lima D, Faheina J, Coelho-Oliveira L, do-Nascimento S, Machado-Silva V, Bento-Ferreira, Olszewski J, Tenorio M, Silva-Lemos A, Ramos-Feijó C, Cardoso D, Correa-Barbosa M, Assunção-Ponte G, Faheina J, da-Silva-Escudero D, Servolo-Medeiros E, Andrade-Oliveira-Reis M, Kostadinov E, Dicheva V, Petrov M, Guo C, Yu H, Liu T, Song G, Wang C, Cañas-Giraldo L, Marin-Tobar D, Trujillo-Ramirez E, Andrea-Rios P, Álvarez-Moreno C, Linares C, González-Rubio P, Ariza-Ayala B, Gamba-Moreno L, Gualtero-Trujill S, Segura-Sarmiento S, Rodriguez-Pena J, Ortega R, Olarte N, Pardo-Lopez Y, Luis Marino Otela-Baicue A, Vargas-Garcia A, Roncancio E, Gomez-Nieto K, Espinosa-Valencia M, Barahona-Guzman N, Avila-Acosta C, Raigoza-Martinez W, Villamil-Gomez W, Chapeta-Parada E, Mindiola-Rochel A, Corchuelo-Martinez A, Martinez A, Lagares-Guzman A, Rodriguez-Ferrer M, Yepes-Gomez D, Muñoz-Gutierrez G, Arguello-Ruiz A, Zuniga-Chavarria M, Maroto-Vargas L, Valverde-Hernández M, Solano-Chinchilla A, Calvo-Hernandez I, Chavarria-Ugalde O, Tolari G, Rojas-Fermin R, Diaz-Rodriguez C, Huascar S, Ortiz M, Bovera M, Alquinga N, Santacruz G, Jara E, Delgado V, Salgado-Yepez E, Valencia F, Pelaez C, Gonzalez-Flores H, Coello-Gordon E, Picoita F, Arboleda M, Garcia M, Velez J, Valle M, Unigarro L, Figueroa V, Marin K, Caballero-Narvaez H, Bayani V, Ahmed S, Alansary A, Hassan A, Abdel-Halim M, El-Fattah M, Abdelaziz-Yousef R, Hala A, Abdelhady K, Ahmed-Fouad H, Mounir-Agha H, Hamza H, Salah Z, Abdel-Aziz D, Ibrahim S, Helal A, AbdelMassih A, Mahmoud AR, Elawady B, El-sherif R, Fattah-Radwan Y, Abdel-Mawla T, Kamal-Elden N, Kartsonaki M, Rivera D, Mandal S, Mukherjee S, Navaneet P, Padmini B, Sorabjee J, Sakle A, Potdar M, Mane D, Sale H, Abdul-Gaffar M, Kazi M, Chabukswar S, Anju M, Gaikwad D, Harshe A, Blessymole S, Nair P, Khanna D, Chacko F, Rajalakshmi A, Mubarak A, Kharbanda M, Kumar S, Mathur P, Saranya S, Abubakar F, Sampat S, Raut V, Biswas S, Kelkar R, Divatia J, Chakravarthy M, Gokul B, Sukanya R, Pushparaj L, Thejasvini A, Rangaswamy S, Saini N, Bhattacharya C, Das S, Sanyal S, Chaudhury B, Rodrigues C, Khanna G, Dwivedy A, Binu S, Shetty S, Eappen J, Valsa T, Sriram A, Todi S, Bhattacharyya M, Bhakta A, Ramachandran B, Krupanandan R, Sahoo P, Mohanty N, Sahu S, Misra S, Ray B, Pattnaik S, Pillai H, Warrier A, Ranganathan L, Mani A, Rajagopal S, Abraham B, Venkatraman R, Ramakrishnan N, Devaprasad D, Siva K, Divekar D, Satish Kavathekar M, Suryawanshi M, Poojary A, Sheeba J, Patil P, Kukreja S, Varma K, Narayanan S, Sohanlal T, Agarwal A, Agarwal M, Nadimpalli G, Bhamare S, Thorat S, Sarda O, Nadimpalli P, Nirkhiwale S, Gehlot G, Bhattacharya S, Pandya N, Raphel A, Zala D, Mishra S, Patel M, Aggarwal D, Jawadwal B, Pawar N, Kardekar S, Manked A, Tamboli A, Manked A, Khety Z, Singhal T, Shah S, Kothari V, Naik R, Narain R, Sengupta S, Karmakar A, Mishra S, Pati B, Kantroo V, Kansal S, Modi N, Chawla R, Chawla A, Roy I, Mukherjee S, Bej M, Mukherjee P, Baidya S, Durell A, Vadi S, Saseedharan S, Anant P, Edwin J, Sen N, Sandhu K, Pandya N, Sharma S, Sengupta S, Palaniswamy V, Sharma P, Selvaraj M, Saurabh L, Agarwal M, Punia D, Soni D, Misra R, Harsvardhan R, Azim A, Kambam C, Garg A, Ekta S, Lakhe M, Sharma C, Singh G, Kaur A, Singhal S, Chhabra K, Ramakrishnan G, Kamboj H, Pillai S, Rani P, Singla D, Sanaei A, Maghsudi B, Sabetian G, Masjedi M, Shafiee E, Nikandish R, Paydar S, Khalili H, Moradi A, Sadeghi P, Bolandparvaz S, Mubarak S, Makhlouf M, Awwad M, Ayyad O, Shaweesh A, Khader M, Alghazawi A, Hussien N, Alruzzieh M, Mohamed Y, ALazhary M, Abdul Aziz O, Alazmi M, Mendoza J, De Vera P, Rillorta A, de Guzman M, Girvan M, Torres M, Alzahrani N, Alfaraj S, Gopal U, Manuel M, Alshehri R, Lessing L, Alzoman H, Abdrahiem J, Adballah H, Thankachan J, Gomaa H, Asad T, AL-Alawi M, Al-Abdullah N, Demaisip N, Laungayan-Cortez E, Cabato A, Gonzales J, Al Raey M, Al-Darani S, Aziz M, Al-Manea B, Samy E, AlDalaton M, Alaliany M, Alabdely H, Helali N, Sindayen G, Malificio A, Al-Dossari H, Kelany A, Algethami A, Mohamed D, Yanne L, Tan A, Babu S, Abduljabbar S, Al-Zaydani M, Ahmed H, Al Jarie A, Al-Qathani A, Al-Alkami H, AlDalaton M, Alih S, Alaliany M, Gasmin-Aromin R, Balon-Ubalde E, Diab H, Kader N, Hassan-Assiry I, Kelany A, Albeladi E, Aboushoushah S, Qushmaq N, Fernandez J, Hussain W, Rajavel R, Bukhari S, Rushdi H, Turkistani A, Mushtaq