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Ruiz R, Montagud-Martínez R, Dorta-Gorrín A, Pablo-Marcos D, Gozalo M, Calvo-Montes J, Navas J, Rodrigo G. Rapid and Accurate Detection of the SARS-CoV-2 Omicron Variant with a CRISPR-Cas12a Reaction in the RT-qPCR Pot. ACS Omega 2024; 9:18046-18050. [PMID: 38680362 PMCID: PMC11044157 DOI: 10.1021/acsomega.3c09717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 05/01/2024]
Abstract
Gene sequencing in back of reverse transcription-quantitative polymerase chain reaction (RT-qPCR) is the current approach for discriminating infections produced by different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants in the clinic. However, sequencing is often a time-consuming step, which hinders the deployment of a very fast response during a pandemic. Here, we propose to run a CRISPR-Cas12a reaction after completing the RT-qPCR and in the very same pot to detect with high specificity genetic marks characterizing variants of concern. A crRNA was appropriately designed to detect the S gene of the SARS-CoV-2 Omicron BA.1 variant. A significant response with >20-fold dynamic range was obtained for the Omicron BA.1 S gene, while the Delta S gene did not produce any detectable signal. The sensitivity of the method was analyzed with a series of diluted samples and different Cas12a nucleases. A correlation between the RT-qPCR CT values and the CRISPR-Cas12a reaction signals was observed. Variant discrimination with the CRISPR-Cas12a reaction was possible in some minutes with high accuracy from patient samples. In conclusion, CRISPR-Cas systems seem ready to be exploited in the clinic to boost personalized diagnoses and accelerate epidemiological surveillance in a cost-effective way.
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Affiliation(s)
- Raúl Ruiz
- Instituto
de Biología Integrativa de Sistemas (I2SysBio), CSIC—Universitat de València, 46980 Paterna, Spain
| | - Roser Montagud-Martínez
- Instituto
de Biología Integrativa de Sistemas (I2SysBio), CSIC—Universitat de València, 46980 Paterna, Spain
| | - Alexis Dorta-Gorrín
- Facultad
de Medicina, Universidad de Cantabria, 39011 Santander, Spain
- Instituto
de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Daniel Pablo-Marcos
- Servicio
de Microbiología, Hospital Universitario
Marqués de Valdecilla, 39008 Santander, Spain
| | - Mónica Gozalo
- Instituto
de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
- Servicio
de Microbiología, Hospital Universitario
Marqués de Valdecilla, 39008 Santander, Spain
- Centro
de Investigación Biomédica en Red de Enfermedades Infecciosas
(CIBERINFEC), Instituto de Salud Carlos
III, 28029 Madrid, Spain
| | - Jorge Calvo-Montes
- Instituto
de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
- Servicio
de Microbiología, Hospital Universitario
Marqués de Valdecilla, 39008 Santander, Spain
- Centro
de Investigación Biomédica en Red de Enfermedades Infecciosas
(CIBERINFEC), Instituto de Salud Carlos
III, 28029 Madrid, Spain
| | - Jesús Navas
- Facultad
de Medicina, Universidad de Cantabria, 39011 Santander, Spain
- Instituto
de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Guillermo Rodrigo
- Instituto
de Biología Integrativa de Sistemas (I2SysBio), CSIC—Universitat de València, 46980 Paterna, Spain
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Croset F, Llàcer P, Núñez J, Campos J, García M, Pérez A, Fernández C, Fabregate M, López G, Tello S, Fernández JM, Ruiz R, Manzano L. Loop diuretic down-titration at discharge in patients hospitalized for acute heart failure. ESC Heart Fail 2024. [PMID: 38454739 DOI: 10.1002/ehf2.14749] [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: 11/21/2023] [Revised: 01/31/2024] [Accepted: 02/19/2024] [Indexed: 03/09/2024] Open
Abstract
AIMS The current literature provides limited guidance on the best diuretic strategy post-hospitalization for acute heart failure (AHF). It is postulated that the efficacy and safety of the outpatient diuretic regimen may be significantly influenced by the degree of fluid overload (FO) encountered during hospitalization. We hypothesize that in patients with more pronounced FO, reducing their regular oral diuretic dosage might be associated with an elevated risk of unfavourable clinical outcomes. METHODS AND RESULTS It was a retrospective observational study of 410 patients hospitalized for AHF in which the dose of furosemide at admission and discharge was collected. Patients were categorized across diuretic dose status into two groups: (i) the down-titration group and (ii) the stable/up-titration group. FO status was evaluated by a clinical congestion score and circulating biomarkers. The endpoint of interest was the composite of time to all-cause death and/or heart failure readmission. A multivariable Cox proportional hazard regression model was constructed to analyse the endpoints. The median age was 86 (78-92) years, 256 (62%) were women, and 80% had heart failure with preserved ejection fraction. After multivariate adjustment, the down-titration furosemide equivalent dose remained not associated with the risk of the combined endpoint in the whole sample (hazard ratio 1.34, 95% confidence interval 0.86-2.06, P = 0.184). The risk of the combination of death and/or worsening heart failure associated with the diuretic strategy at discharge was significantly influenced by FO status, including clinical congestion scores and circulating proxies of FO like BNP and cancer antigen 125. CONCLUSIONS In patients hospitalized for AHF, furosemide down-titration does not imply an increased risk of mortality and/or heart failure readmission. However, FO status modifies the effect of down-titration on the outcome. In patients with severe congestion or residual congestion at discharge, down-titration was associated with an increased risk of mortality and/or heart failure readmission.
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Affiliation(s)
- François Croset
- Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
- Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - Pau Llàcer
- Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
- Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - Julio Núñez
- Department of Cardiology, Hospital Clínico Universitario, Universitat de València, INCLIVA, Valencia, Spain
- CIBER Cardiovascular, Madrid, Spain
| | - Jorge Campos
- Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Marina García
- Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Alberto Pérez
- Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Cristina Fernández
- Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Martín Fabregate
- Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Genoveva López
- Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Susana Tello
- Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - José María Fernández
- Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Raúl Ruiz
- Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Luis Manzano
- Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
- Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, IRYCIS, Madrid, Spain
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Dolcemascolo R, Heras-Hernández M, Goiriz L, Montagud-Martínez R, Requena-Menéndez A, Ruiz R, Pérez-Ràfols A, Higuera-Rodríguez RA, Pérez-Ropero G, Vranken WF, Martelli T, Kaiser W, Buijs J, Rodrigo G. Repurposing the mammalian RNA-binding protein Musashi-1 as an allosteric translation repressor in bacteria. eLife 2024; 12:RP91777. [PMID: 38363283 PMCID: PMC10942595 DOI: 10.7554/elife.91777] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Abstract
The RNA recognition motif (RRM) is the most common RNA-binding protein domain identified in nature. However, RRM-containing proteins are only prevalent in eukaryotic phyla, in which they play central regulatory roles. Here, we engineered an orthogonal post-transcriptional control system of gene expression in the bacterium Escherichia coli with the mammalian RNA-binding protein Musashi-1, which is a stem cell marker with neurodevelopmental role that contains two canonical RRMs. In the circuit, Musashi-1 is regulated transcriptionally and works as an allosteric translation repressor thanks to a specific interaction with the N-terminal coding region of a messenger RNA and its structural plasticity to respond to fatty acids. We fully characterized the genetic system at the population and single-cell levels showing a significant fold change in reporter expression, and the underlying molecular mechanism by assessing the in vitro binding kinetics and in vivo functionality of a series of RNA mutants. The dynamic response of the system was well recapitulated by a bottom-up mathematical model. Moreover, we applied the post-transcriptional mechanism engineered with Musashi-1 to specifically regulate a gene within an operon, implement combinatorial regulation, and reduce protein expression noise. This work illustrates how RRM-based regulation can be adapted to simple organisms, thereby adding a new regulatory layer in prokaryotes for translation control.
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Affiliation(s)
- Roswitha Dolcemascolo
- Institute for Integrative Systems Biology (I2SysBio), CSIC – University of ValenciaPaternaSpain
- Department of Biotechnology, Polytechnic University of ValenciaValenciaSpain
| | - María Heras-Hernández
- Institute for Integrative Systems Biology (I2SysBio), CSIC – University of ValenciaPaternaSpain
| | - Lucas Goiriz
- Institute for Integrative Systems Biology (I2SysBio), CSIC – University of ValenciaPaternaSpain
- Department of Applied Mathematics, Polytechnic University of ValenciaValenciaSpain
| | - Roser Montagud-Martínez
- Institute for Integrative Systems Biology (I2SysBio), CSIC – University of ValenciaPaternaSpain
- Department of Biotechnology, Polytechnic University of ValenciaValenciaSpain
| | | | - Raúl Ruiz
- Institute for Integrative Systems Biology (I2SysBio), CSIC – University of ValenciaPaternaSpain
| | - Anna Pérez-Ràfols
- Giotto Biotech SRLSesto FiorentinoItaly
- Magnetic Resonance Center (CERM), Department of Chemistry Ugo Schiff, Consorzio Interuniversitario Risonanze Magnetiche di Metalloproteine (CIRMMP), University of FlorenceSesto FiorentinoItaly
| | - R Anahí Higuera-Rodríguez
- Dynamic Biosensors GmbHPlaneggGermany
- Department of Physics, Technical University of MunichGarchingGermany
| | - Guillermo Pérez-Ropero
- Ridgeview Instruments ABUppsalaSweden
- Department of Chemistry – BMC, Uppsala UniversityUppsalaSweden
| | - Wim F Vranken
- Structural Biology Brussels, Vrije Universiteit BrusselBrusselsBelgium
- Interuniversity Institute of Bioinformatics in Brussels, Université Libre de Bruxelles – Vrije Universiteit BrusselBrusselsBelgium
| | | | | | - Jos Buijs
- Ridgeview Instruments ABUppsalaSweden
- Department of Immunology, Genetics, and Pathology, Uppsala UniversityUppsalaSweden
| | - Guillermo Rodrigo
- Institute for Integrative Systems Biology (I2SysBio), CSIC – University of ValenciaPaternaSpain
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Llàcer P, Croset F, de la Espriella R, Torres E, Campos J, García-Melero M, Pérez-Nieva A, Pumares M, Fabregate M, López G, Ruiz R, Tello S, Fernández JM, Núñez J, Manzano L. Trajectory of Urine Albumin-Creatinine Ratio in Patients with Acute Heart Failure. Cardiorenal Med 2024; 14:74-80. [PMID: 38286116 DOI: 10.1159/000536222] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/18/2023] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION Albuminuria is prevalent in patients with chronic heart failure and is a risk factor for disease progression. However, its clinical meaning in acute heart failure remains elusive. This study analyzed the trajectory of urine albumin to creatinine ratio (UACR) between admission and discharge and its association with decongestion. METHODS In this prospective observational study, 63 patients were enrolled. UACR, B-type natriuretic peptide (BNP), and clinical congestion score (CCS) were obtained at admission and discharge. We used linear mixed regression analysis to compare changes in the natural logarithm of UACR (logUACR) and its association with changes in markers of decongestion. Estimates were reported as least squares mean with their respective 95% CIs. RESULTS The median age of the study population was 87 years, 68.5% were women, and 69.8% had a left ventricular ejection fraction >50%. LogUACR at discharge significantly decreased in the overall population compared to admission (Δ -0.47, 95% CI: -0.78 to -0.15, p value = 0.003). The magnitude of UACR drop at discharge was associated with changes in surrogate markers of decongestion. Patients who showed a greater reduction in BNP at discharge exhibited a greater reduction in UACR (p = 0.016). The same trend was also found with clinical decongestion, as assessed by changes in CCS, however, without achieving statistical significance (p = 0.171). UACR change at discharge was not associated with changes in serum creatinine (p value = 0.923). CONCLUSION In elderly patients with AHF and volume overload, the level of UACR significantly decreased upon discharge compared to admission. This reduction in UACR was closely linked to decreases in BNP.
