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Gómez-Ríos MÁ, Sastre JA, Onrubia-Fuertes X, López T, Abad-Gurumeta A, Casans-Frances R, Gómez-Ríos D, Garzón JC, Martínez-Pons V, Casalderrey-Rivas M, Fernández-Vaquero MÁ, Martínez-Hurtado E, Martín-Larrauri R, Reviriego-Agudo L, Gutierrez-Couto U, García-Fernández J, Serrano-Moraza A, Rodríguez Martín LJ, Camacho Leis C, Espinosa Ramírez S, Fandiño Orgeira JM, Vázquez Lima MJ, Mayo-Yáñez M, Parente-Arias P, Sistiaga-Suárez JA, Bernal-Sprekelsen M, Charco-Mora P. Spanish Society of Anesthesiology, Reanimation and Pain Therapy (SEDAR) Spanish Society of Emergency and Emergency Medicine (SEMES) and Spanish Society of Otolaryngology, Head and Neck Surgery (SEORL-CCC) Guideline for difficult airway management. Part I. Rev Esp Anestesiol Reanim (Engl Ed) 2024:S2341-1929(24)00021-0. [PMID: 38340791 DOI: 10.1016/j.redare.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/28/2023] [Indexed: 02/12/2024]
Abstract
The Airway Management section of the Spanish Society of Anesthesiology, Resuscitation, and Pain Therapy (SEDAR), the Spanish Society of Emergency Medicine (SEMES), and the Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC) present the Guide for the comprehensive management of difficult airway in adult patients. Its principles are focused on the human factor, cognitive processes for decision-making in critical situations, and optimization in the progression of strategies application to preserve adequate alveolar oxygenation in order to enhance safety and the quality of care. The document provides evidence-based recommendations, theoretical-educational tools, and implementation tools, mainly cognitive aids, applicable to airway management in the fields of anesthesiology, critical care, emergencies, and prehospital medicine. For this purpose, an extensive literature search was conducted following PRISMA-R guidelines and was analyzed using the GRADE methodology. Recommendations were formulated according to the GRADE methodology. Recommendations for sections with low-quality evidence were based on expert opinion through consensus reached via a Delphi questionnaire.
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Affiliation(s)
- M Á Gómez-Ríos
- Anesthesiology and Perioperative Medicine. Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.
| | - J A Sastre
- Anesthesiology and Perioperative Medicine. Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | | | - T López
- Anesthesiology and Perioperative Medicine. Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - A Abad-Gurumeta
- Department of Anesthesiology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - R Casans-Frances
- Department of Anesthesiology. Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain
| | | | - J C Garzón
- Anesthesiology and Perioperative Medicine. Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - V Martínez-Pons
- Department of Anesthesiology, Hospital Universitari i Politecnic La Fe, Valencia, Spain
| | - M Casalderrey-Rivas
- Department of Anesthesiology, Complejo Hospitalario Universitario de Ourense, Ourense, Spain
| | - M Á Fernández-Vaquero
- Department of Anesthesiology, Hospital Clínica Universitaria de Navarra, Madrid, Spain
| | - E Martínez-Hurtado
- Department of Anesthesiology. Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain
| | | | - L Reviriego-Agudo
- Department of Anesthesiology. Hospital Clínico Universitario, Valencia, Spain
| | - U Gutierrez-Couto
- Biblioteca, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - J García-Fernández
- Department of Anesthesiology, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, Spain; Presidente de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SEDAR)
| | | | | | - C Camacho Leis
- Servicio de Urgencias Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | | | - J M Fandiño Orgeira
- Servicio de Urgencias Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - M J Vázquez Lima
- Emergency Department, Hospital do Salnes, Vilagarcía de Arousa, Pontevedra, Spain; President of the Spanish Emergency Medicine Society (SEMES)
| | - M Mayo-Yáñez
- Department of Otorhinolaryngology - Head Neck Surgery, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - P Parente-Arias
- Department of Otorhinolaryngology - Head Neck Surgery, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - J A Sistiaga-Suárez
- Department of Otorhinolaryngology, Hospital Universitario Donostia, Donostia, Gipuzkoa, Spain
| | - M Bernal-Sprekelsen
- Department of Otorhinolaryngology, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain; President of the Spanish Society for Otorhinolaryngology Head & Neck Surgery (SEORL-CCC)
| | - P Charco-Mora
- Department of Anesthesiology, Hospital Universitari i Politecnic La Fe, Valencia, Spain
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Sastre JA, López T, Gómez-Ríos MA, Garzón JC, Mariscal ML, Martínez-Hurtado E, Freire-Otero M, Redondo JM, Gómez G, Casalderrey-Rivas M. Current practice of rapid sequence induction in adults: A national survey among anesthesiologists in Spain. Rev Esp Anestesiol Reanim (Engl Ed) 2020; 67:381-390. [PMID: 32564884 DOI: 10.1016/j.redar.2020.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/03/2020] [Accepted: 03/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Rapid sequence induction (RSI) in adults has undergone changes in recent years due to pharmacological and technological advances. The objective of this survey was to evaluate current practice among Spanish anesthesiologists. METHODS A 31-item questionnaire regarding RSI practice was sent to anesthesiologists working in Spanish public hospitals. Differences in responses according to the type of hospital or experience of the respondent were compared for all data using the chi-square and Fisher's exact test. RESULTS Approximately 15.89% of Spanish anesthesiologists participated in the survey (1002 questionnaires). The results show considerable heterogeneity in most aspects of RSI. Less than 20% of respondents administer sodium citrate. Sixty-four percent place a nasogastric tube in patients with intestinal obstruction. Gastric residue is assessed by ultrasound in 6% of cases. Only 25% of respondents measure ETO2 to check the effectiveness of preoxygenation, and 22% use nasal oxygen insufflation with nasal prongs or THRIVE. Sixty two percent of respondents apply cricoid pressure, but only 50% release the pressure when encountering intubation difficulty. Up to 40% of respondents reported cases of aspiration despite applying cricoid pressure. Propofol was the most commonly used hypnotic (97.6%), but there was no clear preference in the choice of neuromuscular relaxant (suxamethonium versus rocuronium ratio of approximately 1:1). Only 44% of respondents calculated the dose of sugammadex that would be required for emergency reversal of rocuronium. CONCLUSIONS The survey showed significant variation in RSI practice, similar to that of other countries. Quality prospective studies are needed to standardize clinical practice.
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Affiliation(s)
- J A Sastre
- Servicio de Anestesiología y Reanimación, Complejo Asistencial Universitario de Salamanca, Salamanca, España; Grupo Español de Vía Aérea Difícil (GEVAD), España; Difficult Airway Society, UK.
| | - T López
- Servicio de Anestesiología y Reanimación, Complejo Asistencial Universitario de Salamanca, Salamanca, España; Grupo Español de Vía Aérea Difícil (GEVAD), España
| | - M A Gómez-Ríos
- Departamento de Anestesia y Medicina Perioperatoria, Complejo Hospitalario Universitario de A Coruña, A Coruña, España; Grupo Español de Vía Aérea Difícil (GEVAD), España
| | - J C Garzón
- Servicio de Anestesiología y Reanimación, Complejo Asistencial Universitario de Salamanca, Salamanca, España; Grupo Español de Vía Aérea Difícil (GEVAD), España
| | - M L Mariscal
- Servicio de Anestesiología y Reanimación, Hospital Universitario de Getafe, Getafe, Madrid, España; Grupo Español de Vía Aérea Difícil (GEVAD), España
| | - E Martínez-Hurtado
- Servicio de Anestesiología y Reanimación, Hospital Universitario Infanta Leonor, Madrid, España; Grupo Español de Vía Aérea Difícil (GEVAD), España
| | - M Freire-Otero
- Departamento de Anestesia y Medicina Perioperatoria, Complejo Hospitalario Universitario de A Coruña, A Coruña, España
| | - J M Redondo
- Servicio de Anestesiología y Reanimación, Hospital Universitario de Cáceres, Cáceres, España
| | - G Gómez
- Servicio de Anestesiología y Reanimación, Hospital Universitario Son Espases, Palma, Mallorca, España
| | - M Casalderrey-Rivas
- Servicio de Anestesiología y Reanimación, Complexo Hospitalario Universitario de Ourense, Ourense, España
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Gasull M, Castell C, Pallarès N, Miret C, Pumarega J, Téllez-Plaza M, López T, Salas-Salvadó J, Lee DH, Goday A, Porta M. Blood Concentrations of Persistent Organic Pollutants and Unhealthy Metabolic Phenotypes in Normal-Weight, Overweight, and Obese Individuals. Am J Epidemiol 2018; 187:494-506. [PMID: 29106481 DOI: 10.1093/aje/kwx267] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 06/23/2017] [Indexed: 12/19/2022] Open
Abstract
Factors underlying metabolic phenotypes, such as the metabolically healthy but obese phenotype, remain unclear. Differences in metabolic phenotypes-particularly, among individuals with a similar body mass index-could be related to concentrations of persistent organic pollutants (POPs). To our knowledge, no studies have analyzed POPs and metabolic phenotypes in normal-weight persons. We investigated the relationships between serum concentrations of POPs and metabolic phenotypes in 860 normal-weight, overweight, and obese participants in the 2002 Catalan Health Interview Survey (Spain). POP concentrations were significantly higher in metabolically unhealthy than in metabolically healthy individuals. In models adjusting for body mass index and other confounders, hexachlorobenzene, β-hexachlorocyclohexane, and polychlorinated biphenyls were associated with the unhealthy metabolic phenotype and metabolic syndrome. Among normal-weight individuals, the adjusted prevalence ratio of having an unhealthy phenotype for the upper category of the sum of orders of the 6 mentioned POPs (all individually associated with metabolic phenotypes) was 4.1 (95% confidence interval: 1.7, 10.0). Among overweight and obese individuals, the corresponding prevalence ratio for the sum of polychlorinated biphenyls was 1.4 (95% confidence interval: 1.0, 1.8). Our results supported the hypothesis that POP concentrations are associated with unhealthy metabolic phenotypes, not only in obese and overweight individuals but also (and probably more strongly) in normal-weight individuals.