J, Bohlega E, Simon S, Damlig E, Elsherbini S, Abraham S, Kaid E, Al-Attas A, Hawsawi G, Hussein B, Esam B, Caminade Y, Santos A, Abdulwahab M, Aldossary A, Al-Suliman S, AlTalib A, Albaghly N, HaqlreMia M, Kaid E, Altowerqi R, Ghalilah K, Alradady M, Al-Qatri A, Chaouali M, Shyrine E, Philipose J, Raees M, AbdulKhalik N, Madco M, Acostan C, Safwat R, Halwani M, Abdul-Aal N, Thomas A, Abdulatif S, Ali-Karrar M, Al-Gosn N, Al-Hindi A, Jaha R, AlQahtani S, Ayugat E, Al-Hussain M, Aldossary A, Al-Suliman S, Al-Talib A, Albaghly N, Haqlre-Mia M, Briones S, Krishnan R, Tabassum K, Alharbi L, Madani A, Al-Hindi A, Al-Gethamy M, Alamri D, Spahija G, Gashi A, Kurian A, George S, Mohamed A, Ramapurath R, Varghese S, Abdo N, Foda-Salama M, Al-Mousa H, Omar A, Salama M, Toleb M, Khamis S, Kanj S, Zahreddine N, Kanafani Z, Kardas T, Ahmadieh R, Hammoud Z, Zeid I, Al-Souheil A, Ayash H, Mahfouz T, Kondratas T, Grinkeviciute D, Kevalas R, Dagys A, Mitrev Z, Bogoevska-Miteva Z, Jankovska K, Guroska S, Petrovska M, Popovska K, Ng C, Hoon Y, Hasan YM, Othman-Jailani M, Hadi-Jamaluddin M, Othman A, Zainol H, Wan-Yusoff W, Gan C, Lum L, Ling C, Aziz F, Zhazali R, Abud-Wahab M, Cheng T, Elghuwael I, Wan-Mat W, Abd-Rahman R, Perez-Gomez H, Kasten-Monges M, Esparza-Ahumada S, Rodriguez-Noriega E, Gonzalez-Diaz E, Mayoral-Pardo D, Cerero-Gudino A, Altuzar-Figueroa M, Perez-Cruz J, Escobar-Vazquez M, Aragon D, Coronado-Magana H, Mijangos-Mendez J, Corona-Jimenez F, Aguirre-Avalos G, Lopez-Mateos A, Martinez-Marroquin M, Montell-Garcia M, Martinez-Martinez A, Leon-Sanchez E, Gomez-Flores G, Ramirez M, Gomez M, Lozano M, Mercado V, Zamudio-Lugo I, Gomez-Gonzalez C, Miranda-Novales M, Villegas-Mota I, Reyes-Garcia C, Ramirez-Morales M, Sanchez-Rivas M, Cureno-Diaz M, Matias-Tellez B, Gonzalez-Martinez J, Juarez-Vargas R, Pastor-Salinas O, Gutierrez-Munoz V, Conde-Mercado J, Bruno-Carrasco G, Manrique M, Monroy-Colin V, Cruz-Rivera Z, Rodriguez-Pacheco J, Cruz N, Hernandez-Chena B, Guido-Ramirez O, Arteaga-Troncoso G, Guerra-Infante F, Lopez-Hurtado M, Caleco JD, Leyva-Medellin E, Salamanca-Meneses A, Cosio-Moran C, Ruiz-Rendon R, Aguilar-Angel L, Sanchez-Vargas M, Mares-Morales R, Fernandez-Alvarez L, Castillo-Cruz B, Gonzalez-Ma M, Zavala-Ramír M, Rivera-Reyna L, del-Moral-Rossete L, Lopez-Rubio C, Valadez-de-Alba M, Bat-Erdene A, Chuluunchimeg K, Baatar O, Batkhuu B, Ariyasuren Z, Bayasgalan G, Baigalmaa S, Uyanga T, Suvderdene P, Enkhtsetseg D, Suvd-Erdene D, Chimedtseye E, Bilguun G, Tuvshinbayar M, Dorj M, Khajidmaa T, Batjargal G, Naranpurev M, Bat-Erdene A, Bolormaa T, Battsetseg T, Batsuren C, Batsaikhan N, Tsolmon B, Saranbaatar A, Natsagnyam P, Nyamdawa O, Madani N, Abouqal R, Zeggwagh A, Berechid K, Dendane T, Koirala A, Giri R, Sainju S, Acharya S, Paul N, Parveen A, Raza A, Nizamuddin S, Sultan F, Imran X, Sajjad R, Khan M, Sana F, Tayyab N, Ahmed A, Zaman G, Khan I, Khurram F, Hussain A, Zahra F, Imtiaz A, Daud N, Sarwar M, Roop Z, Yusuf S, Hanif F, Shumaila X, Zeb J, Ali S, Demas S, Ariff S, Riaz A, Hussain A, Kanaan A, Jeetawi R, Castaño E, Moreno-Castillo L, García-Mayorca E, Prudencio-Leon W, Vivas-Pardo A, Changano-Rodriguez M, Castillo-Bravo L, Aibar-Yaranga K, Marquez-Mondalgo V, Mueras-Quevedo J, Meza-Borja C, Flor J, Fernandez-Camacho Y, Banda-Flores C, Pichilingue-Chagray J, Castaneda-Sabogal A, Caoili J, Mariano M, Maglente R, Santos S, de-Guzman G, Mendoza M, Javellana O, Tajanlangit A, Tapang A, Sg-Buenaflor M, Labro E, Carma R, Dy A, Fortin J, Navoa-Ng J, Cesar J, Bonifacio B, Llames M, Gata H, Tamayo A, Calupit H, Catcho V, Bergosa L, Abuy M, Barteczko-Grajek B, Rojek S, Szczesny A, Domanska M, Lipinska G, Jaroslaw J, Wieczoreka A, Szczykutowicza A, Gawor M, Piwoda M, Rydz-Lutrzykowska J, Grudzinska M, Kolat-Brodecka P, Smiechowicz K, Tamowicz B, Mikstacki A, Grams A, Sobczynski P, Nowicka M, Kretov V, Shalapuda V, Molkov A, Puzanov S, Utkin I, Tchekulaev A, Tulupova V, Vasiljevic S, Nikolic L, Ristic G, Eremija J, Kojovic J, Lekic D, Simic A, Hlinkova S, Lesnakova A, Kadankunnel S, Abdo-Ali M, Pimathai R, Wanitanukool S, Supa N, Prasan P, Luxsuwong M, Khuenkaew Y, Lamngamsupha J, Siriyakorn N, Prasanthai V, Apisarnthanarak A, Borgi A, Bouziri A, Cabadak H, Tuncer G, Bulut C, Hatipoglu C, Sebnem F, Demiroz A, Kaya A, Ersoz G, Kuyucu N, Karacorlu S, Oncul O, Gorenek L, Erdem H, Yildizdas D, Horoz