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Gómez-Olivas JD, Campos-Rodriguez F, Nagore E, Martorell A, García-Rio F, Cubillos C, Hernandez L, Bañuls J, Arias E, Ortiz P, Cabriada V, Gardeazabal J, Montserrat JM, Carrera C, Masa JF, Gomez de Terreros J, Abad J, Boada A, Mediano O, Castillo-Garcia M, Chiner E, Landete P, Mayos M, Fortuna A, Barbé F, Sanchez-de-la-Torre M, Cano-Pumarega I, Perez-Gil A, Gomez-Garcia T, Cullen D, Somoza M, Formigon M, Aizpuru F, Oscullo G, Garcia-Ortega A, Almendros I, Farré R, Gozal D, Martinez-Garcia MA. Role of Sleep Apnea and Long-Term CPAP Treatment in the Prognosis of Patients With Melanoma: A Prospective Multicenter Study of 443 Patients. Chest 2023; 164:1551-1559. [PMID: 37348828 DOI: 10.1016/j.chest.2023.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 05/20/2023] [Accepted: 06/02/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND OSA has been associated with increased incidence and aggressiveness of melanoma. However, the long-term impact of OSA and CPAP treatment on the prognosis of melanoma remains unexplored. RESEARCH QUESTION Are OSA and CPAP treatment associated independently with a poor prognosis for cutaneous melanoma? STUDY DESIGN AND METHODS Four hundred forty-three patients with a diagnosis of cutaneous melanoma (2012-2015) underwent a sleep study within 6 months of diagnosis. The main 5-year outcome of the study was a composite of melanoma recurrence, metastasis, or mortality. Patients were divided into four groups: baseline apnea-hypopnea index (AHI) of fewer than 10 events/h (no OSA; control group), OSA treated with CPAP and good adherence, untreated or poor CPAP adherence in moderate (AHI, 10-29 events/h), and severe OSA (AHI, ≥ 30 events/h). Survival analysis was used to determine the independent role of OSA and CPAP treatment on melanoma composite outcome. RESULTS Three hundred ninety-one patients (88.2%) were available for analysis at 5-year follow-up (mean age, 65.1 ± 15.2 years; 49% male; Breslow index, 1.7 ± 2.5 mm). One hundred thirty-nine patients had AHI of fewer than 10 events/h (control group); 78 patients with OSA were adherent to CPAP; and 124 and 50 patients had moderate and severe OSA, respectively, without CPAP treatment. Median follow-up was 60 months (interquartile range, 51-74 months). During follow-up, 32 relapses, 53 metastases, and 52 deaths occurred (116 patients showed at least one of the main composite outcomes). After adjusting for age, sex, sentinel lymph nodes affected at diagnosis, BMI, diabetes, nighttime with an oxygen saturation below 90%, Breslow index, Epworth sleepiness scale scores, and melanoma treatment, moderate (hazard ratio [HR], 2.45; 95% CI, 1.09-5.49) and severe OSA (HR, 2.96; 95% CI, 1.36-6.42) were associated with poorer prognosis of melanoma compared with the control group. However, good adherence to CPAP avoided this excess risk (HR, 1.66; 95% CI, 0.71-3.90). INTERPRETATION Moderate to severe untreated OSA is an independent risk factor for poor prognosis of melanoma. Treatment with CPAP is associated with improved melanoma outcomes compared with untreated moderate to severe OSA.