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Affiliation(s)
- Pau Llàcer
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
- Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Madrid, Spain
| | - François Croset
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
- Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Madrid, Spain
| | - Rafael de la Espriella
- Cardiology Department, Hospital Clínico Universitario, Universitat de València, INCLIVA, Valencia, Spain
| | - Elena Torres
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Jorge Campos
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Marina García-Melero
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Alberto Pérez-Nieva
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - María Pumares
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Martín Fabregate
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Genoveva López
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Raúl Ruiz
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Susana Tello
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - José María Fernández
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Julio Núñez
- Cardiology Department, Hospital Clínico Universitario, Universitat de València, INCLIVA, Valencia, Spain
- CIBER Cardiovascular, Madrid, Spain
| | - Luis Manzano
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
- Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Madrid, Spain
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Salinas CE, Patey OV, Murillo C, Gonzales M, Espinoza V, Mendoza S, Ruiz R, Vargas R, Perez Y, Montaño J, Toledo-Jaldin L, Badner A, Jimenez J, Peñaranda J, Romero C, Aguilar M, Riveros L, Arana I, Giussani DA. Preeclampsia and risk of maternal pulmonary hypertension at high altitude in Bolivia. J Dev Orig Health Dis 2023; 14:523-531. [PMID: 37497575 DOI: 10.1017/s2040174423000193] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Women with a history of preeclampsia (PE) have a greater risk of pulmonary arterial hypertension (PAH). In turn, pregnancy at high altitude is a risk factor for PE. However, whether women who develop PE during highland pregnancy are at risk of PAH before and after birth has not been investigated. We tested the hypothesis that during highland pregnancy, women who develop PE are at greater risk of PAH compared to women undergoing healthy highland pregnancies. The study was on 140 women in La Paz, Bolivia (3640m). Women undergoing healthy highland pregnancy were controls (C, n = 70; 29 ± 3.3 years old, mean±SD). Women diagnosed with PE were the experimental group (PE, n = 70, 31 ± 2 years old). Conventional (B- and M-mode, PW Doppler) and modern (pulsed wave tissue Doppler imaging) ultrasound were applied for cardiovascular íííassessment. Spirometry determined maternal lung function. Assessments occurred at 35 ± 4 weeks of pregnancy and 6 ± 0.3 weeks after birth. Relative to highland controls, highland PE women had enlarged right ventricular (RV) and right atrial chamber sizes, greater pulmonary artery dimensions and increased estimated RV contractility, pulmonary artery pressure and pulmonary vascular resistance. Highland PE women had lower values for peripheral oxygen saturation, forced expiratory flow and the bronchial permeability index. Differences remained 6 weeks after birth. Therefore, women who develop PE at high altitude are at greater risk of PAH before and long after birth. Hence, women with a history of PE at high altitude have an increased cardiovascular risk that transcends the systemic circulation to include the pulmonary vascular bed.
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Affiliation(s)
- C E Salinas
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | - O V Patey
- Department of Physiology, Development & Neuroscience, University of Cambridge, Cambridge, UK
| | - C Murillo
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | - M Gonzales
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | - V Espinoza
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | - S Mendoza
- Centro de Salud Tembladerani, La Paz, Bolivia
| | - R Ruiz
- Hospital Materno Infantil, La Paz, Bolivia
| | - R Vargas
- Hospital de la Mujer, La Paz, Bolivia
| | - Y Perez
- Hospital de la Mujer, La Paz, Bolivia
| | - J Montaño
- Hospital de la Mujer, La Paz, Bolivia
| | | | - A Badner
- Hospital Materno Infantil, La Paz, Bolivia
| | - J Jimenez
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | | | - C Romero
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | - M Aguilar
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | - L Riveros
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | - I Arana
- Grupo Premio Nobel, La Paz, Bolivia
| | - D A Giussani
- Department of Physiology, Development & Neuroscience, University of Cambridge, Cambridge, UK
- BHF Centre for Research Excellence, University of Cambridge, Cambridge, UK
- Strategic Research Initiative in Reproduction, University of Cambridge, Cambridge, UK
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Llàcer P, Núñez J, Croset F, García M, Fabregate M, Ruiz R, López G, Fernández C, Del Hoyo B, Campos J, Gomis A, Manzano L. Usefulness of urinary potassium to creatinine ratio to predict diuretic response in patients with acute heart failure and preserved ejection fraction. Clin Cardiol 2023; 46:906-913. [PMID: 37287326 PMCID: PMC10436792 DOI: 10.1002/clc.24040] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 05/06/2023] [Accepted: 05/10/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Patients with acute heart failure (AHF) require intensification in the diuretic strategy. However, the optimal diuretic strategy remains unclear. In this work, we aimed to evaluate the role of urinary potassium to creatinine ratio (K/Cr) to predict diuretic and natriuretic response to thiazide or mineralocorticoid receptor antagonists (MRAs) in a cohort of patients with AHF and preserved ejection fraction (AHF-pEF). HYPOTHESIS Patients with a high urinary K/Cr ratio will have a better diuretic and natriuretic response with spironolactone versus chlorthalidone. METHODS This is a study of 44 patients with AHF-pEF with suboptimal loop diuretic response. The primary endpoint was the baseline K/Cr associated with natriuretic and diuretic effect of chlorthalidone versus spironolactone at 24 and 72 h. Mixed linear regression models were used to analyze the endpoints. Estimates were reported as least squares mean with their respective 95% confidence interval (CIs). RESULTS The median age of the study population was 85 years (82.5-88.5), and 30 (68.2%) were women. The inferential multivariate analysis suggested a greater natriuretic and diuretic effect of chlorthalidone across K/Cr levels. In the upper category, chlorthalidone translated into a statistically increase in natriuresis at 24 and 72 h. Chlorthalidone versus spironolactone showed ∆uNa of 25.7 mmol/L at 24 h (95% CI = -3.7 to 55.4, p = .098) and ∆uNa of 24.8 mmol/L at 72 h (95% CI = -4 to 53.6, p = .0106). The omnibus p value is .027. Multivariate analyses revealed a significant increase in 72 h cumulative diuresis irrespective of K/Cr status in those on chlorthalidone. CONCLUSIONS In patients with AHF-pEF and suboptimal diuretic response, diuresis and natriuresis are higher with the administration of chlorthalidone over spironolactone. These data don't support the hypothesis that the K/Cr ratio can help guide the choice of thiazide diuretic versus MRA in AHF-pEF patients on loop diuretic.
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Affiliation(s)
- Pau Llàcer
- Internal Medicine DepartmentHospital Universitario Ramón y Cajal, IRYCISMadridSpain
- Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la SaludUniversidad de AlcaláMadridSpain
| | - Julio Núñez
- Cardiology Department, Hospital Clínico UniversitarioUniversitat de València, INCLIVAValenciaSpain
- CIBER CardiovascularMadridSpain
| | - François Croset
- Internal Medicine DepartmentHospital Universitario Ramón y Cajal, IRYCISMadridSpain
- Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la SaludUniversidad de AlcaláMadridSpain
| | - Marina García
- Internal Medicine DepartmentHospital Universitario Ramón y Cajal, IRYCISMadridSpain
| | - Martín Fabregate
- Internal Medicine DepartmentHospital Universitario Ramón y Cajal, IRYCISMadridSpain
| | - Raúl Ruiz
- Internal Medicine DepartmentHospital Universitario Ramón y Cajal, IRYCISMadridSpain
| | - Genoveva López
- Internal Medicine DepartmentHospital Universitario Ramón y Cajal, IRYCISMadridSpain
| | - Cristina Fernández
- Internal Medicine DepartmentHospital Universitario Ramón y Cajal, IRYCISMadridSpain
| | - Beatriz Del Hoyo
- Internal Medicine DepartmentHospital Universitario Ramón y Cajal, IRYCISMadridSpain
| | - Jorge Campos
- Internal Medicine DepartmentHospital Universitario Ramón y Cajal, IRYCISMadridSpain
| | - Antonio Gomis
- Nephrology DepartmentHospital Universitario Ramón y CajalMadridSpain
| | - Luis Manzano
- Internal Medicine DepartmentHospital Universitario Ramón y Cajal, IRYCISMadridSpain
- Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la SaludUniversidad de AlcaláMadridSpain
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7
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Goiriz L, Ruiz R, Garibo-i-Orts Ò, Conejero JA, Rodrigo G. A variant-dependent molecular clock with anomalous diffusion models SARS-CoV-2 evolution in humans. Proc Natl Acad Sci U S A 2023; 120:e2303578120. [PMID: 37459528 PMCID: PMC10372551 DOI: 10.1073/pnas.2303578120] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/11/2023] [Indexed: 07/20/2023] Open
Abstract
The evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in humans has been monitored at an unprecedented level due to the public health crisis, yet the stochastic dynamics underlying such a process is dubious. Here, considering the number of acquired mutations as the displacement of the viral particle from the origin, we performed biostatistical analyses from numerous whole genome sequences on the basis of a time-dependent probabilistic mathematical model. We showed that a model with a constant variant-dependent evolution rate and nonlinear mutational variance with time (i.e., anomalous diffusion) explained the SARS-CoV-2 evolutionary motion in humans during the first 120 wk of the pandemic in the United Kingdom. In particular, we found subdiffusion patterns for the Primal, Alpha, and Omicron variants but a weak superdiffusion pattern for the Delta variant. Our findings indicate that non-Brownian evolutionary motions occur in nature, thereby providing insight for viral phylodynamics.
