1
|
Oliveira M, Falato C, Cejalvo JM, Vila MM, Tolosa P, Salvador-Bofill FJ, Cruz J, Arumi M, Luna AM, Guerra JA, Vidal M, Martínez-Sáez O, Paré L, González-Farré B, Sanfeliu E, Ciruelos E, Espinosa-Bravo M, Pernas S, Izarzugaza Y, Esker S, Fan PD, Parul P, Santhanagopal A, Sellami D, Villacampa G, Ferrero-Cafiero JM, Pascual T, Prat A. Patritumab Deruxtecan in Untreated Hormone Receptor-Positive/HER2-Negative Early Breast Cancer: Final Results from Part A of the Window-of-Opportunity SOLTI TOT-HER3 Pre-Operative Study. Ann Oncol 2023:S0923-7534(23)00685-3. [PMID: 37211044 DOI: 10.1016/j.annonc.2023.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/27/2023] [Accepted: 05/07/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Patritumab deruxtecan (HER3-DXd) is a HER3-directed antibody-drug conjugate composed of a fully human anti-HER3 monoclonal antibody (patritumab) covalently linked to a topoisomerase I inhibitor payload via a stable, tumor-selective, tetrapeptide-based cleavable linker. TOT-HER3 is a window-of-opportunity study designed to assess the biological activity, measured by CelTIL score [ = -.8 × tumor cellularity (in %) + 1.3 × TILs (in %)], and clinical activity of HER3-DXd during short-term (21 days) pre-operative treatment in patients with primary operable HER2-negative early breast cancer. PATIENTS AND METHODS Patients with previously untreated hormone receptor (HR)-positive/HER2-negative tumors were allocated to one of four cohorts according to baseline ERBB3 mRNA expression. All patients received one dose of HER3-DXd 6.4 mg/kg. The primary objective was to evaluate change from baseline in CelTIL score. RESULTS Seventy-seven patients were evaluated for efficacy. A significant change in CelTIL score was observed, with a median increase from baseline of 3.5 (interquartile range, -3.8 to 12.7; P=.003). Among patients evaluable for clinical response (n=62), an overall response rate of 45% was observed (tumor measurement by caliper), with a trend toward an increase in CelTIL score among responders compared with non-responders (mean difference, +11.9 vs +1.9). Change in CelTIL score was independent of baseline ERBB3 mRNA and HER3 protein levels. Genomic changes occurred, including switching toward a less proliferative tumor phenotype based on PAM50 subtypes, suppression of cell proliferation genes, and induction of genes associated with immunity. Treatment-emergent adverse events were observed in 96% of patients (14% grade ≥3); most common were nausea, fatigue, alopecia, diarrhea, vomiting, abdominal pain, and neutrophil count decrease. CONCLUSIONS A single dose of HER3-DXd was associated with clinical response, increased immune infiltration, suppression of proliferation in HR-positive/HER2-negative early breast cancer, and a tolerable safety profile consistent with previously reported results. These findings support further study of HER3-DXd in early breast cancer.
Collapse
Affiliation(s)
- M Oliveira
- Medical Oncology Department, Vall d'Hebron University Hospital, and Breast Cancer Group, Vall D'Hebron Institute of Oncology (VHIO), Barcelona, Spain;; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - C Falato
- SOLTI Breast Cancer Research Group, August Pi Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain, and Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden
| | - J M Cejalvo
- SOLTI Breast Cancer Research Group, Department of Medical Oncology, Hospital Clinico Universitario de Valencia, Valencia, Spain
| | - M Margelí Vila
- SOLTI Breast Cancer Research Group, Medical Oncology Department, ICO - Institut Català d'Oncologia Badalona (Hospital Universitario Germans Trias i Pujol), Badalona, Spain
| | - P Tolosa
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital 12 de Octubre, Madrid, Spain
| | - F J Salvador-Bofill
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - J Cruz
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - M Arumi
- Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - A M Luna
- Centro Integral Oncológico Clara Campal HM (CIOCC), Madrid, Spain
| | - J A Guerra
- Medical Oncology Department, Hospital de Fuenlabrada, Fuenlabrada, Spain
| | - M Vidal
- Medical Oncology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - O Martínez-Sáez
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapies in Solid Tumors, August Pi Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - L Paré
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - B González-Farré
- SOLTI Breast Cancer Research Group, Pathology Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - E Sanfeliu
- SOLTI Breast Cancer Research Group, Pathology Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - E Ciruelos
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital 12 de Octubre, Centro Integral Oncológico Clara Campal HM (CIOCC), Madrid, Spain
| | - M Espinosa-Bravo
- SOLTI Breast Cancer Research Group, Breast Cancer Surgical Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | - S Pernas
- SOLTI Breast Cancer Research Group, Department of Medical Oncology, Catalan Institute of Oncology - ICO, Breast Cancer Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Y Izarzugaza
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Fundación Jimenez Díaz, Madrid, Spain
| | - S Esker
- Research and Development, Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - P-D Fan
- Research and Development, Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - P Parul
- Research and Development, Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - A Santhanagopal
- Research and Development, Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - D Sellami
- Research and Development, Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - G Villacampa
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | | | - T Pascual
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapies in Solid Tumors, August Pi Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - A Prat
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapies in Solid Tumors, August Pi Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain;.
| |
Collapse
|
2
|
Teixeira C, Santos S, Guerra J, Barros H. Maternal care experience and postpartum depressive symptoms among migrant and native in Portugal. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Migration is a risk factor for both, poor maternal experience with healthcare services (MEHCS) and postpartum depressive symptoms (PPDS), a matter of concern due to their adverse consequences. We aimed to assess the association between MEHCS and PPDS taking into account the migration status.
Methods
This is part of a population-based study (baMBINO project), enrolling native (PT; n = 1568), permanent migrant (PM; n = 676) and temporary migrant (TM; n = 757) women recruited at delivery (2017-2019) in 32 Portuguese public hospitals. MEHCS was assessed based on 39 items of the Migrant Friendly Maternal Care Questionnaire asking about how women have experienced maternal care during pregnancy, during delivery and after birth. Items were grouped into 9 components each one assessing a different issue of MEHCS. For each component women were classified as having “good” or “less than good” experience. PPDS were assessed using the Edinburgh Postnatal Depression Scale (cut-off≥12). Multivariate logistic regression model was fitted to estimate the association between MEHCS and PPDS. Adjusted odds ratio (aOR) and respective 95% confidence interval were obtained.
Results
PPDS were reported by 3.8%, 5.8% and 8.2% of PT, PM and TM women, respectively (p < 0.001). After adjustment, 4 out 9 components of MEHCS appeared related with PPDS, such that women reporting less than good experience with “understanding information” (aOR=1.72 95%CI:1.14-2.60), “decisions according to maternal wishes” (aOR=1.56 95% CI:1.04-2.34), “time waiting for healthcare” (aOR=1.50 95%CI:1.04-2.18) and “healthcare provider's attitudes during pregnancy” (aOR=1.58 95%CI:1.01-2.47) showed higher odds of PPDS than women reporting good experience.
Conclusions
Further than the migration status, poor experience with some issues of maternal care seems play a role in the risk of PPDS
Key messages
Collapse
Affiliation(s)
- C Teixeira
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto , Porto, Portugal
- Escola Superior de Saúde, Instituto Politécnico de Bragança , Bragança, Portugal
| | - S Santos
- Departamento de Psiquiatria, Centro Hospitalar Universitário do Porto , Porto, Portugal
| | - J Guerra
- Departamento de Psiquiatria, Centro Hospitalar Universitário do Porto , Porto, Portugal
| | - H Barros
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto , Porto, Portugal
- Ciências de Saúde Publica e Forenses, Faculdade de Medicina, Universidade do Porto , Porto, Portugal
| |
Collapse
|
3
|
Mendes Andrade V, Silva P, Cunha J, Gil M, Guerra J, Medeiros M, Guimarães T, Calais F, Severo L, Campos Pinheiro L. Peyronie’s disease: Differences in male and female personal experience. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02058-4] [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: 11/05/2022] Open
|
4
|
Mendes Andrade V, Guimarães T, Medeiros M, Guerra J, Gil M, Cunha J, Silva P, Pina J, Campos Pinheiro L. Will be the systematic biopsy useful when added to the MRI/TRUS fusion biopsy? EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00665-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
5
|
Guimaraes T, Medeiros M, Andrade V, Guerra J, Gil M, Bernardino R, Pinheiro H, Pina J, Campos Pinheiro L. Kidney retained fragmented double J stent - a challenging problem for urologist with potential medico-legal serious implication. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00093-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
6
|
MARQUES F, Costa C, Gameiro J, Melo M, Gonçalves S, Santana A, Guerra J, Lopes J. POS-779 AGE OF LIVING KIDNEY DONORS: DOES IT MATTER? Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
7
|
Magalhães L, Silveira H, Prestes S, Costa Magalhães LK, Santana RA, Ramasawmy R, Oliveira J, Roque CCR, Silva Junior RCA, Fé N, Duarte R, Maciel M, Ortiz J, Morais R, Monteiro WM, Guerra JA, Barbosa Guerra MGV. Bioecological aspects of triatomines and marsupials as wild Trypanosoma cruzi reservoirs in urban, peri-urban and rural areas in the Western Brazilian Amazon. Med Vet Entomol 2021; 35:389-399. [PMID: 33394514 DOI: 10.1111/mve.12507] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 06/12/2023]
Abstract
In the Amazon region, Trypanosoma cruzi transmission cycles involve a great diversity of Triatominae vectors and mammal reservoirs. Some Rhodnius spp. mainly inhabit palm trees that act as microhabitats for hosts and vectors. The current study aimed to describe aspects of the bio-ecology of the vectors and reservoirs of T. cruzi in relation to human populations resident near areas with large quantities of palm trees, in rural, peri-urban and urban collection environments, located in the Western Brazilian Amazon. Rhodnius pictipes and Didelphis marsupialis were respectively the most predominant vector and reservoir, with rates of 71% for R. pictipes and 96.5% for D. marsupialis. The vast majority of T. cruzi isolates clustered with TcI. The most prevalent haplotype was TcI COII1 (69.7%). Mauritia flexuosa and Attalea phalerata were the main ecological indicators of infestation by triatomines. Birds were the most common food source (27,71%). T. cruzi isolated from R. robustus has the haplotype HUM-13, previously detected in a chronic Chagas patient living in the same area. Our results demonstrate the relevance of this study, with the occurrence of elevated infection rates in animals, and suggest the importance of the Amazon zones where there is a risk of infection in humans.
Collapse
Affiliation(s)
- L Magalhães
- Programa de Pós-graduação em Medicina Tropical, Unversidade do Estado do Amazonas, Amazonas, Brasil
| | - H Silveira
- Programa de Pós-graduação em Medicina Tropical, Unversidade do Estado do Amazonas, Amazonas, Brasil
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisboa, Portugal
| | - S Prestes
- Programa de Pós-graduação em Medicina Tropical, Unversidade do Estado do Amazonas, Amazonas, Brasil
| | - L K Costa Magalhães
- Programa de Pós-graduação em Medicina Tropical, Unversidade do Estado do Amazonas, Amazonas, Brasil
| | - R A Santana
- Programa de Pós-graduação em Medicina Tropical, Unversidade do Estado do Amazonas, Amazonas, Brasil
| | - R Ramasawmy
- Programa de Pós-graduação em Medicina Tropical, Unversidade do Estado do Amazonas, Amazonas, Brasil
| | - J Oliveira
- Fundação de Medicina Tropical - Heitor Vieira Dourado, Amazonas, Brasil
| | - C C R Roque
- Fundação de Medicina Tropical - Heitor Vieira Dourado, Amazonas, Brasil
| | | | - N Fé
- Fundação de Medicina Tropical - Heitor Vieira Dourado, Amazonas, Brasil
| | - R Duarte
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública (ENSP), Rio de Janeiro, Brasil
| | - M Maciel
- Programa de Pós-graduação em Medicina Tropical, Unversidade do Estado do Amazonas, Amazonas, Brasil
| | - J Ortiz
- Programa de Pós-graduação em Medicina Tropical, Unversidade do Estado do Amazonas, Amazonas, Brasil
| | - R Morais
- Programa de Pós-graduação em Medicina Tropical, Unversidade do Estado do Amazonas, Amazonas, Brasil
| | - W M Monteiro
- Programa de Pós-graduação em Medicina Tropical, Unversidade do Estado do Amazonas, Amazonas, Brasil
- Fundação de Medicina Tropical - Heitor Vieira Dourado, Amazonas, Brasil
| | - J A Guerra
- Programa de Pós-graduação em Medicina Tropical, Unversidade do Estado do Amazonas, Amazonas, Brasil
- Fundação de Medicina Tropical - Heitor Vieira Dourado, Amazonas, Brasil
| | - M G V Barbosa Guerra
- Programa de Pós-graduação em Medicina Tropical, Unversidade do Estado do Amazonas, Amazonas, Brasil
- Fundação de Medicina Tropical - Heitor Vieira Dourado, Amazonas, Brasil
| |
Collapse
|
8
|
Canario R, Peixoto A, Pinto P, Guerra J, Barbosa A, Bartosch C, Teixeira M, Paredes J. 768P P-cadherin prognostic significance in high-grade serous ovarian cancer wildtype for BRCA1/2. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
9
|
Abstract
Introduction In palliative care, depression and pain are prevalent variables with a reciprocal and controversial relationship. Depression is common in people with chronical diseases. In the last decades, self-compassion has been pointed as a protective psychological process to negative affect. Objectives The current study aimed to test the role of self-compassion in the relationship between pain and depression in palliative patients. Methods Sample was composed of 33 patients in palliative care, with a mean of 74.12 years of age (SD = 12.76). Participants completed self-report questionnaires and data was analyzed using SPSS. Results From the descriptive analysis of the results of the Geriatric Depression Scale, 22 patients were depressed (66.6%), 9 of them in severe depression (27.7%). Self-compassion presented a negative and moderate correlation with depression. Depression was positively correlated with pain. A hierarchical regression to predict depression was conducted. Firstly, pain was entered as a predictive variable with a significant effect. Secondly, self-compassion was entered, and the model was significantly incremented, explaining 41% of depression. Only self-compassion was significant in this model. Conclusions Discussion and conclusion: The association between pain and depression in palliative care corroborate previous research. Results seemed to show that self-compassion has a significant effect in the relationship between pain and depression. Cultivating a compassion self-to-self relationship might have an important effect attenuating the link between pain and depression in palliative care.