O, Guclu E, Kaya G, Karabay O, Altindis M, Oztoprak N, Sahip Y, Uzun C, Erben N, Usluer G, Ozgunes I, Ozcelik M, Ceyda B, Oral M, Unal N, Cigdem Y, Bayar M, Bermede O, Saygili S, Yesiler I, Memikoglu O, Tekin R, Oncul A, Gunduz A, Ozdemir D, Geyik M, Erdogan S, Aygun C, Dilek A, Esen S, Turgut H, Sungurtekin H, Ugurcan D, Yarar V, Bilir Y, Bayram N, Devrim I, Agin H, Ceylan G, Yasar N, Oruc Y, Ramazanoglu A, Turhan O, Cengiz M, Yalcin A, Dursun O, Gunasan P, Kaya S, Senol G, Kocagoz A, Al-Rahma H, Annamma P, El-Houfi A, Vidal H, Perez F, D-Empaire G, Ruiz Y, Hernandez D, Aponte D, Salinas E, Vidal H, Navarrete N, Vargas R, Sanchez E, Ngo Quy C, Thu T, Nguyet L, Hang P, Hang T, Hanh T, Anh D. International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2012-2017: Device-associated module. Am J Infect Control 2020; 48:423-432. [PMID: 31676155 DOI: 10.1016/j.ajic.2019.08.023] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS During the 6-year study period, prospective data from 532,483 ICU patients hospitalized in 242 hospitals, for an aggregate of 2,197,304 patient days, were collected through the INICC Surveillance Online System (ISOS). The Centers for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI) were applied. RESULTS Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the medical-surgical ICUs, the pooled central line-associated bloodstream infection rate was higher (5.05 vs 0.8 per 1,000 central line-days); the ventilator-associated pneumonia rate was also higher (14.1 vs 0.9 per 1,000 ventilator-days,), as well as the rate of catheter-associated urinary tract infection (5.1 vs 1.7 per 1,000 catheter-days). From blood cultures samples, frequencies of resistance, such as of Pseudomonas aeruginosa to piperacillin-tazobactam (33.0% vs 18.3%), were also higher. CONCLUSIONS Despite a significant trend toward the reduction in INICC ICUs, DA-HAI rates are still much higher compared with CDC-NHSN's ICUs representing the developed world. It is INICC's main goal to provide basic and cost-effective resources, through the INICC Surveillance Online System to tackle the burden of DA-HAIs effectively.
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Chen-Zhao X, Hernando O, López M, Sánchez E, Montero A, García-Aranda M, Ciérvide R, Valero J, Alonso R, Cárdenas-Rebollo JM, Vicente E, Quijano Y, Cubillo A, Álvarez R, Prados S, Plaza C, García J, Zucca D, Fernández-Letón P, Rubio C. A prospective observational study of the clinical and pathological impact of stereotactic body radiotherapy (SBRT) as a neoadjuvant strategy of chemoradiation in pancreatic cancer. Clin Transl Oncol 2020; 22:1499-1505. [PMID: 31974820 DOI: 10.1007/s12094-020-02287-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 01/01/2020] [Indexed: 01/30/2023]
Abstract
PURPOSE/OBJECTIVE(S) To improve the curative resection rates and prognoses, a variety of neoadjuvant (NA) strategies have been explored in PDAC. In our institution, non-metastatic PDACs have been treated with a NA intent with induction multiagent chemotherapy and SBRT. The primary endpoint was to increase R0 resection rate. The secondary endpoints were the analysis of the clinical tolerance, the pathological response, the local control (LC) and the OS. MATERIALS/METHODS All consecutive patients with non-metastatic PDAC underwent SBRT as part of the NA strategy were included. A total dose of 40-62 Gy were delivered in 5-10 fractions. Surgery was performed after SBRT and restaging. RESULTS Since February 2014 to December 2018, 45 patients were enrolled. Thirty-two patients underwent surgery (71.1%), 10 out of 15 were initially unresectable disease patients (66.75%). R0 resection rate was 93% (30 patients) and pN0 status was achieved in 20 patients (60.6%). Tumour regression grade (TRG): 12 patients with complete response or marked response (TRG 0-1: 37.5%), 16 patients with moderate response (TRG 2: 50%) and four patients with poor response (TRG 3: 12.5%). The median follow-up was 16.2 m (range 6.6-59.6 m) since diagnosis. The LC rate achieved was very high (95.5%). Actuarial 12 and 24 m OS was 67.4% and 35.9% respectively. No grade 3 or higher toxicity related to SBRT was observed. CONCLUSION The results are encouraging, suggesting that SBRT has a significant role in the management of these patients and further studies will be necessary to prove these findings.