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Affiliation(s)
- Lucas Goiriz
- BioInstituto de Biología Integrativa de Sistemas, Consejo Superior de Investigaciones Científicas – Universitat de València, 46980Paterna, Spain
- Institut Universitari de Matemàtica Pura i Aplicada, Universitat Politècnica de València, 46022Valencia, Spain
| | - Raúl Ruiz
- BioInstituto de Biología Integrativa de Sistemas, Consejo Superior de Investigaciones Científicas – Universitat de València, 46980Paterna, Spain
| | - Òscar Garibo-i-Orts
- Institut Universitari de Matemàtica Pura i Aplicada, Universitat Politècnica de València, 46022Valencia, Spain
| | - J. Alberto Conejero
- Institut Universitari de Matemàtica Pura i Aplicada, Universitat Politècnica de València, 46022Valencia, Spain
| | - Guillermo Rodrigo
- BioInstituto de Biología Integrativa de Sistemas, Consejo Superior de Investigaciones Científicas – Universitat de València, 46980Paterna, Spain
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8
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Márquez-Costa R, Montagud-Martínez R, Marqués MC, Albert E, Navarro D, Daròs JA, Ruiz R, Rodrigo G. Multiplexable and Biocomputational Virus Detection by CRISPR-Cas9-Mediated Strand Displacement. Anal Chem 2023; 95:9564-9574. [PMID: 37204239 PMCID: PMC10255568 DOI: 10.1021/acs.analchem.3c01041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/05/2023] [Indexed: 05/20/2023]
Abstract
Recurrent disease outbreaks caused by different viruses, including the novel respiratory virus SARS-CoV-2, are challenging our society at a global scale; so versatile virus detection methods would enable a calculated and faster response. Here, we present a novel nucleic acid detection strategy based on CRISPR-Cas9, whose mode of action relies on strand displacement rather than on collateral catalysis, using the Streptococcus pyogenes Cas9 nuclease. Given a preamplification process, a suitable molecular beacon interacts with the ternary CRISPR complex upon targeting to produce a fluorescent signal. We show that SARS-CoV-2 DNA amplicons generated from patient samples can be detected with CRISPR-Cas9. We also show that CRISPR-Cas9 allows the simultaneous detection of different DNA amplicons with the same nuclease, either to detect different SARS-CoV-2 regions or different respiratory viruses. Furthermore, we demonstrate that engineered DNA logic circuits can process different SARS-CoV-2 signals detected by the CRISPR complexes. Collectively, this CRISPR-Cas9 R-loop usage for the molecular beacon opening (COLUMBO) platform allows a multiplexed detection in a single tube, complements the existing CRISPR-based methods, and displays diagnostic and biocomputing potential.
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Affiliation(s)
- Rosa Márquez-Costa
- Institute
for Integrative Systems Biology (I2SysBio), CSIC − University
of Valencia, 46980 Paterna, Spain
| | - Roser Montagud-Martínez
- Institute
for Integrative Systems Biology (I2SysBio), CSIC − University
of Valencia, 46980 Paterna, Spain
| | - María-Carmen Marqués
- Institute
for Integrative Systems Biology (I2SysBio), CSIC − University
of Valencia, 46980 Paterna, Spain
| | - Eliseo Albert
- Microbiology
Service, Clinic University Hospital, INCLIVA
Biomedical Research Institute, 46010 Valencia, Spain
| | - David Navarro
- Microbiology
Service, Clinic University Hospital, INCLIVA
Biomedical Research Institute, 46010 Valencia, Spain
- Department
of Microbiology, School of Medicine, University
of Valencia, 46010 Valencia, Spain
| | - José-Antonio Daròs
- Instituto
de Biología Molecular y Celular de Plantas (IBMCP), CSIC − Universitat Politècnica de València, 46022 Valencia, Spain
| | - Raúl Ruiz
- Institute
for Integrative Systems Biology (I2SysBio), CSIC − University
of Valencia, 46980 Paterna, Spain
| | - Guillermo Rodrigo
- Institute
for Integrative Systems Biology (I2SysBio), CSIC − University
of Valencia, 46980 Paterna, Spain
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9
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Llàcer P, Croset F, Núñez J, Campos J, Fernández C, Fabregate M, Del Hoyo B, Ruiz R, López G, Tello S, Lorenzo A, Fernández JM, Manzano L. Prognostic significance of plasma chloride in elderly patients hospitalized for acute heart failure. ESC Heart Fail 2023. [PMID: 37349910 PMCID: PMC10375113 DOI: 10.1002/ehf2.14434] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/24/2023] [Accepted: 05/24/2023] [Indexed: 06/24/2023] Open
Abstract
AIMS Previous studies demonstrated the relationship between hypochloraemia and poor prognosis in patients hospitalized for acute heart failure (AHF). However, the usefulness of chloride in clinical practice remains uncertain, notably in very old patients with predominantly heart failure (HF) with preserved ejection fraction (HFpEF). We aimed to evaluate the prognostic impact of chloride in a cohort of very aged patients with AHF and the possible existence of different phenotypes of hypochloraemia with distinct clinical significance. METHODS AND RESULTS It was an observational study of 429 patients hospitalized for AHF in which chloraemia was measured. Two different phenotypes of hypochloraemia were identified by their relationship with estimated plasma volume status (ePVS) as a proxy of intravascular congestion. The endpoint of interest was time to all-cause mortality and the composite of death and/or HF readmission. A multivariable Cox proportional hazard regression model was constructed to analyse the endpoints. The median age was 85 (78-92) years, 266 (62%) were women, and 80% had HFpEF. After multivariable analysis, chloraemia, but not natraemia, was associated with the risk of death and HF readmission in a U-shaped pattern. The phenotype characterized by hypochloraemia and low ePVS (depletional) was associated with an increased risk of mortality when compared with patients with normochloraemia [hazard ratio (HR) 1.86, P = 0.008]. In contrast, hypochloraemia with high ePVS (dilutional) had no prognostic significance (HR 0.94, P = 0.855). CONCLUSIONS In very old patients hospitalized with AHF, plasma chloride was associated with the risk of death and HF readmission in a U-shaped pattern and could potentially be used for congestion phenotyping.
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Affiliation(s)
- Pau Llàcer
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
- Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - François Croset
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Julio Núñez
- Cardiology Department, Hospital Clínico Universitario, Universitat de València, INCLIVA, Valencia, Spain
- CIBER Cardiovascular, Madrid, Spain
| | - Jorge Campos
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Cristina Fernández
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Martín Fabregate
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Beatriz Del Hoyo
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Raúl Ruiz
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Genoveva López
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Susana Tello
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Ana Lorenzo
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - José María Fernández
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Luis Manzano
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
- Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, IRYCIS, Madrid, Spain
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10
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Arana Iñiguez I, Recreo Baquedano A, Ruiz R, Ariceta López A, Ramírez Cervera JL, Piñera A, Talavera Utrera G, Pérez Otermin I, Otegi Altolagirre I, Blázquez Lautre L. P-104 A STEP-UP APPROACH FROM IPOM + IN MINIMALLY INVASIVE ABDOMINAL WALL SURGERY. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
To compare the early outcomes of two different techniques for ventral hernia repair in our abdominal wall surgery unit.
Materials and Methods
A prospective non-randomized review was perfomed including patients who underwent laparoscopic hernia repair from January 2018 to April 2022. All patients were followed-up for 1 month and the hernia orifice was closed in all cases. Patients and hernias characteristics, operative data and early complications were reviewed. Postoperative pain was defined as ≥4 value in Visual Analogue Scale.
We compared 2 laparoscopic techniques: intraperitoneal mesh fixed with a double crown of resorbable tackers (IPOM+) and self gripping sublay positioned mesh (preperitoneal –PREP- or retromuscular –RIVES- position).
Outcomes
During the study period, 44 patients were assigned into 2 groups: 31 (70%) in IPOM+ group and 13 (30%) in Rives/Preperitoneal group. No differences were found in risk factors, population and hernia data between both groups. 6 patients (19%) from IPOM+ group presented postoperative pain and only 1 patient (7,7%) in Rives/Prep group (p: 0,30). There was no differences in other complications, length of stay or operative time.
Conlusion
Early outcomes of sublay techniques (Rives or preperitoneal) do not report more complications during perioperative time, but they could help reducing immediately postoperatorive pain.
