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Serra J, Marques-Dos-Santos C, Marinheiro J, Cruz S, Cameira MR, de Vries W, Dalgaard T, Hutchings NJ, Graversgaard M, Giannini-Kurina F, Lassaletta L, Sanz-Cobeña A, Quemada M, Aguilera E, Medinets S, Einarsson R, Garnier J. Assessing nitrate groundwater hotspots in Europe reveals an inadequate designation of Nitrate Vulnerable Zones. Chemosphere 2024; 355:141830. [PMID: 38552801 DOI: 10.1016/j.chemosphere.2024.141830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/07/2024] [Accepted: 03/26/2024] [Indexed: 04/02/2024]
Abstract
Monitoring networks show that the European Union Nitrates Directive (ND) has had mixed success in reducing nitrate concentrations in groundwater. By combining machine learning and monitored nitrate concentrations (1992-2019), we estimate the total area of nitrate hotspots in Europe to be 401,000 km2, with 47% occurring outside of Nitrate Vulnerable Zones (NVZs). We also found contrasting increasing or decreasing trends, varying per country and time periods. We estimate that only 5% of the 122,000 km2 of hotspots in 2019 will meet nitrate quality standards by 2040 and that these may be offset by the appearance of new hotspots. Our results reveal that the effectiveness of the ND is limited by both time-lags between the implementation of good practices and pollution reduction and an inadequate designation of NVZs. Substantial improvements in the designation and regulation of NVZs are necessary, as well as in the quality of monitoring stations in terms of spatial density and information available concerning sampling depth, if the objectives of EU legislation to protect groundwater are to be achieved.
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Affiliation(s)
- J Serra
- Forest Research Centre CEF, Associate Laboratory TERRA, Instituto Superior de Agronomía, Universidade de Lisboa, 1349-017, Lisbon, Portugal.
| | - C Marques-Dos-Santos
- Forest Research Centre CEF, Associate Laboratory TERRA, Instituto Superior de Agronomía, Universidade de Lisboa, 1349-017, Lisbon, Portugal
| | - J Marinheiro
- Forest Research Centre CEF, Associate Laboratory TERRA, Instituto Superior de Agronomía, Universidade de Lisboa, 1349-017, Lisbon, Portugal
| | - S Cruz
- Forest Research Centre CEF, Associate Laboratory TERRA, Instituto Superior de Agronomía, Universidade de Lisboa, 1349-017, Lisbon, Portugal
| | - M R Cameira
- LEAF-Linking Landscape, Environment, Agriculture and Food-Research Center, Associated Laboratory TERRA, Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017, Lisbon, Portugal
| | - W de Vries
- Environmental Systems Analysis Group, Wageningen University and Research, Wageningen, the Netherlands
| | - T Dalgaard
- Department of Agroecology, Aarhus University, Blichers Allé 20, DK-8830, Tjele, Denmark
| | - N J Hutchings
- Department of Agroecology, Aarhus University, Blichers Allé 20, DK-8830, Tjele, Denmark
| | - M Graversgaard
- Department of Agroecology, Aarhus University, Blichers Allé 20, DK-8830, Tjele, Denmark
| | - F Giannini-Kurina
- Department of Agroecology, Aarhus University, Blichers Allé 20, DK-8830, Tjele, Denmark
| | - L Lassaletta
- CEIGRAM/ETSIAAB, Universidad Politécnica de Madrid, 28040, Madrid, Spain
| | - A Sanz-Cobeña
- CEIGRAM/ETSIAAB, Universidad Politécnica de Madrid, 28040, Madrid, Spain
| | - M Quemada
- CEIGRAM/ETSIAAB, Universidad Politécnica de Madrid, 28040, Madrid, Spain
| | - E Aguilera
- CEIGRAM/ETSIAAB, Universidad Politécnica de Madrid, 28040, Madrid, Spain
| | - S Medinets
- Odesa National I. I. Mechnikov University, 7 Mayakovskogo lane, 65082, Odesa, Ukraine; UK Centre for Ecology & Hydrology (Edinburgh), Bush Estate, EH26 0QB, Penicuik, UK
| | - R Einarsson
- Department of Energy and Technology, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - J Garnier
- SU CNRS EPHE, UMR Metis, 7619, Paris, France
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2
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Sousa AS, Serra J, Estevens C, Costa R, Ribeiro AJ. Leveraging a multivariate approach towards enhanced development of direct compression extended release tablets. Int J Pharm 2023; 646:123432. [PMID: 37739095 DOI: 10.1016/j.ijpharm.2023.123432] [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: 06/21/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023]
Abstract
Extended release formulations play a crucial role in the pharmaceutical industry by maintaining steady plasma levels, reducing side effects, and improving therapeutic efficiency and compliance. One commonly used method to develop extended release formulations is direct compression, which offers several advantages, such as simplicity, time savings, and cost-effectiveness. However, successful direct compression-based extended release formulations require careful assessment and an understanding of the excipients' attributes. The scope of this work is the characterization of the compaction behavior of some matrix-forming agents and diluents for the development of extended release tablets. Fifteen excipients commonly used in extended release formulations were evaluated for physical, compaction and tablet properties. Powder properties (e.g., particle size, flow properties, bulk density) were evaluated and linked to the tablet's mechanical properties in a fully integrated approach, and data were analyzed by constructing a principal component analysis (PCA). Significant variability was observed among the various excipients. The present work successfully demonstrates the applicability of PCA as an effective tool for comparative analysis, pattern and clustering recognition and correlations between excipients and their properties, facilitating the development and manufacturing of direct compressible extended release formulations.
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Affiliation(s)
- A S Sousa
- Universidade de Coimbra, Faculdade de Farmácia, 3000-148 Coimbra, Portugal; Grupo Tecnimede, Quinta da Cerca, Caixaria, 2565-187 Dois Portos, Portugal
| | - J Serra
- Grupo Tecnimede, Quinta da Cerca, Caixaria, 2565-187 Dois Portos, Portugal
| | - C Estevens
- Grupo Tecnimede, Quinta da Cerca, Caixaria, 2565-187 Dois Portos, Portugal
| | - R Costa
- Grupo Tecnimede, Quinta da Cerca, Caixaria, 2565-187 Dois Portos, Portugal
| | - A J Ribeiro
- Universidade de Coimbra, Faculdade de Farmácia, 3000-148 Coimbra, Portugal; i3S, IBMC, Rua Alfredo Allen, 4200-135 Porto, Portugal.
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3
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González-Rodríguez L, Pérez-Davila S, Lama R, López-Álvarez M, Serra J, Novoa B, Figueras A, González P. 3D printing of PLA:CaP:GO scaffolds for bone tissue applications. RSC Adv 2023; 13:15947-15959. [PMID: 37260570 PMCID: PMC10227527 DOI: 10.1039/d3ra00981e] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/11/2023] [Indexed: 06/02/2023] Open
Abstract
Graphene oxide (GO) has attracted increasing interest for biomedical applications owing to its outstanding properties such as high specific surface area, ability to bind functional molecules for therapeutic purposes and solubility, together with mechanical resistance and good thermal conductivity. The combination of GO with other biomaterials, such as calcium phosphate (CaP) and biodegradable polymers, presents a promising strategy for bone tissue engineering. Presently, the development of these advanced biomaterials benefits from the use of additive manufacturing techniques, such as 3D printing. In this study, we develop a 3D printed PLA:CaP:GO scaffold for bone tissue engineering. First, GO was characterised alone by XPS to determine its main bond contributions and C : O ratio. Secondly, we determined the GO dose which ensures the absence of toxicity, directly exposed in vitro (human osteoblast-like cells MG-63) and in vivo (zebrafish model). In addition, GO was microinjected in the zebrafish to evaluate its effect on immune cells, quantifying the genetic expression of the main markers. Results indicated that the GO tested (C : O of 2.14, 49.50% oxidised, main bonds: C-OH, C-O-C) in a dose ≤0.25 mg mL-1 promoted MG63 cells viability percentages above 70%, and in a dose ≤0.10 mg mL-1 resulted in the absence of toxicity in zebrafish embryos. The immune response evaluation reinforced this result. Finally, the optimised GO dose (0.10 mg mL-1) was combined with polylactic acid (PLA) and CaP to obtain a 3D printed PLA:CaP:GO scaffold. Physicochemical characterisation (SEM/EDS, XRD, FT-Raman, nano-indentation) was performed and in vivo tests confirmed its biocompatibility, enabling a novel approach for bone tissue-related applications.
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Affiliation(s)
- L González-Rodríguez
- CINTECX, Universidade de Vigo, Grupo de Novos Materiais 36310 Vigo Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO 36213 Vigo Spain
| | - S Pérez-Davila
- CINTECX, Universidade de Vigo, Grupo de Novos Materiais 36310 Vigo Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO 36213 Vigo Spain
| | - R Lama
- Institute of Marine Reseach (IIM), CSIC Eduardo Cabello 6 36208 Vigo Spain
| | - M López-Álvarez
- CINTECX, Universidade de Vigo, Grupo de Novos Materiais 36310 Vigo Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO 36213 Vigo Spain
| | - J Serra
- CINTECX, Universidade de Vigo, Grupo de Novos Materiais 36310 Vigo Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO 36213 Vigo Spain
| | - B Novoa
- Institute of Marine Reseach (IIM), CSIC Eduardo Cabello 6 36208 Vigo Spain
| | - A Figueras
- Institute of Marine Reseach (IIM), CSIC Eduardo Cabello 6 36208 Vigo Spain
| | - P González
- CINTECX, Universidade de Vigo, Grupo de Novos Materiais 36310 Vigo Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO 36213 Vigo Spain
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Opdam F, Heymach J, Barve M, Tu HY, Wu YL, Gibson N, Sadrolhefazi B, Serra J, Yoh K, Yamamoto N. 40P Updated data from the phase I Beamion Lung 1 trial of BI 1810631, a HER2 TKI, in patients (pts) with advanced solid tumours with HER2 aberrations. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00294-0] [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: 04/04/2023]
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Sousa AS, Serra J, Estevens C, Costa R, Ribeiro AJ. A quality by design approach in oral extended release drug delivery systems: where we are and where we are going? J Pharm Investig 2022. [DOI: 10.1007/s40005-022-00603-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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6
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Opdam F, Heymach J, Barve M, Gibson N, Sadrolhefazi B, Serra J, Yamamoto N, Yoh K, Wu YL. EP08.02-049 A Phase I Trial of the HER2 Exon 20 Inhibitor, BI 1810631, In Patients With Advanced Solid Tumors With HER2 Aberrations. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.731] [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: 10/14/2022]
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7
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Schol J, Wauters L, Dickman R, Drug V, Mulak A, Serra J, Enck P, Tack J. United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis. United European Gastroenterol J 2022; 9:883-884. [PMID: 35099124 DOI: 10.1002/ueg2.12090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- J Schol
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - L Wauters
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - R Dickman
- Division of Gastroenterology, Rabin Medical Center, Beilinson Hospital, Petach Tikwa, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - V Drug
- University of Medicine and Pharmacy Gr T Popa Iasi and University Hospital St Spiridon, Iasi, Romania
| | - A Mulak
- Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wroclaw, Poland
| | - J Serra
- Digestive System Research Unit. University Hospital Vall d'Hebron. Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas (CIBERehd). Barcelona, Spain
| | - P Enck
- Department of Internal Medicine VI: Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - J Tack
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
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Ioaquín AB, Piedra A, Mosquera J, Riudavets M, Gomez-Randulfe M, Campelo MG, Sullivan I, Serra J, Aguado M, Tarruella MM. 131P Predictive factors of response to PD-(L)1 inhibitors in patients with advanced non-small cell lung (NSCLC) and high PD-L1 expression. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01973-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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9
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Clemente V, Allen-Gomes A, Tavares D, Azevedo C, Marques D, Serra J. How severe insomnia is (as measured by the insomnia severity index) depending on whether patients are using versus not using sleeping medication? Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Garcia-Garcia C, Rueda F, Vila J, De Diego O, Oliveras T, Labata C, Serra J, Ferrer M, El Ouaddi N, Cediel G, Elosua R, Lupon J, Bayes-Genis A. P1729Cardiogenic shock in ST elevation myocardial infarction: prevalence, management and acute phase and one-year mortality over the last three decades. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0484] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiogenic shock (CS) is an ominous complication of ST elevation myocardial infarction (STEMI). However, the widespread use of reperfusion therapies and invasive management could have reduced the prevalence of CS and improved the prognosis of these patients in the last decades.