Collapse
|
10
|
Lee DJ, Repole T, Taussig E, Edwards S, Misegades J, Guerra J, Lisle A. Self-Management in Persons with Limb Loss: A Systematic Review. Can Prosthet Orthot J 2021; 4:35098. [PMID: 37614928 PMCID: PMC10443519 DOI: 10.33137/cpoj.v4i1.35098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/24/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Self-management is an integral component of managing long-term conditions and diseases. For a person with limb loss, this self-management process involves caring for the residual limb, the prosthesis, and the prosthetic socket-residual limb interface. Failure to properly self-manage can result in unwanted secondary complications such as skin breakdown, falls, or non-use of the prosthesis. However, there is little evidence on what self-management interventions are effective at preventing secondary complications. To understand the impact of self-management after the loss of a limb, it is necessary to determine what the current evidence base supports. OBJECTIVES The purpose of this study is to examine the available literature on self-management interventions and/or outcomes for persons with limb loss and describe how it may impact residual limb health or prosthesis use. METHODOLOGY A systematic review of multiple databases was carried out using a variety of search terms associated with self-management. The results were reviewed and selected based on the inclusion criteria: self-management interventions or direct outcomes related to self-management, which includes the skin integrity of the residual limb, problem-solving the fit of the prosthesis, and education in the prevention of secondary complications associated with prosthesis use. The Cincinnati Childrens' LEGEND (Let Evidence Guide Every New Decision) appraisal forms were used to analyze the articles and assign grades. FINDINGS Out of the 40 articles identified for possible inclusion in this study, 33 were excluded resulting in seven articles being selected for this review. Three out of the seven articles focused on silicone liner management while the other four articles focused on skin issues. CONCLUSIONS Self-management for a person with limb loss is a key component of preventing complications associated with loss of limb and prosthesis use. There is a lack of high-quality experimental studies exploring the most appropriate intervention for teaching self-management when compared to other conditions, specifically diabetes. Further research in the area of self-management is necessary to understand how to best prevent unwanted secondary complications.
Collapse
Affiliation(s)
- DJ Lee
- *CORRESPONDING AUTHOR Daniel J. Lee, PT, PhD, DPT, GCS, COMT Touro College, Department of Physical Therapy, Bayshore, NY USA.Email:
| | | | | | | | | | | | | |
Collapse
|
11
|
Apaza Ticona L, Bermejo P, Guerra JA, Abad MJ, Beltrán M, Martín Lázaro R, Alcamí J, Bedoya LM. Ethanolic extract of Artemisia campestris subsp. glutinosa (Besser) Batt. inhibits HIV-1 replication in vitro through the activity of terpenes and flavonoids on viral entry and NF-κB pathway. J Ethnopharmacol 2020; 263:113163. [PMID: 32758575 PMCID: PMC7397943 DOI: 10.1016/j.jep.2020.113163] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/26/2020] [Accepted: 07/06/2020] [Indexed: 05/17/2023]
Abstract
ETHNO-PHARMACOLOGICAL RELEVANCE The genus Artemisia spp. is well known for its anti-infectious properties and its high content in anti-infectious compounds, like the well-known sweet wormwood (Artemisia annua L.). Another Artemisia species, Artemisia campestris subsp. glutinosa (Besser) Batt., field wormwood, has been traditionally used as medicinal plant in the Mediterranean region. AIM OF THE STUDY The aim of this study is to investigate the anti-HIV activity of field wormwood, to identify the compounds responsible for this activity and their structure and mechanism of action. MATERIALS AND METHODS Antiviral activity of isolated compounds and extracts was evaluated in HIV-1 infections of lymphoblastoid cells. We also evaluated the mechanism of action of isolated compounds. Viral entry was studied comparing the inhibitory effect of isolated compounds on wild type HIV-1 and VSV pseudotyped HIV-1. To assess the viral transcriptional effect, plasmids encoding luciferase reporter genes under the control of the whole genome of HIV-1 or NF-κB or Sp1 transcription factors were transfected in the presence of the compounds under evaluation. Finally, antioxidant activity was assessed by quantitation of reduced and total glutathione in treated cell cultures. RESULTS Ethanolic and aqueous extracts of Artemisia campestris subsp. glutinosa (Besser) Batt. subsp. glutinosa displayed anti-HIV activity in vitro, although ethanolic extract was more powerful (IC50 14.62 μg/mL). Bio-guided ethanolic extract fractionation leads to the isolation and characterization of two terpenes, damsin and canrenone, and four flavonoids, 6, 2', 4'-trimethoxyflavone, acerosin, cardamonin and xanthomicrol. All the isolated compounds inhibited HIV-1 replication in vitro with IC50 values between the middle nanomolar and the low micromolar range. Their anti-HIV mechanism of action is due to the bloking of viral entry and/or transcription inhibition, without correlation with the antioxidant activity, through interference with the cellular transcription factors NF-κB and Sp1, which are targets that are not currently reached by antiretroviral therapy. CONCLUSION We describe here the anti-HIV activity of field wormwood, Artemisia campestris subsp. glutinosa (Besser) Batt., and the isolation and study of the mechanism of action of two terpenes and four flavonoids, responsible, at least in part, for its activity, through the inhibition of two different cellular targets affecting the HIV replication cycle. The activity of these compounds in cellular targets could explain why plant extracts can be used in the treatment of different diseases. Besides, the presence of several compounds with dual and different mechanisms of action could prove useful in the treatment of HIV-1 infection, since it could aid to overcome drug resistances and simplify drug therapy. This work is a further step in understanding the anti-infectious activity of wormwood species and their use in treating infectious diseases.
Collapse
Affiliation(s)
- L Apaza Ticona
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Universidad Complutense de Madrid, Plza. Ramón y Cajal S/n, 28040, Madrid, Spain; Department of Organic Chemistry, Faculty of Sciences, Universidad Autónoma de Madrid, Cantoblanco, 28049, Madrid, Spain.
| | - P Bermejo
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Universidad Complutense de Madrid, Plza. Ramón y Cajal S/n, 28040, Madrid, Spain.
| | - J A Guerra
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Universidad Complutense de Madrid, Plza. Ramón y Cajal S/n, 28040, Madrid, Spain.
| | - M J Abad
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Universidad Complutense de Madrid, Plza. Ramón y Cajal S/n, 28040, Madrid, Spain.
| | - M Beltrán
- AIDS Immunopathology Department, National Centre of Microbiology, Instituto de Salud Carlos III, Ctra. Pozuelo Km. 2, 28224, Madrid, Spain.
| | - R Martín Lázaro
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Universidad Complutense de Madrid, Plza. Ramón y Cajal S/n, 28040, Madrid, Spain.
| | - J Alcamí
- AIDS Immunopathology Department, National Centre of Microbiology, Instituto de Salud Carlos III, Ctra. Pozuelo Km. 2, 28224, Madrid, Spain.
| | - L M Bedoya
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Universidad Complutense de Madrid, Plza. Ramón y Cajal S/n, 28040, Madrid, Spain; AIDS Immunopathology Department, National Centre of Microbiology, Instituto de Salud Carlos III, Ctra. Pozuelo Km. 2, 28224, Madrid, Spain.
| |
Collapse
|
12
|
Guerra J, Smith L, Vicinanza D, Stubbs B, Veronese N, Williams G. The use of sonification for physiotherapy in human movement tasks: A scoping review. Sci Sports 2020. [DOI: 10.1016/j.scispo.2019.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
13
|
Teixeira P, Oliveira P, Guerra J, Hamerschlak N, Colombini M, Kalil R. Factor X deficiency and pregnancy: case report and counselling. Haemophilia 2020; 26:e148-e150. [PMID: 32458586 DOI: 10.1111/hae.12506] [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] [Accepted: 05/05/2014] [Indexed: 11/29/2022]
Affiliation(s)
- P Teixeira
- Hematology Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - P Oliveira
- Hematology Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - J Guerra
- Hematology Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - N Hamerschlak
- Hematology Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - M Colombini
- Hematology Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - R Kalil
- Hematology Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| |
Collapse
|
14
|
Guerra J, Valadao AL, Vlachakis D, Polak K, Vila IK, Taffoni C, Prabakaran T, Marriott AS, Kaczmarek R, Houel A, Auzemery B, Déjardin S, Boudinot P, Nawrot B, Jones NJ, Paludan SR, Kossida S, Langevin C, Laguette N. Lysyl-tRNA synthetase produces diadenosine tetraphosphate to curb STING-dependent inflammation. Sci Adv 2020; 6:eaax3333. [PMID: 32494729 PMCID: PMC7244319 DOI: 10.1126/sciadv.aax3333] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 03/11/2020] [Indexed: 05/03/2023]
Abstract
Inflammation is an essential part of immunity against pathogens and tumors but can promote disease if not tightly regulated. Self and non-self-nucleic acids can trigger inflammation, through recognition by the cyclic GMP-AMP (cGAMP) synthetase (cGAS) and subsequent activation of the stimulator of interferon genes (STING) protein. Here, we show that RNA:DNA hybrids can be detected by cGAS and that the Lysyl-tRNA synthetase (LysRS) inhibits STING activation through two complementary mechanisms. First, LysRS interacts with RNA:DNA hybrids, delaying recognition by cGAS and impeding cGAMP production. Second, RNA:DNA hybrids stimulate LysRS-dependent production of diadenosine tetraphosphate (Ap4A) that in turn attenuates STING-dependent signaling. We propose a model whereby these mechanisms cooperate to buffer STING activation. Consequently, modulation of the LysRS-Ap4A axis in vitro or in vivo interferes with inflammatory responses. Thus, altogether, we establish LysRS and Ap4A as pharmacological targets to control STING signaling and treat inflammatory diseases.
Collapse
Affiliation(s)
- J. Guerra
- Institut de Génétique Humaine, CNRS, Université de Montpellier, Molecular Basis of Inflammation Laboratory, Montpellier, France
| | - A.-L. Valadao
- Institut de Génétique Humaine, CNRS, Université de Montpellier, Molecular Basis of Inflammation Laboratory, Montpellier, France
| | - D. Vlachakis
- Laboratory of Genetics, Department of Biotechnology, School of Food, Biotechnology and Development, Agricultural University of Athens, Athens, Greece
| | - K. Polak
- Institut de Génétique Humaine, CNRS, Université de Montpellier, Molecular Basis of Inflammation Laboratory, Montpellier, France
| | - I. K. Vila
- Institut de Génétique Humaine, CNRS, Université de Montpellier, Molecular Basis of Inflammation Laboratory, Montpellier, France
| | - C. Taffoni
- Institut de Génétique Humaine, CNRS, Université de Montpellier, Molecular Basis of Inflammation Laboratory, Montpellier, France
| | - T. Prabakaran
- Department of Biomedicine, Aarhus University, 8000 Aarhus C, Denmark
| | - A. S. Marriott
- Department of Biology, Edge Hill University, Ormskirk, L39 4QP, UK
| | - R. Kaczmarek
- Centre of Molecular and Macromolecular Studies, Polish Academy of Sciences, 112 Sienkiewicza Str., 90-363 Lodz, Poland
| | - A. Houel
- Université Paris-Saclay, INRAE, UVSQ, VIM, 78350 Jouy-en-Josas, France
| | - B. Auzemery
- Institut de Génétique Humaine, CNRS, Université de Montpellier, Molecular Basis of Inflammation Laboratory, Montpellier, France
| | - S. Déjardin
- Institut de Génétique Humaine, CNRS, Université de Montpellier, Molecular Basis of Inflammation Laboratory, Montpellier, France
| | - P. Boudinot
- Université Paris-Saclay, INRAE, UVSQ, VIM, 78350 Jouy-en-Josas, France
| | - B. Nawrot
- Centre of Molecular and Macromolecular Studies, Polish Academy of Sciences, 112 Sienkiewicza Str., 90-363 Lodz, Poland
| | - N. J. Jones
- Department of Biochemistry, Institute of Integrative Biology, University of Liverpool, Crown Street, Liverpool, L69 7ZB, UK
| | - S. R. Paludan
- Department of Biomedicine, Aarhus University, 8000 Aarhus C, Denmark
| | - S. Kossida
- Institut de Génétique Humaine, CNRS, Université de Montpellier, IMGT, the International ImMunoGeneTics Information System, Montpellier, France
| | - C. Langevin
- Université Paris-Saclay, INRAE, UVSQ, VIM, 78350 Jouy-en-Josas, France
| | - N. Laguette
- Institut de Génétique Humaine, CNRS, Université de Montpellier, Molecular Basis of Inflammation Laboratory, Montpellier, France
| |
Collapse
|
15
|
Collazos J, de la Fuente B, de la Fuente J, García A, Gómez H, Menéndez C, Enríquez H, Sánchez P, Alonso M, López-Cruz I, Martín-Regidor M, Martínez-Alonso A, Guerra J, Artero A, Blanes M, Asensi V. Factors associated with sepsis development in 606 Spanish adult patients with cellulitis. BMC Infect Dis 2020; 20:211. [PMID: 32164590 PMCID: PMC7066725 DOI: 10.1186/s12879-020-4915-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 02/21/2020] [Indexed: 11/16/2022] Open
Abstract
Background Cellulitis, a frequent cause of admission of adult patients to medical wards, occasionally evolves to sepsis. In this study we analyze the factors related to sepsis development. Methods Prospective and observational study of 606 adult patients with cellulitis admitted to several Spanish hospitals. Comorbidities, microbiological, clinical, lab, diagnostic, and treatment data were analyzed. Sepsis was diagnosed according to the criteria of the 2016 International Sepsis Definitions Conference. Multiple logistic regression modelling was performed to determine the variables independently associated with sepsis development. Results Mean age was 63.4 years and 51.8% were men. Overall 65 (10.7%) patients developed sepsis, 7 (10.8%) of whom died, but only 4 (6.2%) due to cellulitis. Drawing of blood (P < 0.0001) or any (P < 0.0001) culture, and identification of the agent (P = 0.005) were more likely among patients with sepsis. These patients had also a longer duration of symptoms (P = 0.04), higher temperature (P = 0.03), more extensive cellulitis (P = 0.02), higher leukocyte (P < 0.0001) and neutrophil (P < 0.0001) counts, serum creatinine (P = 0.001), and CRP (P = 0.008) than patients without sepsis. Regarding therapy, patients with sepsis were more likely to undergo changes in the initial antimicrobial regimen (P < 0.0001), received more antimicrobials (P < 0.0001), received longer intravenous treatment (P = 0.03), and underwent surgery more commonly (P = 0.01) than patients without sepsis. Leukocyte counts (P = 0.002), serum creatinine (P = 0.003), drawing of blood cultures (P = 0.004), change of the initial antimicrobial regimen (P = 0.007) and length of cellulitis (P = 0.009) were independently associated with sepsis development in the multivariate analysis. Conclusions Increased blood leukocytes and serum creatinine, blood culture drawn, modification of the initial antimicrobial regimen, and maximum length of cellulitis were associated with sepsis in these patients.