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Affiliation(s)
- Magda Gasull
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Centro de Investigación Biomédica en Red—Epidemiología y Salud Pública
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Conxa Castell
- Department of Health, Generalitat de Catalunya, Barcelona, Spain
| | - Natàlia Pallarès
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Centro de Investigación Biomédica en Red—Epidemiología y Salud Pública
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carme Miret
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Pumarega
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Centro de Investigación Biomédica en Red—Epidemiología y Salud Pública
| | - María Téllez-Plaza
- Institute for Biomedical Research, Hospital Clinic de Valencia
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Tomàs López
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Centro de Investigación Biomédica en Red—Epidemiología y Salud Pública
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Pere Virgili Health Research Center, Rovira i Virgili University, Reus, Spain
- Centro de Investigación Biomédica en Red—Fisiopatología de la Obesidad y Nutrición
| | - Duk-Hee Lee
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Albert Goday
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red—Fisiopatología de la Obesidad y Nutrición
- Department of Endocrinology and Nutrition, Hospital del Mar
| | - Miquel Porta
- Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer
- Centro de Investigación Biomédica en Red—Epidemiología y Salud Pública
- Department of Preventive Medicine and Public Health, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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Sastre JA, López T, Reta L. Changes in density spectral array of bilateral BIS during carotid external compression in cardiac surgery. J Clin Monit Comput 2018; 32:1147-1148. [PMID: 29445904 DOI: 10.1007/s10877-018-0112-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 02/06/2018] [Indexed: 11/28/2022]
Affiliation(s)
- José A Sastre
- Department of Anesthesiology, Complejo Asistencial Universitario de Salamanca, Paseo de San Vicente, 58-182, 37007, Salamanca, Spain.
| | - T López
- Department of Anesthesiology, Nuestra Señora de Sonsoles Hospital, Ávila, Spain
| | - Leyre Reta
- Salamanca University Hospital, Salamanca, Spain
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Pumarega J, Gasull M, Lee DH, López T, Porta M. Number of Persistent Organic Pollutants Detected at High Concentrations in Blood Samples of the United States Population. PLoS One 2016; 11:e0160432. [PMID: 27508420 PMCID: PMC4979965 DOI: 10.1371/journal.pone.0160432] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 07/19/2016] [Indexed: 12/16/2022] Open
Abstract
Human exposure to environmental chemicals as persistent organic pollutants (POPs) is usually assessed considering each pollutant individually, with little attention to concentrations of mixtures in individuals or social groups. Yet, it may be relatively common for humans to have low and high concentrations of numerous POPs. The study objectives were to analyze the number of POPs detected per person at high concentrations in the U.S. population, and the associations between such type of indicators and socioeconomic factors as gender, race / ethnicity, education, and poverty level. From 91 POPs analyzed in serum samples of 4,739 individuals in three subsamples of the National Health and Nutrition Examination Survey (NHANES) 2003-2004 (the last period with valid updated individual data for the compounds considered in the present study), we computed the number of POPs whose serum concentrations were above selected cutoff points. POPs included were 13 organochlorine compounds (OCs), 10 polybrominated diphenyl ethers (PBDEs), the polybrominated biphenyl (PBB) 153, 38 polychlorinated biphenyls (PCBs), 17 polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDDs/Fs), and 12 perfluorinated compounds (PFCs). Over 13% of participants had ≥10 of the 37 most detected POPs each at a concentration in the top decile (P90). Over 30% of subjects with total toxic equivalency (TEQ) ≥P75, had ≥10 of 24 POPs not included in TEQ calculations at concentrations ≥P90. Compared to non-Hispanic whites, the adjusted odds ratio of having ≥10 of the 37 POPs at P90 was 9.2 for non-Hispanic blacks and 0.18 for Mexican Americans. Poverty, body mass index, age, and gender were also independently associated with having ≥10 POPs in the top decile. More than one tenth of the US population may have ≥10 POPs each at concentrations in the top decile. Such pattern is nine times more frequent in Non-Hispanic blacks and four times less frequent in Mexican Americans than in non-Hispanic whites.
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Affiliation(s)
- José Pumarega
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Magda Gasull
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Duk-Hee Lee
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Tomàs López
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Miquel Porta
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- School of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
- * E-mail:
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Gavila J, Seguí MÁ, Calvo L, López T, Alonso JJ, Farto M, Sánchez-de la Rosa R. Evaluation and management of chemotherapy-induced cardiotoxicity in breast cancer: a Delphi study. Clin Transl Oncol 2016; 19:91-104. [PMID: 27101413 PMCID: PMC5215075 DOI: 10.1007/s12094-016-1508-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 03/25/2016] [Indexed: 12/03/2022]
Abstract
Purpose While much progress has been made in the treatment of breast cancer, cardiac complications resulting from therapy remain a significant concern. Both anthracyclines and novel targeted agents can inflict cardiac damage. The present study aimed to evaluate the difference between what it is currently done and what standards of care should be used to minimizing and managing cardiac toxicity in breast cancer survivors. Methods A two-round multicenter Delphi study was carried out. The panel consisted of 100 oncologists who were asked to define the elected therapies for breast cancer patients, the clinical definition and patterns of cancer drug-derived cardiac toxicity, and those protocols focused on early detection and monitoring of cardiovascular outcomes. Results Experts agreed a more recent definition of cardiotoxicity. Around 38 % of patients with early-stage disease, and 51.3 % cases with advanced metastatic breast cancer had preexisting risk factors for cardiotoxicity. Among risk factors, cumulative dose of anthracycline ≥450 mg/m2 and its combination with other anticancer drugs, and a preexisting cardiovascular disease were considered the best predictors of cardiotoxicity. Echocardiography and radionuclide ventriculography have been the proposed methods for monitoring changes in cardiac structure and function. Breast cancer is generally treated with anthracyclines (80 %), so that the panel strongly stated about the need to plan a strategy to managing cardiotoxicity. A decline of left ventricular ejection fraction (LVEF) >10 %, to an LVEF value <53 % was suggested as a criterion for changing the dose schedule of anthracyclines, or suspending the treatment of chemotherapy plus trastuzumab until the normalization of the left ventricular function. The use of liposomal anthracyclines was strongly suggested as a treatment option for breast cancer patients. Conclusions The present report is the first to produce a set of statements on the prevention, evaluation and monitoring of chemotherapy-induced cardiac toxicity in breast cancer patients.
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Affiliation(s)
- J Gavila
- Servicio de Oncología Médica, Fundación Instituto Valenciano de Oncología, Calle del Profesor Beltrán Bàguena, 8, 46009, Valencia, Spain.
| | - M Á Seguí
- Servicio de Oncología Médica, Corporació Sanitaria ParcTaulí, Barcelona, Spain
| | - L Calvo
- Servicio de Oncología Médica, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - T López
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | - J J Alonso
- Servicio de Cardiología, Hospital Universitario de Getafe, Madrid, Spain
| | - M Farto
- Medical Department, TEVA Pharma, Madrid, Spain
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Vázquez MD, López T, Mateo S, Mosquera T, Monteagudo B. [Papular sarcoidosis of the knees]. Semergen 2016; 42:e125-e127. [PMID: 26803463 DOI: 10.1016/j.semerg.2015.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 11/11/2015] [Accepted: 11/15/2015] [Indexed: 10/22/2022]
Affiliation(s)
- M D Vázquez
- Medicina Familiar y Comunitaria, Centro de Salud Fontenla Maristany, Ferrol, La Coruña, España.
| | - T López
- Medicina Familiar y Comunitaria, Centro de Salud Serantes, Ferrol, La Coruña, España
| | - S Mateo
- Servicio de Dermatología, Hospital Naval, Ferrol, La Coruña, España
| | - T Mosquera
- Servicio de Anatomía Patológica, Hospital Arquitecto Marcide, Ferrol, La Coruña, España
| | - B Monteagudo
- Servicio de Dermatología, Hospital Naval, Ferrol, La Coruña, España
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Porta M, Pumarega J, Gasull M, López T, Lee DH. Number of Persistent Organic Pollutants (POPs) Detected at High Concentrations in the U.S. Population (NHANES 2003–04). Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sastre JA, López T, Garzón JC. [Blind tracheal intubation through two supraglottic devices: i-gel versus Fastrach intubating laryngeal mask airway (ILMA)]. ACTA ACUST UNITED AC 2015; 59:71-6. [PMID: 22480552 DOI: 10.1016/j.redar.2012.02.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 02/06/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES The use of supraglottic devices as a means of rescue in patients difficult to intubate or ventilate has increased in the field of anaesthetics and in emergency medicine. This study is designed to evaluate the success rate of blind intubations using two supraglottic devices, the Fastrach ILMA and the i-gel mask. PATIENTS AND METHODS A total of 80 patients (40 per group) were included. After positioning them a leak test was performed, the glottis view was checked with a fibrobronchoscope, and an attempt was made to introduce an endotracheal tube through the device, and the procedure was repeated. Adequate ventilation was evaluated, as well as the grade of fibrobronchoscope view, the success of the intubation, and the complications observed after their use. RESULTS There were no differences in the incidence of adequate ventilation with either device. The glottis view (Brimacombe scale) was better with i-gel (77.78% versus 68.42%) at the second attempt, but not on the first. A higher percentage of intubations were achieved with the Fastrach ILMA (70% versus 40%; P=.013). The incidence of throat pain was similar with both devices, but post-operative dysphonia was more frequent with i-gel (20% versus 0; P=.0053). CONCLUSIONS Both devices were equally effective in achieving adequate ventilation; however, the Fastrach ILMA enabled a higher number of intubations to be made than i-gel and with a lower incidence of post-operative dysphonia.