Purpose
The aim is to analyze the changes over last three decades in the prevalence, management and acute phase prognosis and 1-year mortality of STEMI patients complicated with CS.
Method
Between February 1989 and December 2017, 7,589 STEMI patients were consecutively admitted in the Coronary Care Unit of a University Hospital and were included in a prospective registry. Depending on the year of admission, patients were classified in five groups: 1989–1994: n=1,337, period 1; 1995–1999: n=960, period 2; 2000–2004: n=1,059, period 3; 2005–2009: n=1,535, period 4 and 2010–2015: n=2,698, period 5). We analyze the trend in prevalence of CS, management and 28-day and 1-year mortality over these five periods.
Results
The global prevalence of CS was 6.1% (466 patients), mean age was 67.7 (SD 11.7) years and 68.7% were men. Prevalence of CS in STEMI decreased from period 1 to 5 (7.3%, 6.4%, 5.5%, 5.8%, 6.0%, p<0.001), although it has been reduced more in women (10.1% in period 1 vs 8.3%, period 5, p<0.001) than in men (6.5% vs 5.4%, period 1 vs 5, respectively (p<0.001). Reperfusion therapy increased from 25.8% in period 1 (all with thrombolysis) vs 83.8% in period 5 (all with primary angioplasty). Intra-aortic balloon contrapulsation was only available from period 3 to 5, and it's used were firstly increased (20.7%, 36% and 37.9%, respectively, p<0.001). Ventricular assistance device (Impella CP) it was only available in 2017 and it was implanted in 10.5% of CS due to STEMI. Although 28-day case fatality is very high (60.7%, 283 patients), it has been reduced from period 1 to 5 (69.6%, 77.3%, 64.7%, 55.9% and 57.8%, respectively, p=0.012). This reduction in 28-day case fatality was higher in women (75.5% in period 1 vs 58.6% in period 5, p=0.12) than in men (66.8% vs 57.3, period 1–5, p=0.019). One-year mortality has been reduced between periods 1–5 (73.7% vs 61.8%, p=0.012). After multivariate adjustment, both 28-day (HR 0.63, 95% CI: 0.45–0.89, p=0.008) and 1-year mortality (HR 0.64, 95% CI: 0.45–0.90, p=0.010) have declined in the last period.
Kaplan-Meier curves, 1-year mortality
Conclusions
Cardiogenic shock development in STEMI patients has been reduced from 7.3% to 6.1% in the last three decades. The whole improvement in management of these patients achieves a 37% of reduction in 28-day case fatality and 1-year all-cause mortality. Despite this improvement, acute phase (28-day) case fatality of STEMI complicated with CS remains over 57% in the primary angioplasty era.
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Affiliation(s)
| | - F Rueda
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - J Vila
- Hospital del Mar, Municipal Institute for Medical Research (IMIM), Barcelona, Spain
| | - O De Diego
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - T Oliveras
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - C Labata
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - J Serra
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M Ferrer
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - N El Ouaddi
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - G Cediel
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - R Elosua
- Hospital del Mar, Municipal Institute for Medical Research (IMIM), Barcelona, Spain
| | - J Lupon
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol University Hospital, Barcelona, Spain
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Riudavets M, Mosquera J, Campelo RG, Serra J, Anguera G, Gallardo P, Sullivan I, Barba A, Majem M. P2.04-52 Impact of Corticosteroids and Antibiotics on Efficacy of Immune-Checkpoint Inhibitors in Patients with Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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12
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Riudavets M, Mosquera J, Campelo RG, Serra J, Anguera G, Gallardo P, Sullivan I, Barba A, Majem M. P1.04-19 Association Between Efficacy and irAEs in Patients with Advanced Non-Small Cell Lung Cancer Receiving Immune-Checkpoint Inhibitors. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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13
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El Ouaddi N, Garcia-Garcia C, De Diego O, Labata C, Rueda F, Oliveras T, Camara ML, Serra J, Berastegui E, Ferrer M, Munoz C, Bayes-Genis A. P865Mechanical Complications in ST elevation myocardial infarction: Trends in prevalence, acute phase prognosis and one-year mortality after the onset of reperfusion network. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0462] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The development of mechanical complications (MC) following an ST elevation myocardial infarction (STEMI) is associated with a high acute phase and long-term mortality. However, the widespread use of reperfusion therapies with primary angioplasty (pPCI) and surgical management could have reduced the prevalence of MC and improved the prognosis of these patients in the last years.
Purpose
The aim is to analyze the changes in the prevalence, management and acute phase prognosis and 1-year mortality of STEMI patients complicated with MC between two periods, before and after the onset of pPCI reperfusion network.
Method
We included all STEMI patients in a single centre prospective registry. Between 1990 and 2000, 2,251 STEMI patients were consecutively admitted in the Coronary Care Unit of a University Hospital (pre-pPCI period). In 2007, pPCI reperfusion program was onset in our centre. Between 2007 and 2017, 3,783 consecutive STEMI patients were included in the registry (post-pCI period). We analyze the prevalence of MC, management (reperfusion therapies, surgery ...) and 28-day and 1-year mortality among these two periods.
Results
A total of 6,034 STEMI patients were included in the registry (men 78.8%, mean age 61.7 years, SD 12.8). Patients admitted in the post-PCI period were older (62.4 vs 60.4 years, p<0.001) and have more prevalence of hypertension and dyslipidemia. Reperfusion therapy increased in post-pPCI period (89.1% vs 49.7%, p<0.001), due to widespread use of pPCI. A total of 105 patients (1.7%) develop any mechanical complication: 35 with ventricular septal rupture (VSR), 22 with papillary muscle rupture (PMR) and 48 patients with free wall rupture (FWR). Prevalence of MC has not been change between both periods. VSR occurred in 0.6% pre-PCI and 0.6% post-pPCI, p=0.98; PMR 0.3% vs 0.4% post-PCI, p=0.33; and FWR 1% vs 0.7% post-PCI, p=0.22). Overall 28-day STEMI mortality has been reduced in post-pPCI period (5.9% vs 10.1%, p<0.001 in acute phase). This 28-day mortality remains very high and without significant changes when MC appears: VSR: post-pPCI 77.3% vs 58.0%, p=0.25; PMR: 25.0% post-PCI vs 58.3%, p=0.69; and FWR: 66.4% post-PCI vs 73.7%, p=0.84). One-year mortality has not been changed between both periods and stays in a very high ratio (65.7% for VRS, 45.4% for PMR and 66.7% for FWR).
Conclusions
Although reperfusion therapy greatly increased with the onset of a pPCI reperfusion network, prevalence of MC has not been change over three decades in our series. Acute phase (28-day) and one-year mortality remains very high and without significant reduction in post-pPCI period.
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Affiliation(s)
- N El Ouaddi
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | | | - O De Diego
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - C Labata
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - F Rueda
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - T Oliveras
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M L Camara
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - J Serra
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - E Berastegui
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M Ferrer
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - C Munoz
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol University Hospital, Barcelona, Spain
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14
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Calmeiro J, Carrascal M, Gomes C, Falcão A, Serra J, Cruz M, Neves B. Impact of different GMP media in the production of dendritic cells for next-generation cancer immunotherapy: Functional and metabolic characterization. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy485.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
BACKGROUND To cope with the daily increments of gastric gas, the stomach can propel gas to the small bowel or trigger the belching reflex. Our aim was to evaluate transit of free gastric gas in healthy humans, and its relationship with abdominal symptoms. METHODS In 24 healthy volunteers a gas mixture was infused into the stomach at 0 mL/min (sham infusion), 25 mL/min, 50 mL/min, and 100 mL/min (n = 6 each) up to 1500 mL. Belching, rectal gas evacuation, and abdominal perception were continuously recorded for 90 min. KEY RESULTS Sham infusion was associated to low rectal gas evacuation (187 ± 94 mL after 90 min), and belching (0 ± 0). In contrast, gastric gas infusion increased rectal gas evacuation (1198 ± 176 mL; P = .025) and belching (4 ± 1 belches; P = .0520) without differences between the infusion rates tested. Overall, there was a negative correlation between rectal gas evacuation and belching (r = -.72; P < .0001): 6 subjects had frequent belching (14 ± 2 belches) and minor rectal gas evacuation (330 ± 112 mL), whereas 12 subjects had virtually no belches (1 ± 1 belches) and greater rectal gas evacuation (1630 ± 147 mL; P < .001 vs belchers for both). Gas infusion induced lower abdominal symptoms in belchers (score increment 0.7 ± 0.3) than in rectal gas evacuators (score increment 1.7 ± 0.5; P = .033). CONCLUSIONS AND INFERENCES An excellent balance between belching and distal gastric empting allows the stomach to adapt to great variations in gas intake. In general, most gastric gas is emptied to distal intestinal segments, but in some circumstances gastric gas induces belching, a mechanism that may improve gas tolerance.