Collapse
Affiliation(s)
- J Collazos
- Infectious Diseases Unit, Hospital de Galdácano, Vizcaya, Spain
| | - B de la Fuente
- Infectious Diseases Unit, Hospital de Cabueñes, Gijón, Spain
| | - J de la Fuente
- Internal Medicine Service, Hospital de Povisa, Vigo, Spain
| | - A García
- Infectious Diseases Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - H Gómez
- Infectious Diseases Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - C Menéndez
- Infectious Diseases Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - H Enríquez
- Internal Medicine Service, Hospital de Povisa, Vigo, Spain
| | - P Sánchez
- Internal Medicine Service, Hospital de Povisa, Vigo, Spain
| | - M Alonso
- Internal Medicine Service, Hospital de Povisa, Vigo, Spain
| | - I López-Cruz
- Internal Medicine Service, Hospital Dr Peset, Valencia, Spain
| | - M Martín-Regidor
- Internal Medicine Service, Complejo Hospitalario de León, León, Spain
| | - A Martínez-Alonso
- Internal Medicine Service, Complejo Hospitalario de León, León, Spain
| | - J Guerra
- Internal Medicine Service, Complejo Hospitalario de León, León, Spain
| | - A Artero
- Internal Medicine Service, Hospital Dr Peset, Valencia, Spain
| | - M Blanes
- Infectious Diseases Unit, Hospital La Fe, Valencia, Spain
| | - V Asensi
- Infectious Diseases Unit, Hospital Universitario Central de Asturias, Oviedo, Spain. .,Group of Translational Research in Infectious Diseases, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.
| |
Collapse
|
16
|
Tejada A, Montañez L, Torres C, Llontop P, Flores L, De Zela F, Winnacker A, Guerra JA. Determination of the fundamental absorption and optical bandgap of dielectric thin films from single optical transmittance measurements. Appl Opt 2019; 58:9585-9594. [PMID: 31873557 DOI: 10.1364/ao.58.009585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 10/28/2019] [Indexed: 06/10/2023]
Abstract
In this work, we propose a method to retrieve the thickness and optical constants of dielectric thin films from single optical transmittance measurements. The method is based on the envelope method and requires a simple dispersion model for the real part of the refractive index with few fitting parameters, while the absorption coefficient can be determined without the aid of a dispersion model. The wavelength-dependent optical constants can be obtained even from spectra that exhibit few interference fringes. We have tested the method with simulated and real transmittance data from thin films in the spectral range covering the fundamental absorption. In order to assess the method's reliability to retrieve the optical constants and optical bandgap, a comparison is performed with the method by Chambouleyron, known as the Pointwise Unconstrained Minimization Approach, and a fit using the Cody-Lorentz dispersion model. We evaluate the methods' capability to retrieve the fundamental absorption and optical bandgap, and their compromise with film thickness accuracy. Finally, the methods are tested and contrasted using optical transmittance of three different semiconductor material thin films.
Collapse
|
17
|
Tucto KY, Aponte W, Dulanto JA, Töfflinger JA, Guerra JA, Grieseler R. Combinatorial approach toward optimization of the light emission intensity of AlO xN y:Yb 3+ thin films. Appl Opt 2019; 58:3097-3103. [PMID: 31044783 DOI: 10.1364/ao.58.003097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 03/15/2019] [Indexed: 06/09/2023]
Abstract
To obtain an adequate luminescent emission, a significant effort must be made to find a suitable host material. An interesting and highly efficient method is a combinatorial approach, which allows high velocity screening of a wider range of properties. In the present work, a compositional gradient-based, thin-film library of a-AlOxNy:Yb3+ has been prepared by radio frequency co-sputtering from two targets. The ytterbium concentration range spreads from 0.9 to 4.2 at. % and the oxygen to nitrogen ratio from 0.6 to 3.6. Using different annealing temperatures, the activation energy of the rare earth ions and activation mechanisms can be evaluated. Finally, optimal elemental compositions in the investigated range are proposed.
Collapse
|
18
|
Gameiro J, Jorge S, Neves M, Santana A, Guerra J. High-Urgency Renal Transplantation for Patients With Vascular Access Failure: A Single-Center Experience. Transplant Proc 2019; 51:1571-1574. [PMID: 30833028 DOI: 10.1016/j.transproceed.2019.01.043] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In the face of access failure for renal replacement therapy or severe complications despite or due to dialysis, high-urgency renal transplant (HU-RT) allocation is possible. Vascular access failure patients have multiple comorbidities and a higher risk of cardiovascular and thrombotic events. Thus, it is presumed that graft and patient survivals might be worse for these patients. The aim of this paper was to analyze the characteristics and outcomes of HU-RT patients due to access failure for renal replacement therapy when comparing them to a population of deceased-donor renal transplant (DDRT) patients. We analyzed data from our Renal Transplantation Unit from January 2006 to April 2017. In this period, 374 patients had a renal transplant. Of these, 11 patients received a high-urgency deceased-donor renal transplant (HU-DDRT). Compared with patients who had a DDRT, HU-DDRT patients were predominantly female (54.5% vs 43.5%, P = .007) and younger (41.6 ± 7.9 vs 49.4 ± 11.8, P = .031). HU-DDRT patients were not significantly more sensitized than DDRT (14.1 ± 27.4 vs 13.5 ± 24.1, P = .935), and had a comparable number of HLA mismatches (3.4 ± 1.4 vs 3.6 ± 1.2, P = .343). Despite the higher incidence in hypertensive (90.9 vs 73.5%, P = .196) and diabetic patients (27.3% vs 15.7%, P = .305) in the HU-DDRT group, this difference was not statistically significant. The percentage of retransplantation was similar in both groups (9.1% vs 7.2%, P = .808). Donor sex, age, and baseline serum creatinine were similar between the groups. There was an increased proportion of expanded criteria donors in HU-DDRT (54.5% vs 25.1%, P = .028). There were no differences in cold or warm ischemia time nor in serum creatinine at discharge or during the first 2 years of follow-up. In both groups, a similar proportion of patients experienced acute rejection episodes. Comparable to DDRT patients, HU-DDRT patients had a high proportion of graft survival at the 1-year follow-up (90.9% vs 93.1%, P = .777). At a 2-year follow-up, graft survival was lower in the HU-DDRT group (81.8% vs 91.5%, P = .267). Mean follow-up for both groups was comparable (78.5 ± 46.7 vs 68.4 ± 40.8 months, P = .424). Overall, graft loss occurred in approximately 36.4% of HU-DDRT patients and 20.9% of DDRT patients (P = .219). Both groups had an overall mortality rate of around 9%. The differences were not statistically significant due to the limited number of patients. More comorbidities and reportedly worse cardiovascular prognosis of access failure (AF) patients and use of expanded criteria donors did not negatively reflect in worse short-term outcomes in our cohort, which highlights the importance of HU-RT in prolonging the survival of AF patients.
Collapse
Affiliation(s)
- J Gameiro
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal.
| | - S Jorge
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal
| | - M Neves
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal
| | - A Santana
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal
| | - J Guerra
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal
| |
Collapse
|
19
|
Guerra J, Dugué F. [The career of medical public health specialists graduated from the French public health medical residency]. Rev Epidemiol Sante Publique 2019; 67:106-113. [PMID: 30733052 DOI: 10.1016/j.respe.2018.12.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 11/27/2018] [Accepted: 12/21/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The French public health medical residency was created in 1984 to train medical public health specialists. Knowledge was lacking on the career of the trained practitioners, with the sole study dating from 1995. In this study, the French national association of medical public health residents aimed to describe the training and career of all medical public health specialists since the inception of the residency. METHODS An online survey took place during the first semester of 2012 to collect information on all medical public health specialists graduated from the French public health medical residency. Descriptive analysis of the collected information was performed. RESULTS Replies from 563 graduated medical public health residents were collected from all over the country and years since the inception of the training. Ninety-eight percent of the informants were in activity. They mostly worked in public healthcare facilities (56%) and public administration (16%). Their main areas of practice were: epidemiology, clinical research, biostatistics (37%); health management information system (19%); health policy (14%). Eighty-eight percent of the respondents held a master degree, 29% a PhD. Practical training during the medical residency was deemed as very useful or needed by 73% of the informants, theoretical training by 43%. Sixty-eight percent of informants were very or fully satisfied by their carrier, 29% rather satisfied. CONCLUSION This is the first study to achieve coverage of more than 45% of all medical public health specialists graduated since the inception of the public health medical residency. Full employment, wide-range activities, evolving carriers can explain the high satisfaction rates. The public health medical residency being the main access point to the public health medical specialty, the impact of the initial training on the career should lead to rethink the design of the public health medical residency to fulfil the needs in the public health sector.
Collapse
Affiliation(s)
- J Guerra
- Collège de liaison des Internes de santé publique (CLISP), 17, rue du Fer-à-Moulins, 75010 Paris, France.
| | - F Dugué
- Collège de liaison des Internes de santé publique (CLISP), 17, rue du Fer-à-Moulins, 75010 Paris, France
| |
Collapse
|
20
|
Rocha V, Donati A, Contin L, Kakizaki P, Machado C, Brito F, Claudino D, Moraes P, Guerra J, Pires M. Photopatch and patch testing in 63 patients with frontal fibrosing alopecia: a case series. Br J Dermatol 2018; 179:1402-1403. [DOI: 10.1111/bjd.16933] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- V.B. Rocha
- IAMSPE, Hospital do Servidor Público Estadual de São Paulo; São Paulo Brazil
| | - A. Donati
- Department of Dermatology; University of São Paulo; São Paulo Brazil
| | - L.A. Contin
- Department of Dermatology; Hospital do Servidor Público Municipal; São Paulo Brazil
| | - P. Kakizaki
- Department of Dermatology; Hospital do Servidor Público Municipal; São Paulo Brazil
| | - C.J. Machado
- Faculty of Medicine; UFMG, Public Health; Belo Horizonte, Minas Gerais Brazil
| | - F.F. Brito
- Department of Dermatology; Hospital do Servidor Público Municipal; São Paulo Brazil
| | - D. Claudino
- Department of Dermatology; Hospital do Servidor Público Municipal; São Paulo Brazil
| | - P. Moraes
- Department of Dermatology; Hospital do Servidor Público Municipal; São Paulo Brazil
| | - J. Guerra
- Department of Dermatology; Hospital do Servidor Público Municipal; São Paulo Brazil
| | - M.C. Pires
- IAMSPE, Hospital do Servidor Público Estadual de São Paulo; São Paulo Brazil
| |
Collapse
|
21
|
Guerra J, Cognat S, Fuchs F. Who Lyon Office: Supporting countries in achieving the international health regulations (2005) core capacities for public health surveillance. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
22
|
Godinho I, Guerra J, Melo MJ, Neves M, Gonçalves J, Santana MA, Gomes da Costa A. Living-Donor Kidney Transplantation: Donor-Recipient Function Correlation. Transplant Proc 2018; 50:719-722. [PMID: 29661423 DOI: 10.1016/j.transproceed.2018.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND With the rising prevalence of living-donor kidney transplantation, evaluation of factors correlated with renal function in the donor-recipient pair constitutes a main goal for kidney transplantation clinicians. Our objective was to analyze the more relevant donor characteristics that contribute to donor and recipient estimated glomerular filtration rates (eGFR) after 1 year. METHODS We evaluated 48 consecutive donor-recipient pairs from our unit. RESULTS Mean donor age was 46 ± 11 years, with 71% being women. Mean recipient age was 35 ± 12 years, with 54% being men. Mean duration of donor hospitalization was 7 ± 2 days. Donor eGFR was 104 ± 11 mL/min/1.73 m2 before donation and 70 ± 14 mL/min/1.73 m2 at discharge. After 1 year, donor eGFR was 71 ± 12 mL/min/1.73 m2 and recipient eGFR was 69 ± 10 mL/min/1.73 m2. Donor eGFR <100 mL/min/1.73 m2 before donation and age >50 years correlated with 17.7- and 8.9-fold increased risks, respectively, of recipient eGFR <60 mL/min/1.73 m2 after 1 year. Donor being female, although statistically associated with worse graft function, compared with a male donor (P = .020), did not represent a significantly increased risk of recipient eGFR <60 mL/min/1.73 m2. Higher donor body mass index (BMI) also associated with a lower kidney function for donors (P = .048). In multivariate linear regression to predict pairs' eGFRs after 1 year, only donor eGFR before donation and at discharge retained statistical significance (P ≤ .001 and P = .045, respectively). CONCLUSIONS Excluding unpredictable complications in the post-transplantation period, donor eGFR before donation, eGFR at discharge, and age were the best parameters to predict recipient and donor eGFRs after 1 year and can be used as a tool for managing expectations regarding the post-transplantation period.