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Affiliation(s)
- I Arana Iñiguez
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - A Recreo Baquedano
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - R Ruiz
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - A Ariceta López
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - J L Ramírez Cervera
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - A Piñera
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - G Talavera Utrera
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - I Pérez Otermin
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - I Otegi Altolagirre
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - L Blázquez Lautre
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
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11
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Ruiz-Casado A, Hijos M, Ruiz R, Romero J. Orbital metastasis from oesophageal cancer. When the ophtalmologist meets gastrointestinal specialists. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:594-595. [PMID: 35879175 DOI: 10.1016/j.oftale.2022.04.001] [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: 04/05/2022] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Affiliation(s)
- A Ruiz-Casado
- Departamento de Oncología Médica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
| | - M Hijos
- Departamento de Oftalmología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - R Ruiz
- Departamento de Radiología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - J Romero
- Departamento de Radioterapia, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
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12
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Xiao H, Chen C, Shiu J, Ruiz R, Caldwell M, Lander A, Ganesan A. 079 Identifying signaling networks in melanoma tumors that promote the uncontrolled growth of BRAF mutant melanocytes. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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13
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Marqués MC, Sánchez-Vicente J, Ruiz R, Montagud-Martínez R, Márquez-Costa R, Gómez G, Carbonell A, Daròs JA, Rodrigo G. Diagnostics of Infections Produced by the Plant Viruses TMV, TEV, and PVX with CRISPR-Cas12 and CRISPR-Cas13. ACS Synth Biol 2022; 11:2384-2393. [PMID: 35793201 PMCID: PMC9295153 DOI: 10.1021/acssynbio.2c00090] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Viral infections in plants threaten food security. Thus, simple and effective methods for virus detection are required to adopt early measures that can prevent virus spread. However, current methods based on the amplification of the viral genome by polymerase chain reaction (PCR) require laboratory conditions. Here, we exploited the CRISPR-Cas12a and CRISPR-Cas13a/d systems to detect three RNA viruses, namely, Tobacco mosaic virus, Tobacco etch virus, and Potato virus X, in Nicotiana benthamiana plants. We applied the CRISPR-Cas12a system to detect viral DNA amplicons generated by PCR or isothermal amplification, and we also performed a multiplexed detection in plants with mixed infections. In addition, we adapted the detection system to bypass the costly RNA purification step and to get a visible readout with lateral flow strips. Finally, we applied the CRISPR-Cas13a/d system to directly detect viral RNA, thereby avoiding the necessity of a preamplification step and obtaining a readout that scales with the viral load. These approaches allow for the performance of viral diagnostics within half an hour of leaf harvest and are hence potentially relevant for field-deployable applications.
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Affiliation(s)
- María-Carmen Marqués
- Institute
for Integrative Systems Biology (I2SysBio), CSIC—Universitat de València, Paterna 46980, Spain
| | - Javier Sánchez-Vicente
- Instituto
de Biología Molecular y Celular de Plantas, CSIC—Universitat Politècnica de València, València 46022, Spain
| | - Raúl Ruiz
- Institute
for Integrative Systems Biology (I2SysBio), CSIC—Universitat de València, Paterna 46980, Spain
| | - Roser Montagud-Martínez
- Institute
for Integrative Systems Biology (I2SysBio), CSIC—Universitat de València, Paterna 46980, Spain
| | - Rosa Márquez-Costa
- Institute
for Integrative Systems Biology (I2SysBio), CSIC—Universitat de València, Paterna 46980, Spain
| | - Gustavo Gómez
- Institute
for Integrative Systems Biology (I2SysBio), CSIC—Universitat de València, Paterna 46980, Spain
| | - Alberto Carbonell
- Instituto
de Biología Molecular y Celular de Plantas, CSIC—Universitat Politècnica de València, València 46022, Spain
| | - José-Antonio Daròs
- Instituto
de Biología Molecular y Celular de Plantas, CSIC—Universitat Politècnica de València, València 46022, Spain
| | - Guillermo Rodrigo
- Institute
for Integrative Systems Biology (I2SysBio), CSIC—Universitat de València, Paterna 46980, Spain
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14
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Llàcer P, Núñez J, García M, Ruiz R, López G, Fabregate M, Fernández C, Croset F, Del Hoyo B, Gomis A, Manzano L. Comparison of chlorthalidone and spironolactone as additional diuretic therapy in patients with acute heart failure and preserved ejection fraction. Eur Heart J Acute Cardiovasc Care 2022; 11:350-355. [PMID: 35167653 DOI: 10.1093/ehjacc/zuac006] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/17/2022] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
AIMS Patients with acute heart failure (AHF) require intensification in the diuretic strategy. However, the optimal diuretic strategy remains unclear. In this work, we aimed to evaluate the effect of chlorthalidone compared with spironolactone on diuretic efficacy and safety profile in a cohort of patients with AHF and preserved ejection fraction (AHF-pEF). METHODS AND RESULTS It was a prospective observational study in a single centre in Spain, included 44 consecutive patients admitted between June 2020 and March 2021, with AHF-pEF in which an additional diuretic was prescribed. The primary endpoint was changes in urinary sodium at 24 and 72 h, and the secondary were urine output, and other security endpoints. Mixed linear regression models were used to analyse the endpoints. Estimates were reported as least squares mean with their respective 95% confidence intervals. The median age of the study population was 85 years (82.5-88.5), and 30 (68.2%) were women. After multivariate analysis, the linear mixed regression analysis confirmed a greater natriuretic response of chlorthalidone over spironolactone, especially at 24 h (P = 0.009). Multivariate analysis also showed a greater cumulative diuretic response in those treated with chlorthalidone (P = 0.001). We did not find significant differences in glomerular filtration rate, serum sodium, and serum potassium at 72 h, neither significant differences were found in 24 and 72 h in systolic blood pressure. CONCLUSION In patients with AHF and left ventricular ejection fraction ≥50% receiving intravenous loop diuretics, chlorthalidone administration was associated with a greater short-term natriuresis.
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Affiliation(s)
- Pau Llàcer
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
- Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - Julio Núñez
- Cardiology Department, Hospital Clínico Universitario, Universitat de València, INCLIVA, Valencia, Spain
- CIBER Cardiovascular, Madrid, Spain
| | - Marina García
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Raúl Ruiz
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Genoveva López
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Martín Fabregate
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Cristina Fernández
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - François Croset
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Beatriz Del Hoyo
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Antonio Gomis
- Nephrology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Luis Manzano
- Internal Medicine Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
- Department of Medicine and Medical Specialties, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, IRYCIS, Madrid, Spain
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15
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Rodríguez F, Caruana P, De la Fuente N, Español P, Gámez M, Balart J, Llurba E, Rovira R, Ruiz R, Martín-Lorente C, Corchero JL, Céspedes MV. Nano-Based Approved Pharmaceuticals for Cancer Treatment: Present and Future Challenges. Biomolecules 2022; 12:biom12060784. [PMID: 35740909 PMCID: PMC9221343 DOI: 10.3390/biom12060784] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 02/01/2023] Open
Abstract
Cancer is one of the main causes of death worldwide. To date, and despite the advances in conventional treatment options, therapy in cancer is still far from optimal due to the non-specific systemic biodistribution of antitumor agents. The inadequate drug concentrations at the tumor site led to an increased incidence of multiple drug resistance and the appearance of many severe undesirable side effects. Nanotechnology, through the development of nanoscale-based pharmaceuticals, has emerged to provide new and innovative drugs to overcome these limitations. In this review, we provide an overview of the approved nanomedicine for cancer treatment and the rationale behind their designs and applications. We also highlight the new approaches that are currently under investigation and the perspectives and challenges for nanopharmaceuticals, focusing on the tumor microenvironment and tumor disseminate cells as the most attractive and effective strategies for cancer treatments.
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Affiliation(s)
- Francisco Rodríguez
- Grup d’Oncologia Ginecològica i Peritoneal, Institut d’Investigacions Biomédiques Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (F.R.); (P.C.); (R.R.)
| | - Pablo Caruana
- Grup d’Oncologia Ginecològica i Peritoneal, Institut d’Investigacions Biomédiques Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (F.R.); (P.C.); (R.R.)
| | - Noa De la Fuente
- Servicio de Cirugía General y del Aparato Digestivo, Hospital HM Rosaleda, 15701 Santiago de Compostela, Spain;
| | - Pía Español
- Department of Obstetrics and Gynecology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain; (P.E.); (E.L.); (R.R.)
| | - María Gámez
- Department of Pharmacy, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain;
| | - Josep Balart
- Department of Radiation Oncology, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain;
| | - Elisa Llurba
- Department of Obstetrics and Gynecology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain; (P.E.); (E.L.); (R.R.)
| | - Ramón Rovira
- Department of Obstetrics and Gynecology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain; (P.E.); (E.L.); (R.R.)
| | - Raúl Ruiz
- Grup d’Oncologia Ginecològica i Peritoneal, Institut d’Investigacions Biomédiques Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (F.R.); (P.C.); (R.R.)
| | - Cristina Martín-Lorente
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain;
| | - José Luis Corchero
- Institut de Biotecnologia i de Biomedicina and CIBER-BBN, Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
- Correspondence: (J.L.C.); (M.V.C.); Tel.: +34-93-5812148 (J.L.C.); +34-93-400000 (ext. 1427) (M.V.C.)
| | - María Virtudes Céspedes
- Grup d’Oncologia Ginecològica i Peritoneal, Institut d’Investigacions Biomédiques Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (F.R.); (P.C.); (R.R.)
- Correspondence: (J.L.C.); (M.V.C.); Tel.: +34-93-5812148 (J.L.C.); +34-93-400000 (ext. 1427) (M.V.C.)
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16
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Marqués MC, Ruiz R, Montagud-Martínez R, Márquez-Costa R, Albert S, Domingo-Calap P, Rodrigo G. CRISPR-Cas12a-Based Detection of SARS-CoV-2 Harboring the E484K Mutation. ACS Synth Biol 2021; 10:3595-3599. [PMID: 34783536 PMCID: PMC8610009 DOI: 10.1021/acssynbio.1c00323] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The novel respiratory virus SARS-CoV-2 is rapidly evolving across the world with the potential of increasing its transmission and the induced disease. Here, we applied the CRISPR-Cas12a system to detect, without the need of sequencing, SARS-CoV-2 genomes harboring the E484K mutation, first identified in the Beta variant and catalogued as an escape mutation. The E484K mutation creates a canonical protospacer adjacent motif for Cas12a recognition in the resulting DNA amplicon, which was exploited to obtain a differential readout. We analyzed a series of fecal samples from hospitalized patients in Valencia (Spain), finding one infection with SARS-CoV-2 harboring the E484K mutation, which was then confirmed by sequencing. Overall, these results suggest that CRISPR diagnostics can be a useful tool in epidemiology to monitor the spread of escape mutations.