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Affiliation(s)
- Jose Daniel Gómez-Olivas
- Respiratory Department, Hospital Universitario y Politecnico la Fe, Hospital de Manises, Valencia, Spain
| | - Francisco Campos-Rodriguez
- Respiratory Department, Instituto Andaluz de Investigación, Seville, Spain; Hospital Valme, IBIS, Instituto Andaluz de Investigación, Seville, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Eduardo Nagore
- Dermatology Department, Instituto Valenciano de Oncologia, Hospital de Manises, Valencia, Spain
| | | | - Francisco García-Rio
- Respiratory Department, Hospital Universitario La Paz, IdiPaz, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Carolina Cubillos
- Respiratory Department, Hospital Universitario La Paz, IdiPaz, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Luis Hernandez
- Respiratory Department, Hospital General Universitario Balmis de Alicante, UMH, Spain; Clinical Medicine Department, UMH, Spain
| | - Jose Bañuls
- Dermatology Department, Hospital General Universitario Balmis de Alicante, UMH, Spain; Clinical Medicine Department, UMH, Spain
| | - Eva Arias
- Respiratory Department, Hospital Universitario 12 de Octubre, Spain
| | - Pablo Ortiz
- Dermatology Department, Hospital Universitario 12 de Octubre, Spain
| | - Valentin Cabriada
- Respiratory Department, Hospital Universitario Cruces, Barakaldo, Spain
| | - Juan Gardeazabal
- Dermatology Department, Hospital Universitario Cruces, Barakaldo, Spain
| | - Josep Maria Montserrat
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Respiratory Department, Hospital Clinic-IDIBAPS, Spain
| | | | - Juan Fernando Masa
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Respiratory Department, Hospital Universitario San Pedro de Alcantara, Caceres, Spain
| | - Javier Gomez de Terreros
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Respiratory Department, Hospital Universitario San Pedro de Alcantara, Caceres, Spain
| | - Jorge Abad
- Respiratory Department, Hospital Universitario Germans Trials I Pujol, Spain
| | - Adam Boada
- Dermatology Department, Hospital Universitario Germans Trials I Pujol, Spain
| | - Olga Mediano
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Respiratory Department, Hospital Universitario General de Guadalajara, Guadalajara, Spain
| | - Marta Castillo-Garcia
- Respiratory Department, Hospital Universitario General de Guadalajara, Guadalajara, Spain
| | - Eusebi Chiner
- Respiratory Department, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Pedro Landete
- Respiratory Department, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Mercedes Mayos
- Respiratory Department, Hospital Universitario Santa Creu i Sant Pau, Spain
| | - Ana Fortuna
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Respiratory Department, Hospital Universitario Santa Creu i Sant Pau, Spain
| | - Ferrán Barbé
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Group of Precision Medicine in Chronic Diseases, Respiratory Department, University Hospital Arnau de Vilanova and Santa María, Spain; Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida. IRBLleida, Lleida, Spain
| | - Manuel Sanchez-de-la-Torre
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Group of Precision Medicine in Chronic Diseases, Respiratory Department, University Hospital Arnau de Vilanova and Santa María, Spain; Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida. IRBLleida, Lleida, Spain
| | | | - Amalia Perez-Gil
- Dermatology Department, Instituto Andaluz de Investigación, Seville, Spain
| | - Teresa Gomez-Garcia
- Respiratory Department, Fundacion Jimenez Diaz, Madrid, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Daniela Cullen
- Dermatology Department, Fundacion Jimenez Diaz, Madrid, Spain
| | - Maria Somoza
- Respiratory Department, Consorcio Sanitario Terrassa, Spain
| | | | - Felipe Aizpuru
- Biostatistical Service, BioAraba, Health Research Institute, OSI Araba University Hospital, Basque Health Service, University of the Basque Country, Leioa, Spain
| | - Grace Oscullo
- Respiratory Department, Hospital Universitario y Politecnico la Fe, Hospital de Manises, Valencia, Spain
| | - Alberto Garcia-Ortega
- Respiratory Department, Hospital Universitario y Politecnico la Fe, Hospital de Manises, Valencia, Spain
| | - Isaac Almendros
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, Madrid, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Unitat de Biofisica i Bioenginyeria, Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain
| | - Ramón Farré
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, Madrid, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Unitat de Biofisica i Bioenginyeria, Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain
| | - David Gozal
- Department of Child Health and Child Health Research Institute, School of Medicine, The University of Missouri, Columbia, MO
| | - Miguel Angel Martinez-Garcia
- Respiratory Department, Hospital Universitario y Politecnico la Fe, Hospital de Manises, Valencia, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain.