Collapse
Affiliation(s)
- I Godinho
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
| | - J Guerra
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - M J Melo
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - M Neves
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - J Gonçalves
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - M A Santana
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - A Gomes da Costa
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| |
Collapse
|
23
|
Cortes A, Apala JV, Malon D, Guerra J, Gion-Cortes M, Manso L, Hornedo J, Gonzalez-Cortijo L, Mouron S, Quintela-Fandino M. Abstract OT2-07-02: CNIO-BR-009 trial: Targeting mitochondrial metabolism with ME-344 in breast cancer upon bevacizumab-induced vascular normalization: A phase 0 randomized clinical trial. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot2-07-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Antiangiogenic agents have shown activity in breast cancer; however their use should be optimized. One potential solution is designing rational combinations based on blocking specific mechanisms of resistance. We previously published that tumors exposed to bevacizumab (BEV) can either experience vascular pruning (followed by increased tumor hypoxia) or vascular normalization (followed by a switch to mitochondrial metabolism). FDG-PET can monitor which pattern is occurring as early as 8 days after the first dose (Mol Oncol; 10: 704-18). We have also shown that when vascular normalization occurs, tumors become highly sensitive to mitochondrial inhibitors (Cell Rep 2016; 15: 1-14). ME-344 is a mitocondrial respiration inhibitor that has recently completed phase I. We sought to test the pharmacodynamic effects of ME-344 and its effects in Ki67 and cleaved caspase 3 (CC3) after single-dose BEV in treatment-naive early HER2-negative breast cancer patients, and whether the effects are restricted or not to those patients experiencing vascular normalization as predicted by FDG-PET.
Trial design
Placebo-controlled, two-arm, randomized, multicentric phase 0 trial. Treatment-naive HER2-negative breast cancer patients undergo a breast FDG-PET and a baseline tumor biopsy (frozen and paraffinized cores), followed by a single (15 mg/kg) BEV dose. FDG-PET is repeated on day +8. Patients are then randomized to three ME-344 (10 mg/kg) doses or placebo (days +8, +15 and +22). A second biopsy is then harvested, ending trial procedures. Patients can then follow surgery or neoadjuvant treatment according to their physician's criterion. Serial paraffinized biopsies are used to measure Ki67 and CC3; frozen biopsies are used for measuring mitochondrial activity with SDH enzymo-histochemistry (EHC) and assessing vessel architecture. Toxicity is graded with NCI CTC AE V4.03 criteria.
Eligibility criteria
1) Women >18 year old; 2) diagnosed of HER2-negative breast cancer; 3) patients must be treatment-naive; 4) ECOG 0/1; 5) lack of neuropathy; 6) primary tumor > 1cm .
Specific aims
Primary:
1) To study the effects in cell replication and cell death as a surrogate measure of efficacy of ME-344 added to BEV in treatment-naive breast cancer.
2) To determine if FDG-PET accurately detects patients experiencing vascular normalization early after BEV dosing.
3) To observe the effects of ME-344 in mitochondrial activity at the tumor level by performing SDH EHC.
4) To assess if ME-344 efficacy (measured by changes in CC3 and Ki67) is restricted or not to those patients experiencing vascular normalization and mitochondrial switch.
Secondary:
5) To study the tolerability of the combination of BEV plus ME-344.
Statistical methods
The sample size is calculated on the basis of the expected change in Ki-67 staining in the primary tumors in patients receiving ME-344 (-10% on average). With an α and β errors of 5% and 20% respectively, the minimum number of patients necessary to observe a 10% decrease is 20 per arm. Changes in CC3, KI67, SDH activity and FDG-PET SUV will be compared with intra-subject measurements and Z-scores.
Accrual: 13 of 40 planned patients.
Contact: acsalgado86@gmail.com
Citation Format: Cortes A, Apala JV, Malon D, Guerra J, Gion-Cortes M, Manso L, Hornedo J, Gonzalez-Cortijo L, Mouron S, Quintela-Fandino M. CNIO-BR-009 trial: Targeting mitochondrial metabolism with ME-344 in breast cancer upon bevacizumab-induced vascular normalization: A phase 0 randomized clinical trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT2-07-02.
Collapse
Affiliation(s)
- A Cortes
- Hospital Ramon y Cajal; CNIO - Spanish National Cancer Research Center; Hospital de Fuenlabrada; Hospital 12 de Octubre; Hospital Quirón Pozuelo
| | - JV Apala
- Hospital Ramon y Cajal; CNIO - Spanish National Cancer Research Center; Hospital de Fuenlabrada; Hospital 12 de Octubre; Hospital Quirón Pozuelo
| | - D Malon
- Hospital Ramon y Cajal; CNIO - Spanish National Cancer Research Center; Hospital de Fuenlabrada; Hospital 12 de Octubre; Hospital Quirón Pozuelo
| | - J Guerra
- Hospital Ramon y Cajal; CNIO - Spanish National Cancer Research Center; Hospital de Fuenlabrada; Hospital 12 de Octubre; Hospital Quirón Pozuelo
| | - M Gion-Cortes
- Hospital Ramon y Cajal; CNIO - Spanish National Cancer Research Center; Hospital de Fuenlabrada; Hospital 12 de Octubre; Hospital Quirón Pozuelo
| | - L Manso
- Hospital Ramon y Cajal; CNIO - Spanish National Cancer Research Center; Hospital de Fuenlabrada; Hospital 12 de Octubre; Hospital Quirón Pozuelo
| | - J Hornedo
- Hospital Ramon y Cajal; CNIO - Spanish National Cancer Research Center; Hospital de Fuenlabrada; Hospital 12 de Octubre; Hospital Quirón Pozuelo
| | - L Gonzalez-Cortijo
- Hospital Ramon y Cajal; CNIO - Spanish National Cancer Research Center; Hospital de Fuenlabrada; Hospital 12 de Octubre; Hospital Quirón Pozuelo
| | - S Mouron
- Hospital Ramon y Cajal; CNIO - Spanish National Cancer Research Center; Hospital de Fuenlabrada; Hospital 12 de Octubre; Hospital Quirón Pozuelo
| | - M Quintela-Fandino
- Hospital Ramon y Cajal; CNIO - Spanish National Cancer Research Center; Hospital de Fuenlabrada; Hospital 12 de Octubre; Hospital Quirón Pozuelo
| |
Collapse
|
24
|
Ministro A, Ferreira T, Batista L, Santana A, Alves N, Guerra J, Fernandes E Fernandes J. Mycotic Pseudoaneurysm After Kidney Transplantation: Two Case Reports. Transplant Proc 2018; 49:906-912. [PMID: 28457423 DOI: 10.1016/j.transproceed.2017.01.052] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Vascular complications after kidney transplantation may cause allograft loss. Here, we describe 2 patients with extrarenal mycotic pseudoaneurysm after kidney transplantation. PATIENTS Patient 1 was a 54-year-old man who developed pseudoaneurysm 60 days after transplantation, and patient 2 was a 48-year-old woman who was diagnosed with a pseudoaneurysm 5 months after transplantation. RESULTS Patient 1 had a deceased-donor kidney transplant with end-to-side external iliac arterial anastomosis that was reconstructed 8 days after transplantation owing to rupture and major bleeding. At 60 days after transplantation, he had high serum creatinine level and Doppler ultrasonography showed a pseudoaneurysm of the arterial graft anastomosis and postanastomotic renal artery stenosis. Treatment included surgical excision of the pseudoaneurysm, vascular reconstruction, and fluconazole, with mycologic culture of the resected pseudoaneurysm showing Candida albicans. Patient 2 developed nondisabling intermittent claudication at 5 months after kidney transplantation, with a pseudoaneurysm subsequently observed on Doppler ultrasonography and computerized tomographic angiography. Treatment included renal artery thrombectomy and common iliac bypass to the hilar donor renal artery with inverted ipsilateral long saphenous vein. Operative samples showed C albicans, and she was treated with fluconazole. Both patients had satisfactory outcomes, and both kidney allografts were preserved. CONCLUSIONS Extrarenal mycotic pseudoaneurysms after kidney transplantation require a high index of suspicion for early diagnosis, and preservation of the kidney graft may be achieved with the use of surgical treatment and antifungal therapy.
Collapse
Affiliation(s)
- A Ministro
- Kidney Transplant Unit, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon Academic Medical Center, Lisbon, Portugal; Vascular Surgery Department, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon Academic Medical Center, Lisbon, Portugal.
| | - T Ferreira
- Vascular Surgery Department, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon Academic Medical Center, Lisbon, Portugal
| | - L Batista
- Kidney Transplant Unit, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon Academic Medical Center, Lisbon, Portugal
| | - A Santana
- Kidney Transplant Unit, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon Academic Medical Center, Lisbon, Portugal
| | - N Alves
- Kidney Transplant Unit, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon Academic Medical Center, Lisbon, Portugal
| | - J Guerra
- Kidney Transplant Unit, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon Academic Medical Center, Lisbon, Portugal
| | - J Fernandes E Fernandes
- Vascular Surgery Department, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon Academic Medical Center, Lisbon, Portugal
| |
Collapse
|
25
|
Rodrigues N, Santana A, Guerra J, Neves M, Nascimento C, Gonçalves J, da Costa AG. Serum Magnesium and Related Factors in Long-Term Renal Transplant Recipients: An Observational Study. Transplant Proc 2017; 49:799-802. [PMID: 28457398 DOI: 10.1016/j.transproceed.2017.01.070] [Citation(s) in RCA: 6] [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: 10/19/2022]
Abstract
BACKGROUND Low serum magnesium (MgS) is a known risk factor for cardiovascular and mineral bone disease. In renal transplant recipients (RTRs), low MgS levels have been related to higher glomerular filtration rates (GFR) and with calcineurin inhibitors, particularly tacrolimus. We aimed to evaluate MgS in renal transplant recipients with over 1 year of follow-up to establish related risk factors and the impact of the use of cyclosporine versus tacrolimus. METHODS Cross-sectional study of 94 RTRs with more than 12 months of follow-up. Hypomagnesemia was defined as serum magnesium level <1.5 mg/dL. RESULTS Hypomagnesemia was found in 5.3% of patients. MgS showed a negative correlation with creatinine clearance. A positive correlation between MgS with urinary magnesium and phosphorus was found. Cyclosporine versus tacrolimus analysis did not show a significant difference regarding MgS when considering all the population and the subgroup of patients with GFR >45 mL/min/1.73 m2. On the subgroup with GFR <45 mL/min/1.73 m2, those on tacrolimus had lower MgS than those on cyclosporine, but those same patients presented with significantly different GFR, higher in the tacrolimus subgroup. CONCLUSIONS Hypomagnesemia has a low prevalence in RTRs with more than 1 year of follow-up. MgS levels evidenced a strong correlation with GFR. A significant difference on MgS levels between patients on tacrolimus and cyclosporine was found only when considering GFR <45 mL/min/1.73 m2, in which patients on tacrolimus had significantly higher GFR than patients on cyclosporine, which may explain these results.
Collapse
Affiliation(s)
- N Rodrigues
- Department of Nephrology and Renal Transplantation, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
| | - A Santana
- Department of Nephrology and Renal Transplantation, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - J Guerra
- Department of Nephrology and Renal Transplantation, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - M Neves
- Department of Nephrology and Renal Transplantation, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - C Nascimento
- Department of Nephrology and Renal Transplantation, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - J Gonçalves
- Department of Nephrology and Renal Transplantation, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - A G da Costa
- Department of Nephrology and Renal Transplantation, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| |
Collapse
|
26
|
Guerra JA, Dhall G, Marachelian A, Castillo E, Malvar J, Wong K, Sposto R, Finlay JL. Marrow-ablative chemotherapy followed by tandem autologous hematopoietic cell transplantation in pediatric patients with malignant brain tumors. Bone Marrow Transplant 2017; 52:1543-1548. [PMID: 28783147 DOI: 10.1038/bmt.2017.166] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 04/29/2017] [Accepted: 06/18/2017] [Indexed: 11/09/2022]
Abstract
To improve survival in young children with malignant brain tumors, irradiation-avoiding or -minimizing marrow-ablative chemotherapy (HDCx) with autologous hematopoietic cell transplantation (AuHCT) has been investigated. We evaluated the outcome of 44 children with malignant brain tumors treated with HDCx and tandem AuHCT at Children's Hospital Los Angeles between June 1999 and July 2012. Forty-four children with malignant brain tumors were studied. Twenty-one had medulloblastoma/primitive neuro-ectodermal tumor, eight atypical teratoid/rhabdoid tumor (ATRT), five high-grade glioma, four malignant germ cell tumor, three ependymoma and three choroid plexus carcinoma. Twenty-nine patients received three tandem transplants and 15 received two tandem transplants, respectively. The 5-year PFS and overall survivals (OS) for all patients were 46.3±8.2% and 51.7±8.5%, respectively. The PFS and OS for 27 newly diagnosed patients were 68.9±9.9% and 73.5±9.3%, respectively, compared with 17 transplanted at relapse 11.8±9.8% (P<0.001) and 15.1±12.3% (P=0.0231), respectively. The 5-year PFS and OS in 13 previously unirradiated patients were 74±13% and 74±13% versus 33.2±9.8% and 40.2±10.6% in 31 irradiated patients (P=0.11 and P=0.239), respectively. One patient died of transplant-related toxicity. HDCx with tandem AuHCT is feasible and safe in children with malignant brain tumors with encouraging irradiation-free survival in newly diagnosed children.