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Affiliation(s)
- X Chen-Zhao
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain.
| | - O Hernando
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - M López
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - E Sánchez
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - A Montero
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - M García-Aranda
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - R Ciérvide
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - J Valero
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - R Alonso
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - J M Cárdenas-Rebollo
- Department of Applied Mathematics and Statistics, CEU San Pablo University, Madrid, Spain
| | - E Vicente
- General and Gastrointestinal Surgery, University Hospital HM Sanchinarro, Madrid, Spain
| | - Y Quijano
- General and Gastrointestinal Surgery, University Hospital HM Sanchinarro, Madrid, Spain
| | - A Cubillo
- Medical Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - R Álvarez
- Medical Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - S Prados
- Gastroenterology, University Hospital HM Sanchinarro, Madrid, Spain
| | - C Plaza
- Anatomical Pathology, University Hospital HM Sanchinarro, Madrid, Spain
| | - J García
- Medical Physics, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - D Zucca
- Medical Physics, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - P Fernández-Letón
- Medical Physics, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - C Rubio
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
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Valdés-Bango M, Meler E, Cobo T, Hernández S, Caballero A, García F, Ribera L, Guirado L, Ferrer P, Salvia D, Figueras F, Palacio M, Goncé A, López M. [A clinical management protocol for COVID-19 infection in pregnant women]. Clin Invest Ginecol Obstet 2020; 47:118-127. [PMID: 32834309 PMCID: PMC7328537 DOI: 10.1016/j.gine.2020.06.014] [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] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/29/2020] [Indexed: 01/08/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) has caused a large global outbreak and has had a major impact on health systems and societies worldwide. The generation of knowledge about the disease has occurred almost as fast as its global expansion. Very few studies have reported on the effects of the infection on maternal health, since its onset. The mother and foetus do not seem to be at particularly high risk. Nevertheless, obstetrics and maternal-foetal medicine practice have made profound changes in order to adapt to the pandemic. In addition, there are aspects specific to COVID-19 and gestation that should be known by specialists. In this review an evidenced-based protocol is presented for the management of COVID-19 in pregnancy.
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Affiliation(s)
- M. Valdés-Bango
- Servicio de Medicina Maternofetal, Centro de Medicina Maternofetal y Neonatal de Barcelona (Hospital Clínic y Hospital Sant Joan de Déu), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Centro de Investigación Biomédica en Red Enfermedades Raras (CIBER-ER), Barcelona, España
| | - E. Meler
- Servicio de Medicina Maternofetal, Centro de Medicina Maternofetal y Neonatal de Barcelona (Hospital Clínic y Hospital Sant Joan de Déu), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Centro de Investigación Biomédica en Red Enfermedades Raras (CIBER-ER), Barcelona, España
| | - T. Cobo
- Servicio de Medicina Maternofetal, Centro de Medicina Maternofetal y Neonatal de Barcelona (Hospital Clínic y Hospital Sant Joan de Déu), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Centro de Investigación Biomédica en Red Enfermedades Raras (CIBER-ER), Barcelona, España
| | - S. Hernández
- Servicio de Medicina Maternofetal, Centro de Medicina Maternofetal y Neonatal de Barcelona (Hospital Clínic y Hospital Sant Joan de Déu), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Centro de Investigación Biomédica en Red Enfermedades Raras (CIBER-ER), Barcelona, España
| | - A. Caballero
- Servicio de Anestesiología, Hospital Clínic, Universitat de Barcelona, Barcelona, España
| | - F. García
- Servicio de Enfermedades Infecciosas, Hospital Clínic, Universitat de Barcelona, Barcelona, España
| | - L. Ribera
- Servicio de Medicina Maternofetal, Centro de Medicina Maternofetal y Neonatal de Barcelona (Hospital Clínic y Hospital Sant Joan de Déu), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Centro de Investigación Biomédica en Red Enfermedades Raras (CIBER-ER), Barcelona, España
| | - L. Guirado
- Servicio de Medicina Maternofetal, Centro de Medicina Maternofetal y Neonatal de Barcelona (Hospital Clínic y Hospital Sant Joan de Déu), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Centro de Investigación Biomédica en Red Enfermedades Raras (CIBER-ER), Barcelona, España
| | - P. Ferrer
- Servicio de Medicina Maternofetal, Centro de Medicina Maternofetal y Neonatal de Barcelona (Hospital Clínic y Hospital Sant Joan de Déu), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Centro de Investigación Biomédica en Red Enfermedades Raras (CIBER-ER), Barcelona, España
| | - D. Salvia
- Servicio de Neonatología, Hospital Clínic, Universitat de Barcelona, Barcelona, España
| | - F. Figueras
- Servicio de Medicina Maternofetal, Centro de Medicina Maternofetal y Neonatal de Barcelona (Hospital Clínic y Hospital Sant Joan de Déu), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Centro de Investigación Biomédica en Red Enfermedades Raras (CIBER-ER), Barcelona, España
| | - M. Palacio
- Servicio de Medicina Maternofetal, Centro de Medicina Maternofetal y Neonatal de Barcelona (Hospital Clínic y Hospital Sant Joan de Déu), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Centro de Investigación Biomédica en Red Enfermedades Raras (CIBER-ER), Barcelona, España
| | - A. Goncé
- Servicio de Medicina Maternofetal, Centro de Medicina Maternofetal y Neonatal de Barcelona (Hospital Clínic y Hospital Sant Joan de Déu), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Centro de Investigación Biomédica en Red Enfermedades Raras (CIBER-ER), Barcelona, España
| | - M. López
- Servicio de Medicina Maternofetal, Centro de Medicina Maternofetal y Neonatal de Barcelona (Hospital Clínic y Hospital Sant Joan de Déu), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Centro de Investigación Biomédica en Red Enfermedades Raras (CIBER-ER), Barcelona, España,Autor para correspondencia
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Varón-Vega F, Hernández Á, López M, Cáceres E, Giraldo-Cadavid LF, Uribe-Hernandez AM, Crevoisier S. [Usefulness of diaphragmatic ultrasound in predicting extubation success]. Med Intensiva 2019; 45:226-233. [PMID: 31870509 DOI: 10.1016/j.medin.2019.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/16/2019] [Accepted: 10/24/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate the diagnostic accuracy of diaphragmatic ultrasound in predicting extubation success. DESIGN A diagnostic accuracy study was carried out. SCOPE Intensive Care Unit of an Academic hospital in the city of Bogotá (Colombia). PATIENTS OR PARTICIPANTS A consecutive sample of patients >18 years of age subjected to invasive mechanical ventilation for >48h. INTERVENTIONS Diaphragmatic ultrasound evaluation at the end of spontaneous ventilation testing. MAIN VARIABLES OF INTEREST Diaphragmatic excursion (DE, cm), inspiration time (TPIAdia, s), diaphragm contraction speed (DE/TPIAdia, cm/s) and total time (Ttot, s) were evaluated, together with thickening fraction (TFdi, %). RESULTS A total of 84 patients were included, 79.8% (n=67) with successful extubation and 20.2% (n=17) with failed extubation. The variable with the best discriminatory capacity in predicting extubation success was diaphragm contraction speed, with AUC-ROC 0.70 (p=0.008). CONCLUSIONS Diaphragm contraction speed exhibited acceptable discriminatory capacity. Ultrasound could be part of a multifactorial approach in the extubation process.