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Affiliation(s)
- J A Sastre
- Servicio de Anestesiología y Reanimación, Complejo Asistencial Universitario de Salamanca, Salamanca, España
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López T, Pumarega JA, Pollack AZ, Lee DH, Richiardi L, Jacobs DR, Schisterman EF, Porta M. Adjusting serum concentrations of organochlorine compounds by lipids and symptoms: a causal framework for the association with K-ras mutations in pancreatic cancer. Chemosphere 2014; 114:219-25. [PMID: 25113205 PMCID: PMC6196356 DOI: 10.1016/j.chemosphere.2014.04.066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 04/16/2014] [Accepted: 04/18/2014] [Indexed: 05/20/2023]
Abstract
In clinically aggressive diseases, patients experience pathophysiological changes that often alter concentrations of lipids and environmental lipophilic factors; such changes are related to disease signs and symptoms. The aim of the study was to compare the effects of correcting for total serum lipids (TSL) and other clinical factors on the odds of mutations in the K-ras oncogene by organochlorine compounds (OCs), in logistic models, in 103 patients with exocrine pancreatic cancer (EPC) using a causal directed acyclic graph (DAG) framework. Results and likelihood of bias were discussed in the light of possible causal scenarios. The odds of K-ras mutated EPC was associated with some TSL-corrected OCs, including p,p'-DDT (p-value: 0.008) and polychlorinated biphenyl 138 (p-trend: 0.024). When OCs were not corrected by TSL, the OR of a K-ras mutation was significant for p,p'-DDT (p-trend: 0.035). Additionally adjusting for cholestatic syndrome increased the ORs of TSL-corrected OCs. When models were adjusted by the interval from first symptom to blood extraction (ISE), the ORs increased for both TSL-corrected and uncorrected OCs. Models with TSL-corrected OCs and adjusted for cholestatic syndrome or ISE yielded the highest ORs. We show that DAGs clarify the covariates necessary to minimize bias, and demonstrate scenarios under which adjustment for TSL-corrected OCs and failure to adjust for symptoms or ISE may induce bias. Models with TSL-uncorrected OCs may be biased too, and adjusting by symptoms or ISE may not control such biases. Our findings may have implications as well for studying environmental causes of other clinically aggressive diseases.
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Affiliation(s)
- Tomàs López
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Facultat de Medicina, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - José A Pumarega
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
| | - Anna Z Pollack
- Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA
| | - Duk-Hee Lee
- Department of Preventive Medicine and Health Promotion Research Center, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Torino, Italy
| | - David R Jacobs
- Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Enrique F Schisterman
- Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA
| | - Miquel Porta
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Facultat de Medicina, Universitat Autònoma de Barcelona, Catalonia, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain.
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Mora Casterá E, Sánchez Sempere M, Lucas J, Jiménez M, Giménez Richarte Á, López T. C0409: Assessment Of Different Coagulation Assays in Real Patients Under Stable Treatment with Dabigatran Etexilate and Rivaroxaban. Thromb Res 2014. [DOI: 10.1016/s0049-3848(14)50146-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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López T, Prado-Barragán A, Nevárez-Moorillón G, Contreras J, Rodríguez R, Aguilar C. Incremento de la capacidad antioxidante de extractos de pulpa de café por fermentación láctica en medio sólido. CyTA - Journal of Food 2013. [DOI: 10.1080/19476337.2013.773563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gasull M, Pumarega J, Rovira G, López T, Alguacil J, Porta M. Relative effects of educational level and occupational social class on body concentrations of persistent organic pollutants in a representative sample of the general population of Catalonia, Spain. Environ Int 2013; 60:190-201. [PMID: 24064380 DOI: 10.1016/j.envint.2013.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 03/04/2013] [Revised: 07/04/2013] [Accepted: 08/02/2013] [Indexed: 05/19/2023]
Abstract
Scant evidence is available worldwide on the relative influence of occupational social class and educational level on body concentrations of persistent organic pollutants (POPs) in the general population. The objective was to analyse such influence in a representative sample of the general population of Catalonia, Spain. Participants in the Catalan Health Interview Survey aged 18-74 were interviewed face-to-face, gave blood, and underwent a physical exam. The role of age, body mass index (BMI), and parity was analysed with General Linear Models, and adjusted geometric means (GMs) were obtained. Crude (unadjusted) concentrations were higher in women and men with lower education, and in women, but not men, in the less affluent social class. After adjusting for age, in women there were no associations between POP levels and social class or education. After adjusting for age and BMI, men in the less affluent class had higher p,p'-DDE concentrations than men in class I (p-value=0.016), while men in class IV had lower HCB than men in the upper class (p-value<0.03). Also in contrast with some expectations, positive associations between education and POP levels were observed after adjusting for age and BMI in men; e.g., men with university studies had higher HCB concentrations than men with first stage of primary schooling (adjusted GM 153.9 and 80.5ng/g, respectively) (p-value<0.001). When education and social class were co-adjusted for, some positive associations with education in men remained statistically significant, whereas class remained associated only with p,p'-DDE. Educational level influenced blood concentrations of POPs more than occupational social class, especially in men. In women, POP concentrations were mainly explained by age/birth cohort, parity and BMI. In men, while concentrations were also mainly explained by age/birth cohort and BMI, both social class and education showed positive associations. Important characteristics of socioeconomic groups as age and BMI may largely explain crude differences among such groups in internal contamination by POPs. The absence of clear patterns of relationships between blood concentrations of POPs and indicators of socioeconomic position may fundamentally be due to the widespread, lifelong, and generally invisible contamination of human food webs. Decreasing historical trends would also partly explain crude socioeconomic differences apparently due to birth cohort effects.
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Affiliation(s)
- Magda Gasull
- Hospital del Mar Institute of Medical Research-IMIM, Barcelona, Catalonia, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
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Cadenas R, Iniesta AM, Refoyo E, Antorrena I, Guzman G, Cuesta E, Salvador O, López T, Moreno M, López-Sendon JL. 1069Cardiovascular Magnetic Resonance: a trial to assess its
utility for “infarction with normal coronary arteries”. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet070aw] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Amaral AFS, Porta M, Silverman DT, Milne RL, Kogevinas M, Rothman N, Cantor KP, Jackson BP, Pumarega JA, López T, Carrato A, Guarner L, Real FX, Malats N. Pancreatic cancer risk and levels of trace elements. Gut 2012; 61:1583-8. [PMID: 22184070 PMCID: PMC3310963 DOI: 10.1136/gutjnl-2011-301086] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Knowledge on the aetiology of exocrine pancreatic cancer (EPC) is scant. The best established risk factor for EPC is tobacco smoking. Among other carcinogens, tobacco contains cadmium, a metal previously associated with an increased risk of EPC. This study evaluated the association between concentrations of trace elements in toenails and EPC risk. METHODS The study included 118 EPC cases and 399 hospital controls from eastern Spain. Levels of 12 trace elements were determined in toenail samples by inductively coupled plasma mass spectrometry. OR and 95% CI, adjusted for potential confounders, were calculated using logistic regression. RESULTS Significantly increased risks of EPC were observed among subjects whose concentrations of cadmium (OR 3.58, 95% CI 1.86 to 6.88; p(trend)=5×10(-6)), arsenic (OR 2.02, 95% CI 1.08 to 3.78; p(trend)=0.009) and lead (OR 6.26, 95% CI 2.71 to 14.47; p(trend)=3×10(-5)) were in the highest quartile. High concentrations of selenium (OR 0.05, 95% CI 0.02 to 0.15; p(trend)=8×10(-11)) and nickel (OR 0.27, 95% CI 0.12 to 0.59; p(trend)=2×10(-4)) were inversely associated with the risk of EPC. CONCLUSION Novel associations are reported of lead, nickel and selenium toenail concentrations with pancreas cancer risk. Furthermore, the results confirm previous associations with cadmium and arsenic. These novel findings, if replicated in independent studies, would point to an important role of trace elements in pancreatic carcinogenesis.