Collapse
Affiliation(s)
- J A Guerra
- Sections of Pediatric Hematology-Oncology-BMT and Neuro-oncology, Department of Pediatrics, HIMA San Pablo Oncology Hospital, Caguas, Puerto Rico
| | - G Dhall
- The Neuro-oncology Program, Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A Marachelian
- The Neuro-oncology Program, Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - E Castillo
- Bone Marrow Transplant Division, Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles,Los Angeles, California, USA
| | - J Malvar
- Bone Marrow Transplant Division, Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles,Los Angeles, California, USA
| | - K Wong
- The Neuro-oncology and Radiation Oncology Programs, Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - R Sposto
- Children's Center for Cancer and Blood Diseases, Department of Statistics, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - J L Finlay
- Division of Hematology, Oncology and BMT, Neuro-oncology Program, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| |
Collapse
|
27
|
Pereira M, Guerra J, Neves M, Gonçalves J, Santana A, Nascimento C, da Costa AG. Predictive Factors of Acute Rejection in Low Immunologic Risk Kidney Transplant Recipients Receiving Basiliximab. Transplant Proc 2017; 48:2280-2283. [PMID: 27742279 DOI: 10.1016/j.transproceed.2016.06.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The optimal immunosuppressive induction therapy in kidney transplant recipients with low immunologic risk of acute rejection (AR) is still controversial. The use of basiliximab (BSX) has led to a significant decrease of AR with a low side effect profile. OBJECTIVE This study sought to evaluate predictive risk factors for AR in low immunologic risk patients subjected to immunosuppressive induction therapy with BSX. METHODS We reviewed all low immunologic risk patients (panel reactive antibody [PRA] level <50%, who had undergone a first deceased-donor transplant) subjected to immunosuppressive induction therapy with BSX, calcineurin inhibitor, mycophenolate mofetil, and prednisolone (n = 346). AR was defined as any rejection occurring until 12 months posttransplantation. Predictive risk factors for AR were evaluated by logistic regression and, to find the best cut-off of PRA related to a higher incidence of AR, receiver-operator characteristic (ROC) curve analysis was performed. RESULTS The rate of AR was 7.8%. Multivariate logistic regression analysis identified age at the time of transplantation (P = .040) and PRA level (P = .001) as independent risk factors for AR. ROC curve analysis confirmed that PRA >10% was related to an increased incidence of AR (19.2% vs 6.0%, P = .005). CONCLUSIONS A higher incidence of AR was observed in low immunologic risk kidney transplant patients with a PRA level >10%. These data support the use of more intensive immunosuppressive induction therapy in patients with low immunologic risk and a PRA level >10%.
Collapse
Affiliation(s)
- M Pereira
- Nephrology and Kidney Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
| | - J Guerra
- Nephrology and Kidney Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - M Neves
- Nephrology and Kidney Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - J Gonçalves
- Nephrology and Kidney Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - A Santana
- Nephrology and Kidney Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - C Nascimento
- Nephrology and Kidney Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - A G da Costa
- Nephrology and Kidney Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| |
Collapse
|
28
|
Rob D, Špunda R, Lindner J, Šmalcová J, Šmíd O, Kovárník T, Linhart A, Bìlohlávek J, Marinoni MM, Cianchi G, Trapani S, Migliaccio ML, Gucci L, Bonizzoli M, Cramaro A, Cozzolino M, Valente S, Peris A, Grins E, Kort E, Weiland M, Shresta NM, Davidson P, Algotsson L, Fitch S, Marco G, Sturgill J, Lee S, Dickinson M, Boeve T, Khaghani A, Wilton P, Jovinge S, Ahmad AN, Loveridge R, Vlachos S, Patel S, Gelandt E, Morgan L, Butt S, Whitehorne M, Kakar V, Park C, Hayes M, Willars C, Hurst T, Best T, Vercueil A, Auzinger G, Adibelli B, Akovali N, Torgay A, Zeyneloglu P, Pirat A, Kayhan Z, Schmidbauer SS, Herlitz J, Karlsson T, Friberg H, Knafelj R, Radsel P, Duprez F, Bonus T, Cuvelier G, Mashayekhi S, Maka M, Ollieuz S, Reychler G, Mosaddegh R, Abbasi S, Talaee S, Zotzmann VZ, Staudacher DS, Wengenmayer TW, Dürschmied DD, Bode CB, Nelskylä A, Nurmi J, Jousi M, Schramko A, Mervaala E, Ristagno G, Skrifvars M, Ozsoy G, Kendirli T, Azapagasi E, Perk O, Gadirova U, Ozcinar E, Cakici M, Baran C, Durdu S, Uysalel A, Dogan M, Ramoglu M, Ucar T, Tutar E, Atalay S, Akar R, Kamps M, Leeuwerink G, Hofmeijer J, Hoiting O, Van der Hoeven J, Hoedemaekers C, Konkayev A, Kuklin V, Kondratyev T, Konkayeva M, Akhatov N, Sovershaev M, Tveita T, Dahl V, Wihersaari L, Skrifvars MB, Bendel S, Kaukonen KM, Vaahersalo J, Romppanen J, Pettilä V, Reinikainen M, Lybeck A, Cronberg T, Nielsen N, Friberg H, Rauber M, Steblovnik K, Jazbec A, Noc M, Kalasbail P, Garrett F, Kulstad E, Bergström DJ, Olsson HR, Schmidbauer S, Friberg H, Mandel I, Mikheev S, Podoxenov Y, Suhodolo I, Podoxenov A, Svirko J, Sementsov A, Maslov L, Shipulin V, Vammen LV, Rahbek SR, Secher NS, Povlsen JP, Jessen NJ, Løfgren BL, Granfeldt AG, Grossestreuer A, Perman S, Patel P, Ganley S, Portmann J, Cocchi M, Donnino M, Nassar Y, Fathy S, Gaber A, Mokhtar S, Chia YC, Lewis-Cuthbertson R, Mustafa K, Sabra A, Evans A, Bennett P, Eertmans W, Genbrugge C, Boer W, Dens J, De Deyne C, Jans F, Skorko A, Thomas M, Casadio M, Coppo A, Vargiolu A, Villa J, Rota M, Avalli L, Citerio G, Moon JB, Cho JH, Park CW, Ohk TG, Shin MC, Won MH, Papamichalis P, Zisopoulou V, Dardiotis E, Karagiannis S, Papadopoulos D, Zafeiridis T, Babalis D, Skoura A, Staikos I, Komnos A, Passos SS, Maeda F, Souza LS, Filho AA, Granjeia TAG, Schweller M, Franci D, De Carvalho Filho M, Santos TM, De Azevedo P, Wall R, Welters I, Tansuwannarat P, Sanguanwit P, Langer T, Carbonara M, Caccioppola A, Fusarini CF, Carlesso E, Paradiso E, Battistini M, Cattaneo E, Zadek F, Maiavacca R, Stocchetti N, Pesenti A, Ramos A, Acharta F, Toledo J, Perezlindo M, Lovesio L, Dogliotti A, Lovesio C, Schroten N, Van der Veen B, De Vries MC, Veenstra J, Abulhasan YB, Rachel S, Châtillon-Angle M, Alabdulraheem N, Schiller I, Dendukuri N, Angle M, Frenette C, Lahiri S, Schlick K, Mayer SA, Lyden P, Akatsuka M, Arakawa J, Yamakage M, Rubio J, Mateo-Sidron JAR, Sierra R, Celaya M, Benitez L, Alvarez-Ossorio S, Rubio J, Mateo-Sidron JAR, Sierra R, Fernandez A, Gonzalez O, Engquist H, Rostami E, Enblad P, Toledo J, Ramos A, Acharta F, Canullo L, Nallino J, Dogliotti A, Lovesio C, Perreault M, Talic J, Frenette AJ, Burry L, Bernard F, Williamson DR, Adukauskiene D, Cyziute J, Adukauskaite A, Malciene L, Luca L, Rogobete A, Bedreag O, Papurica M, Sarandan M, Cradigati C, Popovici S, Vernic C, Sandesc D, Avakov V, Shakhova I, Trimmel H, Majdan M, Herzer GH, Sokoloff CS, Albert M, Williamson D, Odier C, Giguère J, Charbonney E, Bernard F, Husti Z, Kaptás T, Fülep Z, Gaál Z, Tusa M, Donnelly J, Aries M, Czosnyka M, Robba C, Liu M, Ercole A, Menon D, Hutchinson P, Smielewski P, López R, Graf J, Montes JM, Kenawi M, Kandil A, Husein K, Samir A, Heijneman J, Huijben J, Abid-Ali F, Stolk M, Van Bommel J, Lingsma H, Van der Jagt M, Cihlar RC, Mancino G, Bertini P, Forfori F, Guarracino F, Pavelescu D, Grintescu I, Mirea L, Alamri S, Tharwat M, Kono N, Okamoto H, Uchino H, Ikegami T, Fukuoka T, Simoes M, Trigo E, Coutinho P, Pimentel J, Franci A, Basagni D, Boddi M, Cozzolino M, Anichini V, Cecchi A, Peris A, Markopoulou D, Venetsanou K, Papanikolaou I, Barkouri T, Chroni D, Alamanos I, Cingolani E, Bocci MG, Pisapia L, Tersali A, Cutuli SL, Fiore V, Palma A, Nardi G, Antonelli M, Coke R, Kwong A, Dwivedi DJ, Xu M, McDonald E, Marshall JC, Fox-Robichaud AE, Charbonney E, Liaw PC, Kuchynska I, Malysh IR, Zgrzheblovska LV, Mestdagh L, Verhoeven EF, Hubloue I, Ruel-laliberte J, Zarychanski R, Lauzier F, Bonaventure PL, Green R, Griesdale D, Fowler R, Kramer A, Zygun D, Walsh T, Stanworth S, Léger C, Turgeon AF, Baron DM, Baron-Stefaniak J, Leitner GC, Ullrich R, Tarabrin O, Mazurenko A, Potapchuk Y, Sazhyn D, Tarabrin P, Tarabrin O, Mazurenko A, Potapchuk Y, Sazhyn D, Tarabrin P, Pérez AG, Silva J, Artemenko V, Bugaev A, Tokar I, Konashevskaya S, Kolesnikova IM, Roitman EV, Kiss TR, Máthé Z, Piros L, Dinya E, Tihanyi E, Smudla A, Fazakas J, Ubbink R, Boekhorst te P, Mik E, Caneva L, Ticozzelli G, Pirrelli S, Passador D, Riccardi F, Ferrari F, Roldi EM, Di Matteo M, Bianchi I, Iotti GA, Zurauskaite G, Voegeli A, Meier M, Koch D, Haubitz S, Kutz A, Bargetzi M, Mueller B, Schuetz P, Von Meijenfeldt G, Van der Laan M, Zeebregts C, Christopher KB, Vernikos P, Melissopoulou T, Kanellopoulou G, Panoutsopoulou M, Xanthis D, Kolovou K, Kypraiou T, Floros J, Broady H, Pritchett C, Marshman M, Jannaway N, Ralph C, Lehane CL, Keyl CK, Zimmer EZ, Trenk DT, Ducloy-Bouthors AS, Jonard MJ, Fourrier F, Piza F, Correa T, Marra A, Guerra J, Rodrigues R, Vilarinho A, Aranda V, Shiramizo S, Lima MR, Kallas E, Cavalcanti AB, Donoso M, Vargas P, Graf J, McCartney J, Ramsay S, McDowall K, Novitzky-Basso I, Wright C, Medic MG, Bielen L, Radonic V, Zlopasa O, Vrdoljak NG, Gasparovic V, Radonic R, Narváez G, Cabestrero D, Rey L, Aroca M, Gallego S, Higuera J, De Pablo R, González LR, Chávez GN, Lucas JH, Alonso DC, Ruiz MA, Valarezo LJ, De Pablo Sánchez R, Real AQ, Wigmore TW, Bendavid I, Cohen J, Avisar I, Serov I, Kagan I, Singer P, Hanison J, Mirza U, Conway D, Takasu A, Tanaka H, Otani N, Ohde S, Ishimatsu S, Coffey F, Dissmann P, Mirza K, Lomax M, Dissmann P, Coffey F, Mirza K, Lomax M, Miner JR, Leto R, Markota AM, Gradišek PG, Aleksejev VA, Sinkovič AS, Romagnoli S, Chelazzi C, Zagli G, Benvenuti F, Mancinelli P, Boninsegni P, Paparella L, Bos AT, Thomas O, Goslar T, Knafelj R, Perreault M, Martone A, Sandu PR, Rosu VA, Capilnean A, Murgoi P, Frenette AJ, Lecavalier A, Jayaraman D, Rico P, Bellemare P, Gelinas C, Williamson D, Nishida T, Kinoshita T, Iwata N, Yamakawa K, Fujimi S, Maggi L, Sposato F, Citterio G, Bonarrigo C, Rocco M, Zani V, De Blasi RA, Alcorn D, Barry L, Riedijk MA, Milstein DM, Caldas J, Panerai R, Camara L, Ferreira G, Bor-Seng-Shu E, Lima M, Galas F, Mian N, Nogueira R, de Oliveira GQ, Almeida J, Jardim J, Robinson TG, Gaioto F, Hajjar LA, Zabolotskikh I, Musaeva T, Saasouh W, Freeman J, Turan A, Saseedharan S, Pathrose E, Poojary S, Messika J, Martin Y, Maquigneau N, Henry-Lagarrigue M, Puechberty C, Stoclin A, Martin-Lefevre L, Blot F, Dreyfuss D, Dechanet A, Hajage D, Ricard J, Almeida E, Almeida J, Landoni G, Galas F, Fukushima J, Fominskiy E, De Brito C, Cavichio L, Almeida L, Ribeiro U, Osawa E, Boltes R, Battistella L, Hajjar L, Fontela P, Lisboa T, Junior LF, Friedman GF, Abruzzi F, Primo JAP, Filho PM, de Andrade JS, Brenner KM, boeira MS, Leães C, Rodrigues C, Vessozi A, Machado AS, Weiler M, Bryce H, Hudson A, Law T, Reece-Anthony R, Molokhia A, Abtahinezhadmoghaddam F, Cumber E, Channon L, Wong A, Groome R, Gearon D, Varley J, Wilson A, Reading J, Wong A, Zampieri FG, Bozza FA, Ferez M, Fernandes H, Japiassú A, Verdeal J, Carvalho AC, Knibel M, Salluh JI, Soares M, Gao J, Ahmadnia E, Patel B, McCartney J, MacKay A, Binning S, Wright C, Pugh RJ, Battle C, Hancock C, Harrison W, Szakmany T, Mulders F, Vandenbrande J, Dubois J, Stessel B, Siborgs K, Ramaekers D, Soares M, Silva UV, Homena WS, Fernandes GC, Moraes AP, Brauer L, Lima MF, De Marco F, Bozza FA, Salluh JI, Maric N, Mackovic M, Udiljak N, Bosso CE, Caetano RD, Cardoso AP, Souza OA, Pena R, Mescolotte MM, Souza IA, Mescolotte GM, Bangalore H, Borrows E, Barnes D, Ferreira V, Azevedo L, Alencar G, Andrade A, Bierrenbach A, Buoninsegni LT, Bonizzoli M, Cecci L, Cozzolino M, Peris A, Lindskog J, Rowland K, Sturgess P, Ankuli A, Molokhia A, Rosa R, Tonietto T, Ascoli A, Madeira L, Rutzen W, Falavigna M, Robinson C, Salluh J, Cavalcanti A, Azevedo L, Cremonese R, Da Silva D, Dornelles A, Skrobik Y, Teles J, Ribeiro T, Eugênio C, Teixeira C, Zarei M, Hashemizadeh H, Eriksson M, Strandberg G, Lipcsey M, Larsson A, Lignos M, Crissanthopoulou E, Flevari K, Dimopoulos P, Armaganidis A, Golub JG, Markota AM, Stožer AS, Sinkovič AS, Rüddel H, Ehrlich C, Burghold CM, Hohenstein