1
|
Pavía-López AA, Magaña-Serrano JA, Cigarroa-López JA, Chávez-Mendoza A, Mayorga-Butrón JL, Araiza-Garaygordobil D, Ivey-Miranda JB, Méndez-Machado GF, González-Godínez H, Aguilera-Mora LF, Jordán-Ríos A, Olmos-Domínguez L, Olalde-Román MJ, Miranda-Malpica EM, Vázquez-Ortiz Z, Rayo-Chávez J, Mendoza AA, Márquez-Murillo MF, Chávez-Leal SA, Gabriel AÁS, Silva-García MA, Pacheco-Bouthiller AD, Aldrete-Velazco JA, Guizar-Sánchez CA, Gaxiola-López E, Guerra-López A, Figueiras-Graillet L, Sánchez-Miranda G, Mendoza-Zavala GH, Aceves-García M, Chávez-Negrete A, Arroyo-Hernández M, Montaño-Velázquez BB, Romero-Moreno LF, Baquero-Hoyos MM, Velasco-Hidalgo L, Rodríguez-Lozano AL, Aguilar-Gómez NE, Rodríguez-Vega M, Cossío-Aranda JE. Clinical practice guidelines for diagnostic and treatment of the chronic heart failure. Arch Cardiol Mex 2024; 94:1-74. [PMID: 38648647 DOI: 10.24875/acm.m24000095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/08/2024] [Indexed: 04/25/2024] Open
Abstract
Chronic heart failure continues to be one of the main causes of impairment in the functioning and quality of life of people who suffer from it, as well as one of the main causes of mortality in our country and around the world. Mexico has a high prevalence of risk factors for developing heart failure, such as high blood pressure, diabetes, and obesity, which makes it essential to have an evidence-based document that provides recommendations to health professionals involved in the diagnosis and treatment of these patients. This document establishes the clinical practice guide (CPG) prepared at the initiative of the Mexican Society of Cardiology (SMC) in collaboration with the Iberic American Agency for the Development and Evaluation of Health Technologies, with the purpose of establishing recommendations based on the best available evidence and agreed upon by an interdisciplinary group of experts. This document complies with international quality standards, such as those described by the US Institute of Medicine (IOM), the National Institute of Clinical Excellence (NICE), the Intercollegiate Network for Scottish Guideline Development (SIGN) and the Guidelines International Network (G-I-N). The Guideline Development Group was integrated in a multi-collaborative and interdisciplinary manner with the support of methodologists with experience in systematic literature reviews and the development of CPG. A modified Delphi panel methodology was developed and conducted to achieve an adequate level of consensus in each of the recommendations contained in this CPG. We hope that this document contributes to better clinical decision making and becomes a reference point for clinicians who manage patients with chronic heart failure in all their clinical stages and in this way, we improve the quality of clinical care, improve their quality of life and reducing its complications.
Collapse
Affiliation(s)
- Abel A Pavía-López
- Coordinador de las Guías Mexicanas de Práctica Clínica de la Sociedad Mexicana de Cardiología, Centro Médico ABC, Ciudad de México, México
| | - José A Magaña-Serrano
- Jefe de la División de Insuficiencia Cardiaca y Trasplante, Hospital Asociación Mexicana de Insuficiencia Cardiaca, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Ciudad de México, México
- Presidente de la Asociación Mexicana de Insuficiencia Cardiaca, Ciudad de México, México
| | - José A Cigarroa-López
- Jefe de la Clínica de Insuficiencia Cardiaca y Trasplante, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Ciudad de México, México
| | - Adolfo Chávez-Mendoza
- Jefe de la Clínica de Insuficiencia Cardiaca Hospital de Día, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Ciudad de México, México
| | - José L Mayorga-Butrón
- Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de México, México
- Unidad de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
- Ibero American Agency for Development & Assessment of Health Technologies
| | - Diego Araiza-Garaygordobil
- Adscrito a la Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Juan B Ivey-Miranda
- Adscrito a la Clínica de Insuficiencia Cardiaca Avanzada y Trasplante, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Ciudad de México, México
| | - Gustavo F Méndez-Machado
- Cardiólogo Especialista en Insuficiencia Cardiaca, Imperial College, Londres, Reino Unido
- Unidad de Investigación Clínica Hospital Ángeles Xalapa, Veracruz, México
| | | | - Luisa F Aguilera-Mora
- Directora de la Clínica de Insuficiencia Cardiaca, Instituto Cardiovascular de Mínima Invasión, Hospital Puerta de Hierro, Zapopan, Jalisco, México
| | - Antonio Jordán-Ríos
- Coordinador Digital, Sociedad Mexicana de Cardiología A.C., México
- Cardiólogo Clínico, Ecocardiografía Adultos, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Luis Olmos-Domínguez
- Cardiólogo Adscrito a la Clínica de Insuficiencia Cardiaca, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Ciudad de México, México
| | - Marcos J Olalde-Román
- Cardiólogo Adscrito a la Clínica de Insuficiencia Cardiaca, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Ciudad de México, México
| | | | | | - Jorge Rayo-Chávez
- Adscrito a la Clínica de Insuficiencia Cardiaca, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Ciudad de México, México
| | - Alexandra A Mendoza