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Affiliation(s)
- F Varón-Vega
- Unidad de Cuidado Intensivo Médico, Fundación Neumológica Colombiana, Bogotá, Colombia; Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia; Departamento de Anestesiología y Cuidados Intensivos, Universidad de Navarra, Pamplona, España
| | - Á Hernández
- Unidad de Cuidado Intensivo Médico, Fundación Neumológica Colombiana, Bogotá, Colombia
| | - M López
- Unidad de Cuidado Intensivo Médico, Fundación Neumológica Colombiana, Bogotá, Colombia
| | - E Cáceres
- Unidad de Cuidado Intensivo Médico, Fundación Neumológica Colombiana, Bogotá, Colombia
| | - L F Giraldo-Cadavid
- Departamento de Investigación, Fundación Neumológica Colombiana, Bogotá, Colombia; Departamento de Epidemiología y de Medicina Interna, Universidad de La Sabana, Chía, Colombia
| | - A M Uribe-Hernandez
- Unidad de Cuidado Intensivo Médico, Fundación Neumológica Colombiana, Bogotá, Colombia; Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia; Departamento de Investigación, Fundación Neumológica Colombiana, Bogotá, Colombia.
| | - S Crevoisier
- Medicina Crítica y Cuidado Intensivo, Universidad de La Sabana, Chía, Colombia
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Amato F, Pérez N, López M, Ripoll A, Alastuey A, Pandolfi M, Karanasiou A, Salmatonidis A, Padoan E, Frasca D, Marcoccia M, Viana M, Moreno T, Reche C, Martins V, Brines M, Minguillón MC, Ealo M, Rivas I, van Drooge B, Benavides J, Craviotto JM, Querol X. Vertical and horizontal fall-off of black carbon and NO 2 within urban blocks. Sci Total Environ 2019; 686:236-245. [PMID: 31176822 DOI: 10.1016/j.scitotenv.2019.05.434] [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] [Received: 03/06/2019] [Revised: 05/28/2019] [Accepted: 05/28/2019] [Indexed: 06/09/2023]
Abstract
While exposure to traffic pollutants significantly decreases with distance from the curb, very dense urban architectures hamper such dispersion. Moreover, the building height reduces significantly the dispersion of pollutants. We have investigated the horizontal variability of Black Carbon (BC) and the vertical variability of NO2 and BC within the urban blocks. Increasing the distance from road BC concentrations decreased following an exponential curve reaching halving distances at 25 m (median), although with a wide variability among sites. Street canyons showed sharper fall-offs than open roads or roads next to a park. Urban background concentrations were achieved at 67 m distance on average, with higher distances found for more trafficked roads. Vertical fall-off of BC was less pronounced than the horizontal one since pollutants homogenize quickly vertically after rush traffic hours. Even shallower vertical fall-offs were found for NO2. For both pollutants, background concentrations were never reached within the building height. A street canyon effect was also found exacerbating concentrations at the lowest floors of the leeward side of the road. These inputs can be useful for assessing population exposure, air quality policies, urban planning and for models validation.
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Affiliation(s)
- F Amato
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain.
| | - N Pérez
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
| | - M López
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
| | - A Ripoll
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
| | - A Alastuey
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
| | - M Pandolfi
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
| | - A Karanasiou
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
| | - A Salmatonidis
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
| | - E Padoan
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain; University of Turin, Turin, Italy
| | - D Frasca
- Chemistry Department, Sapienza University of Rome, Rome, Italy
| | - M Marcoccia
- Chemistry Department, Sapienza University of Rome, Rome, Italy
| | - M Viana
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
| | - T Moreno
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
| | - C Reche
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
| | - V Martins
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
| | - M Brines
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
| | - M C Minguillón
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
| | - M Ealo
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
| | | | - B van Drooge
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
| | - J Benavides
- Barcelona Supercomputing Center, Barcelona, Spain
| | | | - X Querol
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Research Council (CSIC), Barcelona, Spain
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Bautista F, Cañete A, Ramírez-Villar GL, Fernández JM, Fuster JL, Diaz de Heredia C, Astigarraga I, García-Ariza M, Rives S, Dapena JL, Márquez C, Molinés A, Bermúdez MDM, Gallego S, Andrés MDM, Verdu-Amoros J, Hernández C, López M, Catalá A, Lassaletta Á, Cruz O, Ramírez M, Lendínez F, Carboné A, Gomez Sirvent J, Tallón M, Acha T, Moreno L, Fernández-Teijeiro A. ECLIM-SEHOP, a new platform to set up and develop international academic clinical trials for childhood cancer and blood disorders in Spain. Clin Transl Oncol 2019; 21:1763-1770. [DOI: 10.1007/s12094-019-02221-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 10/25/2022]
Abstract
Abstract
Introduction
Cancer and blood disorders in children are rare. The progressive improvement in survival over the last decades largely relies on the development of international academic clinical trials that gather the sufficient number of patients globally to elaborate solid conclusions and drive changes in clinical practice. The participation of Spain into large international academic trials has traditionally lagged behind of other European countries, mainly due to the burden of administrative tasks to open new studies, lack of financial support and limited research infrastructure in our hospitals.