C, Winning J, Sellami W, Hajjej Z, Bousselmi M, Gharsallah H, Labbene I, Ferjani M, Sattler J, Steinbrunner D, Poppert H, Schneider G, Blobner M, Kanz KG, Schaller SJ, Apap K, Xuereb G, Xuereb G, Apap K, Massa L, Xuereb G, Apap K, Massa L, Delvau N, Penaloza A, Liistro G, Thys F, Delattre IK, Hantson P, Roy PM, Gianello P, Hadîrcă L, Ghidirimschi A, Catanoi N, Scurtov N, Bagrinovschi M, Sohn YS, Cho YC, Golovin B, Creciun O, Ghidirimschi A, Bagrinovschi M, Tabbara R, Whitgift JZ, Ishimaru A, Yaguchi A, Akiduki N, Namiki M, Takeda M, Tamminen JN, Reinikainen M, Uusaro A, Taylor CG, Mills ED, Mackay AD, Ponzoni C, Rabello R, Serpa A, Assunção M, Pardini A, Shettino G, Corrêa T, Vidal-Cortés PV, Álvarez-Rocha L, Fernández-Ugidos P, Virgós-Pedreira A, Pérez-Veloso MA, Suárez-Paul IM, Del Río-Carbajo L, Fernández SP, Castro-Iglesias A, Butt A, Alghabban AA, Khurshid SK, Ali ZA, Nizami IN, Salahuddin NS, Alshahrani M, Alsubaie AW, Alshamsy AS, Alkhiliwi BA, Alshammari HK, Alshammari MB, Telmesani NK, Alshammari RB, Asonto LP, Zampieri FG, Damiani LP, Bozza F, Salluh JI, Cavalcanti AB, El Khattate A, Bizrane M, Madani N, Belayachi J, Abouqal R, Ramnarain D, Gouw-Donders B, Benstoem C, Moza A, Meybohm P, Stoppe C, Autschbach R, Devane D, Goetzenich A, Taniguchi LU, Araujo L, Salgado G, Vieira JM, Viana J, Ziviani N, Pessach I, Lipsky A, Nimrod A, O´Connor M, Matot I, Segal E, Kluzik A, Gradys A, Smuszkiewicz P, Trojanowska I, Cybulski M, De Jong A, Sebbane M, Chanques G, Jaber S, Rosa R, Robinson C, Bessel M, Cavalheiro L, Madeira L, Rutzen W, Oliveira R, Maccari J, Falavigna M, Sanchez E, Dutra F, Dietrich C, Balzano P, Rezende J, Teixeira C, Sinha S, Majhi K, Gorlicki JG, Pousset FP, Kelly J, Aron J, Gilbert AC, Urankar NP, Knafelj R, Irazabal M, Bosque M, Manciño J, Kotsopoulos A, Jansen N, Abdo W, Casey ÚM, O’Brien B, Plant R, Doyle B. 37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3). Crit Care 2017. [PMCID: PMC5374552 DOI: 10.1186/s13054-017-1630-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
29
|
Guerra J, Isnard M, Guichon C. Postdischarge surveillance of surgical site infections using telephone calls and a follow-up card in a resource-limited setting. J Hosp Infect 2017; 96:16-19. [PMID: 28381341 DOI: 10.1016/j.jhin.2017.02.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/19/2017] [Indexed: 10/20/2022]
Abstract
The use of a follow-up card and telephone calls appeared to be an efficient modality for postdischarge surveillance of surgical site infections (SSIs) in Cambodia. One hundred and sixty-one patients were given a follow-up card and asked to present it to any healthcare practitioner they visited during the 30 days following their surgery. Patients were subsequently telephoned to collect information. After discharge, 87% of the patients provided follow-up data. Of these, 25 patients with no SSIs detected during hospitalization reported that 'white liquid had discharged from the surgical wound'; among them, nine cases of purulent drainage were reported by a practitioner.
Collapse
Affiliation(s)
- J Guerra
- Preah Kossamak Hospital, Khan Tuol Kok, Phnom Penh City, Cambodia.
| | - M Isnard
- Preah Kossamak Hospital, Khan Tuol Kok, Phnom Penh City, Cambodia
| | - C Guichon
- Prupet NGO, Centre Hospitalier Moulins, Moulins Cedex, France
| |
Collapse
|
30
|
Quintela-Fandino M, Manso L, Mouron S, Lopez-Acosta JF, García-Saenz JA, Holgado E, Pascual-Martinez T, Medicna L, Guerra J, Gonzalez-Cortijo L, Mañes S. Abstract OT3-01-02: CNIO-BR-008 trial: Reversion of T-cell exhaustion caused by chronic treatment with hypoxia-inducing antiangiogenic treatment by durvalumab in HER2-negative breast cancer: A pilot proof-of-concept trial. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot3-01-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The role of immune checkpoints in tumor progression is less relevant in breast cancer than in other malignancies. However, in preclinical experimentation we found a niche for immune checkpoint inhibitors. In an immunocompetent model of HER2-negative breast cancer (MMTV-PyMT) we observed that antiangiogenic agents may induce either a tumor normoxic or hypoxic adaptation. Normoxic adaptation leads to a therapeutically exploitable dependence on mitochondrial metabolism (Cell Rep 2016; 15: 1-14). Hypoxic adaptation (usually caused by monoclonal antibody type antiangiogenics) induces an increase in PGE2 and PGA synthesis, followed by a switch of the tryptophan metabolism from 5HIAA to kinurenine that culminates in differentiation of naive T-cells to Tregs and expression of PD-L1 in the hypoxic areas. The exhausted T-cell response observed in this model can be restored with PD-L1 inhibitors. We sought to prove the relevance of T-cell exhaustion an its reversibility by the anti-PD-L1 antibody durvalumab in patients receiving chronic bevacizumab (Bev).
Trial design
Single-arm, prospective, multicentric, phase II open-label trial. Patients receiving Bev maintenance after a chemotherapy+Bev regimen administered in the first line of metastatic disease that experience disease progression (PD) during maintenance will be candidates. The treatment will start by adding durvalumab (10 mg/kg q2w) to the ongoing Bev (15 mg/kg q3 w). Patients will undergo serial tumor biopsies, tumor-cfDNA sequencing (baseline and progression), and immunophenotyping (baseline and q4w). RECIST/I-RECIST and NCI CTC AE V4.03 criteria will be used for assessing disease response and toxicity.
Elegibility criteria
Women >18 year old diagnosed of HER2-negative advanced breast cancer; 2) have received chemotherapy plus Bev for the first line treatment and experienced PR, CR or SD, 3) followed by maintenance with three-weekly Bev in monotherapy for at least 6 weeks before diagnosis of PD. 4) Concurrent hormonal therapy is allowed for ER+ patients, but reception of previous immunotherapy is precluded. 5) Adequate organ function defined according to standard parameters.
Specific aims
Primary:
1) To determine the relative percentages of innate and adaptive immune cell subpopulations and ascertain the status of T-cell function and polarization by multiparametric flow cytometry in patients with acquired resistance against Bev
2) To assess the reversibility of the abnormalities evidenced in (1) by durvalumab
3) To determine the disease control rate of the combination, and its relationship with (1) and (2)
Secondary:
4) To determine potential tumor neoantigens generated by chronic tumor hypoxia secondary to the antiangiogenic treatment.
Statistical methods
The sample size is calculated on the basis of the expected change in the Treg percentage in peripheral blood (10%), with an alpha and beta errors of 5% and 20% respectively. The minimum number of patients necessary to observe a 10% decrease is 25. Changes in lymphocytes will be compared with intra-subject measurements and Z-scores.
Accrual: 2 of 25 (target accrual) patients have been recruited.
Contact info: mquintela@cnio.es.
Citation Format: Quintela-Fandino M, Manso L, Mouron S, Lopez-Acosta JF, García-Saenz JA, Holgado E, Pascual-Martinez T, Medicna L, Guerra J, Gonzalez-Cortijo L, Mañes S. CNIO-BR-008 trial: Reversion of T-cell exhaustion caused by chronic treatment with hypoxia-inducing antiangiogenic treatment by durvalumab in HER2-negative breast cancer: A pilot proof-of-concept trial [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT3-01-02.
Collapse
Affiliation(s)
- M Quintela-Fandino
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - L Manso
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - S Mouron
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - JF Lopez-Acosta
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - JA García-Saenz
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - E Holgado
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - T Pascual-Martinez
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - L Medicna
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - J Guerra
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - L Gonzalez-Cortijo
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - S Mañes
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| |
Collapse
|
31
|
Moreno F, Martínez-Jañez N, Garau I, Guerra JA, Alarcón J, Bermejo B, Gonzalez-Cortijo L, Bueno C, Lao J, Bezares S, Rosell L, Blanch A, Caballero R, Carrasco E, Rojo F, Martín M, O'Connor M, Hernando A, Albanell J. Abstract OT3-02-07: A phase II study to compare fulvestrant (F) 500mg plus placebo versus (vs) F 500mg plus palbociclib (P) as first line treatment for postmenopausal women with hormone receptor (HR)-positive advanced breast cancer (BC) sensitive to endocrine therapy (ET). “The FLIPPER study” (GEICAM/2014-12). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot3-02-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Delaying/overcoming resistance to ET in HR-positive HER2-negative BC patients (pts) is a major need to futhrt improve safe and efficacious treatment options. F is a selective estrogen receptor (ER) downregulator currently indicated for the treatment of HR-positive metastatic BC in postmenopausal women with disease progression following anti-estrogen therapy. In FIRST trial F 500mg improved median time to progression (TTP) over anastrozole (23.4 vs 13.1 months, respectively) in untreated metastatic BC. P is a selective reversible inhibitor of cyclin-dependent kinase 4/6. FDA granted its accelerated approval based on progression-free survival (PFS) in combination with letrozole for postmenopausal women with ER-positive and HER2-negative advanced BC as initial ET (PALOMA-1). In another study, after progression to ET, P in combination with F resulted in longer PFS than F alone (PALOMA-3).
The high median TTP achieved with F alone (FIRST) coupled with the significant benefit of adding P to F (PALOMA-3) suggest that F 500mg in combination with P in the first-line setting may significantly improve long-term disease control.
Trial Design:This is an international, randomized, double-blind, multicentre phase II study comparing F 500mg in combination with P vs F 500mg plus placebo as first line therapy in postmenopausal women with HR-positive, HER2-negative metastatic BC who have received ≥5 years of adjuvant ET for early disease and remained disease free for >12 months following its completion or have “de novo” metastatic disease. HR and HER2 status will be based on central testing on the most recent tumour biopsy. Patients will be randomized 1:1. The primary objective is to compare the efficacy of both treatment arms in terms of PFS at 1 year according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 by investigator assessment. As secondary efficacy objectives,PFS, Objective Response Rate (ORR), Clinical Benefit Rate (CBR), Overall Survival (OS), and 1-year and 2-year survival probabilities, have been considered. Other secondary objectives include the comparison of safety, tolerability and health-related quality of life between the treatment arms. As exploratory objectives, the identification of promising biomarkers related with response to study therapy and primary/acquired drug resistance. Pts will be stratified by the site of disease (visceral vs non-visceral) and disease presentation at study entry (recurrent disease vs metastatic “de novo”). With a sample size of 190 pts, the analysis would have 80% power to detect a difference between both treatment arms, assuming PFS proportions of 0.545 and 0.695, respectively. This study is sponsored by GEICAM and Cancer Trials Ireland (formerly ICORG) is also participating. Recruitment started in February 2016 with 14 pts included. Analysis of the primary endpoint is planned for Q1 2018. ClinicalTrials.gov identifier:NCT02690480.
Citation Format: Moreno F, Martínez-Jañez N, Garau I, Guerra JA, Alarcón J, Bermejo B, Gonzalez-Cortijo L, Bueno C, Lao J, Bezares S, Rosell L, Blanch A, Caballero R, Carrasco E, Rojo F, Martín M, O'Connor M, Hernando A, Albanell J. A phase II study to compare fulvestrant (F) 500mg plus placebo versus (vs) F 500mg plus palbociclib (P) as first line treatment for postmenopausal women with hormone receptor (HR)-positive advanced breast cancer (BC) sensitive to endocrine therapy (ET). “The FLIPPER study” (GEICAM/2014-12) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT3-02-07.