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Affiliation(s)
- María-Carmen Marqués
- Institute for Integrative Systems Biology (I2SysBio), CSIC − University of Valencia, 46980 Paterna, Spain
| | - Raúl Ruiz
- Institute for Integrative Systems Biology (I2SysBio), CSIC − University of Valencia, 46980 Paterna, Spain
| | - Roser Montagud-Martínez
- Institute for Integrative Systems Biology (I2SysBio), CSIC − University of Valencia, 46980 Paterna, Spain
| | - Rosa Márquez-Costa
- Institute for Integrative Systems Biology (I2SysBio), CSIC − University of Valencia, 46980 Paterna, Spain
| | - Sandra Albert
- Institute for Integrative Systems Biology (I2SysBio), CSIC − University of Valencia, 46980 Paterna, Spain
| | - Pilar Domingo-Calap
- Institute for Integrative Systems Biology (I2SysBio), CSIC − University of Valencia, 46980 Paterna, Spain
| | - Guillermo Rodrigo
- Institute for Integrative Systems Biology (I2SysBio), CSIC − University of Valencia, 46980 Paterna, Spain
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17
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Ruiz R, Galvez-Nino M, Roque K, Montes J, Nuñez M, Raez L, Sánchez-Gambetta S, Jauregui S, Viale S, Smith E, Mas L, Pinto J. P59.30 Genomic Landscape of Lung Cancer in the Young. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.619] [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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18
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Galvez-Nino M, Ruiz R, Lozano S, Roque K, Coanqui O, Valdivieso N, Olivera M, Mas L. P07.02 Real World data of Advanced Non-Small Cell Lung Cancer Patients EGFR Mutated from a Peruvian Cohort. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.291] [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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Martín-Fernández JM, Fleischer A, Vallejo-Diez S, Palomino E, Sánchez-Gilabert A, Ruiz R, Bejarano Y, Llinàs P, Gayá A, Bachiller D. New Bicistronic TALENs Greatly Improve Genome Editing. ACTA ACUST UNITED AC 2021; 52:e104. [PMID: 32023363 DOI: 10.1002/cpsc.104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Genome editing has become one of the most powerful tools in present-day stem cell and regenerative medicine research, but despite its rapid acceptance and widespread use, some elements of the technology still need improvement. In this unit, we present data regarding the use of a new, more efficient type of transcription activator-like effector nuclease (TALEN) for gene editing. Our group has generated bicistronic genes in which classical TALEN coding sequences are linked by 2A elements to different reporter molecules, such as fluorochromes (TALEN-F) or membrane receptors (TALEN-M). This structure results in two proteins transcribed from the same transcript, of which the second (the reporter) can be used as the target for selection by fluorescence-assisted cell sorting (FACS) or magnetic-activated cell sorting (MACS). The application of these new TALEN genes allows a rapid enrichment of cells in which both members of the TALEN pair are active, thus eliminating the need for lengthy selection in culture and laborious characterization of a large number of clones. © 2020 by John Wiley & Sons, Inc. Basic Protocol 1: Generation of new TALENs Basic Protocol 2: Genome editing using TALEN-F Alternate Protocol 1: Generation of TALEN-M Support Protocol 1: mRNA in vitro transcription (IVT) of TALEN-T2A-reporter expression vector Alternate Protocol 2: Editing of primary T cells using TALEN-M Basic Protocol 3: Verifying gene editing Support Protocol 2: Rapid expansion protocol for edited T-cells.
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Affiliation(s)
| | - Aarne Fleischer
- Karuna Good Cells Technologies SL, Vitoria-Gasteiz, Álava, Spain.,Consejo Superior de Investigaciones Científicas (CSIC/IMEDEA), Esporles, Spain
| | - Sara Vallejo-Diez
- Consejo Superior de Investigaciones Científicas (CSIC/IMEDEA), Esporles, Spain
| | - Esther Palomino
- Consejo Superior de Investigaciones Científicas (CSIC/IMEDEA), Esporles, Spain
| | - Almudena Sánchez-Gilabert
- Karuna Good Cells Technologies SL, Vitoria-Gasteiz, Álava, Spain.,Consejo Superior de Investigaciones Científicas (CSIC/IMEDEA), Esporles, Spain
| | - Raúl Ruiz
- Consejo Superior de Investigaciones Científicas (CSIC/IMEDEA), Esporles, Spain
| | - Yazmine Bejarano
- Consejo Superior de Investigaciones Científicas (CSIC/IMEDEA), Esporles, Spain.,Current address: Centro de Investigación del Cáncer, Campus Miguel de Unamuno, Salamanca, Spain
| | - Pere Llinàs
- Consejo Superior de Investigaciones Científicas (CSIC/IMEDEA), Esporles, Spain.,Current address: Josep Carreras Leukaemia Research Institute (IJC), Ctra. de Can Ruti, Camí de les Escoles, Badalona, Spain
| | - Antoni Gayá
- Instituto de Investigación Sanitaria Illes Balears (IDISBA), Fundació Banc de Sang i Teixits de les Illes Balears (FBSTIB), Grupo de Terapia Celular e Ingenieria Tisular, Palma de Mallorca, Spain
| | - Daniel Bachiller
- Consejo Superior de Investigaciones Científicas (CSIC/IMEDEA), Esporles, Spain
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Paytan T, Ruiz R, Araujo J, Juarez D, Gutierrez J, Morante Z, Aguilar A, Mas L. P09.24 Real-World Data in Non-Small Cell Lung Cancer Treated with Checkpoint Inhibitors in a Latin American Institution. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gutierrez J, Araujo J, Ruiz R, Pinto J, Flores C, Morante Z, Amorin E, Mas L. P33.21 Epidemiological Characteristics and Survival in Patients With Lung Cancer in a Peruvian Private Institution Between 2011-2014. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.690] [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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Juarez D, Ruiz R, Gutierrez J, Mas L, Morante Z, Aguilar A, Flores C, Paytan T. P76.32 Real-World Data in Non-Small Cell Lung Cancer with Activating EGFR Mutation Treated with First and Second Generation TKI. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1089] [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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Pino L, Triana I, Mejia J, Camelo M, Galvez-Nino M, Ruiz R, Roque K, Moreno J, Olivera M, Valdiviezo N, Coanqui O, Mas L. P09.14 Predictive Analytics in Real-World Data from Peru: The New Models for Personalized Oncology. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Japaridze M, Markby J, Ruiz R, Khonelidze I, Danelia M, Gabisonia I, Adamia E, Shilton S. Novel approach to near POC testing for HCV RNA; integration of HCV RNA testing into existing near POC machines used in National TB program, Georgia. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1351] [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] Open
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Redondo-Salvo S, Fernández-López R, Ruiz R, Vielva L, de Toro M, Rocha EPC, Garcillán-Barcia MP, de la Cruz F. Pathways for horizontal gene transfer in bacteria revealed by a global map of their plasmids. Nat Commun 2020; 11:3602. [PMID: 32681114 PMCID: PMC7367871 DOI: 10.1038/s41467-020-17278-2] [Citation(s) in RCA: 148] [Impact Index Per Article: 37.0] [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: 10/15/2019] [Accepted: 06/19/2020] [Indexed: 01/04/2023] Open
Abstract
Plasmids can mediate horizontal gene transfer of antibiotic resistance, virulence genes, and other adaptive factors across bacterial populations. Here, we analyze genomic composition and pairwise sequence identity for over 10,000 reference plasmids to obtain a global map of the prokaryotic plasmidome. Plasmids in this map organize into discrete clusters, which we call plasmid taxonomic units (PTUs), with high average nucleotide identity between its members. We identify 83 PTUs in the order Enterobacterales, 28 of them corresponding to previously described archetypes. Furthermore, we develop an automated algorithm for PTU identification, and validate its performance using stochastic blockmodeling. The algorithm reveals a total of 276 PTUs in the bacterial domain. Each PTU exhibits a characteristic host distribution, organized into a six-grade scale (I–VI), ranging from plasmids restricted to a single host species (grade I) to plasmids able to colonize species from different phyla (grade VI). More than 60% of the plasmids in the global map are in groups with host ranges beyond the species barrier. Plasmids can mediate gene transfer across bacterial populations. Here, the authors describe a global map of the prokaryotic plasmidome, where plasmids organize into discrete ‘plasmid taxonomic units’ based on their genomic composition and pairwise sequence identity.
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Affiliation(s)
- Santiago Redondo-Salvo
- Instituto de Biomedicina y Biotecnología de Cantabria (IBBTEC), Universidad de Cantabria-CSIC, C/Albert Einstein 22, 39011, Santander, Spain
| | - Raúl Fernández-López
- Instituto de Biomedicina y Biotecnología de Cantabria (IBBTEC), Universidad de Cantabria-CSIC, C/Albert Einstein 22, 39011, Santander, Spain
| | - Raúl Ruiz
- Instituto de Biomedicina y Biotecnología de Cantabria (IBBTEC), Universidad de Cantabria-CSIC, C/Albert Einstein 22, 39011, Santander, Spain
| | - Luis Vielva
- Departamento de Ingeniería de las Comunicaciones, Universidad de Cantabria, Santander, Spain
| | - María de Toro
- CIBIR, Centro de Investigación Biomédica de La Rioja, Logroño, Spain
| | - Eduardo P C Rocha
- Microbial Evolutionary Genomics, Institut Pasteur, CNRS, UMR3525, Paris, France
| | - M Pilar Garcillán-Barcia
- Instituto de Biomedicina y Biotecnología de Cantabria (IBBTEC), Universidad de Cantabria-CSIC, C/Albert Einstein 22, 39011, Santander, Spain
| | - Fernando de la Cruz
- Instituto de Biomedicina y Biotecnología de Cantabria (IBBTEC), Universidad de Cantabria-CSIC, C/Albert Einstein 22, 39011, Santander, Spain.