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Affiliation(s)
- N Caballero
- Motility and Functional Gut Disorders Unit, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), University Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.,Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - I Marin
- Motility and Functional Gut Disorders Unit, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), University Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.,Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - J Serra
- Motility and Functional Gut Disorders Unit, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), University Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.,Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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Rodriguez-Gomez O, Sanabria A, Perez-Cordon A, Sanchez-Ruiz D, Abdelnour C, Valero S, Hernandez I, Rosende-Roca M, Mauleon A, Vargas L, Alegret M, Espinosa A, Ortega G, Guitart M, Gailhajanet A, Sotolongo-Grau O, Moreno-Grau S, Ruiz S, Tarragona M, Serra J, Martin E, Peleja E, Lomeña F, Campos F, Vivas A, Gomez-Chiari M, Tejero MA, Giménez J, Pesini P, Sarasa M, Martinez G, Ruiz A, Tarraga L, Boada M. FACEHBI: A Prospective Study of Risk Factors, Biomarkers and Cognition in a Cohort of Individuals with Subjective Cognitive Decline. Study Rationale and Research Protocols. J Prev Alzheimers Dis 2018; 4:100-108. [PMID: 29186280 DOI: 10.14283/jpad.2016.122] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Long-term longitudinal studies with multimodal biomarkers are needed to delve into the knowledge of preclinical AD. Subjective cognitive decline has been proposed as a risk factor for the development of cognitive impairment. Thus, including individuals with SCD in observational studies may be a cost-effective strategy to increase the prevalence of preclinical AD in the sample. OBJECTIVES To describe the rationale, research protocols and baseline characteristics of participants in the Fundació ACE Healthy Brain Initiative (FACEHBI). DESIGN FACEHBI is a clinical trial (EudraCT: 2014-000798-38) embedded within a long-term observational study of individuals with SCD. SETTING Participants have been recruited at the memory clinic of Fundació ACE (Barcelona) from two different sources: patients referred by a general practitioner and individuals from an Open House Initiative. PARTICIPANTS 200 individuals diagnosed with SCD with a strictly normal performance in a comprehensive neuropsychological battery. MEASUREMENTS Individuals will undergo an extensive neuropsychological protocol, risk factor assessment and a set of multimodal biomarkers including florbetaben PET, structural and functional MRI, diffusion tensor imaging, determination of amyloid species in plasma and neurophthalmologic assessment with optical coherence tomography. RESULTS Two hundred individuals have been recruited in 15 months. Mean age was 65.9 years; mean MMSE was 29.2 with a mean of 14.8 years of education. CONCLUSIONS FACEHBI is a long-term study of cognition, biomarkers and lifestyle that has been designed upon an innovative symptom-based approach using SCD as target population. It will shed light on the pathophysiology of preclinical AD and the role of SCD as a risk marker for the development of cognitive impairment.
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Affiliation(s)
- O Rodriguez-Gomez
- Octavio Rodriguez-Gomez, MD., Gran Via De Carles III, 85 BIS. CP: 08028. Barcelona. Spain, E-mail: , Fax: 0034 934193542, Telephone number: 0034 934304720
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Garcia-Garcia C, Oliveras T, Serra J, Rueda F, Labata C, Ferrer M, De Diego O, Aranyo J, Martinez MJ, Mauri J, Fernandez-Nofrerias E, Rodriguez-Leor O, Carrillo X, Abdul-Jawad O, Bayes-Genis A. P3618Early acute phase mortality and complications of STEMI patients: trends over the last three decades. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3618] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - T Oliveras
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Serra
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - F Rueda
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - C Labata
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Ferrer
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - O De Diego
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Aranyo
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M J Martinez
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Mauri
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | | | | | - X Carrillo
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - O Abdul-Jawad
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol University Hospital, Badalona, Spain
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Ferrer M, Garcia-Garcia C, Labata C, De Diego O, Serra J, Rueda F, Oliveras T, Fadeuilhe E, Andres J, Bayes-Genis A. P833From coronary to critical cardiovascular care unit: cause of mortality and patients profile analysis over three decades. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p833] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Ferrer
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | | | - C Labata
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - O De Diego
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Serra
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - F Rueda
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - T Oliveras
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - E Fadeuilhe
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Andres
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol University Hospital, Badalona, Spain
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Garcia-Garcia C, Rueda F, Oliveras T, Serra J, Labata C, Ferrer M, De Diego O, Cediel G, Rodriguez-Leor O, Carrillo X, Lupon J, Bayes-Genis A. P779Cardiogenic shock in STEMI patients:prevalence, management and acute phase mortality over the last three decades. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p779] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - F Rueda
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - T Oliveras
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Serra
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - C Labata
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Ferrer
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - O De Diego
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - G Cediel
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | | | - X Carrillo
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Lupon
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol University Hospital, Badalona, Spain
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Garcia-Perez E, Schönberger T, Sumalla M, Stierstorfer B, Solà R, Doods H, Serra J, Gorodetskaya N. Behavioural, morphological and electrophysiological assessment of the effects of type 2 diabetes mellitus on large and small nerve fibres in Zucker diabetic fatty, Zucker lean and Wistar rats. Eur J Pain 2018; 22:1457-1472. [DOI: 10.1002/ejp.1235] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2018] [Indexed: 01/09/2023]
Affiliation(s)
| | - T. Schönberger
- Boehringer Ingelheim Pharma GmbH & Co. KG; Biberach an der Riss Germany
| | - M. Sumalla
- Neuroscience Technologies; Barcelona Spain
| | - B. Stierstorfer
- Boehringer Ingelheim Pharma GmbH & Co. KG; Biberach an der Riss Germany
| | - R. Solà
- Neuroscience Technologies; Barcelona Spain
| | - H. Doods
- Boehringer Ingelheim Pharma GmbH & Co. KG; Biberach an der Riss Germany
| | - J. Serra
- Neuroscience Technologies; Barcelona Spain
| | - N. Gorodetskaya
- Boehringer Ingelheim Pharma GmbH & Co. KG; Biberach an der Riss Germany
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Yee D, Sablin MP, Iwata H, Johnston EL, Bogenrieder T, Serra J, Hua H, Lo Russo P, Prat A. Abstract OT3-06-02: A phase Ib trial of xentuzumab and abemaciclib in patients with locally advanced or metastatic solid tumors, including hormone receptor-positive, HER2-negative breast cancer (plus endocrine therapy). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot3-06-02] [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: Resistance to endocrine therapy remains an important clinical problem in hormone receptor-positive (HR+), HER2-negative (HER2-) breast cancer (BC), necessitating alternative treatment options. The insulin-like growth factor (IGF) axis and cyclin D-cyclin-dependent kinase (CDK) 4/6-retinoblastoma pathway have been implicated in the pathogenesis and resistance mechanisms of a variety of cancers, including BC. Binding of IGF-I and -II to the IGF receptor results in upregulation of cyclin D1, and subsequent progression through the cell cycle, thus providing rationale for the simultaneous inhibition of IGF-I and -II and CDK4/6. This Phase Ib trial assesses the maximum-tolerated dose (MTD)/recommended phase II dose (RP2D), safety and preliminary efficacy of the IGF-ligand-neutralizing antibody, xentuzumab, in combination with abemaciclib, a selective, small-molecule inhibitor of both CDK4 and 6, in patients (pts) with solid tumors. The trial includes four dose finding cohorts followed by two expansion cohorts. Only those cohorts that will include pts with postmenopausal HR+, HER2- BC will be presented here.
Trial design: In this phase Ib multicenter, non-randomized, open-label, dose escalation trial (BI 1280.18 [NCT03099174]), the key aims in the BC cohorts (Cohorts B–D, F) are to define the MTD or recommended phase 2 dose (RP2D), and to evaluate the preliminary efficacy, safety and tolerability of xentuzumab plus abemaciclib in combination with endocrine therapies. Eligible pts include adults ≥18 yrs (≥20 for Japan), with measurable or evaluable disease, adequate organ function, ECOG PS ≤1, and postmenopausal locally advanced or metastatic HR+, HER2- BC (Cohorts B–D, F). CDK4/6 inhibitor-naïve pts (Cohorts B–D) and pts who have received prior CDK4/6 inhibitors (palbociclib or ribociclib) plus aromatase inhibitors (Cohort F) are included. The MTD/RP2D of xentuzumab plus abemaciclib to be used in Cohorts B–D will be established in pts with solid tumors (Cohort A) who will receive xentuzumab (starting dose 1000mg weekly iv) plus abemaciclib (starting dose 150mg every 12 hours). CDK4/6 inhibitor-naïve pts with BC will receive xentuzumab plus abemaciclib at the RP2D determined in Cohort A in combination with letrozole (2.5mg/day; Cohort B), anastrozole (1mg/day; Cohort C), or fulvestrant (500mg/month; Cohort D). CDK4/6 inhibitor pre-treated pts with BC (Cohort F) will receive xentuzumab plus abemaciclib and fulvestrant at the RP2D determined in Cohort D. Primary endpoints in the BC cohorts are the MTD and/or RP2D of xentuzumab plus abemaciclib in combination with endocrine therapies, and the objective response (OR) in CDK4/6 inhibitor pre-treated pts with advanced BC (Cohort F); disease control (DC), duration of DC, time to OR, duration of OR, and progression-free survival (PFS) in Cohort F are secondary endpoints. Additionally, PK outcomes, safety and tolerability will be assessed in all cohorts. This study will be conducted in the US, Europe and Japan. Pt screening started in May 2017. Target enrolment is ˜88 pts, including ˜56 pts with advanced HR+, HER2- BC, of whom ˜20 had previously been treated with CDK 4/6 inhibitors.
Citation Format: Yee D, Sablin MP, Iwata H, Johnston EL, Bogenrieder T, Serra J, Hua H, Lo Russo P, Prat A. A phase Ib trial of xentuzumab and abemaciclib in patients with locally advanced or metastatic solid tumors, including hormone receptor-positive, HER2-negative breast cancer (plus endocrine therapy) [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 OT3-06-02.