Methods
The objective of ECLIM-SEHOP platform (Ensayos Clínicos Internacionales Multicéntricos-SEHOP) is to overcome these difficulties and position Spain among the European countries leading the advances in cancer and blood disorders, facilitate the access of our patients to novel diagnostic and therapeutic approaches and, most importantly, continue to improve survival and reducing long-term sequelae. ECLIM-SEHOP provides to the Spanish clinical investigators with the necessary infrastructural support to open and implement academic clinical trials and registries.
Results
In less than 3 years from its inception, the platform has provided support to 20 clinical trials and 8 observational studies, including 8 trials and 4 observational studies where the platform performs all trial-related tasks (integral support: trial setup, monitoring, etc.) with more than 150 patients recruited since 2017 to these studies. In this manuscript, we provide baseline metrics for academic clinical trial performance that permit future comparisons.
Conclusions
ECLIM-SEHOP facilitates Spanish children and adolescents diagnosed with cancer and blood disorders to access state-of-the-art diagnostic and therapeutic strategies.
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Linares JP, Ibañez C, Arguis M, Sandoval E, Pereda D, Carretero M, Navarro R, Matute P, Carramiñana A, López M, Fita G, Gomar C, Rovira I. Left atrial dissection: taken from darkness by transoesophageal echocardiography. J Cardiothorac Vasc Anesth 2019. [DOI: 10.1053/j.jvca.2019.07.032] [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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Guillén G, López-Fernández S, Molino JA, Bueno J, López M. [Pilot experience with indocyanine green navigation in pediatric surgery]. Cir Pediatr 2019; 32:121-127. [PMID: 31486303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Indocyanine Green (ICG) fluorescence is a new tool for navigated minimal invasive and open surgery, with multiple possible uses, that can increase safety and improve surgical results, facilitating intraoperative decision making. We hereby present our pilot series using ICG navigation in different procedures of pediatric surgery. MATERIAL AND METHODS As a proof of concept, between May 2017 and March 2019, we have used this technique as a help for decision making in these scenarios: visualization of the biliary tract, vascular and lymphatic structures, neoplastic tissue and other anatomic landmarks. The route of administration, timing and dosage changed depending on the indication. A 30º optic, with a conventional and near-infrared light emitter, connected to a high definition system specially equipped was used. RESULTS We considered that the technique might be useful in 20 patients (22 procedures): 6 involving the biliary tract (5 cholecystectomies, 1 choledochal stenosis), 9 oncologic procedures (5 laparoscopic and 4 open), 7 miscellanea (pulmonary nodule resections, long-gap esophageal atresia, anastomotic leak, etc). There were no complications regarding ICG administration. We considered that the system provided relevant information or affected intraoperative decision making in 90% of the cases. CONCLUSIONS ICG navigation was easy to perform and complication free. Our preliminary results suggest that ICG navigation, in open and endoscopic procedures, might provide a qualitative leap regarding safety and facilitate the performance of certain pediatric surgical procedures, particularly in oncology, liver surgery and neonatal surgery.
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Affiliation(s)
- G Guillén
- Servicio de Cirugía Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona
| | - S López-Fernández
- Servicio de Cirugía Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona
| | - J A Molino
- Servicio de Cirugía Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona
| | - J Bueno
- Servicio de Cirugía Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona
| | - M López
- Servicio de Cirugía Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona
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Gonzalez C, Martínez A, Martínez H, Tovar S, López M, Cruz J. Michelin vialés technique with tovaŕs modification for bilateral cleft lip treatment at inicitiva UVA. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.033] [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: 10/26/2022]
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Rodríguez BÁ, Montero Á, Calvo F, Valero J, Aramburu F, García J, Ciérvide R, López M, De la Casa M, Martí J, Sánchez E, García-Aranda M, Chen X, Hernando O, Alonso R, Rodríguez S, de la Peña PG, Rubio C. EP-1670 Painful osteoarthritis responds to low-dose radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32090-0] [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: 10/26/2022]
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López M, Baeza-Brotons F, López I, Tenza-Abril AJ, Aragonés L. Factors influencing the rate of beach sand wear: Activation layer thickness and sediment durability. Sci Total Environ 2019; 658:367-373. [PMID: 30579194 DOI: 10.1016/j.scitotenv.2018.12.211] [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] [Received: 11/06/2018] [Revised: 12/13/2018] [Accepted: 12/13/2018] [Indexed: 06/09/2023]
Abstract
The construction of harbours on the coast and/or dams in river courses prevents the contribution of sediments from rivers and ravines to the coastline and interferes with natural coastal dynamics. In the present study, the main objective is to provide information to the coastal engineer to predict and quantify the wear and tear of sand for artificial beach nourishment, as well as the durability of the intervention. For this purpose: (i) the amount of sample used in laboratory tests is related to the actual activation layer due to waves, and (ii) the material durability (aging) is demonstrated. Sands belonging to 9 beaches in the province of Alicante (Spain) were tested and studied, with different sample quantities (60, 75, 100, 120 and 150 g), the granulometry, calcimetry and wear (using the accelerated particle wear test, APW). The results showed that (generally) the greater the amount of sample used (activation layer), the greater the mass loss (reduction to size <0.063 mm) during the first cycle of the wear test. This may be due to the fact that the greater the amount of material in suspension (as a consequence of greater energy for the same volume of water), the greater the possibility of collision between particles, and therefore, greater particle wear and greater erosion on the beach. In addition, when the same material was subjected to new wear test cycles, that is, without the addition of new material (as is currently happening on the coasts), the durability of the same was compromised up to its wear limit. Particle wear reduces the median sediment size, which encourages movement towards the off-shore zone. Therefore, the wave energy, the material durability and the median sand diameter are elements to be taken into account in a beach nourishment.