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Affiliation(s)
- André F. S. Amaral
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Miquel Porta
- Institut Municipal d'Investigació Mèdica (IMIM), Universitat Autònoma de Barcelona, and CIBERESP, Spain
| | - Debra T. Silverman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Roger L. Milne
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | | | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | - Brian P. Jackson
- Trace Element Analysis Core, Department of Earth Sciences, Dartmouth College, Hanover, NH, USA
| | - José A. Pumarega
- Institut Municipal d'Investigació Mèdica (IMIM), Universitat Autònoma de Barcelona, and CIBERESP, Spain
| | - Tomàs López
- Institut Municipal d'Investigació Mèdica (IMIM), Universitat Autònoma de Barcelona, and CIBERESP, Spain
| | - Alfredo Carrato
- Hospital Ramón y Cajal, Madrid, and Hospital General de Elche, Spain
| | | | - Francisco X. Real
- Epithelial Carcinogenesis Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain, and Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
| | - Núria Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
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Porta M, López T, Gasull M, Rodríguez-Sanz M, Garí M, Pumarega J, Borrell C, Grimalt JO. Distribution of blood concentrations of persistent organic pollutants in a representative sample of the population of Barcelona in 2006, and comparison with levels in 2002. Sci Total Environ 2012; 423:151-161. [PMID: 22397902 DOI: 10.1016/j.scitotenv.2012.02.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 01/31/2012] [Accepted: 02/01/2012] [Indexed: 05/31/2023]
Abstract
INTRODUCTION POP biomonitoring programs are useful for exposure assessment, to analyze patterns, and to evaluate policies. However, population-representative surveys are scarce and heterogeneous. Reports on time trends in representative samples using the same methods are rare. OBJECTIVES To analyze the distribution of serum concentrations of 19 POPs in the general population of Barcelona city in 2006, and to compare it with the distribution in 2002. METHODS 231 participants in the Barcelona Health Survey were interviewed face-to-face, gave blood, and underwent a physical exam. Density plots ("POP Geoffrey Rose curves") were used to represent the full population distribution of each compound. RESULTS Eight POPs were each detected in >80% of the study subjects: p,p'-DDT, p,p'-DDE, PCB congeners 118, 138, 153 and 180, HCB and β-HCH. The minimum number of POPs detected in one person was 5, and 72% of the population accumulated ≥ 10 compounds. p,p'-DDE and HCB showed the highest concentrations (median=219 and 109 ng/g lipid, respectively). Concentrations decreased by 34-56% from 2002 to 2006. The decrease was similar in women and men, and in all age groups/birth cohorts. It was larger with increasing BMI; for p,p'-DDT, HCB and β-HCH the decrease in obese individuals was 31-44 percentage points larger than in subjects with normal weight. The distribution of POP concentrations was always switched towards higher values in women than men. POP levels also differed significantly by age, body mass index, weight gain, birth place and social class, but not by parity and breastfeeding. The two younger cohorts had a higher DDT/DDE ratio than the oldest cohort. CONCLUSION Although human POP contamination remains common in the city of Barcelona, concentrations decreased significantly in 4years. Our approach suggests innovative ways to conceive, analyze and present results for other monitoring programs.
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Affiliation(s)
- Miquel Porta
- Hospital del Mar Research Institute- IMIM, Barcelona, Catalonia, Spain.
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Albarran L, López T, Quintana P, Chagoya V. Stability of hepatoprotecting agent IFC-305 encapsulated into sol-gel titania nanoparticles and drug release evaluation: water and drug concentration effect. J Nanosci Nanotechnol 2012; 12:2199-2205. [PMID: 22755038 DOI: 10.1166/jnn.2012.5750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
IFC-305 was encapsulated into nanostructured titania and functionalized with OH groups by the sol-gel process using titanium n-butoxide, to be used in a drug delivery system for the treatment of liver cancer. Synthesis was carried out at different molar hydrolysis ratios: 4, 8, 16 and 24 mol of water; and drug concentration of 10, 20 and 30%. Characterization of IFC-titania reservoirs was carried out by Fourier transformed infrared spectroscopy (FTIR), X-ray diffraction (XRD), thermal analysis (DTA-TGA), scanning electron microscopy (SEM), and N2 adsorption-desorption isotherms (BET), confirms that IFC-305 is entrapped and stabilized in the TiO2-OH matrix. Drug liberation in vitro was determined by UV spectrometry over a period of 1000 h. This study demonstrated that the higher water content and the higher amount of loaded IFC, favored hydrogen bonding between titania-OH surface and IFC-NH groups, increasing the rate of drug release.
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Affiliation(s)
- L Albarran
- Universidad Autónoma Metropolitana-Xochimilco, Calzada del Hueso 1100, Col. Villa Quietud, Coyoacán, C.P 04960, D.F. México
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Lugo-Huitrón R, Blanco-Ayala T, Ugalde-Muñiz P, Carrillo-Mora P, Pedraza-Chaverrí J, Silva-Adaya D, Maldonado PD, Torres I, Pinzón E, Ortiz-Islas E, López T, García E, Pineda B, Torres-Ramos M, Santamaría A, La Cruz VPD. On the antioxidant properties of kynurenic acid: free radical scavenging activity and inhibition of oxidative stress. Neurotoxicol Teratol 2011; 33:538-47. [PMID: 21763768 DOI: 10.1016/j.ntt.2011.07.002] [Citation(s) in RCA: 209] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Revised: 06/21/2011] [Accepted: 07/03/2011] [Indexed: 01/27/2023]
Abstract
Kynurenic acid (KYNA) is an endogenous metabolite of the kynurenine pathway for tryptophan degradation and an antagonist of both N-methyl-D-aspartate (NMDA) and alpha-7 nicotinic acetylcholine (α7nACh) receptors. KYNA has also been shown to scavenge hydroxyl radicals (OH) under controlled conditions of free radical production. In this work we evaluated the ability of KYNA to scavenge superoxide anion (O(2)(-)) and peroxynitrite (ONOO(-)). The scavenging ability of KYNA (expressed as IC(50) values) was as follows: OH=O(2)(-)>ONOO(-). In parallel, the antiperoxidative and scavenging capacities of KYNA (0-150 μM) were tested in cerebellum and forebrain homogenates exposed to 5 μM FeSO(4) and 2.5 mM 3-nitropropionic acid (3-NPA). Both FeSO(4) and 3-NPA increased lipid peroxidation (LP) and ROS formation in a significant manner in these preparations, whereas KYNA significantly reduced these markers. Reactive oxygen species (ROS) formation were determined in the presence of FeSO(4) and/or KYNA (0-100 μM), both at intra and extracellular levels. An increase in ROS formation was induced by FeSO(4) in forebrain and cerebellum in a time-dependent manner, and KYNA reduced this effect in a concentration-dependent manner. To further know whether the effect of KYNA on oxidative stress is independent of NMDA and nicotinic receptors, we also tested KYNA (0-100 μM) in a biological preparation free of these receptors - defolliculated Xenopus laevis oocytes - incubated with FeSO(4) for 1 h. A 3-fold increase in LP and a 2-fold increase in ROS formation were seen after exposure to FeSO(4), whereas KYNA attenuated these effects in a concentration-dependent manner. In addition, the in vivo formation of OH evoked by an acute infusion of FeSO(4) (100 μM) in the rat striatum was estimated by microdialysis and challenged by a topic infusion of KYNA (1 μM). FeSO(4) increased the striatal OH production, while KYNA mitigated this effect. Altogether, these data strongly suggest that KYNA, in addition to be a well-known antagonist acting on nicotinic and NMDA receptors, can be considered as a potential endogenous antioxidant.
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Affiliation(s)
- R Lugo-Huitrón
- Laboratorio de Aminoácidos Excitadores, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, S.S.A., Mexico D.F. 14269, Mexico
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López T, Albarrán L, Espinoza K, Kozina A, Rodriguez-Reinoso F. Comparison of nanostructured titania matrices obtained by carbon template and sol-gel methods for controlled release of fluoxetine. J Nanosci Nanotechnol 2011; 11:5508-5514. [PMID: 21770211 DOI: 10.1166/jnn.2011.3429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Two types of titania matrix were investigated as a support for the prolonged drug delivery of the antidepressant fluoxetine. Sample MT was synthesized using carbon template and consisted of titania microtubes on which then fluoxetine was adsorbed. Sample SG was synthesized by the sol-gel method when the drug was added during the reaction. The morphology of the powder surfaces was found to be different: nanotubes versus almost spherical particles with much larger surface area of SG and smaller pores. The relative degrees of hydroxyl coverage of the surface were studied by FTIR-spectroscopy and were found to be much larger for the sol-gel complex. Theoretical modeling was applied to consider possible interactions between the drug and the matrices. The liberation of the drug was proved to be faster from complex MT and was attributed to weaker drug-matrix interactions in combination with larger pore size.
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Affiliation(s)
- T López
- Universidad Autónoma Metropolitana-Xochimilco, Health Department, Calzada del Hueso 1100, 04960 México DF, México
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López T, Espinoza KA, Kozina A, Castillo P, Silvestre-Albero A, Rodriguez-Reinoso F, Alexander-Katz R. Influence of water/alkoxide ratio in the synthesis of nanosized sol-gel titania on the release of phenytoin. Langmuir 2011; 27:4004-4009. [PMID: 21366276 DOI: 10.1021/la104612g] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The sol-gel method was used to synthesize inorganic reservoirs with encapsulated antiepileptic drug phenytoin. The drug release profile was shown to depend on the morphology and surface properties of the matrix. A parameter of the synthesis such as water/alkoxide ratio r(w) was varied in order to investigate its influence on the matrix properties and as a result on the drug release profile. It was found that the specific surface area and crystallization degree decrease with an increase of r(w), whereas the hydroxyl group coverage increases with an increase of r(w). Drug release kinetics studies revealed that the initial release rate increases with an increase of water content in the reaction, whereas the long time release rate first slightly increases with an increase of water content from 4 to 8 and then decreases for r(w) = 16. The interplay of different parameters of the matrix is shown to be responsible for such a dependence and is discussed in the Article.
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Affiliation(s)
- T López
- Laboratorio de Nanotecnología para Medicina, Instituto Nacional de Neurología y Neurocirugía MVS, 14269 México DF, México.
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Abstract
ABSTRACTWe have prepared nanoparticles of titania using the sol-gel technique. The samples were characterized by FTIR, DTA, TGA, EPR and XRD. The properties observed with these techniques are correlated in the temperature region between 200 and 800°C. The Ti-OH bonds are basic to interpret this correlation.