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Affiliation(s)
- D Yee
- Masonic Cancer Center, Minnesota, MN; Institut Curie, Paris, France; Aichi Cancer Center Hospital, Nagoya, Japan; Eli Lilly and Company, Indianapolis, IN; Boehringer Ingelheim RCV, Vienna, Austria; Boehringer Ingelheim España S.A., Barcelona, Spain; Boegringer Ingelheim (China) Investment Co., Ltd, Shanghai, China; Yale Cancer Center, Connecticut, CT; Hospital Clínic, Barcelona, Spain
| | - MP Sablin
- Masonic Cancer Center, Minnesota, MN; Institut Curie, Paris, France; Aichi Cancer Center Hospital, Nagoya, Japan; Eli Lilly and Company, Indianapolis, IN; Boehringer Ingelheim RCV, Vienna, Austria; Boehringer Ingelheim España S.A., Barcelona, Spain; Boegringer Ingelheim (China) Investment Co., Ltd, Shanghai, China; Yale Cancer Center, Connecticut, CT; Hospital Clínic, Barcelona, Spain
| | - H Iwata
- Masonic Cancer Center, Minnesota, MN; Institut Curie, Paris, France; Aichi Cancer Center Hospital, Nagoya, Japan; Eli Lilly and Company, Indianapolis, IN; Boehringer Ingelheim RCV, Vienna, Austria; Boehringer Ingelheim España S.A., Barcelona, Spain; Boegringer Ingelheim (China) Investment Co., Ltd, Shanghai, China; Yale Cancer Center, Connecticut, CT; Hospital Clínic, Barcelona, Spain
| | - EL Johnston
- Masonic Cancer Center, Minnesota, MN; Institut Curie, Paris, France; Aichi Cancer Center Hospital, Nagoya, Japan; Eli Lilly and Company, Indianapolis, IN; Boehringer Ingelheim RCV, Vienna, Austria; Boehringer Ingelheim España S.A., Barcelona, Spain; Boegringer Ingelheim (China) Investment Co., Ltd, Shanghai, China; Yale Cancer Center, Connecticut, CT; Hospital Clínic, Barcelona, Spain
| | - T Bogenrieder
- Masonic Cancer Center, Minnesota, MN; Institut Curie, Paris, France; Aichi Cancer Center Hospital, Nagoya, Japan; Eli Lilly and Company, Indianapolis, IN; Boehringer Ingelheim RCV, Vienna, Austria; Boehringer Ingelheim España S.A., Barcelona, Spain; Boegringer Ingelheim (China) Investment Co., Ltd, Shanghai, China; Yale Cancer Center, Connecticut, CT; Hospital Clínic, Barcelona, Spain
| | - J Serra
- Masonic Cancer Center, Minnesota, MN; Institut Curie, Paris, France; Aichi Cancer Center Hospital, Nagoya, Japan; Eli Lilly and Company, Indianapolis, IN; Boehringer Ingelheim RCV, Vienna, Austria; Boehringer Ingelheim España S.A., Barcelona, Spain; Boegringer Ingelheim (China) Investment Co., Ltd, Shanghai, China; Yale Cancer Center, Connecticut, CT; Hospital Clínic, Barcelona, Spain
| | - H Hua
- Masonic Cancer Center, Minnesota, MN; Institut Curie, Paris, France; Aichi Cancer Center Hospital, Nagoya, Japan; Eli Lilly and Company, Indianapolis, IN; Boehringer Ingelheim RCV, Vienna, Austria; Boehringer Ingelheim España S.A., Barcelona, Spain; Boegringer Ingelheim (China) Investment Co., Ltd, Shanghai, China; Yale Cancer Center, Connecticut, CT; Hospital Clínic, Barcelona, Spain
| | - P Lo Russo
- Masonic Cancer Center, Minnesota, MN; Institut Curie, Paris, France; Aichi Cancer Center Hospital, Nagoya, Japan; Eli Lilly and Company, Indianapolis, IN; Boehringer Ingelheim RCV, Vienna, Austria; Boehringer Ingelheim España S.A., Barcelona, Spain; Boegringer Ingelheim (China) Investment Co., Ltd, Shanghai, China; Yale Cancer Center, Connecticut, CT; Hospital Clínic, Barcelona, Spain
| | - A Prat
- Masonic Cancer Center, Minnesota, MN; Institut Curie, Paris, France; Aichi Cancer Center Hospital, Nagoya, Japan; Eli Lilly and Company, Indianapolis, IN; Boehringer Ingelheim RCV, Vienna, Austria; Boehringer Ingelheim España S.A., Barcelona, Spain; Boegringer Ingelheim (China) Investment Co., Ltd, Shanghai, China; Yale Cancer Center, Connecticut, CT; Hospital Clínic, Barcelona, Spain
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Lages J, De Santis M, Serra J, Moita J. Obstructive sleep apnea and malignant melanoma – a clinical case. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Serra J, Almeida N, Moita J. Waking up to a sudden death or with panic attack?.. – A case report. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Yee D, Prat A, Sablin M, Iwata H, Johnston E, Bogenrieder T, Serra J, Hua H, LoRusso P. A phase Ib trial of xentuzumab and abemaciclib in patients with locally advanced or metastatic solid tumors, hormone receptor-positive (HR+), HER2-negative (HER2-) breast cancer (BC; +/- endocrine therapy), or non-small-cell lung cancer (NSCLC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx656.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
BACKGROUND Swallowed gas is an important source of abdominal gas, and aerophagia is often believed as a putative cause of gas-related abdominal symptoms. However, altered gas-swallow during meals has not been demonstrated. Our aim was to characterize the number of gas swallows during meals in patients complaining of excessive belching and gaseousness and a control group without abdominal symptoms during a 24-h period. METHODS A 24-h pH-impedance monitoring was performed in 10 patients with excessive belching, and 11 patients without digestive symptoms or reflux in the pH-impedance study. During the study, patients followed their daily routine and customary meals, without any specific limitation. In each patient the number and content of swallows and belches were analyzed. KEY RESULTS Total meal periods were similar in controls (75±26 min) and patients (79±21 min; P=.339), but the number of gaseous swallows was greater in patients (114±13 swallows) than controls (71±8 swallows; P=.007), due to a greater frequency of gaseous swallows during meals (15±2 swallows/10 min vs 10±1 swallows/10 min, respectively; P=.008). During the 24-h study period, 66±13 belches were recorded in patients, but only 13±3 belches in controls (P<.001), mainly gastric belches (80±4% and 92±2% of belches, patients, and controls, respectively) which showed a good correlation with the number of gaseous swallows performed during meals (r=.756; P=.011). CONCLUSION AND INFERENCES Gas is frequently swallowed during meals. Patients complaining of excessive belching have a different swallow pattern during meals, with an increased ingestion of gas that correlates with increased gastric belching events.
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Affiliation(s)
- N Caballero
- Motility and Functional Gut Disorders Unit, University Hospital Germans Trias i Pujol, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Badalona, Spain.,Department of Medicine, Autonomous University of Barcelona, Badalona, Spain
| | - J Serra
- Motility and Functional Gut Disorders Unit, University Hospital Germans Trias i Pujol, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Badalona, Spain.,Department of Medicine, Autonomous University of Barcelona, Badalona, Spain
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Cisternas D, Scheerens C, Omari T, Monrroy H, Hani A, Leguizamo A, Bilder C, Ditaranto A, Ruiz de León A, Pérez de la Serna J, Valdovinos MA, Coello R, Abrahao L, Remes-Troche J, Meixueiro A, Zavala MA, Marin I, Serra J. Anxiety can significantly explain bolus perception in the context of hypotensive esophageal motility: Results of a large multicenter study in asymptomatic individuals. Neurogastroenterol Motil 2017; 29. [PMID: 28480513 DOI: 10.1111/nmo.13088] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 03/14/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Previous studies have not been able to correlate manometry findings with bolus perception. The aim of this study was to evaluate correlation of different variables, including traditional manometric variables (at diagnostic and extreme thresholds), esophageal shortening, bolus transit, automated impedance manometry (AIM) metrics and mood with bolus passage perception in a large cohort of asymptomatic individuals. METHODS High resolution manometry (HRM) was performed in healthy individuals from nine centers. Perception was evaluated using a 5-point Likert scale. Anxiety was evaluated using Hospitalized Anxiety and Depression scale (HAD). Subgroup analysis was also performed classifying studies into normal, hypotensive, vigorous, and obstructive patterns. KEY RESULTS One hundred fifteen studies were analyzed (69 using HRM and 46 using high resolution impedance manometry (HRIM); 3.5% swallows in 9.6% of volunteers were perceived. There was no correlation of any of the traditional HRM variables, esophageal shortening, AIM metrics nor bolus transit with perception scores. There was no HRM variable showing difference in perception when comparing normal vs extreme values (percentile 1 or 99). Anxiety but not depression was correlated with perception. Among hypotensive pattern, anxiety was a strong predictor of variance in perception (R2 up to .70). CONCLUSION AND INFERENCES Bolus perception is less common than abnormal motility among healthy individuals. Neither esophageal motor function nor bolus dynamics evaluated with several techniques seems to explain differences in bolus perception. Different mechanisms seem to be relevant in different manometric patterns. Anxiety is a significant predictor of bolus perception in the context of hypotensive motility.