Collapse
Affiliation(s)
- F Moreno
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - N Martínez-Jañez
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - I Garau
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - JA Guerra
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - J Alarcón
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - B Bermejo
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - L Gonzalez-Cortijo
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - C Bueno
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - J Lao
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - S Bezares
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - L Rosell
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - A Blanch
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - R Caballero
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - E Carrasco
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - F Rojo
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - M Martín
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - M O'Connor
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - A Hernando
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - J Albanell
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| |
Collapse
|
32
|
Pereira M, Guerra J, Gonçalves J, Santana A, Nascimento C, da Costa AG. Hyperacute Rejection in a Kidney Transplant With Negative Crossmatch: A Case Report. Transplant Proc 2016; 48:2384-2386. [PMID: 27742303 DOI: 10.1016/j.transproceed.2016.06.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Hyperacute rejection (HAR) is a rare event that can be prevented by crossmatch tests that detect anti-human leukocyte antigen antibodies against the donor. We present the case of a 43-year-old man who underwent a deceased-donor kidney transplantation with a negative complement-dependent cytotoxicity and a negative flow cytometry crossmatch. Luminex technology detected anti-DQ donor-specific antibodies (DSA) with a mean fluorescence intensity of 11,000. A single plasmapheresis session was carried out, followed by immunosuppression with immunoglobulin, antithymocyte globulin, tacrolimus, and methylprednisolone. Minutes after graft reperfusion, in the presence of clinical evidence of HAR, the patient underwent nephrectomy. The investigation for the presence of anti-major histocompatibility complex class I-related chain A and anti-endothelial antibodies was negative. This case reinforces the importance of DSA, and more specifically, of anti-DQ DSA in the allogeneic response when detected by solid-phase tests, even with a negative crossmatch, assuming they can be responsible for HAR.
Collapse
Affiliation(s)
- M Pereira
- Nephrology and Kidney Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
| | - J Guerra
- Nephrology and Kidney Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - J Gonçalves
- Nephrology and Kidney Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - A Santana
- Nephrology and Kidney Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - C Nascimento
- Nephrology and Kidney Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - A G da Costa
- Nephrology and Kidney Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| |
Collapse
|
33
|
Abstract
BACKGROUND The major issues involved in the decision to donate are the perioperative risk and the risk of chronic kidney disease or even end-stage renal disease. The usual glomerular filtration rate (GFR) in kidney donors after transplantation is approximately 70% of the predonation rate; however, some have a GFR <60 mL/min/1.73 m(2). So after kidney donation, mild to moderate renal insufficiency may occur. Thus, it is important to identify predictor factors of postdonation kidney function. OBJECTIVES To evaluate the influence of predictor factors in the evolution of the remaining kidney function and to quantify nonpredictable and unexpected developments in GFR at 1 year post donation. METHODS We performed a study of the evolution of renal function pre- and postnephrectomy of 55 living donors without perioperative comorbidities and a mean follow-up of 6.03 ± 2.7 years. RESULTS One year after nephrectomy donor function was 32% lower than the prenephrectomy value and 21% of donors had an eGFR <60 mL/min/1.73 m(2). In multivariate logistic regression a living donor with a predonation eGFR <100 but >80 mL/min/1.73 m(2) had 5.24 times a chance of having an eGFR <60 mL/min/1.73 m(2) at 1 year post donation than if he had an eGFR ≥100 mL/min/1.73 m(2). Among 15 donors with prenephrectomy eGFR ≥80 and <100 mL/min/1.73m(2), 8 (53%), RR = 3.26 (1.517-7.012) had eGFR <60 mL/min/ 1.73 m(2). CONCLUSIONS The eGFR predonation and donor age influenced the first-year postnephrectomy eGFR. Some donors had a more accelerated eGFR fall, not always related to predonation eGFR and age.
Collapse
Affiliation(s)
- J Guerra
- Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
| | - M J Melo
- Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - A Santana
- Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - J Gonçalves
- Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - C Nascimento
- Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - A G da Costa
- Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| |
Collapse
|
34
|
Guerra J, Luciolli E, Felce A, Ghersi B, Guilmineau F, Rousseau M, Soudrie B, Urtizberea A, Holstein J. Validité de la description d’un groupe spécifique de patients par le PMSI-SSR. Rev Epidemiol Sante Publique 2015; 63:247-52. [DOI: 10.1016/j.respe.2015.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 12/13/2014] [Accepted: 04/08/2015] [Indexed: 11/25/2022] Open
|
35
|
Guerra J, Melo MJ, Gonçalves JA, Nascimento C, Santana A, da Costa AG. Renal transplantation in type 1 diabetes mellitus: an unusual case report. Transplant Proc 2015; 47:1042-4. [PMID: 26036514 DOI: 10.1016/j.transproceed.2015.03.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Diabetes mellitus (DM) may progress to diabetic nephropathy (DN) in approximately 40% of cases and it accounts for one of the most common causes of end-stage of renal disease (ESRD). The pathogenesis of DN involves complex interactions between metabolic and hemodynamic factors. DM type 1 has a dominant impact on morbidity and mortality after renal transplantation. We report a kidney transplantation patient with DM and DN as the etiology of end-stage renal disease and whose post-transplantation evolution over 19 years was remarkably atypical. DM was diagnosed at the age of 7 years and the patient suffered a rapid and aggressive progression of her disease with early development of DN and diabetic retinopathy. Nineteen years post-transplantation, the patient shows neither deterioration of graft function nor clinical reactivation of DN. There seems to be two quite distinct answers to the same injury supported by a group of factors that led to micro- and macrovascular lesions, all present before transplantation and potentially aggravated through some immunosuppressive therapy. This clinical evolution suggests the hypothesis that not only the graft but also the donor may have inherent characteristics that enabled him to display the resistance to DN despite the genetic susceptibility of the receptor. The answers to these questions would help to explain why some patients with diabetes progress to macro- and microvascular complications and others remain resistant to developing these vascular disorders. In this case, the resistance to DN is apparently a feature related to the donor.
Collapse
Affiliation(s)
- J Guerra
- Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
| | - M J Melo
- Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - J A Gonçalves
- Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - C Nascimento
- Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - A Santana
- Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - A G da Costa
- Nephrology and Renal Transplantation Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| |
Collapse
|
36
|
Soria A, Pagola I, Ortega MJ, Brea L, Fiuza C, Cebolla H, Palomo I, Montil M, Malón D, Guerra J, Lucia A, Ruiz A. Abstract P3-08-17: Objectively measured physical activity in breast cancer survivors. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-08-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Obesity and physical inactivity are poor prognostic indicators for breast cancer (BC). Cardiorespiratory fitness (VO2max) is a good predictor of survival. Despite preserved LVEF, cardiorespiratory function is impaired in women with breast cancer after the completion of adjuvant therapy. International organizations recommend at least 150 minutes per week of moderate-vigorous physical activity (MVPA). Some studies show that a minority of cancer survivors are meeting the PA recommendations. A limitation of physical activity (PA) research has been the use of self-reported measures.
Eligibility criteria: 1) Age 18-79, 2) Able to walk a mile, 3) More than one year from diagnosis, 4) More than 3 months since the last therapy, 5) No evidence of disease.
Aims: Objective assessment of physical activity in breast cancer survivors. Adherence to international recommendations.
Material and methods: PA was evaluated through accelerometry (600 minutes per day, 5 days per week, 2 week-end days were required to consider as valid accelerometry values). Cardiorespiratory fitness was assessed through the “one-mile test”.
Results: 92 women (W) with BC history were included. 86 W were evaluable for accelerometry. 85 W were evaluable for VO2max. Age: 54.02 years (33-77), BMI: 27.89 (SD 8.89), waist perimeter: 89.74 cm (SD 17.37), median time from diagnosis 3.94 years, treatment with anthracyclines 55 W (63.9%), radiotherapy 69 W (80.23%). Accelerometry (86W): Average weekly time MVPA 351.14 min/wk (SD: 168.98). 76 (88%) met international recommendations of PA. Women previously treated with anthracyclines (47 W; 340.25 min/wk), radiotherapy (59 w; 343 min/wk) and both (48 W; 331 min/wk) exercised less than women who did not receive these therapies (8 W; 386 min/wk). This association was not statistically significant.
Average VO2max was 24.8 ml/kg/min (SD: 7.6).There was a significant effect of anthracyclines for VO2 max. Women not treated with anthracyclines had a VO2max: 26.41 whereas treated W had VO2max 22.08 ml/kg/min.
Discussion: A cohort of Spanish women met international recommendations of PA when it was objectively assessed. This cohort exhibited a poor cardiometabolic and cardiorespiratory profile. Previous exposure to anthracyclines predicted a poorer cardiorespiratory fitness. Specific research to investigate the role of exercise to mitigate that dysfunction in breast cancer survivors is warranted.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-08-17.
Collapse
Affiliation(s)
- A Soria
- Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid, Spain; Universidad Europea de Madrid, Spain; Universidad Nacional de Educación a Distancia, Spain; Hospital Universitario Puerta de Hierro, Spain
| | - I Pagola
- Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid, Spain; Universidad Europea de Madrid, Spain; Universidad Nacional de Educación a Distancia, Spain; Hospital Universitario Puerta de Hierro, Spain
| | - MJ Ortega
- Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid, Spain; Universidad Europea de Madrid, Spain; Universidad Nacional de Educación a Distancia, Spain; Hospital Universitario Puerta de Hierro, Spain
| | - L Brea
- Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid, Spain; Universidad Europea de Madrid, Spain; Universidad Nacional de Educación a Distancia, Spain; Hospital Universitario Puerta de Hierro, Spain
| | - C Fiuza
- Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid, Spain; Universidad Europea de Madrid, Spain; Universidad Nacional de Educación a Distancia, Spain; Hospital Universitario Puerta de Hierro, Spain
| | - H Cebolla
- Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid, Spain; Universidad Europea de Madrid, Spain; Universidad Nacional de Educación a Distancia, Spain; Hospital Universitario Puerta de Hierro, Spain
| | - I Palomo
- Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid, Spain; Universidad Europea de Madrid, Spain; Universidad Nacional de Educación a Distancia, Spain; Hospital Universitario Puerta de Hierro, Spain
| | - M Montil
- Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid, Spain; Universidad Europea de Madrid, Spain; Universidad Nacional de Educación a Distancia, Spain; Hospital Universitario Puerta de Hierro, Spain
| | - D Malón
- Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid, Spain; Universidad Europea de Madrid, Spain; Universidad Nacional de Educación a Distancia, Spain; Hospital Universitario Puerta de Hierro, Spain
| | - J Guerra
- Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid, Spain; Universidad Europea de Madrid, Spain; Universidad Nacional de Educación a Distancia, Spain; Hospital Universitario Puerta de Hierro, Spain
| | - A Lucia
- Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid, Spain; Universidad Europea de Madrid, Spain; Universidad Nacional de Educación a Distancia, Spain; Hospital Universitario Puerta de Hierro, Spain
| | - A Ruiz
- Hospital Universitario Fuenlabrada, Fuenlabrada, Madrid, Spain; Universidad Europea de Madrid, Spain; Universidad Nacional de Educación a Distancia, Spain; Hospital Universitario Puerta de Hierro, Spain
| |
Collapse
|
37
|
Padonou G, Le Port A, Cottrell G, Guerra J, Choudat I, Rachas A, Bouscaillou J, Massougbodji A, Garcia A, Martin-Prevel Y. Prematurity, intrauterine growth retardation and low birth weight: risk factors in a malaria-endemic area in southern Benin. Trans R Soc Trop Med Hyg 2013; 108:77-83. [DOI: 10.1093/trstmh/trt099] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
38
|
Estevez M, Rodriguez JR, Vargas S, Guerra JA, Brostow W, Lobland HEH. Scratch and abrasion properties of polyurethane-based micro- and nano-hybrid obturation materials. J Nanosci Nanotechnol 2013; 13:4446-4455. [PMID: 23862519 DOI: 10.1166/jnn.2013.7227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Polyurethane-based micro- and nano-hybrid composites were produced with controlled porosity to be used as obturation materials. In addition to hydroxyapatite (HAp) micro-particles in the composites, two different ceramics particle types were also added: alumina micro-particles and silica nano-particles. Particles of different sizes provide the materials with improved mechanical properties: the use of micro- and nano-particles produces a better packing because the nano-particles fill the interstitial space left by the micro-particles, rendering an improvement in the mechanical properties. The silica and alumina particles provide the materials with appropriate abrasion and scratching properties, while the HAp provides the required bio-acceptance. The polymeric matrix was a mono-component solvent-free polyurethane. The porosity was selected by controlling the chemical reaction.
Collapse
Affiliation(s)
- Miriam Estevez
- Centro de Fisica Aplicada y Tecnología Avanzada (CFATA), Universidad Nacional Autonoma de Mexico, Campus Juriquilla, Queretaro 04510, CP 76230, Mexico
| | | | | | | | | | | |
Collapse
|
39
|
Teixeira C, El Bouazzaoui Z, Guerra J, Raimundo M, Santana A, Mil-Homens MC, Gomes da Costa A. Are there real advantages of induction therapy with basiliximab in renal transplantation? Transplant Proc 2013; 45:1073-5. [PMID: 23622629 DOI: 10.1016/j.transproceed.2013.02.088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Randomized clinical trials have supported the use of interleukin-2 receptor (IL-2R) antagonists as induction therapy in renal transplantation. This strategy has reduced the incidence of acute rejection episodes (ARE) but not improved graft survival. Our objective was to investigate the impact of induction therapy using the IL-2R antagonist basiliximab, as compared with no induction therapy, on relevant clinical outcomes-initial length of stay, incidence of ARE, long-term graft function, and graft survival. METHODS We retrospectively reviewed the medical records of patients transplanted in a tertiary care center between 1996 and 2011. We selected patients who received cyclosporine, mycophenolate mofetil, and prednisolone (n = 334) to classify as: no induction therapy (n = 131; group 1); induction therapy with basiliximab (n = 203; group 2). Estimated glomerular filtration rate (eGFR) was assessed with the 4-variable Modification of Diet in Renal Disease (MDRD) equation. RESULTS Mean follow-up was 72.7 ± 35.4 months. Patients who received basiliximab had a shorter mean hospital stay (19.2 versus 22.5 days; P = .02), lower incidence of ARE (10.8% versus 23.7%; P = .02) and better graft function post transplantation at 12 months (mean eGFR 59.4 ± 18.4 versus 54.8 ± 18.7 mL/min/1.73 m(2); P = .015) and 5 years (mean eGFR 64.1 ± 21.5 versus 55.4 ± 19.6 mL/min/1.73 m(2); P = .009). On multivariate analysis, induction therapy with basiliximab was independently associated with a lower incidence of ARE and better graft function at 1 and 5 years after transplantation. There was no difference in 5-year graft survival between the two groups (log-rank: P = .54). CONCLUSIONS Induction therapy with basiliximab was associated with a reduced incidence of ARE and better long-term graft function but no difference in 5-year graft survival.