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López T, Alvarez M, González RD, Uddin MJ, Bustos J, Arroyo S, Sánchez A. Synthesis, characterization and in vitro cytotoxicity of Pt-TiO2 nanoparticles. ADSORPTION 2011. [DOI: 10.1007/s10450-011-9330-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [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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Parker LA, Porta M, Lumbreras B, López T, Guarner L, Hernández-Aguado I, Carrato A, Corominas JM, Rifà J, Fernandez E, Alguacil J, Malats N, Real FX. Clinical validity of detecting K-ras mutations for the diagnosis of exocrine pancreatic cancer: a prospective study in a clinically-relevant spectrum of patients. Eur J Epidemiol 2011; 26:229-36. [PMID: 21298467 DOI: 10.1007/s10654-011-9547-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Accepted: 01/20/2011] [Indexed: 12/22/2022]
Abstract
The diagnostic utility of detecting K-ras mutations for the diagnosis of exocrine pancreatic cancer (EPC) has not been properly studied, and few reports have analysed a clinically relevant spectrum of patients. The objective was to evaluate the clinical validity of detecting K-ras mutations in the diagnosis of EPC in a large sample of clinically relevant patients. We prospectively identified 374 patients in whom one of the following diagnoses was suspected at hospital admission: EPC, chronic pancreatitis, pancreatic cysts, and cancer of the extrahepatic biliary system. Mutations in the K-ras oncogene were analysed by PCR and artificial RFLP in 212 patients. The sensitivity and specificity of the K-ras mutational status for the diagnosis of EPC were 77.7% (95% CI: 69.2-84.8) and 78.0% (68.1-86.0), respectively. The diagnostic accuracy was hardly modified by sex and age. In patients with either mutated K-ras or CEA > 5 ng/ml, the sensitivity and specificity were 81.0% (72.9-87.6) and 62.6% (72.9-87.6), respectively. In patients with mutated K-ras and CEA > 5 ng/ml the sensitivity was markedly reduced. In comparisons with a variety of non-EPC patient groups sensitivity and specificity were both always greater than 75%. In this clinically relevant sample of patients the sensitivity and specificity of K-ras mutations were not sufficiently high for independent diagnostic use. However, it seems premature to rule out the utility of K-ras analysis in conjunction with other genetic and 'omics' technologies.
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Affiliation(s)
- Lucy A Parker
- Department of Public Health, Miguel Hernández University, Alicante, Spain
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Bosch de Basea M, Porta M, Alguacil J, Puigdomènech E, Gasull M, Garrido JA, López T. Relationships between occupational history and serum concentrations of organochlorine compounds in exocrine pancreatic cancer. Occup Environ Med 2010; 68:332-8. [PMID: 21098829 DOI: 10.1136/oem.2009.054197] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Previous studies investigating associations between occupational history and risk of exocrine pancreatic cancer (EPC) did not use biomarkers of exposure. The only two studies that measured internal concentrations of organochlorine compounds (OCs) in EPC did not analyse their relationship with occupation. OBJECTIVE To analyse the relationship between occupational history and blood concentrations of seven OCs in patients with EPC. METHODS Incident cases of EPC were prospectively identified, and during hospital admission were interviewed face-to-face on occupational history and life-style factors (n = 135). Occupations were coded according to the International Standard of Occupations 1988. Some occupational exposures were also assessed with the Finnish job-exposure matrix (Finjem). Serum concentrations of OCs were analysed by high-resolution gas chromatography with electron-capture detection. RESULTS Craftsmen and related trades workers had significantly higher concentrations of polychlorinated biphenyl (PCB) congeners 138, 153 and 180. Years worked in agriculture did not influence concentrations of p,p'-DDT, p,p'-DDE, hexachlorobenzene or β-hexachlorocyclohexane. Subjects who ever worked in agriculture had lower concentrations of PCBs (all p < 0.05). Occupational exposure to lead, nickel and low frequency magnetic fields was significantly associated with higher concentrations of PCBs. CONCLUSIONS Certain occupations were associated with higher concentrations of PCBs, suggesting that these compounds may account for some increased risks found in previous studies. The lack of association between work in agriculture and concentrations of OC pesticides is consistent with occupation playing a lesser role than diet in influencing OC concentrations. Occupational studies on the relationships among exposure to industrial agents and EPC risk may need to consider adjusting for exposure to PCBs.
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Affiliation(s)
- Magda Bosch de Basea
- Clinical and Molecular Epidemiology of Cancer Unit, Institut Municipal d'Investigació Mèdica, Universitat Autònoma de Barcelona, Carrer del Dr Aiguader 88, E-08003 Barcelona, Catalonia, Spain
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Brogly N, Guasch E, Puertas L, Alsina E, López T, Gilsanz F. Défaillance cardiaque aiguë associée à une cardiomyopathie dilatée en post-partum précoce : traitement par ballon de contrepulsion aortique et lévosimendan. ACTA ACUST UNITED AC 2010; 29:807-10. [DOI: 10.1016/j.annfar.2010.08.008] [Citation(s) in RCA: 6] [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] [Received: 04/01/2009] [Accepted: 08/27/2010] [Indexed: 10/19/2022]
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Porta M, Gasull M, Puigdomènech E, Garí M, Bosch de Basea M, Guillén M, López T, Bigas E, Pumarega J, Llebaria X, Grimalt JO, Tresserras R. Distribution of blood concentrations of persistent organic pollutants in a representative sample of the population of Catalonia. Environ Int 2010; 36:655-64. [PMID: 20569985 DOI: 10.1016/j.envint.2010.04.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 04/12/2010] [Accepted: 04/20/2010] [Indexed: 05/09/2023]
Abstract
BACKGROUND Although virtually all populations worldwide are commonly exposed to numerous persistent organic pollutants (POPs) and human concentrations vary widely, only a few countries conduct nationwide surveillance programs of POP concentrations in representative samples of the general population. OBJECTIVE To evaluate the distribution of serum concentrations of nineteen POPs and their main predictors in a representative sample of the general population of Catalonia. METHODS Participants in the Catalan Health Interview Survey aged 18-74 years were interviewed face-to-face, gave blood, and underwent a physical exam. Graphs (including "POP Geoffrey Rose curves") were used to represent the full population distribution of each POP in the 919 participants. Through multivariate statistical models we analyzed the influence on POP concentrations of sex, age, body mass index (BMI), socioeconomic status and, in women, parity. RESULTS We detected dichlorodiphenyltrichloroethane (p,p'-DDT), dichlorodiphenyldichloroethane (p,p'-DDE), polychlorinated biphenyls (PCBs) congeners 118, 138, 153 and 180, hexachlorobenzene (HCB) and beta-hexachlorocyclohexane (beta-HCH) in more than 85% of the subjects. p,p'-DDE, HCB and beta-HCH showed the highest concentrations (median=399, 159 and 92 ng/g lipid, respectively). Distributions were highly skewed and interindividual differences were up to 7700-fold. POP levels differed significantly by gender, age, BMI, educational level, and parity. CONCLUSIONS In Catalonia, an advanced European society, exposure to POPs remains common, a vast majority of the population has much lower blood concentrations than a relative minority, and the population distributions of POP are hence highly skewed to the right. Shifting distributions towards lower concentrations requires more energetic policies and population strategies.
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Affiliation(s)
- Miquel Porta
- Institut Municipal d'Investigació Mèdica, Barcelona, Catalonia, Spain.
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López T, Figueras F, Manjarrez J, Bustos J, Alvarez M, Silvestre-Albero J, Rodríguez-Reinoso F, Martínez-Ferre A, Martínez E. Catalytic nanomedicine: A new field in antitumor treatment using supported platinum nanoparticles. In vitro DNA degradation and in vivo tests with C6 animal model on Wistar rats. Eur J Med Chem 2010; 45:1982-90. [PMID: 20153564 DOI: 10.1016/j.ejmech.2010.01.043] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2009] [Revised: 12/29/2009] [Accepted: 01/19/2010] [Indexed: 10/19/2022]
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Porta M, López T, Pumarega J, Jariod M, Crous-Bou M, Marco E, Rifà J, Grimalt JO, Malats N, Real FX. In pancreatic ductal adenocarcinoma blood concentrations of some organochlorine compounds and coffee intake are independently associated with KRAS mutations. Mutagenesis 2009; 24:513-21. [PMID: 19797353 DOI: 10.1093/mutage/gep037] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
While KRAS activation is a fundamental initiating event in the aetiopathogenesis of pancreatic ductal adenocarcinoma (PDA), environmental factors influencing the occurrence and persistence of KRAS mutations remain largely unknown. The objective was to test the hypothesis that in PDA there are aetiopathogenic relationships among concentrations of some organochlorine compounds (OCs) and the mutational status of the KRAS oncogene, as well as among the latter and coffee intake. Incident cases of PDA were interviewed and had blood drawn at hospital admission (N = 103). OCs were measured by high-resolution gas chromatography with electron capture detection. Cases whose tumours harboured a KRAS mutation had higher concentrations of p,p'-dichlorodiphenyltrichloroethane (DDT), p,p'-dichlorodiphenyldichloroethene (DDE) and polychlorinated biphenyls (PCBs) 138, 153 and 180 than cases with wild-type KRAS, but differences were statistically significant only for p,p'-DDT and PCBs 138 and 153. The association between coffee intake and KRAS mutations remained significant (P-trend < 0.015) when most OCs where accounted for. When p,p'-DDT, PCB 153, coffee and alcohol intake were included in the same model, all were associated with KRAS (P = 0.042, 0.007, 0.016 and 0.025, respectively). p,p'-DDT, p,p'-DDE and PCB 138 were significantly associated with the two most prevalent KRAS mutations (Val and Asp). OCs and coffee may have independent roles in the aetiopathogenesis of PDA through modulation of KRAS activation, acquisition or persistence, plausibly through non-genotoxic or epigenetic mechanisms. Given that KRAS mutations are the most frequent abnormality of oncogenes in human cancers, and the lifelong accumulation of OCs in humans, refutation or replication of the findings is required before any implications are assessed.