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Affiliation(s)
- D Cisternas
- Universidad del Desarrollo, Facultad de Medicina, Clínica Alemana de Santiago, Santiago, Chile
| | - C Scheerens
- Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium
| | - T Omari
- Human Physiology, Medical Science and Technology, School of Medicine, FlindersUniversity, Adelaide, SA, Australia
| | - H Monrroy
- Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - A Hani
- San Ignacio Hospital, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - A Leguizamo
- San Ignacio Hospital, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - C Bilder
- Neurogastroenterology, School of Medicine, Universitary Hospital FundacionFavaloro, Buenos Aires, Argentina
| | - A Ditaranto
- Neurogastroenterology, School of Medicine, Universitary Hospital FundacionFavaloro, Buenos Aires, Argentina
| | - A Ruiz de León
- Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain
| | | | - M A Valdovinos
- Motility Lab, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | | | - L Abrahao
- University Hospital Clementino Fraga Filho, Rio de Janeiro, Brazil
| | - J Remes-Troche
- Digestive Physiology and Motility Lab, Medical BiologicalResearchInstitute, Veracruzana University, Veracruz, Mexico
| | - A Meixueiro
- Digestive Physiology and Motility Lab, Medical BiologicalResearchInstitute, Veracruzana University, Veracruz, Mexico
| | - M A Zavala
- Digestive Physiology and Motility Lab, Medical BiologicalResearchInstitute, Veracruzana University, Veracruz, Mexico
| | - I Marin
- Motility and Functional Gut Disorders Unit, Department of Medicine, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Autonomous University of Barcelona, University Hospital Germans TriasiPujol, Badalona, Spain
| | - J Serra
- Motility and Functional Gut Disorders Unit, Department of Medicine, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Autonomous University of Barcelona, University Hospital Germans TriasiPujol, Badalona, Spain
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Prat A, Yee D, Sablin M, Iwata H, Johnston E, Bogenrieder T, Serra J, Stucke-Straub K, Lo Russo P. A Phase Ib trial of xentuzumab and abemaciclib in patients with locally advanced or metastatic solid tumours, hormone receptor-positive (HR+), HER2-negative (HER2-) breast cancer (BC; +/-endocrine therapy), or non-small-cell lung cancer (NSCLC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx364.017] [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: 11/12/2022] Open
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Font A, Real F, Puente J, Vazquez Mazon F, Sala N, Virizuela J, Rodriguez-Vida A, Grande Pulido E, Castellano D, Climent M, Gallardo E, González del Alba A, Fernandez P, Jares P, Aldecoa I, Gibson N, Serra J, Imedio E, Ehrnrooth E, Mellado B. Afatinib in patients with advanced or metastatic urothelial carcinoma (UC) with genetic alterations in ErbB receptors 1–3 who failed on platinum-based chemotherapy: The Phase II LUX-Bladder 1 trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx371.074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Vilalta V, Carrillo X, Fernandez-Nofrerias E, Ferrer M, Rodriguez-Leor O, Oliveras T, Abuli M, Abdul-Jawad O, Serra J, Garcia-Garcia C, Mauri J, Bayes-Genis A. P5563Acute coronary syndrome and cocaine use: prevalence and inhospital outcomes. Single-center 14-year experience. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Z'Graggen WJ, Solà R, Graf NE, Serra J, Bostock H. Sensitivity to ischaemia of single sympathetic nerve fibres innervating the dorsum of the human foot. J Physiol 2017; 595:4467-4473. [PMID: 28378458 DOI: 10.1113/jp274324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 03/30/2017] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS Changes in nerve conduction velocity following an impulse (i.e. velocity recovery cycles) reflect after-potentials, and can provide an indication of altered nerve membrane properties. This study used microneurography to assess the effects of ischaemia on single human sympathetic fibres innervating the dorsum of the foot. It was found that velocity recovery cycles can distinguish whether a sympathetic nerve fibre is depolarized or not. The method may be used to detect membrane depolarization of sympathetic nerve fibres in human patients when autonomic neuropathy is suspected. ABSTRACT The aim of this study was to determine whether velocity recovery cycles (VRCs) could detect the effects of ischaemia on sympathetic nerve fibres. VRCs of human sympathetic nerve fibres of the superficial peroneal nerve innervating the dorsum of the foot were recorded by microneurography in seven healthy volunteers. Sympathetic nerve fibres were identified by studying their response to manoeuvres increasing sympathetic outflow and by measuring activity-dependent slowing at 2 Hz stimulation. VRCs were assessed at rest, during 30 min of induced limb ischaemia and during 20 min of recovery after ischaemia. From each VRC was measured the relative refractory period (RRP), the supernormality and the time to peak supernormality (SN@). During ischaemia, RRP increased from the baseline value of 37.4 ± 8.7 ms (mean ± SEM) to 67.1 ± 12.1 ms (P < 0.01) and SN@ increased from 68.6 ± 9.8 ms to 133.8 ± 11.0 ms (P < 0.005). The difference between SN@ and RRP separated ischaemic from non-ischaemic sympathetic nerve fibres. It is concluded that these sympathetic nerve fibres are sensitive to ischaemia, and that VRCs provide a method to study changes of axonal membrane potential of human sympathetic nerve fibres in vivo.
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Affiliation(s)
- W J Z'Graggen
- Department of Neurosurgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - R Solà
- Neuroscience Technologies, Barcelona, Spain
| | - N E Graf
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - J Serra
- Neuroscience Technologies, Barcelona, Spain
| | - H Bostock
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, UK
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Bastos-Oreiro M, Rodriguez-Macias G, Pradillo V, Martinez S, O'Hara K, Champ D, Font P, Vidan M, Ortiz J, Menarguez J, Serra J, Diéz-Martín J. A PROSPECTIVE STUDY TO EVALUATE THE UTILITY OF GERIATRIC ASSESSMENT AND INTERVENTION IN PATIENTS WITH LYMPHOPROLIFERATIVE DISORDERS IN A TERTIARY HOSPITAL. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- M. Bastos-Oreiro
- Hematology; Hospital General Universitario Gregorio Marañón; Madrid Spain
| | | | - V. Pradillo
- Hematology; Hospital General Universitario Gregorio Marañón; Madrid Spain
| | - S. Martinez
- Geriatry; Hospital General Universitario Gregorio Marañón, Madrid; Spain
| | - K. O'Hara
- Geriatry; Hospital General Universitario Gregorio Marañón, Madrid; Spain
| | - D. Champ
- Hematology; Hospital General Universitario Gregorio Marañón; Madrid Spain
| | - P. Font
- Hematology; Hospital General Universitario Gregorio Marañón; Madrid Spain
| | - M. Vidan
- Geriatry; Hospital General Universitario Gregorio Marañón, Madrid; Spain
| | - J. Ortiz
- Geriatry; Hospital General Universitario Gregorio Marañón, Madrid; Spain
| | - J. Menarguez
- Pathology; Hospital General Universitario Gregorio Marañón; Madrid Spain
| | - J. Serra
- Geriatry; Hospital General Universitario Gregorio Marañón, Madrid; Spain
| | - J. Diéz-Martín
- Hematology; Hospital General Universitario Gregorio Marañón; Madrid Spain
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Marin I, Cisternas D, Abrao L, Lemme E, Bilder C, Ditaranto A, Coello R, Hani A, Leguizamo AM, Meixueiro A, Remes-Troche J, Zavala MA, Ruiz de León A, Perez de la Serna J, Valdovinos MA, Serra J. Normal values of esophageal pressure responses to a rapid drink challenge test in healthy subjects: results of a multicenter study. Neurogastroenterol Motil 2017; 29. [PMID: 28133879 DOI: 10.1111/nmo.13021] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/30/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Multiple water swallow is increasingly used as a complementary challenge test in patients undergoing high-resolution manometry (HRM). Our aim was to establish the range of normal pressure responses during the rapid drink challenge test in a large population of healthy subjects. METHODS Pressure responses to a rapid drink challenge test (100 or 200 mL of water) were prospectively analyzed in 105 healthy subjects studied in nine different hospitals from different countries. Esophageal motility was assessed in all subjects by solid-state HRM. In 18 subjects, bolus transit was analyzed using concomitant intraluminal impedance monitoring. KEY RESULTS A virtually complete inhibition of pressure activity was observed during multiple swallow: Esophageal body pressure was above 20 mm Hg during 1 (0-8) % and above 30 mm Hg during 1 (0-5) % of the swallow period, and the pressure gradient across the esophagogastric junction was low (-1 (-7 to 4) mm Hg). At the end of multiple swallow, a postswallow contraction was evidenced in only 50% of subjects, whereas the remaining 50% had non-transmitted contractions. Bolus clearance was completed after 7 (1-30) s after the last swallow, as evidenced by multichannel intraluminal impedance. CONCLUSIONS & INFERENCES The range of normal pressure responses to a rapid drink challenge test in health has been established in a large multicenter study. Main responses are a virtually complete inhibition of esophageal pressures with a low-pressure gradient across esophagogastric junction. This data would allow the correct differentiation between normal and disease when using this test.
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Affiliation(s)
- I Marin
- Motility and Functional Gut Disorders Unit, University Hospital Germans Trias i Pujol, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Department of Medicine, Autonomous University of Barcelona, Badalona, Spain
| | - D Cisternas
- Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago de Chile, Chile
| | - L Abrao
- University Hospital Clementino Fraga Filho, Rio de Janeiro, Brazil
| | - E Lemme
- University Hospital Clementino Fraga Filho, Rio de Janeiro, Brazil
| | - C Bilder
- Hospital Universitario - Escuela de Medicina, Fundación Favaloro, Buenos Aires, Argentina
| | - A Ditaranto
- Hospital Universitario - Escuela de Medicina, Fundación Favaloro, Buenos Aires, Argentina
| | | | - A Hani
- San Ignacio Hospital Pontificia Universidad Javeriana, Bogotá, Colombia
| | - A M Leguizamo
- San Ignacio Hospital Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | | | - M A Zavala
- Veracruzana University, Veracruz, Mexico
| | | | | | | | - J Serra
- Motility and Functional Gut Disorders Unit, University Hospital Germans Trias i Pujol, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Department of Medicine, Autonomous University of Barcelona, Badalona, Spain
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33
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Rodríguez-Valencia C, Freixeiro P, Serra J, Ferreirós CM, González P, López-Álvarez M. In vitro
evaluation of the antibacterial and osteogenic activity promoted by selenium-doped calcium phosphate coatings. Biomed Mater 2017; 12:015028. [DOI: 10.1088/1748-605x/aa5a6f] [Citation(s) in RCA: 13] [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] [Indexed: 02/07/2023]
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34
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Azpiroz F, Dubray C, Bernalier-Donadille A, Cardot JM, Accarino A, Serra J, Wagner A, Respondek F, Dapoigny M. Effects of scFOS on the composition of fecal microbiota and anxiety in patients with irritable bowel syndrome: a randomized, double blind, placebo controlled study. Neurogastroenterol Motil 2017; 29. [PMID: 27477485 DOI: 10.1111/nmo.12911] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 06/22/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Short-chain fructooligosaccharides (scFOS) have beneficial effects in subjects with minor digestive complaints, but the potential mechanisms involved have not been elucidated. The aim of the study was to evaluate changes in rectal sensitivity related to the clinical effects of scFOS in a selected group of patients with irritable bowel syndrome (IBS) and rectal hypersensitivity. METHODS In 79 IBS patients (defined by Rome III criteria) with rectal hypersensitivity (defined as discomfort threshold ≤44 g) a parallel, placebo-controlled, randomized, and double-blind study was performed to assess the effects of dietary supplementation (5 g d-1 ) with scFOS vs placebo for 4 weeks on rectal sensitivity (primary outcome: tolerance to increasing wall tension applied by a tensostat), clinical outcomes (IBS, anxiety/depression and quality of life scores) and composition of fecal microbiota. KEY RESULTS Rectal discomfort threshold, and IBS and quality of life scores, significantly improved during treatment, but in a similar manner in both scFOS and placebo groups; a post-hoc analysis showed that the effect of scFOS on rectal sensitivity was more pronounced in constipation-predominant-IBS patients (P=.051 vs placebo). Contrary with placebo, scFOS significantly reduced anxiety scores and increased fecal Bifidobacteria (P<.05 for both) without modifying other bacterial groups. CONCLUSIONS & INTERFENCES The effect of scFOS on anxiety may be related to modulation of the gut microbiota; demonstration of effects of scFOS on rectal sensitivity may require higher doses and may depend on the IBS subgroup.