Collapse
Affiliation(s)
- C Teixeira
- Department of Nephrology and Renal Transplantation, Hospital de Santa Maria, Lisbon, Portugal
| | | | | | | | | | | | | |
Collapse
|
40
|
Guerra J, Raimundo M, Teixeira C, Santana A, Cortesão A, Gomes da Costa A. Factors That May Influence Estimated Glomerular Filtration Rate in Patients With Excellent Graft Function 10 Years Posttransplant. Transplant Proc 2013; 45:1060-2. [DOI: 10.1016/j.transproceed.2013.03.003] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
41
|
Girlanda R, Cheema AK, Kaur P, Kwon Y, Li A, Guerra J, Matsumoto CS, Zasloff M, Fishbein TM. Metabolomics of human intestinal transplant rejection. Am J Transplant 2012; 12 Suppl 4:S18-26. [PMID: 22759354 DOI: 10.1111/j.1600-6143.2012.04183.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Surveillance endoscopy with biopsy is the standard method to monitor intestinal transplant recipients but it is invasive, costly and prone to sampling error. Early noninvasive biomarkers of intestinal rejection are needed. In this pilot study we applied metabolomics to characterize the metabolomic profile of intestinal allograft rejection. Fifty-six samples of ileostomy fluid or stool from 11 rejection and 45 nonrejection episodes were analyzed by ultraperformance liquid chromatography in conjunction with Quadrupole time-of-flight mass spectrometry (UPLC-QTOFMS). The data were acquired in duplicate for each sample in positive ionization mode and preprocessed using XCMS (Scripps) followed by multivariate data analysis. We detected a total of 2541 metabolites in the positive ionization mode (mass 50-850 Daltons). A significant interclass separation was found between rejection and nonrejection. The proinflammatory mediator leukotriene E4 was the metabolite with the highest fold change in the rejection group compared to nonrejection. Water-soluble vitamins B2, B5, B6, and taurocholate were also detected with high fold change in rejection. The metabolomic profile of rejection was more heterogeneous than nonrejection. Although larger studies are needed, metabolomics appears to be a promising tool to characterize the pathophysiologic mechanisms involved in intestinal allograft rejection and potentially to identify noninvasive biomarkers.
Collapse
Affiliation(s)
- R Girlanda
- Georgetown Transplant Institute, Washington, DC, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
M. Pavan G, Monteagudo S, Guerra J, Carrion B, Ocana V, Rodriguez-Lopez J, Danani A, C. Perez-Martinez F, Cena V. Role of Generation, Architecture, pH and Ionic Strength on Successful siRNA Delivery and Transfection by Hybrid PPV-PAMAM Dendrimers. Curr Med Chem 2012; 19:4929-41. [DOI: 10.2174/0929867311209024929] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 05/28/2012] [Accepted: 08/01/2012] [Indexed: 11/22/2022]
|
43
|
Abstract
Egypt is the country with the largest hepatitis C virus (HCV) epidemic in the world. In 2008, a Demographic Health Survey (DHS) was carried out in Egypt, providing for the first time a unique opportunity for HCV antibody testing on a nationwide representative sample of individuals. Consenting individuals answered a questionnaire on socio-demographic characteristics and iatrogenic exposures, before providing a blood sample for HCV antibody testing by enzyme-linked immunosorbent assay. Factors independently associated with HCV infection were examined through multivariate logistic regression models. Of 12 780 eligible subjects aged 15-59 years, 11 126 (87.1%) agreed to participate and provided a blood sample. HCV antibody prevalence nationwide was 14.7% (95% CI 13.9-15.5%) in this age group. HCV antibody prevalence gradually increased with age, reaching, in the 50-59 years age group, 46.3% and 30.8% in males and females, respectively. It was higher in males compared to females (17.4% versus 12.2%, respectively, P < 0.001), and in rural compared to urban areas (18.3% versus 10.3%, respectively, P < 0.001). In multivariate analysis, age, male sex, poverty, past history of intravenous anti-schistosomiasis treatment, blood transfusion, and living outside of the Frontier Governorates were all significantly associated with an increased risk of HCV infection. In addition, in urban areas, lack of education and being circumcised for females were associated with an increased risk of HCV infection. This study confirmed on a nationwide representative sample the very high HCV antibody prevalence in Egypt. It stresses the urgent need for strengthening prevention efforts, and bringing down the costs of antiviral drugs for countries like Egypt, where the people in the most precarious situations are also those most likely to be infected by the virus.
Collapse
Affiliation(s)
- J Guerra
- Institut Pasteur, Unité d'épidémiologie des maladies émergentes, Paris, France
| | | | | | | |
Collapse
|
44
|
Riegersperger M, Plischke M, Steiner-Boker S, Seidinger D, Winkelmayer W, Sunder-Plassmann G, Vlahovic P, Vlahovic P, Cvetkovic T, Djordjevic V, Velickovic-Radovanovic R, Stefanovic N, Ignjatovic A, Sladojevic N, Cademartori V, Massarino F, Parodi EL, Russo R, Sofia A, Fontana I, Viviani GL, Garibotto G, Mai M, Mai W, Taner B, Wadei H, Prendergast M, Gonwa T, Martin J, Martin J, Aurore S, Aline CS, Nicolas M, Manolie M, Catherine S, Eric A, Christophe M, Brakemeier S, Liefeldt L, Glander P, Waiser J, Lachmann N, Schonemann C, Zukunft B, Illigens P, Schmidt D, Wu K, Rudolph B, Neumayer HH, Budde K, Pallardo Mateu L, Gavela Martinez E, Sancho Calabuig A, Crespo Albiach J, Beltran Catalan S, Gavela Martinez E, Kanter Berga J, Kimura T, Yagisawa T, Ishikawa N, Sakuma Y, Hujiwara T, Nukui A, Yashi M, Duraes J, Malheiro J, Fonseca I, Rocha A, Martins LS, Almeida M, Dias L, Castro-Henriques A, Cabrita A, Mai M, Mai W, Wadei H, Prendergast M, Gonwa T, Volpe A, Quaglia M, Menegotto A, Fenoglio R, Izzo C, Airoldi A, Terrone C, Stratta P, Ahmed B, Mireille K, Nilufer B, Annick M, Karl Martin W, Anh-Dung H, Dimitri M, Philippe M, Judith R, Daniel A, Liefeldt L, Glander P, Glander P, Lan Y, Schmidt D, Heine C, Budde K, Neumayer HH, Schmidt D, Glander P, Glander P, Budde K, Neumayer HH, Liefeldt L, Quaglia M, Quaglia M, Capone V, Izzo C, Menegotto A, Fenoglio R, Airoldi A, Stratta P, Grace B, Clayton P, Cass A, Mcdonald S, Yagisawa T, Yagisawa T, Yashi M, Kimura T, Nukui A, Fujiwara T, Sakuma Y, Ishikawa N, Iwabuchi T, Muraishi O, Torregrosa V, Barros X, Martinez de Osaba MJ, Paschoalin R, Campistol JM, Hassan R, El-Hefnawy A, Soliman S, Shokeir A, Cobanoglu Kudu A, Gungor O, Kircelli F, Altinel E, Asci G, Ozbek SS, Toz H, Ok E, Sandrini S, Setti G, Valerio F, Possenti S, Torrisi I, Polanco N, Garcia-Puente L, Gonzalez Monte E, Morales E, Gutierrez E, Bengoa I, Hernandez A, Caballero J, Morales JM, Andres A, Sgarlato V, Sgarlato V, Comai G, La Manna G, Moretti I, Grandinetti V, Martelli D, Scolari MP, Stefoni S, Valentini C, Valentini C, Persici E, La Manna G, Cappuccilli ML, Sgarlato V, Liviano D'arcangelo G, Fabbrizio B, Carretta E, Mosconi G, Scolari MP, Feliciangeli G, Grigioni FW, Stefoni S, Apicella L, Guida B, Vitale S, Garofalo G, Russo L, Maresca I, Rossano R, Memoli B, Carrano R, Federico S, Sabbatini M, Carta P, Zanazzi M, DI Maria L, Caroti L, Miejshtri A, Tsalouchos A, Bertoni E, Sezer S, Erkmen Uyar M, Colak T, Bal Z, Tutal E, Kalaci G, Ozdemir Acar FN, Jacquelinet C, Bayat S, Pernin V, Portales P, Szwarc I, Garrigue V, Vetromile F, Delmas S, Eliaou JF, Mourad G, Huber L, Huber L, Slowinski T, Naik M, Glander P, Liefeldt L, Schmidt D, Neumayer HH, Budde K, Nakai K, Fujii H, Kono K, Goto S, Ishimura T, Takeda M, Fujisawa M, Nishi S, Pereira Paschoalin R, Paschoalin R, Torregrosa JV, Barros Freiria X, Duran Rebolledo CE, Sanchez Escuredo A, Sole M, Campistol JM, Youssouf S, Tabbasm F, Bell R, Al-Jayyousi R, Warwick G, Grall A, Treguer L, Essig M, Lecaque C, Noel N, Buchler M, Bertrand D, Rivalan J, Braun L, Villemain F, Hurault de Ligny B, Totet A, Pestourie N, Toubas D, Nevez G, Le Meur Y, Nour el Houda B, Mustapha H, Wafaa F, Inass L, Rambabova Bushljetikj I, Rambabova Bushljetikj I, Masin-Spasovska J, Spasovski G, Popov Z, Sikole A, Ivanovski N, Raimundo M, Guerra J, Teixeira C, Santana A, Silva S, Mil Homens C, Gomes Da Costa A, Loredo D, Cleres M, Gondolesi G, Gutierrez LM, Fortunato RM, Descalzi V, Raffaele P. Transplantation - clinical II. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs248] [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
|
45
|
Solano MO, Soria A, Cebolla H, Martín J, Sebastian T, Ortiz M, García E, Bravo D, Guerra J, Ruiz A. 94 The Oncology Nurse as a Necessary Participant of the Multidisciplinary Cancer Conferences. Eur J Oncol Nurs 2012. [DOI: 10.1016/s1462-3889(12)70107-2] [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]
|
46
|
Guerra J, Bagur C, Girabent M. Adaptación al castellano y validación del cuestionario sobre práctica basada en la evidencia en fisioterapeutas. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.ft.2011.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
47
|
Guerrier G, Guerra J, Fermon F, Talkibing WB, Sekkenes J, Grais RF. Outbreak response immunisation: The experience of Chad during recurrent measles epidemics in 2005 and 2010. Int Health 2011; 3:226-30. [PMID: 24038494 DOI: 10.1016/j.inhe.2011.06.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Despite impressive gains in measles control globally, measles epidemics continue to occur in countries with insufficient vaccination coverage. WHO guidelines now recommend outbreak response immunisation (ORI) for controlling measles outbreaks in certain contexts. The objective of this study was to describe late and early response vaccination activities during two consecutive measles outbreaks that occurred in 2005 and 2010 in N'Djamena, Chad. Using Lot Quality Assurance Sampling, vaccination coverage was estimated to be low before the interventions. Following mass vaccination campaigns, measles cases declined. The timeliness and quality of ORI activities are crucial determinants of success. However, effective outbreak response should be accompanied by strong routine vaccination programmes to ensure sustainable high vaccination coverage.
Collapse
Affiliation(s)
- G Guerrier
- Epicentre, 8 rue Saint Sabin, 75011 Paris, France
| | | | | | | | | | | |
Collapse
|
48
|
Hawksworth J, Cummings L, Guerra J, Girlanda R, Kaufman S, Johnson L, Fishbein T, Matsumoto C. Acute Cellular Rejection In Adult And Pediatric Intestinal Transplantation. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
49
|
Vivanco M, Gabrielli M, Jarufe N, Humeres R, Rios H, Palacios JM, Zapata R, Sanhueza E, Contreras J, Rencore G, Rossi R, Martínez J, Pérez R, Guerra J, Arrese M, Figueroa E, Soza A, Yáñes R, Hepp J. Bridge therapy in hepatocellular carcinoma before liver transplantation: the experience of two Chilean centers. Transplant Proc 2010; 42:296-8. [PMID: 20172335 DOI: 10.1016/j.transproceed.2009.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Orthotopic liver transplantation (OLT) is currently an established therapy for small, early-stage hepatocellular carcinoma (HCC) within the Milan criteria. Long waiting times due to the shortage of donor organs can result in tumor progression and drop-out from OLT candidacy. Therefore a wide variety of procedures are necessary before OLT. The aim of this retrospective study was to review our experience in relation to bridge therapy prior to OLT for HCC. METHODS This was a retrospective database review of all of the patient who underwent transplantation in our institutions between January 1993 and June 2009. We analyzed patients with a diagnosis of HCC in the explant. RESULTS Among 29 patients, including 12 who were diagnosed by the explant and 17 prior to transplantation, 88% underwent bridge therapy during a mean waiting time to OLT of 12 months. Among the 23 procedures, namely 1.5 procedures per patient, included most frequently chemoembolization (48%), alcohol ablation (30%), radiofrequency ablation (13%), and surgery (9%). Thirty-three percent of the explants contained lesions within the Milan criteria. In our series the 5-year survival rate for patients transplanted for HCC was 86%; in the bridge therapy group, it was 73%. CONCLUSIONS The incidence of patients who underwent bridge therapy (52%) was similar to other reported experiences, but the fulfillment of Milan criteria in the explants was lower. Among the bridge therapy group, the survival was slightly lower, probably because this group displayed more advanced disease.
Collapse
Affiliation(s)
- M Vivanco
- Liver Transplantation Program, Clínica Alemana, Santiago, Chile
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Katz L, Amorim M, Souza A, Guerra J, Melo A, Costa A, Heráclio S, Melo B. P1031 Agreement between initial cytology, cytology repeated at the time of colposcopy and histopathology. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)62517-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|