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2
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Gómez Olivas JD, Campos-Rodriguez F, Nagore E, Hernández L, Cabriada V, Abad J, Mediano O, Pastor E, Chiner E, de la Torre MS, Cano I, Somoza M, Garcia-Ortega A, Oscullo G, Martinez-García MA. Sleep Duration and Cutaneous Melanoma Aggressiveness. A Prospective Observational Study in 443 Patients. Arch Bronconeumol 2021; 57:776-778. [PMID: 35698991 DOI: 10.1016/j.arbr.2020.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/22/2020] [Indexed: 06/15/2023]
Affiliation(s)
| | | | - Eduardo Nagore
- Oncology Department, Instituto Valenciano de Oncología, Spain
| | | | | | - Jorge Abad
- Sleep Unit, Hospital Germans Trials i Pujol, Barcelona, Spain
| | - Olga Mediano
- Pneumology Department Hospital de Guadalajara, Spain
| | - Esther Pastor
- Pneumology Department Hospital San Juan Alicante, Spain
| | - Eusebi Chiner
- Pneumology Department Hospital San Juan Alicante, Spain
| | | | - Irene Cano
- Pneumology Department, Hospital Getafe, Madrid, Spain
| | - Maria Somoza
- Pneumology Department, Consorcio Sanitario Terrassa, Barcelona, Spain
| | | | - Grace Oscullo
- Pneumology Department. Hospital Universitario y Politecnico La Fe, Valencia, Spain
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3
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Gómez Olivas JD, Campos-Rodriguez F, Nagore E, Hernández L, Cabriada V, Abad J, Mediano O, Pastor E, Chiner E, de la Torre MS, Cano I, Somoza M, Garcia-Ortega A, Oscullo G, Martinez-García MA. Sleep Duration and Cutaneous Melanoma Aggressiveness. A Prospective Observational Study in 443 Patients. Arch Bronconeumol 2020; 57:S0300-2896(20)30403-8. [PMID: 33309420 DOI: 10.1016/j.arbres.2020.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/18/2020] [Accepted: 10/22/2020] [Indexed: 10/23/2022]
Affiliation(s)
| | | | - Eduardo Nagore
- Oncology Department, Instituto Valenciano de Oncología, Spain
| | | | | | - Jorge Abad
- Sleep Unit, Hospital Germans Trials i Pujol, Barcelona, Spain
| | - Olga Mediano
- Pneumology Department Hospital de Guadalajara, Spain
| | - Esther Pastor
- Pneumology Department Hospital San Juan Alicante, Spain
| | - Eusebi Chiner
- Pneumology Department Hospital San Juan Alicante, Spain
| | | | - Irene Cano
- Pneumology Department, Hospital Getafe, Madrid, Spain
| | - Maria Somoza
- Pneumology Department, Consorcio Sanitario Terrassa, Barcelona, Spain
| | | | - Grace Oscullo
- Pneumology Department. Hospital Universitario y Politecnico La Fe, Valencia, Spain
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Luque L, Rodrigo T, García-García JM, Casals M, Millet JP, Caylà J, Orcau A, Agüero R, Alcázar J, Altet N, Altube L, Álvarez F, Anibarro L, Barrón M, Bermúdez P, Bikuña E, Blanquer R, Borderías L, Bustamante A, Calpe J, Caminero J, Cañas F, Casas F, Casas X, Cases E, Castejón N, Castrodeza R, Cebrián J, Cervera A, Ciruelos J, Delgado A, De Souza M, Díaz D, Domínguez M, Fernández B, Gallardo J, Gallego M, Clemente MG, García C, García F, Garros F, Gort A, Guerediaga A, Gullón J, Hidalgo C, Iglesias M, Jiménez G, Jiménez M, Kindelan J, Laparra J, López I, Lera R, Lloret T, Marín M, Lacasa XM, Martínez E, Martínez A, Medina J, Melero C, Milà C, Millet J, Mir I, Molina F, Morales C, Morales M, Moreno A, Moreno V, Muñoz A, Muñoz C, Muñoz J, Muñoz L, Oribe M, Parra I, Penas A, Pérez J, Rivas P, Rodríguez J, Ruiz-Manzano J, Sala J, Sandel D, Sánchez M, Sánchez M, Sánchez P, Santamaría I, Sanz F, Serrano A, Somoza M, Tabernero E, Trujillo E, Valencia E, Valiño P, Vargas A, Vidal I, Vidal R, Villanueva M, Villar A, Vizcaya M, Zabaleta M, Zubillaga G. Factors Associated With Extrapulmonary Tuberculosis in Spain and Its Distribution in Immigrant Population. Open Respiratory Archives 2020. [DOI: 10.1016/j.opresp.2020.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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5
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Campos-Rodriguez F, Navarro-Soriano C, Reyes-Nuñez N, Torres G, Caballero-Eraso C, Lloberes P, Diaz-Cambriles T, Somoza M, Masa JF, Gonzalez M, Mañas E, de la Peña M, Barbe F, Garcia-Rio F, Montserrat JM, Muriel A, Garcia-Ortega A, Selma MJ, Martinez-Garcia MA. Good long-term adherence to continuous positive airway pressure therapy in patients with resistant hypertension and sleep apnea. J Sleep Res 2019; 28:e12805. [PMID: 30604577 DOI: 10.1111/jsr.12805] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/06/2018] [Accepted: 11/08/2018] [Indexed: 11/29/2022]
Abstract