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de Otálora XD, Ruiz R, Goiri I, Rey J, Atxaerandio R, San Martin D, Orive M, Iñarra B, Zufia J, Urkiza J, García-Rodríguez A. valorisation of spent coffee grounds as functional feed ingredient improves productive performance of Latxa dairy ewes. Anim Feed Sci Technol 2020. [DOI: 10.1016/j.anifeedsci.2020.114461] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Galvez-Nino M, Ruiz R, Roque K, Moreno J, Valdivieso N, Olivera M, Miranda Y, Maquera G, Cabero O, Guillen M, Rojas V, Amorin E, Mas L. P2.05 Real World Data on Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors Use in Advanced Non-small Cell Lung Cancer from a Latin American Cohort. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mas L, Patane A, Arrieta O, Soria T, Cardona A, Martín C, Ruiz-Patiño A, Ruiz R, Rioja P, Lozano S, Barron LZ, Barrón F, Corassa M, Freitas H, De Lima VC, Corrales-Rodriguez L, Sotelo C, Rodríguez J, Ricaurte L, Ávila J, Mayorga D, Bravo M, Archila P, Otero J, Carranza H, Vargas C, Rosell R, Remon J. P1.12 Real World Characterization and Treatment Patterns of Patients with Thymic Carcinoma: Lessons from a Latin American Collaborative Study (CLICaP-LATimus). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.147] [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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Raez L, Saravia D, Sumarriva D, Ruiz R, Izquierdo P, Cress D, Hunis B, Mas L, Lopes G, Kaen D. P2.16-15 Survival and Clinical Immunotherapy Outcomes in Hispanic Patients vs Non-Hispanic White Patients with Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1882] [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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Mas L, Patané A, Arrieta O, Soria T, Cardona A, Martin C, Ruiz-Patiño A, Rojas L, Ruiz R, Rioja P, Lozano S, Barrón ZZ, Corassa M, Freitas H, De Lima VC, Corrales L, Sotelo C, Rodriguez J, Ricaurte L, Ávila J, Mayorga D, Bravo M, Archila P, Otero J, Carranza H, Vargas C, Rosell R, Remon J. EP1.15-28 Survival of Thymoma Is Extensive in Latin-American Patients: Results from Over 10 Years of Experience (CLICaP-LATimus). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2363] [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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Cardona A, Ruiz-Patiño A, Arrieta O, Martin C, Raez L, Barrón ZZ, Barrón F, Ricaurte L, Bravo-Garzón M, Mas L, Corrales L, Rojas L, Lupinacci L, Perazzo F, Bas C, Carranza O, Puparelli C, Rizzo M, Ruiz R, Rolfo C, Archila P, Rodriguez J, Sotelo C, Vargas C, Carranza H, Otero J, Pino L, Ortiz C, Laguado P, Rosell R. EP1.04-46 Immunotherapy at Any Line Improves Survival in Hispanic Patients with Advanced Metastatic NSCLC Compared to Chemotherapy (Quijote-CLICaP). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ruiz R, Morante Z, Namuche F, Urrunaga D, Leon M, Ziegler G, Aguilar A, Chavez Mac Gregor M, Gomez H. Abstract P3-08-18: Clinicopathological characteristics associated with intermediate and high-risk ODx RS. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The gene expression profiling assay OncotypeDx (ODx) prognosticates the risk of estrogen receptor positive (ER+) breast cancer (BC) recurrence and assesses the likely benefit from adjuvant chemotherapy in addition to endocrine therapy. There have been several attempts to develop algorithms that provide similar outcome prediction to the ODx assay with the use of routine clinicopathological characteristics. These models appear to predict high-risk ODx RS but are unable to reliably rule out the presence of patients with intermediate-risk disease. Our objective was to identify the clinicopathological factors associated with intermediate and high-risk categories.
Methods: We retrospectively reviewed the electronic medical records of patients with early-stage ER+ BC for whom ODx recurrence score (RS) was available. Patients were diagnosed and treated at 3 specialized cancer centers between 2010 and 2017. Two multinomial logistic regression models (crude and adjusted) were constructed to assess the association between clinicopathological characteristics and ODx RS as a categorical variable. The adjusted model included the following variables: ODx RS, age, tumor size, node status, grade, lymphovascular invasion and hormonal receptors. The reported association measure was the relative prevalence ratio (RPR) with its respective 95%CI.
Results: A total of 551 patients were included. Patients had a mean age of 56.2 ± 11.9 (SD) (range: 26-89). 9.6% (n=53) of patients were≤40 years old.The size of the tumors ranged from 0.1 cm to 7.2 cm (median = 1.5 cm; IQR 1.0-2.2cm). A minority of patients had lymph node involvement (5.8%, n=32). By subtype, carcinomas were mostly ductal (83.5%, n=460), followed by lobular (10.0%, n=55) and mucinous (3.5%, n=19). The majority of tumor exhibited an intermediate histological grade (71.6%, n=386). Ki 67 was available in 58.8% patients (n= 324), with a median Ki67 of 20 (IQR 10-30). In the adjusted multinomial logistic regression model, factors associated with ODx intermediate-risk category were grade 3 (RPR=4.78; 95%CI: 2.01-11.39) and having either ER or PR <50 (RPR=2.80; 95%CI: 1.83-4.27). Factors associated with ODx high-risk category were grade 3 (RPR=15.89; 95%CI: 3.23-78.19), having either ER or PR <50 (RPR=4.58; 95%CI: 2.37-8.87), age≤40 (RPR=2.96; 95%CI: 1.20-7.29) and T2-3 (RPR=2.20; 95%CI: 1.13-4.32).
Conclusion: Grade 3, ER o PR <50, age ≤40 years and T2-3 are clinicopathological characteristics strongly associated with high-risk ODx RS. The associations with intermediate-risk ODx RS are weaker. The way these factors could be integrated into a clinicopathologic risk prediction model to identify high-risk patients needs further analysis.
Citation Format: Ruiz R, Morante Z, Namuche F, Urrunaga D, Leon M, Ziegler G, Aguilar A, Chavez Mac Gregor M, Gomez H. Clinicopathological characteristics associated with intermediate and high-risk ODx RS [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-18.
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Affiliation(s)
- R Ruiz
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - Z Morante
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - F Namuche
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - D Urrunaga
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - M Leon
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - G Ziegler
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - A Aguilar
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - M Chavez Mac Gregor
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - H Gomez
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
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Ruiz R, Namuche F, Morante Z, Aguilar A, Urrunaga D, Ziegler G, Chavez Mac Gregor M, Leon M, Gomez H. Abstract P3-08-16: Age's importance in early breast cancer: Oncotype Dx results in patients ≤40 years. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
The 21-gene recurrence score (RS) predicts the benefit of adjuvant chemotherapy (CT) in ER-positive HER2-negative breast cancer (BC) and has been validated in population where women under 40 are underrepresented.Young BC pts are more likely to receive adjuvant chemotherapy (CT) in addition to endocrine therapy (ET). Our objective was to assess the RS results in young (≤40 yo) vs older (>40 yo) pts and evaluate the impact of age on clinical decision-making according to RS categories.
Methods
We retrospectively reviewed electronic medical files of all patients with early stage hormone receptor BC for whom RS was available between 2007 and 2017 in 3 specialized cancer centers. We used the Mann-Whitney and Chi-squared tests to assess differences between age group. Similarly, we evaluated the association between age groups and treatment, within each ODx category. To determine if age was associated with CT use in the low risk category, a logistic regression model was constructed.
Results
A total of 551 pts were included, 53 (9.6%) ≤40 yo and 498 (90.4%) >40 yo. No statistical differences were found between the younger and older groups in T (p=0.874), N (p=0.794), stage (p=0.188), or grade (p=0.791). Young patients underwent radical surgery more frequently than their older counterparts (41.5 vs 25.7%, p=0.014). Statistically significant differences were also observed in ER mean, which was lower in the younger group (80 vs 90%, p<0.001). The median RS result was significantly higher in the younger group (19 vs 16, p=0.009). Also, high-risk recurrence score category was significantly more frequent in the younger group (22.6 vs 9.2%, p=0.009). In the intermediate-risk category there were no differences in the proportion of patients who received CT according to age groups (p=0.484). In the low-risk category, 28.0% of patients ≤40 years vs 11.3% of patients >40 years received CT (p=0.037).
Conclusions
Our results indicate that RS tends to be higher in patients with BC ≤ 40 yo and that the frequency of high-risk RS is significantly higher in the younger group, suggesting biological differences between groups. 28% of young patients with low-risk RS from our cohort are overtreated. Based on these results, it should be considered to develop a test adjusted to the age of the patients.
Citation Format: Ruiz R, Namuche F, Morante Z, Aguilar A, Urrunaga D, Ziegler G, Chavez Mac Gregor M, Leon M, Gomez H. Age's importance in early breast cancer: Oncotype Dx results in patients ≤40 years [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-16.
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Affiliation(s)
- R Ruiz
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - F Namuche
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - Z Morante
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - A Aguilar
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - D Urrunaga
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - G Ziegler
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - M Chavez Mac Gregor
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - M Leon
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - H Gomez
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
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Namuche F, Ruiz R, Morante Z, Aguilar A, Gomez H. Abstract P3-08-22: Oncotype Dx recurrence score risk groups according to Ki67, a predictor to be considered. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
The gene expression profiling assay OncotypeDx (ODx) prognosticates the risk of estrogen receptor positive (ER+) breast cancer (BC) recurrence and assesses the likely benefit from adjuvant chemotherapy in addition to endocrine therapy. There have been several attempts to develop algorithms that provide similar outcome prediction to the ODx assay with the use of routine clinicopathological characteristics. Ki67 is frequently incorporated into these assessments, although there is no standard cut-off for its use.
Methods
We retrospectively reviewed the electronic medical records of 330 patients with early stage ER+ BC for whom ODx recurrence score (RS) was available. Patients were diagnosed and treated at two specialized cancer centers between 2014 and 2017.