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Affiliation(s)
- Miquel Porta
- Institut Municipal d'Investigació Mèdica-Hospital del Mar, E-08003 Barcelona, Catalonia, Spain.
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Porta M, Jariod M, López T, Pumarega J, Puigdomènech E, Marco E, Malats N, Grimalt JO, Real FX. Correcting serum concentrations of organochlorine compounds by lipids: alternatives to the organochlorine/total lipids ratio. Environ Int 2009; 35:1080-1085. [PMID: 19581003 DOI: 10.1016/j.envint.2009.06.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Revised: 05/11/2009] [Accepted: 06/05/2009] [Indexed: 05/28/2023]
Abstract
INTRODUCTION When studying the effects of organochlorine compounds (OCs) on human health it is common to correct serum concentrations of OC by total lipids (TL). However, the relationship between serum OCs and serum TL is far from established in many diseases, including several cancers. Our aim was to analyze the relationship between serum OC and TL in patients with pancreatic ductal adenocarcinoma (PDA), and to explore several alternatives to perform the OC lipid correction. METHODS Incident cases of PDA were interviewed and had blood drawn soon around hospital admission (n=144). Serum concentrations of OCs were analysed by high-resolution gas chromatography with electron-capture detection. RESULTS Most patients with high TL had moderate or low concentrations of OCs. By contrast, the variability of OC values among patients with normal TL was large. Correlations were of a similar magnitude between OC and TL and between OC and total cholesterol; while these correlations were weak (all Spearman's rho<0.3 and R(2)<0.11), no OC were significantly correlated with triglycerides. Although all alternatives to the OC/TL linear ratio were statistically significant for at least one OC, their R(2) was always below 10%. CONCLUSIONS In patients with severe diseases as PDA, linear correction of OC by TL as commonly performed in epidemiologic studies may be inappropriate. Results contribute to the scant literature on the rationale to correct serum concentrations of OC by lipids. They suggest that it is unwarranted to routinely correct OC by TL, offer ways to assess such need, and present alternatives as no TL correction, correction by total cholesterol only or use of different statistical models.
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Affiliation(s)
- Miquel Porta
- Institut Municipal d'Investigació Mèdica - Hospital del Mar, E-08003 Barcelona, Catalonia, Spain.
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Crous-Bou M, Porta M, López T, Jariod M, Malats N, Morales E, Guarner L, Rifà J, Carrato A, Real FX. Lifetime history of alcohol consumption and K-ras mutations in pancreatic ductal adenocarcinoma. Environ Mol Mutagen 2009; 50:421-430. [PMID: 19326463 DOI: 10.1002/em.20483] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND In pancreatic ductal adenocarcinoma (PDA), evidence on the etiopathogenic role of alcohol consumption in the occurrence of K-ras mutations is scant, and the role of alcohol in pancreatic carcinogenesis is not well established. We analyzed the relation between lifetime consumption of alcohol and mutations in codon 12 of the K-ras oncogene in patients with PDA. METHODS Incident cases of PDA were prospectively identified and interviewed face-to-face during hospital admission about lifetime alcohol consumption and other lifestyle factors. Logistic regression was used to compare PDA cases (N = 107) with mutated and wild-type K-ras tumors (case-case study). RESULTS Mutated cases were moderate or heavy drinkers more frequently than wild-type cases: the odds ratio adjusted by age, sex, smoking, and history of pancreatitis (ORa) was 3.18 (95% confidence interval: 1.02-9.93; P = 0.046). Total grams of alcohol and years of consumption were higher in mutated than in wild-type cases: the ORa for lifetime alcohol consumption over 507,499 g was 3.35 (95% CI: 0.81-13.88); and for more than 40 years of alcohol consumption it was 4.47 (95% CI: 1.05-19.02). Age at onset of alcohol consumption and years of abstinence were also associated with the presence of K-ras mutations. There were no significant differences in alcohol dependency. CONCLUSIONS Alcohol consumption is weakly associated with an increased risk of having a K-ras mutated PDA. To confirm or to refute the hypothesis that ethanol, acetaldehyde or other alcohol-related substances might influence the acquisition or persistence of K-ras mutations in the pancreatic epithelium, large and unselected studies are warranted.
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Crous-Bou M, Porta M, Morales E, López T, Carrato A, Puigdomènech E, Real FX. Past medical conditions and K-ras mutations in pancreatic ductal adenocarcinoma: a hypothesis-generating study. Cancer Causes Control 2008; 20:591-9. [PMID: 19083106 DOI: 10.1007/s10552-008-9267-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2008] [Accepted: 11/07/2008] [Indexed: 12/20/2022]
Abstract
BACKGROUND In pancreatic ductal adenocarcinoma (PDA) evidence on the etiopathogenic role of past medical conditions in the occurrence and persistence of K-ras mutations is scant. METHODS Incident cases of PDA were interviewed face-to-face about past medical history and other factors. Logistic regression was used to compare PDA cases (n = 120) with wild-type and mutated K-ras tumors (case-case study). RESULTS Patients with wild-type K-ras tumors were more likely to have a prior diagnosis of pancreatitis (Odds ratio [OR] = 6.11, p = 0.041). Diabetes mellitus (DM) was non-significantly more common among cases with a K-ras wild-type tumor, and the OR for DM of >6 years of duration was 4.54 (p = 0.39). Patients with wild-type K-ras were significantly more likely to have had a surgically treated peptic ulcer (OR = 9.03, p = 0.027). The probability of having a K-ras wild-type tumor increased with the number of medical conditions (p for trend = 0.012); the corresponding OR for two or more medical conditions was 4.46 (95% CI: 1.37-14.50). CONCLUSIONS Results raise the hypothesis that pancreatitis and possibly peptic ulcer might influence pancreatic carcinogenesis through pathways independent of K-ras mutation, perhaps related to growth factors or mediators of the inflammatory response. Large unselected studies should be conducted to refute or replicate our findings.
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Affiliation(s)
- Marta Crous-Bou
- Clinical & Molecular Epidemiology of Cancer Unit, Institut Municipal d'Investigació Mèdica (IMIM), Universitat Autònoma de Barcelona, Carrer del Dr. Aiguader 88, 08003 Barcelona, Spain
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Alvarez M, López T, Odriozola JA, Gonzalez RD. Photocatalytic degradation of 2,4-dichlorophenoxyacetic acid over ZrO2, Cu/ZrO2 and Fe/ZrO2 photocatalysts synthesized by sol gel method. J Nanosci Nanotechnol 2008; 8:6414-6418. [PMID: 19205214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Photocatalytic oxidation of 2,4-dichlorophenoxyacetic acid was performed over ZrO2, Cu/ZrO2 and Fe/ZrO2 catalysts prepared by the sol-gel method. The samples were annealed at 400 degrees C. Textural and electronic characterization was carried out using BET and UV-Vis in order to establish the relationship between surface, pore volume and E(g) with the photoactivity of the materials. The degradation of the acid was followed by UV-Vis spectroscopy. The disappearance of the herbicide in solution follows approximately pseudo-first order kinetics. The apparent rate constants were calculated for the three catalysts. The results reveal that Fe/ZrO2 exhibits the best photoactivity for the degradation of 2,4-dichlorophenoxyacetic acid.
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Affiliation(s)
- M Alvarez
- Departamento de Química, Universidad Autónoma Metropolitana-Iztapalapa, A.P 55-534, México DF, 09340 Mexico
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Manriquez ME, Picquart M, Bokhimi X, López T, Quintana P, Coronado JM. X-ray diffraction, and Raman scattering study of nanostructured ZrO2-TiO2 oxides prepared by sol-gel. J Nanosci Nanotechnol 2008; 8:6623-6629. [PMID: 19205251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In the present work, we study the phase composition of ZrO2-TiO2 system by means of XRD and Raman spectroscopy, using also TG-ATD, and N2 adsorption isotherms as complementary characterization techniques. TiO2-ZrO2 samples of selected compositions (0, 10, 90, 50 and 100% in weight of TiO2) were prepared by sol-gel method and annealed at three different temperatures (400, 600 and 800 degrees C). Structural characterization reveals that only the pure oxides are crystalline at 400 degrees C: TiO2 as anatasa with a minor brookite component, and ZrO2 as a mixture of tetragonal (majority) and monoclinic phases. Following the 600 degrees C calcination, the TiO2-ZrO2 50-50% sample forms the ZrTiO4 mixed oxide, although this materials remains partly amorphous. In contrast, samples with higher and lower TiO2 content form solid solutions with, respectively, anatasa and tetragonal ZrO2 structures. Zirconium incorporation into the TiO2 lattice leads to the expansion of the unit cell parameters, and it stabilizes the anatase phase, hindering its transformation into rutile. Similarly, dissolving titanium atoms into the ZrO2 structure delays the transformation from the tetragonal to the monoclinic polymorph.