Although adequate adherence is paramount in achieving the beneficial effects of continuous positive airway pressure therapy in patients with obstructive sleep apnea, long-term adherence and the variables involved in continuous positive airway pressure compliance in patients with resistant hypertension and obstructive sleep apnea are yet unknown. We conducted a prospective, multicentre, observational study in 177 patients recruited from hypertensive units with resistant hypertension confirmed by means of 24-hr blood pressure monitoring (blood pressure ≥ 130 and/or ≥ 80 mmHg, despite taking at least three antihypertensive drugs or < 130/80 mmHg with > 3 drugs) and obstructive sleep apnea (apnea-hypopnea index ≥ 5 in a respiratory polygraph) who were prescribed continuous positive airway pressure treatment. Good adherence was defined as an average cumulative continuous positive airway pressure use of ≥ 4 hr per night at the end of the follow-up. A multivariate Cox regression analysis was performed to identify independent predictors of continuous positive airway pressure adherence. Patients were followed for a median of 57.6 (42-72) months after initiating continuous positive airway pressure therapy. At the end of the follow-up, the median continuous positive airway pressure use was 5.7 (inter-quartile range 3.9-6.6) hr per night, and 132 patients (74.5%) showed good continuous positive airway pressure adherence. The only baseline variable associated with poor adherence was the presence of previous stroke (hazard ratio 4.00, 95% confidence interval 1.92-8.31). Adequate adherence at 1 month also predicted good adherence at the end of the follow-up (hazard ratio 14.4, 95% confidence interval 4.94-56). Both variables also predicted adherence at a threshold of 6 hr per night. Our results show that good continuous positive airway pressure adherence is an achievable and feasible goal in patients with resistant hypertension and obstructive sleep apnea. Previous stroke and short-term adherence predicted long-term adherence.
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Affiliation(s)
- Francisco Campos-Rodriguez
- Respiratory Department, Hospital Universitario de Valme, Sevilla, Spain.,Instituto de Biomedicina de Sevilla (IBIS), Universidad de Sevilla, Sevilla, Spain.,CIBERes, CIBER de enfermedades Respiratorias, Madrid, Spain
| | | | - Nuria Reyes-Nuñez
- Respiratory Department, Hospital Universitario de Valme, Sevilla, Spain
| | - Gerard Torres
- Internal Medicine Service, Hospital Universitari de Santa María, Lleida, Spain
| | | | - Patricia Lloberes
- Respiratory Department, Hospital Universitario Vall Hebron, Barcelona, Spain
| | | | - Maria Somoza
- Respiratory Department, Consorcio Sanitario de Terrassa, Barcelona, Spain
| | - Juan F Masa
- CIBERes, CIBER de enfermedades Respiratorias, Madrid, Spain.,Respiratory Department, Hospital Universitario San Pedro de Alcantara, Caceres, Spain
| | - Monica Gonzalez
- Respiratory Department, Hospital Universitario Marques de Valdecilla, Santander, Spain
| | - Eva Mañas
- Respiratory Department, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - Monica de la Peña
- Respiratory Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Ferran Barbe
- CIBERes, CIBER de enfermedades Respiratorias, Madrid, Spain.,Institut de Recerca Biomédica, IRB Lleida, Lleida, Spain
| | - Francisco Garcia-Rio
- CIBERes, CIBER de enfermedades Respiratorias, Madrid, Spain.,Respiratory Department, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | | | - Alfonso Muriel
- CIBERes, CIBER de enfermedades Respiratorias, Madrid, Spain.,Unidad de Bioestadística Clínica, Hospital Ramón y Cajal, Madrid, Spain.,IRYCIS, Madrid, Spain.,Departamento de Enfermería, Universidad de Alcalá, Madrid, Spain
| | | | - Maria J Selma
- Respiratory Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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6
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Martinez-Garcia MA, Campos-Rodriguez F, Nagore E, Martorell A, Rodriguez-Peralto JL, Riveiro-Falkenbach E, Hernandez L, Bañuls J, Arias E, Ortiz P, Cabriada V, Gardeazabal J, Montserrat JM, Carrera C, Corral J, Masa JF, de Terreros JG, Abad J, Boada A, Mediano O, de Eusebio E, Chiner E, Landete P, Mayos M, Fortuño A, Barbé F, Sánchez de la Torre M, Sanchez de la Torre A, Cano I, Gonzalez C, Pérez-Gil A, Gómez-García T, Cullen D, Somoza M, Formigón M, Aizpuru F, Navarro C, Selma-Ferrer MJ, Garcia-Ortega A, de Unamuno B, Almendros I, Farré R, Gozal D. Sleep-Disordered Breathing Is Independently Associated With Increased Aggressiveness of Cutaneous Melanoma: A Multicenter Observational Study in 443 Patients. Chest 2018; 154:1348-1358. [PMID: 30059679 DOI: 10.1016/j.chest.2018.07.015] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [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: 03/09/2018] [Revised: 05/22/2018] [Accepted: 07/10/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Sleep-disordered breathing (SDB) has been associated with a greater incidence and mortality of cancer, although such findings are inconsistent. However, no large studies are currently available to investigate this association in patients with a specific type of cancer. This study seeks to assess potential relationships between SDB severity and aggressiveness markers of cutaneous melanoma. METHODS Four hundred and forty-three patients with a diagnosis of melanoma underwent a sleep study within 6 months of diagnosis. General demographics were collected, along with melanoma characteristics and polygraphic parameters