Our objective was to determine the ki67's median differences between ODx risk groups.
We used Spearman rho for the correlation between Ki67 and ODx score and used Kruskal-Wallis test for compare medians, pairwaise comparison for the intergroup relations.
Results
Mean age at diagnosis was 57.42 years (range 28-89). Mean tumor diameter was 15.67 mm. 78.9% were intermediate histologic grade and 9.7% patients had lymph node involvement. Median expression of ER and PR were 90% (5-100) and 70% (0-100), respectively. We assessed the correlation between Ki67 and ODx score, with a pearson r:0.31, p<0.001. The data showed a directly proportional trend between Ki67 and ODx score.
Median Ki67 was 20 (1-100). According to ODX RS, 61.5% of tumors were low risk, 30.3% were intermediate risk and, 8.2% were high risk. Median Ki67 within each category group is as follows: low: 15 (IQR:15), intermediate: 20 (IQR:18) and high: 40 (IQR:35), with a statistically significant difference between medians (p<0.001). In the Pairwise comparison intergroup the data showed: Low-Intermediate (p<0.05), Low-High (p<0.001), Intermediate-High (p<0.001).
Conclusions
The data showed directly proportional trend between Ki67 and ODx score. In our population there is a statistically significant difference between Ki67 medians according to ODx risk groups.
Citation Format: Namuche F, Ruiz R, Morante Z, Aguilar A, Gomez H. Oncotype Dx recurrence score risk groups according to Ki67, a predictor to be considered [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-22.
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Affiliation(s)
- F Namuche
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - R Ruiz
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - Z Morante
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - A Aguilar
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - H Gomez
- Oncosalud, Lima, Peru; INEN, Lima, Peru
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Ruiz R, Morante Z, Namuche F, Urrunaga D, Aguilar A, Schwarz J, Leon M, Ziegler G, Chavez Mac Gregor M, Gomez H. Abstract P3-08-17: Evaluation of Oncotype DX testing and subsequent treatment choices in the Latin American setting. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The gene expression profiling assay OncotypeDx (ODx) prognosticates the risk of estrogen receptor positive (ER+) breast cancer (BC) recurrence and assesses the likely benefit from adjuvant chemotherapy in addition to endocrine therapy. Numerous clinical utility studies have shown that acknowledging the RS impacts on clinical decision making, leading to a decrease in chemotherapy (CT) use. However, the cost of the assay limits it widespread use, especially in low and middle-income countries. Our objective was to determine the patterns of use of ODx, its results and the subsequent treatment choices in a large Latin American cohort.
Methods: We retrospectively reviewed the electronic medical records of patients with early-stage ER+ BC for whom ODx recurrence score (RS) was available. Patients were diagnosed and treated at 3 specialized Peruvian cancer centers between 2007 and 2017. Descriptive results for numeric variables were presented as means with standard deviation (SD) or medians with interquartile range (IQR), depending on their distributions; otherwise, we expressed the qualitative variables as numbers with percentages. We evaluated the association between ODx RS category and treatment using the Chi-squared test.
Results: A total of 551 patients were included. Patients had a mean age of 56.2 ± 11.9 (SD) (range: 26-89). 9.6% (n=53) of patients were ≤40 years old. The size of the tumors ranged from 0.1 cm to 7.2 cm (median = 1.5 cm; IQR 1.0-2.2cm). 36 (6.5%) patients had tumors ≤ 0.5cm and 7 (1%) had tumors > 5cm. A minority of patients had lymph node involvement (5.8%, n=32). ODx was ordered in 55 cases (10%) of lobular carcinoma and in 23 cases (4%) of favorable histology tumors (19 mucinous, 4 tubular). Most tumors exhibited an intermediate histological grade (71.6%, n=386). Ki67 was available in 58.8% patients (n= 324), with a median Ki67 of 20 (IQR 10-30). Using commercial cutoffs RS was distributed as follows: low (0–17) = 316 (57.4%), intermediate (18–30) = 177 (32.1%), and high (≥31) = 58 (10.5%). In general, 57.5% (n=317) of patients received endocrine therapy (ET) as their only systemic treatment and 42.5% (n=234), also received CT (ET + CT). In the low-risk category, 87.3% (n=276) of patients received ET and 12.7% (n=40), ET + CT. Within the intermediate-risk category, most patients received ET + CT (77.4%, n=137). Only one patient in the high-risk category did not receive CT. There was a significant association between the RS group and treatment choice (p<0.001).
Impact of ODx RS results on treatment recommendations Oncotype risk categories LowIntermediateHighp valueTreatmentn%n%n%<0.001Endocrine therapy27687.34022.611.7 Chemotherapy + Endocrine therapy4012.713777.45798.3
Conclusion: ODx significantly influenced treatment decisions in our cohort, however an overutilization of CT was found in low-risk patients. Further data analysis is needed to explain the higher than expected use of CT. Also, there is room for improvement in the selection of cases that undergo ODx testing.
Citation Format: Ruiz R, Morante Z, Namuche F, Urrunaga D, Aguilar A, Schwarz J, Leon M, Ziegler G, Chavez Mac Gregor M, Gomez H. Evaluation of Oncotype DX testing and subsequent treatment choices in the Latin American setting [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-17.
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Affiliation(s)
- R Ruiz
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - Z Morante
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - F Namuche
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - D Urrunaga
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - A Aguilar
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - J Schwarz
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - M Leon
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - G Ziegler
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - M Chavez Mac Gregor
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - H Gomez
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
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Morral A, Urrútia G, Gich I, Ruiz R, Bonfill X. Radial extracorporeal shock wave device appearance does not influence clinical outcomes: A randomized controlled trial. J Rehabil Med 2019; 51:201-208. [DOI: 10.2340/16501977-2516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Galvez Nino M, Ruiz R, Pinto J, Raez L, Mas Lopez L. P2.15-07 Lung Cancer in the Young. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1448] [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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Raez L, Saravia D, Munoz-Antonia T, Ruiz R, Cress D, Chiappori A, Hunis B, Sumarriva D, Powery H, Mas Lopez L, Lopes G, Izquierdo P, Antonia S. P2.15-23 Are there Ethnic Disparities in the Clinical Outcomes of Non-Small Cell Lung Cancer Hispanic Patients Treated with Immunotherapy? J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Saravia D, Raez L, Ruiz R, Munoz-Antonia T, Sumarriva D, Cress D, Hunis B, Chiappori A, Powery H, Izquierdo P, Mas L, Lopes G, Antonia S. PS4 Clinical Outcomes in Hispanic Patients Treated with Checkpoint Inhibitors. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rodríguez-Pintó I, Espinosa G, Erkan D, Shoenfeld Y, Cervera R, Cervera R, Espinosa G, Rodríguez-Pintó I, Shoenfeld Y, Erkan D, Piette JC, Jacek M, Roca B, Tektonidou M, Moutsopoulos H, Boffa J, Chapman J, Stojanovich L, Veloso MP, Praprotnik S, Traub B, Levy R, Daryl T, Daryl T, Boffa MC, Makatsaria A, Ruano M, Allievi A, You W, Khamastha M, Hughes S, Menendez Suso J, Pacheco J, Boriotti MF, Dias C, Pangtey G, Miller S, Policepatil S, Larissa L, Marjatta S, Carolyn S, Noortje T, Reiner K, Arteaga S, Leilani T, Langsford D, Niedzwiecki M, Queyrel V, Moroti-Constantinescu R, Romero C, Jeremic K, Urbano A, Hurtado-García R, Kumar Das A, Costedoat-Chalumeau N, Yngvar F, Gomez-Puerta JA, de Meigs E, Smith JP, Zakharova E, Nayer A, Douglas W, Lyndsey R, Blanco V, Vicent C, Natalya K, Damian L, Valentini E, Giula B, Casal Moura M, Araújo Loperena O, Ritter Susan Y, Guettrot Imbert G, Almasri H, Hospach T, Mouna B, Robles A, Wilson H, Guisado P, Ruiz R, Rodriguez J. The effect of triple therapy on the mortality of catastrophic anti-phospholipid syndrome patients. Rheumatology (Oxford) 2018; 57:1264-1270. [DOI: 10.1093/rheumatology/key082] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 02/28/2018] [Indexed: 01/19/2023] Open
Affiliation(s)
| | - Gerard Espinosa
- Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Spain
| | - Doruk Erkan
- Barbara Volcker Center for Women and Rheumatic Disease, Hospital for Special Surgery, New York, NY, USA
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Aviv, Israel
| | - Ricard Cervera
- Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Spain
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Ruiz R, Brygo A, Nicot R, Ferri J. Sialolithiasis removal under general anesthesia: A descriptive retrospective study in the maxillofacial surgery department in Lille University Hospital. Journal of Stomatology, Oral and Maxillofacial Surgery 2018; 119:97-101. [DOI: 10.1016/j.jormas.2017.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 10/01/2017] [Accepted: 11/02/2017] [Indexed: 11/29/2022]
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Ruiz R, Namuche F, Flores C, Aguilar A, Gomez HL. Abstract P1-06-12: Optimizing the use of oncotype Dx in early breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-06-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Oncotype Dx (ODX) prognosticates the risk of recurrence and predicts the benefit of adjuvant chemotherapy in estrogen-receptor-positive breast cancer (BC). However, its cost makes it prohibitive for many health care systems. Our objective was to develop a model that uses routine clinical and pathological parameters to identify ODX high risk patients which require adjuvant chemotherapy.
Methods: We retrospectively reviewed ODX and pathology reports from 190 early BC patients treated between 2014 and 2016 in a specialized cancer center. Our population was divided into a training (n:133) and validation set (n:57). In the training set, among available clinico-pathological variables (age, T, ER, PR, Ki67, Elston-Ellis grade) a multiple linear regression model was carried out to select those significantly associated with ODX. Coefficients of statistically significant variables were used to build an equation. The equation was applied in the training set. These results were confronted to ODX categories. The best threshold for selecting high risk patients was identified in the training set and tested in the validation set.