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Affiliation(s)
- M López
- Dept. of Civil Engineering, University of Alicante, Carretera San Vicent del Raspeig s/n, 03690 Alicante, Spain
| | - F Baeza-Brotons
- Dept. of Civil Engineering, University of Alicante, Carretera San Vicent del Raspeig s/n, 03690 Alicante, Spain
| | - I López
- Dept. of Civil Engineering, University of Alicante, Carretera San Vicent del Raspeig s/n, 03690 Alicante, Spain
| | - A J Tenza-Abril
- Dept. of Civil Engineering, University of Alicante, Carretera San Vicent del Raspeig s/n, 03690 Alicante, Spain
| | - L Aragonés
- Dept. of Civil Engineering, University of Alicante, Carretera San Vicent del Raspeig s/n, 03690 Alicante, Spain.
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Sumarroca A, León X, García J, López M, Costa J, Quer M. PO-156 Risk of appearance of second and successive neoplasms in patients with a head and neck index tumor. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30322-6] [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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González JC, Lop J, García J, López M, Taberna M, Mena M, Alemany L, Sumarroca A, Quer M, León X. PO-103 Competing mortality in oropharyngeal carcinoma according to HPV status. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30269-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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46
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Majercakova K, Valero C, López M, García J, Farré N, Quer M, Craven-Bartle J, León X. Postoperative Staging of the Neck Dissection Using Extracapsular Spread and Lymph Node Ratio As Prognostic Factors in HPV-Negative Head and Neck Squamous Cell Carcinoma Patients (HNSCC). Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Aguilera-Pujabet M, Gander R, Royo GF, López M, Asensio M. [Is the Mathieu urethroplasty a useful technique for urethrocutaneous fistula repair after hypospadias surgery?]. Cir Pediatr 2018; 31:176-181. [PMID: 30371029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM There are multiple surgical techniques for distal urethrocutaneous fistulas (DUCF) repair after hypospadias surgery. Our aim was to analyze our results of simple closure (SC) and salvage mathieu urethroplasty (MU). MATERIAL AND METHODS Retrospective study (2014-2017) of pediatric patients with DUCF who underwent SC and MU. Only subcoronal to distal fistulas were collected, excluding the proximal ones non-tributary of MU. Demographics, clinical data, treatment and results were registered. MAIN RESULTS Over 4 years, 177 hypospadias and 28 UCFs were repaired. 15/28 met the inclusion criteria. Hypospadias type: anterior (10, 66.7%), midshaft (3, 20%) and posterior (2, 13.3%). Mean age at primary urethroplasty was 31.9 months (SD: 16.2). The most common techniques in primary surgery were Thiersch-Duplay (6) and Snodgrass (4). Median time from primary surgery to apparition of the fistula was 5 months (rank: 0-14). The surgical technique used for fistula repair was: SC (7) and MU (8). DUCF succeeded in all patients treated with MU, while among those treated with SC, 71.4% recurred, and only 4 patients underwent finally successful repair with a median of 1.5 interventions. Median follow-up was 25 months (rank: 12-55). CONCLUSIONS MU is a useful, effective and safe technique for DUCF repair. Most importantly, it is easily reproducible. The results of MU seem to be superior to CS and could be considered as a first choice.
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Affiliation(s)
- M Aguilera-Pujabet
- Servicio de Cirugía Pediátrica. Unidad de Urología Pediátrica. Hospital Universitari Vall d'Hebron. Barcelona
| | - R Gander
- Servicio de Cirugía Pediátrica. Unidad de Urología Pediátrica. Hospital Universitari Vall d'Hebron. Barcelona
| | - G F Royo
- Servicio de Cirugía Pediátrica. Unidad de Urología Pediátrica. Hospital Universitari Vall d'Hebron. Barcelona
| | - M López
- Servicio de Cirugía Pediátrica. Unidad de Urología Pediátrica. Hospital Universitari Vall d'Hebron. Barcelona
| | - M Asensio
- Servicio de Cirugía Pediátrica. Unidad de Urología Pediátrica. Hospital Universitari Vall d'Hebron. Barcelona
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López M, Baeza-Brotons F, López I, Tenza-Abril AJ, Aragonés L. Mineralogy and morphology of sand: Key parameters in the durability for its use in artificial beach nourishment. Sci Total Environ 2018; 639:186-194. [PMID: 29787902 DOI: 10.1016/j.scitotenv.2018.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/02/2018] [Accepted: 05/03/2018] [Indexed: 06/08/2023]
Abstract
Sand is the third most consumed material in the world, although it is a very scarce material. An exhaustive knowledge of sand and its behaviour against the waves is important for selecting the most suitable material to avoid shoreline erosion. To this end, a pattern of behaviour against accelerated wear test has been sought for 26 sand samples with different characteristics and origins (natural, dredged and quarried), with a focus on their mineralogy as well as a comparison of beach evolution carried out by other authors. Several techniques have been applied for characterization: granulometry, calcimetry, XRD and SEM. The results show that the different degrees of sand grain wear are not only due to their size and mineralogy, but also to the morphology of the particles.
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Affiliation(s)
- M López
- Dept. of Civil Engineering, University of Alicante, Carretera San Vicent del Raspeig s/n, 03690 Alicante, Spain
| | - F Baeza-Brotons
- Dept. of Civil Engineering, University of Alicante, Carretera San Vicent del Raspeig s/n, 03690 Alicante, Spain
| | - I López
- Dept. of Civil Engineering, University of Alicante, Carretera San Vicent del Raspeig s/n, 03690 Alicante, Spain
| | - A J Tenza-Abril
- Dept. of Civil Engineering, University of Alicante, Carretera San Vicent del Raspeig s/n, 03690 Alicante, Spain
| | - L Aragonés
- Dept. of Civil Engineering, University of Alicante, Carretera San Vicent del Raspeig s/n, 03690 Alicante, Spain.