consisting of the apnea-hypopnea index (AHI) and indices of both continuous and intermittent night-time oxyhemoglobin desaturation (DI4%). An exploration of independent relationships between SDB and various objective melanoma aggressiveness markers (Breslow index, presence of ulceration, presence of regression, mitotic index, stage of severity, damage to the sentinel lymph, and spreading of the melanoma) was performed. RESULTS Patients in the upper tertiles of AHI or DI4% were 1.94 (95% CI, 1.14-3.32; P = .022) and 1.93 (95% CI, 1.14-3.26; P = .013) times more likely, respectively, to present with aggressive melanoma (Breslow index > 1 mm) than those in the lowest tertiles of these sleep attributes after adjustment for age, sex, tumor location, and BMI. This association was particularly prominent among patients < 56 years of age with Breslow index > 2 mm. The presence of the additional markers of aggressiveness was also associated with higher AHI and DI4% values. CONCLUSIONS The severity of SDB was independently associated with greater aggressiveness of cutaneous melanoma, particularly among younger patients.
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Affiliation(s)
| | | | - Eduardo Nagore
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | | | | | | | - Luis Hernandez
- Respiratory Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - Jose Bañuls
- Dermatology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - Eva Arias
- Respiratory Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Pablo Ortiz
- Dermatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Valentin Cabriada
- Respiratory Department, Hospital Universitario Cruces de Bilbao, Bilbao, Spain
| | - Jose Gardeazabal
- Dermatology Department, Hospital Universitario Cruces de Bilbao, Bilbao, Spain
| | - Josep Maria Montserrat
- Respiratory Department, Hospital Clinic-IDIBAPS, Barcelona, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Cristina Carrera
- Dermatology Department, Hospital Clinic-IDIBAPS, Barcelona, Spain
| | - Jaime Corral
- Respiratory Department, Hospital Universitario San Pedro de Alcántara, Cáceres, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Juan Fernando Masa
- Respiratory Department, Hospital Universitario San Pedro de Alcántara, Cáceres, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Javier Gomez de Terreros
- Respiratory Department, Hospital Universitario San Pedro de Alcántara, Cáceres, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Jorge Abad
- Respiratory Department, Hospital Universitario Germans Trials I Pujol, Barcelona, Spain
| | - Adam Boada
- Dermatology Department, Hospital Universitario Germans Trials I Pujol, Barcelona, Spain
| | - Olga Mediano
- Respiratory Department, Hospital Universitario General de Guadalajara, Guadalajara, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Esther de Eusebio
- Dermatology Department, Hospital Universitario General de Guadalajara, Guadalajara, Spain
| | - Eusebi Chiner
- Respiratory Department, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Pedro Landete
- Respiratory Department, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Mercedes Mayos
- Respiratory Department, Hospital Universitario Santa Creu i Sant Pau, Barcelona, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Ana Fortuño
- Respiratory Department, Hospital Universitario Santa Creu i Sant Pau, Barcelona, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Ferrán Barbé
- Respiratory Department, IRBLleida, Lleida, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Manuel Sánchez de la Torre
- Respiratory Department, IRBLleida, Lleida, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Alicia Sanchez de la Torre
- Respiratory Department, IRBLleida, Lleida, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Irene Cano
- Respiratory Department, Hospital Universitario de Getafe, Madrid, Spain
| | - Cristina Gonzalez
- Dermatology Department, Hospital Universitario de Getafe, Madrid, Spain
| | | | - Teresa Gómez-García
- Respiratory Department, Fundación Jimenez Diaz, Madrid, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Daniela Cullen
- Dermatology Department, Fundación Jimenez Diaz, Madrid, Spain
| | - Maria Somoza
- Respiratory Department, Consorcio Sanitario Terrassa, Barcelona, Spain
| | - Manuel Formigón
- Dermatology Department, Consorcio Sanitario Terrassa, Barcelona, Spain
| | - Felipe Aizpuru
- Biostatistical Service, BioAraba, Health Research Institute, OSI Araba University Hospital, Basque Health Service, University of the Basque Country, Bilbao, Spain
| | - Cristina Navarro
- Respiratory Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | | | | | - Blanca de Unamuno
- Dermatology Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - Isaac Almendros
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain, and Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Ramón Farré
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain, and Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; CIBERes, CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - David Gozal