Results: Among the tested variables, tumor size (pT), progesterone receptor (PR), Ki67 and Ellston-Ellis grade were significantly associated with ODX RS (Table 1). The linear predictor is: (0.2544 x pT) – (0.0739 x PR) + (0.0861 x Ki67) + (5.4232 x Elston grade). The threshold score for this equation was set on 14 to discriminate high from low-intermediate risk patients. The test was able to correctly classify high risk patients with a sensitivity of 78%, a specificity of 72% and a negative predictive value of 98%.
Conclusion: With further refinement ODX could be omitted in patients classified as high risk by our predictor therefore restricting and optimizing the use of ODX to a smaller population of patients. The observed ODX distribution in our patients is similar to previously reported series suggesting that this equation could be informative in similar clinical settings. Additional external testing using new datasets is ongoing.
Citation Format: Ruiz R, Namuche F, Flores C, Aguilar A, Gomez HL. Optimizing the use of oncotype Dx in early breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-06-12.
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Affiliation(s)
- R Ruiz
- Oncosalud, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - F Namuche
- Oncosalud, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - C Flores
- Oncosalud, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - A Aguilar
- Oncosalud, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - HL Gomez
- Oncosalud, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Namuche F, Ruiz R, Flores C, Gomez HL, Aguilar A. Abstract P6-09-11: Ki67 cut offs and oncotype DX recurrence score in early breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-09-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The gene expression profiling assay OncotypeDx (ODX) predicts the likelihood of estrogen receptor (ER) positive breast cancer (BC) recurrence and assesses the likely benefit from both hormonal therapy and chemotherapy. Many clinical scores that estimate the risk category of ODX are being tested. Ki67 is frequently incorporated into these assessments, although there is no standard cut-off for its use.
Methods: We retrospectively reviewed the electronic medical records of 190 patients with early stage ER+ BC for whom ODX recurrence score (RS) was available. Patients were diagnosed and treated at a specialized cancer center between 2014 and 2016. Our objective was to find out the degree to which an optimal ki67 cut-off correlates with ODX risk category. We also aim to determine an association between classical clinicopathological variables (St. Gallen (SG) 2015) could predict ODX risk category. Chi square test was used.
Results: The characteristics of patients according to ODX risk category are shown in Table 2. Mean age at diagnosis was 59 years (range 28-89). Mean tumor diameter was 15mm, 84.2% were intermediate grade and 4.7% patients had lymph node involvement. Mean expression of ER, PR and Ki67 were 87%, 53% and 22%, respectively. According to ODX 62.1% patients were low risk, 30.5% were intermediate risk and 7.4% were high risk. An overall concordance of 46.8% (73/190) was found between SG 2015 and the risk category of ODX (75.7% for low, 33.3% for intermediate and 23.9% for high RS). When changing SG Ki67 cutoffs to ≤20% (for low Ki67) and ≥30% (for high Ki67), an overall concordance of 56.3% (107/190) was found (69.6% for low, 47.3% for intermediate and 23.9% for high RS) and this was statistically significant (p=0.00) (Table 3).
Conclusion: In our population there is no a direct correlation between classical clinicopathological variables and ODX score. Despite being a specialized center, the utility of classical clinicopathological variables for predicting ODX risk category is limited.
Citation Format: Namuche F, Ruiz R, Flores C, Gomez HL, Aguilar A. Ki67 cut offs and oncotype DX recurrence score in early breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-09-11.
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Affiliation(s)
- F Namuche
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - R Ruiz
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - C Flores
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - HL Gomez
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - A Aguilar
- Oncosalud, Lima, Peru; INEN, Lima, Peru
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Pineda-Quiroga C, Atxaerandio R, Ruiz R, García-Rodríguez A. Effects of dry whey powder alone or combined with calcium butyrate on productive performance, duodenal morphometry, nutrient digestibility, and ceca bacteria counts of broiler chickens. Livest Sci 2017. [DOI: 10.1016/j.livsci.2017.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Gorostidi M, Villalain C, Ruiz R, Jaunarena I, Lekuona A. Technique for precaval and laterocaval nodes excision at extraperitoneal paraaortic lymphadenectomy. Gynecol Oncol 2017; 148:233-234. [PMID: 29137810 DOI: 10.1016/j.ygyno.2017.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 10/17/2017] [Accepted: 10/24/2017] [Indexed: 10/18/2022]
Abstract
STUDY OBJECTIVE To describe our technique for excision of the pre-caval and laterocaval nodes using an extraperitoneal approach. This technique was developed to make the dissection and excision of the less accessible nodes in an easier and safer way by minimizing the risk of great vessels injury and bleeding. DESIGN Step-by-step description of the surgical procedure using video (Canadian Task Force classification III). SETTING The procedure was performed at a teaching hospital, Hospital Universitario Donostia (Spain). PATIENTS A 52-year-old woman with a body mass index of 33 underwent endoscopic extraperitoneal paraaortic lymphadenectomy for advanced high grade cervical adenocarcinoma FIGO IIB. INTERVENTIONS The patient underwent an endoscopic extraperitoneal para-aortic lymphadenectomy. An anatomical dissection is being performed being the upper limit of the dissection the left renal vein. Focus of the video involves the challenging dissection of the right nodes. MEASUREMENTS AND MAIN RESULTS Firstly we complete a dissection of all the anatomical aortic limits until the renal vein and exeresis of aortic nodes. A plane just above the cava vein is carefully developed by pushing all the lymph nodes to the roof of the dissection. Special care must be taken close to the aortic bifurcation due to the perforating vessels that can be found more frequently in this location. Once all this space is dissected, nodes attached to the roof are easily pushed down. It is useful to use a clip in the upper part, close to the renal vein, to prevent lymphorrhea. Nodes are excised in four blocks, supramesenteric and inframesenteric aortic and precaval nodes. The proximity to the peritoneal roof and the chance for a peritoneal hole and loss of pneumoperitoneum can be less problematic if the right dissection is performed at the end of the procedure. CONCLUSION A complete para-aortic retroperitoneal dissection can be achieved with this extraperitoneal approach. Benefits of this technique are based on the absence of the bowel or other intraperitoneal structures invading the operative field given the barrier-free nature of the retroperitoneal space. Despite the challenge of the access to the right nodes in a retroperitoneal paraaortic lymphadenectomy they can be successfully excised reaching the renal vein including obese patients.
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Affiliation(s)
- M Gorostidi
- Hospital Universitario Donostia, San Sebastián, Spain.
| | | | - R Ruiz
- Hospital Universitario Donostia, San Sebastián, Spain
| | - I Jaunarena
- Hospital Universitario Donostia, San Sebastián, Spain
| | - A Lekuona
- Hospital Universitario Donostia, San Sebastián, Spain
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Barg A, Ruiz R, Hintermann B. [Triple arthrodesis for correction of cavovarus deformity]. Oper Orthop Traumatol 2017; 29:461-472. [PMID: 29052742 DOI: 10.1007/s00064-017-0519-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 07/01/2017] [Accepted: 07/12/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim is to correct the underlying cavovarus deformity and to achieve a pain-free and stable hindfoot. INDICATIONS Rigid neurologic, posttraumatic, congenital, and idiopathic cavovarus deformities. CONTRAINDICATIONS General surgical or anesthesiological risks, infections, critical soft tissue conditions, neurovascular impairment of the lower extremity, noncompliance, patients with severely reduced bone quality, insulin-dependent diabetes mellitus, smoking. SURGICAL TECHNIQUE The talonavicular and subtalar joints are exposed using a single medial approach. Joint cartilage is carefully debrided. Hindfoot reposition with complete correction of cavovarus deformity in all three planes. Joints are stabilized using cannulated screws, followed by wound closure. POSTOPERATIVE MANAGEMENT A soft wound dressing is used. Thromboprophylaxis is recommended. Patient mobilization starts on postoperative day 1 using a stabilizing walking boot or cast for 6 weeks with 15 kg partial weight bearing. Clinical and radiographic follow-up 6 weeks postoperatively to assess osseous consolidation at the arthrodesis site. Following clinical and radiographic follow-up at 6 weeks, full weight bearing is gradually initiated. RESULTS Between January 2012 and July 2014, triple arthrodesis was performed in 11 patients with a mean age of 62 ± 14 years due to cavovarus deformity. The mean follow-up was 34 ± 8 months (range 24-48 months). In all patients, the cavovarus deformity was substantially corrected. Significant pain relief from 7.1 ± 2.2 (range 5-10) to 1.8 ± 1.5 (range 0-4) on the visual analogue scale was observed.
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Affiliation(s)
- A Barg
- Orthopädische Klinik, Universität Utah, 590 Wakara Way, 84108, Salt Lake City, UT, USA.
- Harold K. Dunn Orthopädisches Forschungslabor, Orthopädische Klinik, Universität Utah, Salt Lake City, UT, USA.
| | - R Ruiz
- Klinik für Orthopädie und Traumatologie des Bewegungsapparates, Kantonsspital Baselland, Liestal, Schweiz
| | - B Hintermann
- Klinik für Orthopädie und Traumatologie des Bewegungsapparates, Kantonsspital Baselland, Liestal, Schweiz
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Mingo J, Luna S, Gaafar A, Ruiz R, Carracedo A, Guerra I, López J, Pulido R. The relevance of precision epitope mapping for accurate oncologic diagnostic based on PTEN protein expression in tumours. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx508.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Averós X, Beltrán de Heredia I, Ruiz R, Estevez I. 004 Influence of pre- and postnatal stress on the social motivation and fear response in lambs. J Anim Sci 2017. [DOI: 10.2527/asasann.2017.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sommerville R, Ruiz R, Averós X. A meta-analysis on the effects of the housing environment on the behaviour, mortality, and performance of growing rabbits. Anim Welf 2017. [DOI: 10.7120/09627286.26.2.223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ruiz R, Tedeschi L, Sepúlveda A. Investigation of the effect of pegbovigrastim on some periparturient immune disorders and performance in Mexican dairy herds. J Dairy Sci 2017; 100:3305-3317. [DOI: 10.3168/jds.2016-12003] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 01/29/2023]
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