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Affiliation(s)
- F Azpiroz
- Digestive System Research Unit, University Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - C Dubray
- Inserm CIC-501, Clinical Pharmacology Centre, Clermont-Ferrand Hospital, Clermont-Ferrand, France
| | - A Bernalier-Donadille
- UR454 Microbiology Unit, Clermont-Ferrand Research Centre, Saint Gènes-Champanelle, France
| | - J-M Cardot
- Inserm CIC-501, Clinical Pharmacology Centre, Clermont-Ferrand Hospital, Clermont-Ferrand, France
| | - A Accarino
- Digestive System Research Unit, University Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - J Serra
- Digestive System Research Unit, University Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - A Wagner
- Tereos, ZI et portuaire, Marckolsheim, France
| | - F Respondek
- Tereos, ZI et portuaire, Marckolsheim, France
| | - M Dapoigny
- CHU Clermont-Ferrand, Université d'Auvergne, INSERM UMR 1107, Neuro-Dol, Clermont-Ferrand, France
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Cocho D, Sagales M, Cobo M, Homs I, Serra J, Pou M, Perez G, Pujol G, Tantinya S, Bao P, Aloy A, Sabater R, Gendre J, Otermin P. Reducción de la tasa de broncoaspiración con el test 2 volúmenes/3 texturas con pulsioximetría en una unidad de ictus. Neurologia 2017; 32:22-28. [DOI: 10.1016/j.nrl.2014.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 11/15/2014] [Accepted: 12/02/2014] [Indexed: 10/24/2022] Open
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Pérez-Terán P, Roca O, Rodríguez-Palomares J, Ruiz-Rodríguez JC, Zapatero A, Gea J, Serra J, Evangelista A, Masclans JR. Prospective validation of right ventricular role in primary graft dysfunction after lung transplantation. Eur Respir J 2016; 48:1732-1742. [PMID: 27824609 DOI: 10.1183/13993003.02136-2015] [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] [Received: 12/17/2015] [Accepted: 08/05/2016] [Indexed: 12/29/2022]
Abstract
Primary graft dysfunction is a significant cause of lung transplant morbidity and mortality, but its underlying mechanisms are not completely understood. The aims of the present study were: 1) to confirm that right ventricular function is a risk factor for severe primary graft dysfunction; and 2) to propose a clinical model for predicting the development of severe primary graft dysfunction.A prospective cohort study was performed over 14 months. The primary outcome was development of primary graft dysfunction grade 3. An echocardiogram was performed immediately before transplantation, measuring conventional and speckle-tracking parameters. Pulmonary artery catheter data were also measured. A classification and regression tree was made to identify prognostic models for the development of severe graft dysfunction.70 lung transplant recipients were included. Patients who developed severe primary graft dysfunction had better right ventricular function, as estimated by cardiac index (3.5±0.8 versus 2.6±0.7 L·min-1·m-2, p<0.01) and basal longitudinal strain (-25.7±7.3% versus -19.5±6.6%, p<0.01). Regression tree analysis provided an algorithm based on the combined use of three variables (basal longitudinal strain, pulmonary fibrosis disease and ischaemia time), allowing accurate preoperative discrimination of three distinct subgroups with low (11-20%), intermediate (54%) and high (75%) risk of severe primary graft dysfunction (area under the receiver operating characteristic curve 0.81).Better right ventricular function is a risk factor for the development of severe primary graft dysfunction. Preoperative estimation of right ventricular function could allow early identification of recipients at increased risk, who would benefit the most from careful perioperative management in order to limit pulmonary overflow.
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Affiliation(s)
- Purificación Pérez-Terán
- Critical Care Dept, Hospital del Mar-Parc de Salut Mar, Institut Mar d'Investigacions mèdiques (IMIM), Barcelona, Spain .,Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oriol Roca
- Critical Care Dept, Vall d'Hebron University Hospital, Institut de Recerca Vall d'Hebron (VHIR), Barcelona, Spain.,Ciber de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Juan C Ruiz-Rodríguez
- Critical Care Dept, Vall d'Hebron University Hospital, Institut de Recerca Vall d'Hebron (VHIR), Barcelona, Spain
| | - Ana Zapatero
- Critical Care Dept, Hospital del Mar-Parc de Salut Mar, Institut Mar d'Investigacions mèdiques (IMIM), Barcelona, Spain
| | - Joaquim Gea
- Ciber de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.,Respiratory Dept, Hospital del Mar-Parc de Salut Mar, IMIM, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Joaquim Serra
- Critical Care Dept, Vall d'Hebron University Hospital, Institut de Recerca Vall d'Hebron (VHIR), Barcelona, Spain
| | - Arturo Evangelista
- Cardiology Dept, Vall d'Hebron University Hospital, VHIR, Barcelona, Spain
| | - Joan R Masclans
- Critical Care Dept, Hospital del Mar-Parc de Salut Mar, Institut Mar d'Investigacions mèdiques (IMIM), Barcelona, Spain.,Ciber de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
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Velasquez T, Mackey G, Lusk J, Kyle UG, Fontenot T, Marshall P, Shekerdemian LS, Coss-Bu JA, Nishigaki A, Yatabe T, Tamura T, Yamashita K, Yokoyama M, Ruiz-Rodriguez JC, Encina B, Belmonte R, Troncoso I, Tormos P, Riveiro M, Baena J, Sanchez A, Bañeras J, Cordón J, Duran N, Ruiz A, Caballero J, Nuvials X, Riera J, Serra J, Rutten AMF, van Ieperen SNM, Der Kinderen EPHM, Van Logten T, Kovacikova L, Skrak P, Zahorec M, Kyle UG, Akcan-Arikan A, Silva JC, Mackey G, Lusk J, Goldsworthy M, Shekerdemian LS, Coss-Bu JA, Wood D, Harrison D, Parslow R, Davis P, Pappachan J, Goodwin S, Ramnarayan P, Chernyshuk S, Yemets H, Zhovnir V, Pulitano’ SM, De Rosa S, Mancino A, Villa G, Tosi F, Franchi P, Conti G, Patel B, Khine H, Shah A, Sung D, Singer L, Haghbin S, Inaloo S, Serati Z, Idei M, Nomura T, Yamamoto N, Sakai Y, Yoshida T, Matsuda Y, Yamaguchi Y, Takaki S, Yamaguchi O, Goto T, Longani N, Medar S, Abdel-Aal IR, El Adawy AS, Mohammed HMEH, Mohamed AN, Parry SM, Knight LD, Denehy L, De Morton N, Baldwin CE, Sani D, Kayambu G, da Silva VZM, Phongpagdi P, Puthucheary ZA, Granger CL, Rydingsward JE, Horkan CM, Christopher KB, Muscedere J, Scott SH, Saha T, Hamilton A, Petsikas D, Payne D, Boyd JG, Puthucheary ZA, McNelly AS, Rawal J, McWilliams D, Connolly B, McPhail MJ, Sidhu P, Rowlerson A, Moxham J, Harridge SD, Hart N, Montgomery HE, Jovaisa T, Thomas B, Jones C, Gupta D, Wijayatilake DS, Shum HP, King HS, Chan KC, Tang KB, Yan WW, Arias CC, Latorre J, De La Rica AS, Reeves E, Garrido EM, Feijoo AM, Gancedo CH, Tofiño AL, Rodríguez FG, Gemmell LK, Campbell R, Doherty P, MacKay A, Singh N, Atkins G, Vitaller S, Nagib H, Prieto J, Del Arco A, Zayas B, Gomez C, Tirumala S, Pasha SA, Kumari BK, Martinez-Lopez P, Snelson C, Puerto-Morlán A, Nuevo-Ortega P, Pujol LM, Dolset RA, González BS, Riera SQ, Álvarez JT, Quintana S, Martínez L, Algarte R, Aitken LM, Sánchez B, Trenado J, Tomas E, Brock N, Viegas E, Filipe E, Cottle D, Traynor T, Martínez MVT, Márquez MP, Rattray J, Gómez LC, Martínez NA, Muñoz JMM, Bellver BQ, Varea MM, Llorente MÁA, Calvo CP, Hillier SD, Faulds MC, Hendra H, Kenardy J, Lawrence N, Maekawa K, Hayakawa M, Ono Y, Kodate A, Sadamoto Y, Tominaga N, Mizugaki A, Murakami H, Yoshida T, Hull AM, Katabami K, Wada T, Sawamura A, Gando S, Silva S, Kerhuel L, Malagurski B, Citerio G, Chabanne R, Laureys S, Ullman A, Puybasset L, Nobile L, Pognuz ER, Rossetti AO, Verginella F, Gaspard N, Creteur J, Ben-Hamouda N, Oddo M, Taccone FS, Le Brocque R, Ono Y, Hayakawa M, Iijima H, Maekawa K, Kodate A, Sadamoto Y, Mizugaki A, Murakami H, Katabami K, Wada T, Mitchell M, Sawamura A, Gando S, Kodate A, Katabami K, Wada T, Ono Y, Maekawa K, Hayakawa M, Sawamura A, Gando S, Davis C, Andersen LW, Raymond T, Berg R, Nadkarni V, Grossestreuer A, Kurth T, Donnino M, Krüger A, Ostadal P, Janotka M, Macfarlane B, Vondrakova D, Kongpolprom N, Cholkraisuwat J, Pekkarinen PT, Ristagno G, Masson S, Latini R, Bendel S, Ala-Kokko T, Varpula T, Azevedo JC, Vaahersalo J, Hoppu S, Tiainen M, Mion MM, Plebani M, Pettilä V, Skrifvars M, Son Y, Kim KS, Suh GJ, Rocha LL, Kwon WY, Ko JI, Park MJ, Cavicchi FZ, Iesu E, Nobile L, Vincent JL, Creteur J, Taccone FS, Tanaka H, De Freitas FFM, Otani N, Ode S, Ishimatsu S, Martínez L, Algarte R, Sánchez B, Romero I, Martínez F, Quintana S, Trenado J, Cavalheiro AM, Vondrakova D, Ostadal P, Kruger A, Janotka M, Malek F, Neuzil