- Department of Pediatrics, University of Chicago, Chicago, IL
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Marrone N, Ingram M, Somoza M, Jacob DS, Sanchez A, Adamovich S, Harris FP. Interventional Audiology to Address Hearing Health Care Disparities: Oyendo Bien Pilot Study. Semin Hear 2017; 38:198-211. [PMID: 28522894 PMCID: PMC5435479 DOI: 10.1055/s-0037-1601575] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Interventional audiology, specifically community-based outreach, can connect people with the hearing health care system. Community-based participatory research methods were applied in two phases of research to: (1) investigate the needs of families affected by hearing loss in a rural Arizona community on the U.S.-Mexico border; and (2) evaluate an outreach program on hearing health. The needs assessment included interviews with persons with hearing loss and focus groups with family members and the greater community. The needs assessment revealed that despite perceived severity of hearing loss, help-seeking for audiologic care was limited due to barriers, stigma, and low self-efficacy. Results informed development of a community-based pilot study conducted as part of an academic-community partnership between audiology, public health, and community health workers of a federally qualified health center. An outreach program, Oyendo Bien (hearing wellness), a 5-week, Spanish-language health education program for older adults (n = 21) incorporated communication strategies and behavioral change techniques. Postprogram focus groups revealed increased self-efficacy and decreased stigma. After 1 year, 7 of 9 participants with hearing loss contacted for follow-up had sought some form of hearing-related health care. Future research should further investigate interventional audiology approaches to address health disparities.
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Affiliation(s)
- Nicole Marrone
- Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, Arizona
| | - Maia Ingram
- Arizona Prevention Research Center, University of Arizona, Tucson, Arizona
| | - Maria Somoza
- Mariposa Community Health Center, Nogales, Arizona
| | - Daisey Sánchez Jacob
- Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, Arizona
| | - Adriana Sanchez
- Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, Arizona
| | - Stephanie Adamovich
- Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, Arizona
| | - Frances P. Harris
- Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, Arizona
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Sánchez-de-la-Torre M, Khalyfa A, Sánchez-de-la-Torre A, Martinez-Alonso M, Martinez-García MÁ, Barceló A, Lloberes P, Campos-Rodriguez F, Capote F, Diaz-de-Atauri MJ, Somoza M, González M, Masa JF, Gozal D, Barbé F. Precision Medicine in Patients With Resistant Hypertension and Obstructive Sleep Apnea: Blood Pressure Response to Continuous Positive Airway Pressure Treatment. J Am Coll Cardiol 2015; 66:1023-32. [PMID: 26314530 DOI: 10.1016/j.jacc.2015.06.1315] [Citation(s) in RCA: 140] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 06/12/2015] [Accepted: 06/19/2015] [Indexed: 01/28/2023]
Abstract
BACKGROUND In patients with resistant hypertension (RH) and obstructive sleep apnea (OSA), the blood pressure response to continuous positive airway pressure (CPAP) treatment is highly variable and could be associated with differential micro-ribonucleic acid (miRNA) profiles. Currently, no available methods exist to identify patients who will respond favorably to CPAP treatment. OBJECTIVES The aim of this study was to identify plasma miRNA profiles that predict blood pressure responses to CPAP treatment. METHODS Cardiovascular system-focused circulating miRNA expression was evaluated in plasma samples using an 84-miRNA array among patients with RH and OSA at baseline and after 3 months of adherent CPAP use. Pathway analysis and miRNA target gene enrichment were performed in silico. Plasma levels of peptides and hormones related to cardiovascular function were also measured. RESULTS The OSA responder group exhibited blood pressure decreases exceeding the observed median (>4.5 mm Hg) after CPAP, which were not present in the nonresponder group (≤4.5 mm Hg) (p < 0.01). Three miRNAs provided a discriminatory predictive model for such a favorable blood pressure response to CPAP (area under the curve: 0.92; p = 0.01). Additionally, CPAP treatment significantly altered a total of 47 plasma miRNAs and decreased aldosterone-to-renin ratios in the responder group (p = 0.016) but not in the nonresponder group. CONCLUSIONS A singular pre-CPAP treatment cluster of 3 plasma miRNAs predicts blood pressure responses to CPAP treatment in patients with RH and OSA. CPAP treatment is accompanied by changes in cardiovascular system-related miRNAs that may potentially influence the risk for cardiovascular disease among patients with OSA and RH. (Effect of Continuous Positive Airway Pressure [CPAP] Treatment in the Control of Refractory Hypertension; NCT00616265).