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Affiliation(s)
- M E Manriquez
- Departamento de Química, Universidad Autónoma Metropolitana-Iztapalapa, Apdo. Postal 55-534, México DF 09340, Mexico
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López T, Recillas S, Guevara P, Sotelo J, Alvarez M, Odriozola JA. Pt/TiO2 brain biocompatible nanoparticles: GBM treatment using the C6 model in Wistar rats. Acta Biomater 2008; 4:2037-44. [PMID: 18640082 DOI: 10.1016/j.actbio.2008.05.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2007] [Revised: 05/08/2008] [Accepted: 05/14/2008] [Indexed: 11/29/2022]
Abstract
In the present work we synthesized inorganic oxide nanoparticle carriers of platinum compounds and tested their therapeutic effect on animal models in which C6 glioma cells have been inoculated. TiO(2)-containing Pt(NH(3))(4)Cl(2) complexes were synthesized using sol-gel methods. The platinum species are chemically bonded to the TiO(2) carrier, as shown by Fourier transform infrared spectroscopy of probe molecules. Treatment with TiO(2)-Pt nanoparticles reduces tumour growth rate by up to 56%, showing that a synergistic effect exists between the TiO(2) carrier and the platinum drug.
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Affiliation(s)
- T López
- Universidad Autónoma Metropolitana-Xochimilco, Health Department, Calzada del Hueso 1100, México DF 04960, México
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Porta M, Bosch de Basea M, Benavides FG, López T, Fernandez E, Marco E, Alguacil J, Grimalt JO, Puigdomènech E. Differences in serum concentrations of organochlorine compounds by occupational social class in pancreatic cancer. Environ Res 2008; 108:370-379. [PMID: 18706543 DOI: 10.1016/j.envres.2008.06.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2008] [Revised: 06/13/2008] [Accepted: 06/26/2008] [Indexed: 05/26/2023]
Abstract
BACKGROUND The relationships between social factors and body concentrations of environmental chemical agents are unknown in many human populations. Some chemical compounds may play an etiopathogenic role in pancreatic cancer. OBJECTIVE To analyze the relationships between occupational social class and serum concentrations of seven selected organochlorine compounds (OCs) in exocrine pancreatic cancer: dichlorodiphenyltrichloroethane (p,p'-DDT), dichlorodiphenyldichloroethene (p,p'-DDE), 3 polychlorinated biphenyls (PCBs), hexachlorobenzene, and beta-hexachlorocyclohexane. METHODS Incident cases of exocrine pancreatic cancer were prospectively identified, and interviewed face-to-face during hospital admission (n=135). Serum concentrations of OCs were analyzed by high-resolution gas chromatography with electron-capture detection. Social class was classified according to occupation. RESULTS Multivariate-adjusted concentrations of all seven compounds were higher in occupational social classes IV-V (the less affluent) than in classes I-II; they were higher as well in class III than in classes I-II for four compounds. Concentrations of six OCs were higher in manual workers than in non-manual workers (p<0.05 for PCBs). Social class explained statistically between 3.7% and 5.7% of the variability in concentrations of PCBs, and 2% or less variability in the other OCs. CONCLUSIONS Concentrations of most OCs were higher in the less affluent occupational social classes. In pancreatic cancer the putative causal role of these persistent organic pollutants may not be independent of social class. There is a need to integrate evidence on the contribution of different social processes and environmental chemical exposures to the etiology of pancreatic and other cancers.
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Affiliation(s)
- Miquel Porta
- Institut Municipal d'Investigació Mèdica, Barcelona, Spain.
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Ruiz-Pérez C, Pasán J, Delgado F, Fabelo O, Cañadillas-Delgado L, Sepúlveda E, Déniz M, Hernández-Molina M, Laz M, López T. Water embedded in metal-polycarboxylate crystal host. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308099261] [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: 11/10/2022] Open
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Porta M, Ferrer-Armengou O, Pumarega J, López T, Crous-Bou M, Alguacil J, Fitó M, Jariod M, Vicente Á, Morales E, Covas MI, Puigdomènech E, Gupta N. Exocrine pancreatic cancer clinical factors were related to timing of blood extraction and influenced serum concentrations of lipids. J Clin Epidemiol 2008; 61:695-704. [DOI: 10.1016/j.jclinepi.2007.08.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2007] [Revised: 08/02/2007] [Accepted: 08/09/2007] [Indexed: 12/22/2022]
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Crous-Bou M, Porta M, Morales E, López T, Real F. Past medical conditions and K-rasmutations in pancreatic ductal adenocarcinoma. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)71866-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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López T, Sastre JA, Muriel C. [Use of i-gel airway in an intermediate step toward intubating a difficult airway for thoracic surgery]. Rev Esp Anestesiol Reanim 2008; 55:380-381. [PMID: 18693669 DOI: 10.1016/s0034-9356(08)70599-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Crous-Bou M, De Vivo I, Porta M, Pumarega JA, López T, Alguacil J, Morales E, Malats N, Rifà J, Hunter DJ, Real FX. CYP1B1 polymorphisms and k-ras mutations in patients with pancreatic ductal adenocarcinoma. Dig Dis Sci 2008; 53:1417-21. [PMID: 18347981 DOI: 10.1007/s10620-008-0235-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2007] [Accepted: 02/28/2007] [Indexed: 12/21/2022]
Abstract
The frequency of CYP1B1 polymorphisms in pancreatic cancer has never been reported. There is also no evidence on the relationship between CYP1B1 variants and mutations in ras genes (K-, H- or N-ras) in any human neoplasm. We analyzed the following CYP1B1 polymorphisms in 129 incident cases of pancreatic ductal adenocarcinoma (PDA): the m1 allele (Val to Leu at codon 432) and the m2 allele (Asn to Ser at codon 453). The calculated frequencies for the m1 Val and m2 Asn alleles were 0.45 and 0.68, respectively. CYP1B1 genotypes were out of Hardy-Weinberg equilibrium; this was largely due to K-ras mutated PDA cases. The Val/Val genotype was over five times more frequent in PDA cases with a K-ras mutation than in wild-type cases (OR = 5.25; P = 0.121). In PDA, polymorphisms in CYP1B1 might be related with K-ras activation pathways.
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Affiliation(s)
- Marta Crous-Bou
- Institut Municipal d'Investigació Mèdica (IMIM), CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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Porta M, Puigdomènech E, Ballester F, Selva J, Ribas-Fitó N, Llop S, López T. Monitoring concentrations of persistent organic pollutants in the general population: the international experience. Environ Int 2008; 34:546-561. [PMID: 18054079 DOI: 10.1016/j.envint.2007.10.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2007] [Revised: 10/05/2007] [Accepted: 10/15/2007] [Indexed: 05/25/2023]
Abstract
Assessing the adverse effects on human health of persistent organic pollutants (POPs) and the impact of policies aiming to reduce human exposure to POPs warrants monitoring body concentrations of POPs in representative samples of subjects. While numerous ad hoc studies are being conducted to understand POPs effects, only a few countries are conducting nationwide surveillance programs of human concentrations of POPs, and even less countries do so in representative samples of the general population. We tried to identify all studies worldwide that analyzed the distribution of concentrations of POPs in a representative sample of the general population, and we synthesized the studies' main characteristics, as design, population, and chemicals analyzed. The most comprehensive studies are the National Reports on Human Exposure to Environmental Chemicals (USA), the German Environmental Survey, and the Arctic Monitoring and Assessment Programme. Population-wide studies exist as well in New Zealand, Australia, Japan, Flanders (Belgium) and the Canary Islands (Spain). Most such studies are linked with health surveys, which is a highly-relevant additional strength. Only the German and Flemish studies analyzed POPs by educational level, while studies in the USA offer results by ethnic group. The full distribution of POPs concentrations is unknown in many countries. Knowledge gaps include also the interplay of age, gender, period and cohort effects on the prevalence of exposures observed by cross-sectional surveys. Local and global efforts to minimize POPs contamination, like the Stockholm convention, warrant nationwide monitoring of concentrations of POPs in representative samples of the general population. Results of this review show how such studies may be developed and used.
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Affiliation(s)
- Miquel Porta
- Institut Municipal d'Investigació Mèdica, Barcelona, Spain.
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Pérez-Cadahía B, Laffon B, Porta M, Lafuente A, Cabaleiro T, López T, Caride A, Pumarega J, Romero A, Pásaro E, Méndez J. Relationship between blood concentrations of heavy metals and cytogenetic and endocrine parameters among subjects involved in cleaning coastal areas affected by the 'Prestige' tanker oil spill. Chemosphere 2008; 71:447-455. [PMID: 18221981 DOI: 10.1016/j.chemosphere.2007.10.053] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2007] [Revised: 10/18/2007] [Accepted: 10/28/2007] [Indexed: 05/25/2023]
Abstract
The sinking of the 'Prestige' oil tanker in front of the Galician coast (NW of Spain) in November 2002 offered a unique opportunity to analyze intermediate cytogenetic and endocrine effects among people exposed to the complex mixture of substances that oil constitutes, including several toxic heavy metals. In this work we evaluated the relationship between exposure to heavy metals (blood concentrations of aluminium, cadmium, nickel, lead and zinc) and genotoxic parameters (sister chromatid exchanges, micronucleus test and comet assay) or endocrine parameters (plasmatic concentrations of prolactin and cortisol) in subjects exposed to 'Prestige' oil during cleaning tasks developed after the spillage. Concentrations of lead were significantly related to the comet assay even after adjusting by age, sex and smoking. Cortisol concentrations were significantly influenced by aluminium, nickel (both, inversely) and cadmium (positively). Women had clearly higher concentrations of prolactin and cortisol, even when adjusting by age, smoking, cadmium, aluminium or nickel. Plasmatic cortisol was jointly influenced by gender, smoking and aluminium or nickel (all p<0.05). In women there was a strong relationship between concentrations of cadmium and prolactin (beta=0.37, p=0.031). When the effects of cadmium, aluminium and nickel on cortisol were simultaneously assessed, only the latter two metals remained statistically significant. Among parameters analysed, cortisol appeared to be the most sensitive to the effects of metal exposure. Plasma levels of cortisol deserve further evaluation as a potentially relevant biomarker to assess the effects of exposure to heavy metals.