P, Yeh YC, Chen YS, Wang CH, Huang CH, Lucinio NM, Chao A, Lee CT, Lai CH, Chan WS, Cheng YJ, Sun WZ, Kaese S, Horstmann C, Lebiedz P, Mourad M, Lobato MS, Gaudard P, Eliet J, Zeroual N, Colson P, Ostadal P, Mlcek M, Hrachovina M, Kruger A, Vondrakova D, Janotka M, Ebeling G, Mates M, Hala P, Kittnar O, Neuzil P, Jacky A, Rudiger A, Spahn DR, Bettex DA, Kara A, Akin S, Kraegpoeth A, Dos reis Miranda D, Struijs A, Caliskan K, van Thiel RJ, Dubois EA, de Wilde W, Zijlstra F, Gommers D, Ince C, Marca L, Laerkner E, Xini A, Mongkolpun W, Cordeiro CPR, Leite RT, Lheureux O, Bader A, Rincon L, Santacruz C, Preiser JC, Chao A, De Brito-Ashurst I, Chao AS, Chen YS, Kim W, Ahn C, Cho Y, Lim TH, Oh J, Choi KS, Jang BH, Ha JK, White C, Mecklenburg A, Stamm J, Soeffker G, Kubik M, Sydow K, Reichenspurner H, Kluge S, Braune S, Bergantino B, Ruberto F, Gregory S, Magnanimi E, Privato E, Zullino V, Bruno K, Pugliese F, Sales G, Girotto V, Vittone F, Brazzi L, Fritz C, Forni LG, Kimmoun A, Vanhuyse F, Trifan B, Orlowski S, Albuisson E, Tran N, Levy B, Chhor V, Joachim J, Follin A, Flowers E, Champigneulle B, Chatelon J, Fave G, Mantz J, Pirracchio R, Diaz DD, Villanova M, Aguirregabyria M, Andrade G, López L, Curtis A, Palencia E, John G, Cowan R, Hart R, Lake K, Litchfield K, Song JW, Lee YJ, Cho YJ, Choi S, Wood CA, Vermeir P, Vandijck D, Blot S, Mariman A, Verhaeghe R, Deveugele M, Vogelaers D, Chok L, Bachli EB, Bettex D, Siu K, Cottini SR, Keller E, Maggiorini M, Schuepbach R, Fiks T, Stiphout C, Grevelink M, Vaneker I, Ruijter A, Buise M, Venkatesan K, Spronk PE, Tena SA, Barrachina LG, Portillo JHR, Aznar GP, Campos LM, Sellés MDF, Tomás MA, Muncharaz AB, Skinner L, Muhammad JBH, Monsalvo S, Olavarria E, Stümpfle R, Na SJ, Park J, Chung CR, Park CM, Suh GY, Yang JH, Witter T, Ng L, Brousseau C, Butler MB, Erdogan M, Dougall PCM, Green RS, Abbott TEF, Torrance HDT, Cron N, Vaid N, Emmanuel J, Seet E, Siddiqui SS, Prabu N, Chaudhari HK, Patil VP, Divatia JV, Solanki S, Kulkarni AP, Gutierrez LAR, Bader A, Brasseur A, Baptista N, Lheureux O, Vincent JL, Creteur J, Taccone FS, Hempel D, Stauffert N, Recker F, Schröder T, Reusch S, Schleifer J, Escoval A, Breitkreutz R, Sjövall F, Perner A, Møller MH, Moraes RB, Borges FK, Guillen JAV, Zabaletta WJC, Ruiz-Ramos J, Ramirez P, Tomas E, Marqués-Miñana MR, Villarreal E, Gordon M, Sosa M, Concha P, Castellanos A, Menendez R, Ramírez CS, Santana MC, Balcázar LC, Agrawal R, Escalada SH, Viera MAH, Vázquez CFL, Díaz JJD, Campelo FA, Monroy NS, Santana PS, Santana SR, Gutiérrez-Pizarraya A, Garnacho-Montero J, Mathew R, Martin C, Baumstarck K, Leone M, Martín-Loeches I, Pirracchio R, Legrand M, Mainardi JL, Mantz J, Cholley B, Hubbard A, Varma A, Frontera PR, Vega LMC, Miguelena PRDG, Usón MCV, López AR, Clemente EA, Ibañes PG, Aguilar ALR, Palomar M, Olaechea P, Dima E, Uriona S, Vallverdu M, Catalan M, Nuvials X, Aragon C, Lerma FA, Jeon YD, Jeong WY, Kim MH, Jeong IY, Charitidou E, Ahn MY, Ahn JY, Han SH, Choi JY, Song YG, Kim JM, Ku NS, Bassi GL, Xiol EA, Senussi T, Perivolioti E, Idone FA, Motos A, Chiurazzi C, Travierso C, Fernández-Barat L, Amaro R, Hua Y, Ranzani OT, Bobi Q, Rigol M, Pratikaki M, Torres A, Fernández IF, Soler EA, de Vera APR, Pastor EE, Hernandis V, Ros Martínez J, Rubio RJ, Torner MM, Brugger SC, Vrettou C, Eroles AA, Moles SI, Cabello JT, Schoenenberger JA, Casals XN, Vidal MV, Garrido BB, Martinez MP, Mirabella L, Cotoia A, Giannopoulos A, Tullo L, Stella A, Di Bello F, Di Gregorio A, Dambrosio M, Cinnella G, Rosario LEDLC, Lesmes SPG, Romero JCG, Herrera ANG, 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E, Juliarena A, Bisso MC, Grando M, Tapia A, Camargo M, Ulla DV, Corzo L, dos Santos HP, Ramos A, Doglia JA, Estenssoro E, Carbonara M, Magnoni S, Donald CLM, Shimony JS, Conte V, Triulzi F, Stretti F, Macrì M, Snyder AZ, Stocchetti N, Brody DL, Podlepich V, Shimanskiy V, Savin I, Lapteva K, Chumaev A, Tjepkema-Cloostermans MC, Hofmeijer J, Beishuizen A, Hom H, Blans MJ, van Putten MJAM, Longhi L, Frigeni B, Curinga M, Mingone D, Beretta S, Patruno A, Gandini L, Vargiolu A, Ferri F, Ceriani R, Rottoli MR, Lorini L, Citerio G, Pifferi S, Battistini M, Cordolcini V, Agarossi A, Di Rosso R, Ortolano F, Stocchetti N, Lourido CM, Cabrera JLS, Santana JDM, Alzola LM, del Rosario CG, Pérez HR, Torrent RL, Eslami S, Dalhuisen A, Fiks T, Schultz MJ, Hanna AA, Spronk PE, Wood M, Maslove D. ESICM LIVES 2016: part three. Intensive Care Med Exp 2016. [PMCID: PMC5042925 DOI: 10.1186/s40635-016-0100-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Zöllner C, Morton B, Mitsi E, Pennington SH, Reine J, Wright AD, Parker R, Welters ID, Blakey JD, Rajam G, Ades EW, Ferreira DM, Wang D, Kadioglu A, Gordon SB, Koch R, Kox M, Rahamat-Langedoen J, Schloesser J, de Jonge M, Pickkers P, Bringue J, Guillamat-Prats R, Torrents E, Martinez ML, Camprubí-Rimblas M, Artigas A, Blanch L, Park SY, Park YB, Song DK, Shrestha S, Park SH, Koh Y, Park MJ, Hong CW, Lesur O, Coquerel D, Sainsily X, Cote J, Söllradl T, Murza A, Dumont L, Dumaine R, Grandbois M, Sarret P, Marsault E, Salvail D, Auger-Messier M, Chagnon F, Lauretta MP, Greco E, Dyson A, Singer M, Preau S, Ambler M, Sigurta A, Saeed S, Singer M, Sarıca LT, Zibandeh N, Genc D, Gul F, Akkoc T, Kombak E, Cinel L, Akkoc T, Cinel I, Pollen SJ, Arulkumaran N, Singer M, Torrance HD, Longbottom ER, Warnes G, Hinds CJ, Pennington DJ, Brohi K, O’Dwyer MJ, Kim HY, Na S, Kim J, Chang YF, Chao A, Shih PY, Lee CT, Yeh YC, Chen LW, Adriaanse M, Trogrlic Z, Ista E, Lingsma H, Rietdijk W, Ponssen HH, Schoonderbeek JF, Schreiner F, Verbrugge SJ, Duran S, Gommers DAMPJ, van der Jagt M, Funcke S, Sauerlaender S, Saugel B, Pinnschmidt H, Reuter DA, Nitzschke R, Perbet S, Biboulet C, Lenoire A, Bourdeaux D, Pereira B, Plaud B, Bazin JE, Sautou V, Mebazaa A, Constantin JM, Legrand M, Boyko Y, Jennum P, Nikolic M. ESICM LIVES 2016: part one. Intensive Care Med Exp 2016. [PMCID: PMC5042924 DOI: 10.1186/s40635-016-0098-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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López-Álvarez M, Pérez-Davila S, Rodríguez-Valencia C, González P, Serra J. The improved biological response of shark tooth bioapatites in a comparative in vitro study with synthetic and bovine bone grafts. ACTA ACUST UNITED AC 2016; 11:035011. [PMID: 27271863 DOI: 10.1088/1748-6041/11/3/035011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Autologous bone is considered to be the gold standard for bone tissue regeneration, providing more highly efficient functional responses compared to synthetic materials, and avoiding the rejection risks of allogenic grafts. However, it presents limitations for certain types of surgery due to its high resorption levels and donor site morbidity. Different biphasic synthetic composites, based onnon-apatitic calcium phosphates enriched with apatitic phases-such as hydroxyapatite, and bioderived bone grafts of bovine and porcine origin-are proposed as lower resorption materials due to their higher crystalline structure. The present work proposes two new sources of bioapatites for bone filler applications obtained from the dentine and enameloid of shark teeth, respectively. These bioapatites each present a characteristic apatite-based composition and additional enrichments of specific trace elements, such as magnesium and fluorine, with proven roles in bone metabolism. Their processing and physicochemical characterization (SEM, FT-Raman and XRD) is presented, together with an in vitro evaluation of osteogenic activity compared to a commercial bovine mineralized matrix and synthetic HA/β TCP grafts. The results proved the globular morphology (0.5-1.5 μm) and porosity (~50 μm and ~0.5-1 μm) of shark dentine bioapatites with biphasic composition: apatitic (hydroxyapatite and apatite-(CaF)), non-apatitic (whitlockite), and an apatitic phase (fluorapatite), organized in oriented crystals in enameloid bioapatites. An evaluation of the pre-osteoblast MC3T3-E1 morphology revealed the colonization of pores in dentine bioapatites and an aligned cell growth in the oriented enameloid crystals. A higher proliferation (p < 0.01) was detected at up to 21 d in both the shark bioapatites and synthetic biphasic graft with respect to the bovine mineralized matrix. Finally, the great potential of porous biphasic dentine bioapatites enriched with Mg and the aligned fluorapatite crystals of enameloid bioapatites in promoting greater osteogenic activity was confirmed with a significantly increased ALP synthesis (p < 0.01) compared to the commercial grafts.