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Affiliation(s)
- Manuel Sánchez-de-la-Torre
- Respiratory Department, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Abdelnaby Khalyfa
- Section of Pediatric Sleep Medicine, Department of Pediatrics, Comer Children's Hospital, Pritzker School of Medicine, University of Chicago, Chicago, Illinois; Department of Pediatrics, University of Chicago, Chicago, Illinois
| | - Alicia Sánchez-de-la-Torre
- Respiratory Department, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Montserrat Martinez-Alonso
- Respiratory Department, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Miguel Ángel Martinez-García
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Respiratory Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Antonia Barceló
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Clinic Analysis and Respiratory Services, Hospital Universitari Son Espases, Institut de Investigacio, Palma de Mallorca, Balears, Spain
| | - Patricia Lloberes
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Respiratory Department, Hospital Universitario Vall Hebrón, Barcelona, Spain
| | | | - Francisco Capote
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Respiratory Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | | | - Maria Somoza
- Respiratory Department, Consorcio Sanitario de Terrassa, Barcelona, Spain
| | - Mónica González
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Respiratory Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Juan-Fernando Masa
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Respiratory Department, Hospital Universitario San Pedro de Alcántara, Cáceres, Spain
| | - David Gozal
- Section of Pediatric Sleep Medicine, Department of Pediatrics, Comer Children's Hospital, Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Ferran Barbé
- Respiratory Department, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
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Lieder B, Hochkogler C, Holik AK, Somoza M, Pignitter M, Ley J, Widder S, Krammer G, Somoza V. Implications of the TRPV1 agonist nonivamide for body weight management. Appetite 2015. [DOI: 10.1016/j.appet.2015.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Martínez-Gomis J, Willaert E, Nogues L, Pascual M, Somoza M, Monasterio C. Five years of sleep apnea treatment with a mandibular advancement device. Side effects and technical complications. Angle Orthod 2010; 80:30-36. [PMID: 19852636 PMCID: PMC8978723 DOI: 10.2319/030309-122.1] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2009] [Accepted: 04/01/2009] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE To determine the variation in prevalence of temporomandibular disorders (TMD), other side effects, and technical complications during 5 years of sleep apnea treatment with a mandibular advancement device. MATERIALS AND METHODS Forty patients diagnosed with obstructive sleep apnea received an adjustable appliance at 70% of the maximum protrusion. The protrusion was then progressively increased. TMD (diagnosed according to the Research Diagnostic Criteria for TMD), overjet, overbite, occlusal contacts, subjective side effects, and technical complications were recorded before and a mean of 14, 21, and 58 months after treatment and analyzed by the Wilcoxon test (P < .05). RESULTS Fifteen patients still used the oral appliance at the 5-year follow-up, and no significant variation in TMD prevalence was observed. Subjective side effects were common, and a significant reduction was found in overjet, overbite, and in the number of occlusal contacts. Furthermore, the patients made a mean of 2.5 unscheduled dental visits per year and a mean of 0.8 appliance repairs/relines per year by a dental technician. The most frequent unscheduled visits were needed during the first year and were a result of acrylic breakage on the lateral telescopic attachment, poor retention, and other adjustments to improve comfort. CONCLUSIONS Five-year oral appliance treatment does not affect TMD prevalence but is associated with permanent occlusal changes in most sleep apnea patients during the first 2 years. Patients seek several unscheduled visits, mainly because of technical complications.