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Affiliation(s)
- Beatriz Pérez-Cadahía
- Toxicology Unit, University of A Coruña, Edificio de Servicios Centrales de Investigación, Campus Elviña s/n, E-15071 A Coruña, Spain
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Lemus MA, López T, Recillas S, Frías D, Montes M, Delgado J, Centeno M, Odriozola J. Photocatalytic degradation of 2,4-dichlorophenoxyacetic acid using nanocrystalline cryptomelane composite catalysts. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.molcata.2007.10.037] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Magaña S, Quintana P, Aguilar D, Toledo J, Ángeles-Chávez C, Cortés M, León L, Freile-Pelegrín Y, López T, Sánchez RT. Antibacterial activity of montmorillonites modified with silver. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.molcata.2007.10.024] [Citation(s) in RCA: 200] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Porta M, Grimalt JO, Jariod M, Ruiz L, Marco E, López T, Malats N, Puigdomènech E, Zumeta E. The influence of lipid and lifestyle factors upon correlations between highly prevalent organochlorine compounds in patients with exocrine pancreatic cancer. Environ Int 2007; 33:946-54. [PMID: 17574674 DOI: 10.1016/j.envint.2007.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2007] [Revised: 04/22/2007] [Accepted: 05/14/2007] [Indexed: 05/15/2023]
Abstract
We aimed to analyse the influence of cholesterol and triglycerides, and of tobacco, coffee and alcohol consumption upon correlations between serum concentrations of organochlorine compounds (OCs) in patients with exocrine pancreatic cancer (EPC). Incident cases of EPC diagnosed in eastern Spain were prospectively identified (N=144). OCs were analysed by high-resolution gas chromatography with electron-capture detection. A strong correlation was observed between hexachlorobenzene (HCB) and beta-hexachlorocyclohexane (beta-HCH) (Spearman's rho=0.758). beta-HCH showed rho>0.4 with p,p'-DDT, p,p'-DDE, PCB138 and PCB153 (all p<0.001). Some correlations among compounds were slightly affected by tobacco, coffee or alcohol consumption. We observed a striking diversity of correlation patterns by strata of cholesterol and triglycerides. Most correlations were higher in the lowest category of triglycerides than in the lowest category of cholesterol. Most coefficients above 0.7 were seen in the lowest category of triglycerides (e.g., OC pairs p,p'-DDT and HCB, p,p'-DDT and beta-HCH, p,p'-DDE and beta-HCH, or HCB and beta-HCH). Correlations among OCs may be stronger when concentrations of triglycerides are low than when they are high. This is compatible with a dilution in the early phases of cancer and with a concentration effect as triglycerides become lower in the advanced phases of the disease.
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Affiliation(s)
- Miquel Porta
- Institut Municipal d'Investigació Mèdica, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Sobrino S, Garrido A, López T, Santa-Cruz T, Belda O, Márquez JL. [Upper esophageal hemangioma successfully treated by laser]. Rev Esp Enferm Dig 2007; 99:552-553. [PMID: 18052652 DOI: 10.4321/s1130-01082007000900013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Crous-Bou M, Porta M, López T, Jariod M, Malats N, Alguacil J, Morales E, Fernandez E, Corominas JM, Carrato A, Guarner L, Real FX. Lifetime history of tobacco consumption and K-ras mutations in exocrine pancreatic cancer. Pancreas 2007; 35:135-41. [PMID: 17632319 DOI: 10.1097/mpa.0b013e31805d8fa4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES We analyzed the relation between mutations in codon 12 of the K-ras oncogene and lifetime consumption of tobacco in patients with exocrine pancreatic cancer (EPC). METHODS Incident cases of EPC were prospectively identified and interviewed during hospital admission about smoking and other factors. Exact logistic regression was used to compare EPC cases (N = 107) with and without K-ras mutations (case-case study). RESULTS Mutated cases were nonsignificantly less likely to have been smokers than wild-type cases: the odds ratio adjusted by age and sex was 0.54 (95% confidence interval, 0.10-2.69; P = 0.613). With respect to never smokers, adjusted odds ratios for former and current smokers were 0.79 and 0.36, respectively (P = 0.193). Pack-years smoked, years of smoking, and cigarettes smoked per year also tended to be higher in nonmutated than in mutated cases. Neither age at onset of smoking nor the time between quitting and diagnosis were associated with K-ras. CONCLUSIONS Tobacco does not play a major part in the acquisition of K-ras mutations in the pancreatic epithelium. Although both smoking and K-ras mutations have important roles in the etiopathogenesis of EPC, the 2 processes may act independently.
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Porta M, Pumarega J, Ferrer-Armengou O, López T, Alguacil J, Malats N, Fernàndez E. Timing of blood extraction in epidemiologic and proteomic studies: results and proposals from the PANKRAS II Study. Eur J Epidemiol 2007; 22:577-88. [PMID: 17636417 DOI: 10.1007/s10654-007-9149-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2007] [Accepted: 05/29/2007] [Indexed: 12/22/2022]
Abstract
There are no consensus guidelines or standards for epidemiologic and '-omics' studies using blood biomarkers on how to report the timing of extraction of blood samples. However, disease-induced changes in blood concentrations of exogenous and endogenous compounds may bias studies. The aim of the present report is to describe the timing of blood collection with respect to a variety of relevant clinical events in the PANKRAS II Study, and to suggest ways to display graphically the quantitative information. Subjects were 167 incident cases of exocrine pancreatic cancer prospectively recruited in five teaching hospitals in eastern Spain. Over 80% of patients had blood extracted during the first 6 months since onset of cancer symptoms, and 82% within the first month of admission to a study hospital. Over 80% of cases had blood drawn after an ultrasound, a CT scan or an ERCP, 25% after a laparotomy, and 37% after treatment onset. All three intervals from blood extraction to diagnosis, to treatment onset and to interview had a median of 0 days, and 88% of cases had blood drawn within 2 weeks of diagnosis. Over 72% of cases had concentrations of total lipids in the medium, normal range. Results suggest ways to report intervals involving blood biomarkers and may contribute to develop consensus guidelines and standards on the collection of blood samples in epidemiologic and '-omics' research.
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Affiliation(s)
- Miquel Porta
- Clinical & Molecular Epidemiology of Cancer Unit, Institut Municipal d'Investigació Mèdica, Universitat Autònoma de Barcelona, Carrer del Dr. Aiguader 88, 08003 Barcelona, Catalonia, Spain.
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Bouza C, López T, Palma M, Amate JM. Hospitalised osteoporotic vertebral fractures in Spain: analysis of the national hospital discharge registry. Osteoporos Int 2007; 18:649-57. [PMID: 17221295 DOI: 10.1007/s00198-006-0292-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2006] [Accepted: 11/03/2006] [Indexed: 10/23/2022]
Abstract
UNLABELLED This population-based study reveals clinical and epidemiologic characteristics of hospitalised osteoporosis-related vertebral fractures and indicates an association with a substantial hospital burden in Spain. These data provide a basis for assessing the impact of these fractures on the Spanish health-care system and to estimate future care requirements. INTRODUCTION Vertebral fractures (VF) are recognised as the most frequent complication of osteoporosis. Our objective was to determine the clinico-epidemiological characteristics and health-care burden of hospitalised VF in Spain. METHOD From the 2002 National Hospital Discharge Register, records for all osteoporosis-related VF in the Spanish population aged >or=30 years and over were retrieved. Diagnostic categories included the ICD-9-CM codes 805 and 733.xx. Population data were drawn from the National Statistics Institute. RESULTS In total, 7,100 records were eligible for analysis. According to Deyo-adapted Charlson index, 62% of cases had no associated comorbidity. VF were the cause of hospitalisation in 52% of cases. Overall in-hospital mortality was 3.5%. Men had higher adjusted mortality than women. Mean hospital stay was 11.4+/-0.2 days. Identified cases amounted to a hospitalisation rate of 2.76 cases per 10,000 population aged >or=30 years. Direct inpatient hospital costs exceeded 41 million euros and accounted for 0.078% of Spanish expenditure on hospitalisations and specialised care in 2002. CONCLUSIONS The national discharge database reveals epidemiological features of hospitalised osteoporosis-attributable VF and indicates an association with a substantial hospital burden in Spain. Our data provide a basis for assessing the impact of these fractures on the Spanish health-care system and to estimate future care requirements.
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Affiliation(s)
- C Bouza
- Agency for Health Technology Assessment, Ministry of Health and Consumer Affairs, Madrid, Spain.
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Esteve V, Ribera L, Ponz E, Almirall J, López T, Martínez Ocaña JC, Ibeas J, Rodríguez Jornet A, Andreu X, García M. [Secondary amyloidosis (AA-type) due to localized cutaneous vasculitis]. Nefrologia 2007; 27:634-638. [PMID: 18045042] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
We report a case of a 49 year old man, diagnosed soon after the outcome of casual proteinuria, of AA-type amyloidosis in relation to small and medium vessel cutaneous vasculitis without systemic involvement. This combination is a rare entity and only two cases of cutaneous hypersensibility vasculitis complicated with AA-type amyloidosis had been reported. We describe the results of the use of several immunosuppressive drugs during four years follow up with temporally total remission of the disease.
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Affiliation(s)
- V Esteve
- Servicio de Nefrología, Corporación Sanitaria Parc Taulí, Institut Universitari Parc Taulí (UAB), Sabadell.
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