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Affiliation(s)
- M López-Álvarez
- New Materials Group, Applied Physics Department, Institute of Biomedical Research (IBI), University of Vigo, Campus Lagoas-Marcosende, 36310 Vigo, Spain
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Marin I, Serra J. Patterns of esophageal pressure responses to a rapid drink challenge test in patients with esophageal motility disorders. Neurogastroenterol Motil 2016; 28:543-53. [PMID: 26686375 DOI: 10.1111/nmo.12749] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 11/12/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Multiple rapid swallow has been proposed as a challenge test that can help diagnosis and management of patients with esophageal motility disorders. Our aim was to characterize specific pressure patterns in response to a rapid drink challenge test in patients with esophageal motility disorders, and to determine the potential of these patterns in the diagnosis of patients with esophageal symptoms but normal single swallow manometry. METHODS Pressure responses to a rapid drink challenge test (rapid swallow of 200 mL water) were prospectively analyzed in 30 healthy controls and 285 patients with esophageal symptoms: 33 achalasia, 68 hypocontractile motility, 27 hypercontractile motility and 160 patients with normal manometry. KEY RESULTS Three different patterns of responses were characterized: (i) hypopressive or normal pattern that was shared by healthy subjects and patients with hypocontractile peristalsis, and discriminated patients with non-obstructive hypercontractile motility or achalasia (p < 0.001; sensitivity 80% and specificity 93%), (ii) brief hyperpressive pattern observed in patients with non-obstructive hypercontractile disorders (distal spasm and hypercontractile esophagus), and (iii) prolonged hyperpressive pattern, that discriminated achalasia from patients with non-obstructive hypercontractile disorders (p < 0.001; sensitivity 70% and specificity 85%). Seventeen percent of patients with esophageal symptoms but normal single swallow manometry had abnormal responses to the drink challenge test: 14% a brief hyperpressive pattern, and 3% a prolonged hyperpressive pattern. CONCLUSIONS & INFERENCES Specific patterns of responses to a rapid drink challenge test could help identification of motility disorders in patients with esophageal symptoms but unclear or normal esophageal manometry.
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Affiliation(s)
- I Marin
- Motility and Functional Gut Disorders Unit, University Hospital Germans Trias i Pujol, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Department of Medicine, Autonomous University of Barcelona, Badalona, Spain
| | - J Serra
- Motility and Functional Gut Disorders Unit, University Hospital Germans Trias i Pujol, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Department of Medicine, Autonomous University of Barcelona, Badalona, Spain
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Coello B, López-Álvarez M, Rodríguez-Domínguez M, Serra J, González P. Quantitative evaluation of the mineralization level of dental tissues by Raman spectroscopy. Biomed Phys Eng Express 2015. [DOI: 10.1088/2057-1976/1/4/045204] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Nuvials X, Arnau E, Serra J, Alcaraz R, Caballero J, Laborda C, Pérez M, Larrosa MN, Palomar M. [Empirical antimicrobial therapy in ICU admitted patients. Influence of microbiological confirmation on the length of treatment]. Rev Esp Quimioter 2014; 27:252-260. [PMID: 25536429] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Introduction. Most patients admitted to the Intensive Care Units (ICU) receive antimicrobial treatment. A proper therapeutic strategy may be useful in decreasing inappropriate empirical antibiotic treatments. When the infection is not microbiologically confirmed, the antimicrobial streamlining may be difficult. Nevertheless, there is scant information about the influence of the microbiological confirmation of the infections on empirical antimicrobial treatment duration. Method. Post-hoc analysis of prospective data (ENVIN-UCI register) and observational study of patients admitted (> 24 hours) in a medico-surgical ICU, through the three-months annual surveillance interval for a period of ten years, receiving antimicrobial treatment for treating an infection. Demographic, infection and microbiological data were collected as well as empirical antimicrobial treatment and causes of adaptation. The main goal was to establish the influence of microbiological confirmation on empirical antimicrobial treatment duration. Results. During the study period 1,526 patients were included, 1,260 infections were diagnosed and an empirical antibiotic treatment was started in 1,754 cases. Infections were microbiologically confirmed in 1,073 (62.2%) of the empirical antibiotic treatment. In 593 (55.3%) cases, the antimicrobial treatment was considered appropriate. The main cause of treatment adaptation in the microbiologically confirmed infections was streamlining (39%). The microbiological confirmation of the infection was not associated with significantly shorter empirical antibiotic treatments (6.6 ± 5.2 VS. 6.8 ± 4.5 days). Conclusion. The microbiological confirmation of infections in patients admitted to UCI was associated with a higher reduction of antimicrobial spectrum, although had no effect on the length of empirical antimicrobial therapy.
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Affiliation(s)
- Xavier Nuvials
- Xavier Nuvials, Servei de Medicina Intensiva, Hospital Universitari Arnau de Vilanova, Av. Rovira Roure 80. 25198. Lleida, Spain.
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Affiliation(s)
- J Serra
- Neuroscience Technologies, Ltd.; Barcelona Spain
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Martínez-Moragón E, Palop M, de Diego A, Serra J, Pellicer C, Casán P, Caloto MT, Nocea G. Factors affecting quality of life of asthma patients in Spain: the importance of patient education. Allergol Immunopathol (Madr) 2014; 42:476-84. [PMID: 24094444 DOI: 10.1016/j.aller.2013.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 06/03/2013] [Accepted: 06/10/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Assessment of demographic and clinical factors that have an impact on the quality of life (QoL) of patients with asthma in Spain. PATIENTS AND METHODS Multicenter, prospective, observational, cohort study, conducted in 40 Spanish Pneumology Units during a 12-month period. Data on sociodemographic, clinical variables, asthma treatment and QoL were collected in a case report form. RESULTS 536 patients (64.6% women, mean age: 54) were recruited. Reported QoL was better for patients from Northern and Central Spain as compared with those from the South and the East (p<0.001), students and employed patients as compared with housewives and unemployed (p<0.01), for those who had received asthma information (p<0.01), for those with milder daytime symptoms (p<0.01) and for patients with higher level of education (p<0.05). CONCLUSIONS Among the factors that have a significant effect on patients' QoL only symptom control and patient education on asthma control are modifiable. Therefore, all the strategies should be tailored to improve such factors when managing asthma patients.
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Affiliation(s)
| | - M Palop
- Hospital Sagunto, Valencia, Spain
| | - A de Diego
- Hospital Universitario La Fe, Valencia, Spain
| | - J Serra
- Hospital General de Vic, Barcelona, Spain
| | | | - P Casán
- Hospital Sant Pau, Barcelona, Spain
| | - M T Caloto
- Merck, Sharp & Dohme de España S.A., Madrid, Spain
| | - G Nocea
- Merck, Sharp & Dohme de España S.A., Madrid, Spain
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Díaz-Rodríguez P, González P, Serra J, Landin M. Key parameters in blood-surface interactions of 3D bioinspired ceramic materials. Mater Sci Eng C Mater Biol Appl 2014; 41:232-9. [PMID: 24907756 DOI: 10.1016/j.msec.2014.04.058] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 03/26/2014] [Accepted: 04/22/2014] [Indexed: 11/18/2022]
Abstract
Direct contact of materials with blood components may trigger numerous processes which ultimately lead to hemolysis, clot formation and recruitment of inflammatory cells. In this study, the blood-surface interactions for two inert bioinspired ceramic scaffolds obtained from natural resources; biomorphic carbon and silicon carbides (bioSiC) from different origins have been studied. The response of the blood in contact with carbon is well known, however little has been identified on the influence of their 3D porous structure. Moreover, to our knowledge, there is no reference in the literature about the hemocompatibility of biomorphic silicon carbide as a porous scaffold. The experimental results showed the surface energy to be crucial to evaluate the hemocompatibility of a material however the surface topography and material porosity are also parameters to be considered. Surface roughness modifies clot formation whereas for protein adsorption total sample porosity seems to be the key parameter to be considered for hydrophilic materials (biomorphic silicon carbides), while the size of the pores determines the hemolytic response.
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Affiliation(s)
- P Díaz-Rodríguez
- Dpto. Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad de Santiago de Compostela, Santiago de Compostela, 15782 Spain
| | - P González
- Dpto. Física Aplicada, E.E. Industriais, Universidade de Vigo, Vigo, Spain
| | - J Serra
- Dpto. Física Aplicada, E.E. Industriais, Universidade de Vigo, Vigo, Spain
| | - M Landin
- Dpto. Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad de Santiago de Compostela, Santiago de Compostela, 15782 Spain.
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Serra J, Coffey C, Dunford J, Castillo E. Out-of-Hospital Acute ST-Elevation Myocardial Infarction Identification in San Diego: A Retrospective Analysis on the Effect of Implementing a New Software Algorithm. Ann Emerg Med 2013. [DOI: 10.1016/j.annemergmed.2013.07.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Cordero D, López-Álvarez M, Rodríguez-Valencia C, Serra J, Chiussi S, González P. In vitro
response of pre-osteoblastic cells to laser microgrooved PEEK. Biomed Mater 2013; 8:055006. [DOI: 10.1088/1748-6041/8/5/055006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Garcia-Garcia C, Subirana I, Sala J, Bruguera J, Sanz G, Aros F, Fiol M, Serra J, Marrugat J, Elosua R. Gender differences in clinical features, management and in-hospital prognosis and 7-year mortality of first acute myocardial infarction. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Salva S, Duran N, Rodriguez V, Nieto L, Serra J, Rello J. Clostridium difficile in the ICU: study of the incidence, recurrence, clinical characteristics and complications in a university hospital. Med Intensiva 2013; 38:140-5. [PMID: 23769945 DOI: 10.1016/j.medin.2013.03.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 03/17/2013] [Accepted: 03/27/2013] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Although several studies have established the association between antibiotics and Clostridium difficile infection (CDI), there is a lack of epidemiological studies on the incidence of CDI in European Intensive Care Units outside the context of infection outbreaks. The present study describes the incidence, patient characteristics, complications, and recurrence rates of CDI in a Spanish ICU. DESIGN A retrospective study was carried out. SETTING A clinical-surgical ICU with 34 beds, a tertiary referral hospital with 1400 beds. PATIENTS All patients over 18 years of age admitted to the ICU from January 2010 to December 2011 with diarrhea for more than 48 h. INTERVENTIONS None. STUDY VARIABLES Underlying diseases, risk factors, fever, leukocyte count, complications, recurrence of infection. RESULTS A total of 1936 adult patients were admitted. Seven patients acquired CDI (0.36%), representing an infection rate of 3.1 per 10,000 bed-days and a cumulative incidence rate of 3.6 in two years. The mean age was 61 years. Six patients showed some degree of immunosuppression. The mean APACHE II score at ICU admission was 17 (IQR 13-24). Severe sepsis was reported in 5 cases of CDI, three of which presented shock and multiorgan dysfunction. Four patients presented recurrence of CDI during hospitalization. ICU admission was prolonged for a mean of 24 days (SD 17.8) after diagnosis. CONCLUSIONS Less than 1% of the patients admitted to a clinical-surgical ICU in a large teaching institution in Spain developed CDI. However, a high risk of recurrence/complications was associated with prolonged ICU stay.
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Affiliation(s)
- S Salva
- Critical Care Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - N Duran
- Critical Care Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - V Rodriguez
- Microbiology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - L Nieto
- Microbiology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - J Serra
- Critical Care Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - J Rello
- Critical Care Department, Vall d'Hebron University Hospital, CIBERES & CRIPS, Universitat Autónoma de Barcelona, Barcelona, Spain.
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