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Giné C, Arévalo S, Maíz N, Rodó C, Manrique S, Poca A, Molino JA, Carreras E, López M. Fetoscopic two-layer closure of open neural tube defects. Ultrasound Obstet Gynecol 2018; 52:452-457. [PMID: 29876992 DOI: 10.1002/uog.19104] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 04/21/2018] [Accepted: 05/27/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Fetoscopy for closure of open neural tube defects (NTD) remains controversial, as the use of patches or single-layer closure is not considered to meet the standards of good neurosurgical reconstruction. In this study, we describe a fetoscopic two-layer (myofascial and skin) closure technique for the treatment of NTD in five patients and report the preliminary anatomical outcome at birth. METHODS From February to September 2017, five pregnant women with a fetus with a NTD, including three cases of myelomeningocele and two cases of myelocele, were operated on using a fetoscopic two-layer closure technique. In this technique, with the uterus exteriorized and using three 10-Fr ports, the placode is dissected from the surrounding tissue and detethered, removing the cystic tissue. The skin is undermined by blunt dissection and the defect is sutured to the midline in two layers (myofascial and skin) using a running 4/0 resorbable barbed suture. RESULTS Median gestational age at the procedure was 24 + 3 (range, 23 + 5 to 27 + 3) weeks. Surgery was successful in all cases, without any intraoperative complications. Median time in surgery was 180 (range, 140-180) min and median time for fetoscopy was 105 (range, 65-120) min. In terms of obstetric complications, three cases of premature rupture of membranes and one case of chorioamnionitis were recorded. Median gestational age at delivery was 34 + 1 (range, 25 + 4 to 37 + 2) weeks and two patients delivered vaginally. The closed defect was watertight with good quality tissue in all cases. CONCLUSION Fetoscopic two-layer closure of NTD may improve the quality of the tissue covering the defect, diminishing the need for postnatal surgical revision, and preserving the well-documented beneficial effects of prenatal closure on the neural tissue and hindbrain herniation. However, this technique may not be appropriate for those cases with wide diastasis of the myofascial layer or with a low quantity of available tissue. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- C Giné
- Pediatric Surgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Arévalo
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Maternal-Fetal Medicine Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - N Maíz
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Maternal-Fetal Medicine Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - C Rodó
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Maternal-Fetal Medicine Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - S Manrique
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Anesthesiology and Reanimation Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - A Poca
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Pediatric Neurosurgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Neurotraumatology and Neurosurgery Research Unit (UNINN), Barcelona, Spain
| | - J A Molino
- Pediatric Surgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - E Carreras
- Maternal-Fetal Medicine Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - M López
- Pediatric Surgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
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Gander R, Asensio M, Molino JA, Royo GF, Ariceta G, Muñoz M, López M. Is donor age 6 years or less related to increased risk of surgical complications in pediatric kidney transplantation? J Pediatr Urol 2018; 14:442.e1-442.e8. [PMID: 29636297 DOI: 10.1016/j.jpurol.2018.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 10/15/2017] [Accepted: 03/13/2018] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Despite the widespread organ shortage dilemma, there is hesitancy regarding utilization of young donors (aged ≤6 years) because previous reports have suggested that this is associated with an increased risk of surgical complications and graft loss. OBJECTIVE The aim of this study was to determine if donor age ≤6 years is related to increased risk of surgical complications or allograft loss in pediatric kidney transplantation (KT). STUDY DESIGN A retrospective study of pediatric kidney transplants (KT) undertaken between January 2000 and July 2015. The incidence of surgical and urological complications, and allograft loss were analyzed and compared between donors aged ≤6 years (Group 1) and donors aged >6 years (Group 2). RESULTS A total of 171 pediatric KTs were performed at the current center during the study period. Twenty-eight patients were excluded; as a result, the study comprised 143 patients: 60 (Group 1) and 83 (Group 2). Mean recipient weight was 17 kg (SD 9.7; range 3.2-47) in Group 1 and 38.2 kg (SD 15.3; range 7.8-73) in Group 2. Despite a significantly higher proportion of risk factors in Group 1, no significant between-group differences were observed in terms of: surgical complications (OR 0.4; range 0.1-1.2), early urological complications (OR 2.2; range 0.4-11), late urological complications (OR 0.3; range 0.8-1.4), lymphoceles (OR 6.2; range 0.7-51.7) and allograft loss (OR 1.5; range 0.7-3.1, summary Table). Graft survival at 1 and 5 years was: 81% and 70% (Group 1) and 92% and 79% (Group 2), respectively (P = 0.093). Mean follow-up was 90.13 ± 49.7 months. DISCUSSION The main finding of this retrospective study was that pediatric donor kidneys from donors aged ≤6 years could safely be used in pediatric recipients without an increased risk of surgical and urological complications or graft loss. Nevertheless, KT with small donor kidneys is challenging and should be performed at experienced pediatric centers. CONCLUSION In line with these results, the outcomes of KT using donors aged ≤6 years were encouraging and similar to those obtained with older donors. Thus, this study supported using kidney grafts from young donors, given the organ shortage and potential high mortality risk while awaiting KT.
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Affiliation(s)
- R Gander
- Department of Pediatric Surgery, Pediatric Urology and Renal Transplant Unit, University Hospital Vall d'Hebron, Barcelona, Spain.
| | - M Asensio
- Department of Pediatric Surgery, Pediatric Urology and Renal Transplant Unit, University Hospital Vall d'Hebron, Barcelona, Spain
| | - J A Molino
- Department of Pediatric Surgery, Pediatric Urology and Renal Transplant Unit, University Hospital Vall d'Hebron, Barcelona, Spain
| | - G F Royo
- Department of Pediatric Surgery, Pediatric Urology and Renal Transplant Unit, University Hospital Vall d'Hebron, Barcelona, Spain
| | - G Ariceta
- Department of Pediatric Nephrology, University Hospital Vall d'Hebron, Barcelona, Spain; Department of Pediatrics, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - M Muñoz
- Department of Pediatric Nephrology, University Hospital Vall d'Hebron, Barcelona, Spain
| | - M López
- Department of Pediatric Surgery, University Hospital Vall d'Hebron, Barcelona, Spain
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