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Affiliation(s)
- Jordi Martínez-Gomis
- Department of Prosthodontics, Faculty of Dentistry, University of Barcelona, Campus de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
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Serratrice G, Somoza M. [A case of myositis ossificans of fibrodysplasia ossificans progressiva type]. Rev Rhum Mal Osteoartic 1988; 55:798-9. [PMID: 3194699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Parra A, Somoza M, Sanberg PR, Guillamon A, Somoza E. A computerized system for learned helplessness experiments. Int J Biomed Comput 1988; 22:265-71. [PMID: 3410576 DOI: 10.1016/0020-7101(88)90081-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A microcomputer-based system for carrying out learned helplessness experiments is described. The hardware is inexpensive and easily available. The program is written in BASIC and must be executed in the compiled form in order to keep up with real-time events. It contains an algorithm for calculating inter-trial intervals and allows the experimentor to freely select experimental conditions such as duration of shock, number of trials, etc. The task that the rat is required to do to stop the shock is also selectable, thus giving the experimentor the opportunity to maximize behavioral differences between escapable and inescapable rats while these differences are being induced. Experimental data on 12 rats that went through this automated protocol are analyzed and discussed.
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Affiliation(s)
- A Parra
- Department of Psychiatry, University of Cincinnati Medical Center, OH 45267
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Reyes JT, Hernández P, Soto E, Somoza M. [Evaluation of analgesic effects of a compound on a base of acetaminophen, propoxyphene, hydroxyzine and caffein in various dental surgical procedures]. Quintessencia 1979; 6:67-72. [PMID: 297893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Sanz Colombi A, Somoza M, Monteverde D, Colombi A. [Electrophysiology in neuropathy caused by vincristine]. Arq Neuropsiquiatr 1975; 33:345-52. [PMID: 172049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Ten patients treated with vincristine were submitted for electrophysiological examination. It was investigated the number of motor units within the thenar muscle following a technique described previously (Sica et al. - 1974); motor and sensitive conduction velocities as well as motor distal latencies in the median nerve were studied following conventional techniques. The behaviour of the evoked muscle potential with repetitive supramaximal stimulation over the median nerve was also investigated. The findings were compared with control groups. The estimated number of motor units was disminished in eight of ten patients and the average number was significantly different from the control group (control 318 +/- 71 UM; patients 174 +/- 84 UM; P less than 0.001). The potential amplitudes in most of the surviving units were reduced, others remaining within the normal range. This makes apparent that the peripherical nervous system fails to compensate adequately and, furthermore, a loss of individual muscle fibres occurs within some individual units. The conduction velocities of the fastest conducting motor nerve fibres were reduced and motor distal latencies prolongued (Table 1). Maximal impulse conduction velocities were measured in sensory fibres. In 5 of 7 subjets investigated the values laied just beyond the lower limit of the normal range. The amplitude of the sensory orthodromic evoked potential in the median nerve at the wrist was disminished almost in the whole group. The decremental muscle response to repetitive nerve stimulation, can be interpreted as the result of the damage at the neural apparatus at the motor end plate; it was observed in 57% of the patients. In summary, evidences have been registered showing that the nervous supply to the muscle is affected in patients treated with vincristine; the motor unit behaviour under this conditions is discussed.
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Sanz OP, Colombi A, Somoza M, Monteverde D. Estudio electrofisiologico en la neuropatia por Vincristina. Arq Neuro-Psiquiatr 1975. [DOI: 10.1590/s0004-282x1975000400004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Diez pacientes afectados por diversas patologías que requerían tratamiento crónico con Vincristina, fueron sometidos a estudios electrofisiológicos en los que se valoró: el número de unidades motoras (UM) funcionantes en los músculos de la eminencia tenar, los valores de los incrementos medios de UM, velocidad de conducción motora y su latencia residual en el nervio mediano, la velocidad de conducción sensitiva del mismo nervio y el estado de la transmisión neuromuscular. Los valores obtenidos fueron comparados con grupos controles. Los resultados mostraron disminución del número de UM; las UM remanentes presentaron amplitud reducida junto a otras cuyo tamaño no superaba el del grupo control, hecho que sugiere la incapacidad de lograr una reinervación adecuada. Las velocidades de conducción motora y sensitiva mostraron valores diminuídos, con mayor compromiso en los segmentos distales. Junto a estos datos se halló respuesta miasteniforme al estímulo repetitivo. Todos estos resultados permiten postular la existencia de un compromiso de la unidad motora, abarcando todos sus segmentos, en pacientes intoxicados con Vincristina.
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