- Cardióloga Especialista en Medicina Crítica, Centro Médico ABC Observatorio, Ciudad de México, México
- Jefa de Urgencias y Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Manlio F Márquez-Murillo
- Cardiólogo Especialista en Electrofisiología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Sergio A Chávez-Leal
- Clínica de Insuficiencia Cardiaca, SIMNSA Health Care, Tijuana, Baja California, México
| | - Amada Álvarez-San Gabriel
- Coordinadora del Programa de Insuficiencia Cardiaca, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Marissa A Silva-García
- Cardióloga Adscrita en el Hospital de Ginecología y Obstetricia No. 4 Luis Castelazo Ayala
| | - Alex D Pacheco-Bouthiller
- Director de la Clínica de Arritmias y Estimulación Cardiaca, Instituto Cardiovascular de Mínima Invasión, Hospital Puerta de Hierro, Zapopan, Jalisco, México
| | | | - Carlos A Guizar-Sánchez
- Coordinador del Programa de Insuficiencia Cardiaca, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
- Hospital Central Sur, PEMEX, Ciudad de México, México
| | | | | | | | | | - Genaro H Mendoza-Zavala
- Adscrito a la Clínica de Insuficiencia Cardiaca, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Moisés Aceves-García
- Adscrito a la Clínica de Insuficiencia Cardiaca, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | | | - Marisol Arroyo-Hernández
- Adscrito a la Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
- Servicio de Neumología, Instituto Nacional de Cancerología, Tlapan, México
| | - Bertha B Montaño-Velázquez
- Adscrito a la Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
- Hospital de Especialidades, Centro Médico Nacional La Raza, Ciudad de México, México
| | - Luis F Romero-Moreno
- Adscrito a la Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
- Médico Adscrito a la Fundación Hospital de la Misericordia, Bogotá, Colombia
| | - María M Baquero-Hoyos
- Unidad de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
- Adscrito a la Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Liliana Velasco-Hidalgo
- Unidad de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
- Adscrito a la Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Ana L Rodríguez-Lozano
- Unidad de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
- Adscrito a la Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Nancy E Aguilar-Gómez
- Unidad de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
- Adscrito a la Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Mario Rodríguez-Vega
- Adscrito a la Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | | |
Collapse
|
2
|
Hernández-Pedro N, Arroyo-Hernández M, Barrios-Bernal P, Romero-Nuñez E, Sosa-Hernandez VA, Ávila-Ríos S, Maravillas-Montero JL, Pérez-Padilla R, de Miguel-Perez D, Rolfo C, Arrieta O. Impact of Tyrosine Kinase Inhibitors on the Immune Response to SARS-CoV-2 Vaccination in Patients with Non-Small Cell Lung Cancer. Vaccines (Basel) 2023; 11:1612. [PMID: 37897014 PMCID: PMC10611320 DOI: 10.3390/vaccines11101612] [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: 08/15/2023] [Revised: 10/06/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
Immune dysregulation and cancer treatment may affect SARS-CoV-2 vaccination protection. Antibody production by B-cells play a vital role in the control and clearance of the SARS-CoV-2 virus. This study prospectively explores B-cell seroconversion following SARS-CoV-2 immunization in healthy individuals and non-small cell lung cancer (NSCLC) patients undergoing oncological treatment. 92 NSCLC patients and 27 healthy individuals' blood samples were collected after receiving any COVID-19 vaccine. Serum and mononuclear cells were isolated, and a serum surrogate virus neutralization test kit evaluated SARS-CoV-2 antibodies. B-cell subpopulations on mononuclear cells were characterized by flow cytometry. Patients were compared based on vaccination specifications and target mutation oncological treatment. A higher percentage of healthy individuals developed more SARS-CoV-2 neutralizing antibodies than NSCLC patients (63% vs. 54.3%; p = 0.03). NSCLC patients receiving chemotherapy (CTX) or tyrosine kinase inhibitors (TKIs) developed antibodies in 45.2% and 53.7%, of cases, respectively, showing an impaired antibody generation. CTX patients exhibited trends towards lower median antibody production than TKIs (1.0, IQR 83 vs. 38.23, IQR 89.22; p = 0.069). Patients receiving immunotherapy did not generate antibodies. A sub-analysis revealed that those with ALK mutations exhibited non-significant trends towards higher antibody titers (63.02, IQR 76.58 vs. 21.78, IQR 93.5; p = 0.1742) and B-cells quantification (10.80, IQR 7.52 vs. 7.22, IQR 3.32; p = 0.1382) against the SARS-CoV-2 spike protein than EGFR patients; nonetheless, these differences were not statistically significant. This study shows that antibodies against SARS-CoV-2 may be impaired in patients with NSCLC secondary to EGFR-targeted TKIs compared to ALK-directed treatment.
Collapse
Affiliation(s)
- Norma Hernández-Pedro
- Laboratorio de Medicina Personalizada, Instituto Nacional de Cancerología, S.S.A., San Fernando 22 Sección XVI, Tlalpan, Mexico City 14080, Mexico; (N.H.-P.); (P.B.-B.); (E.R.-N.)
| | - Marisol Arroyo-Hernández
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, S.S.A., San Fernando 22 Sección XVI, Tlalpan, Mexico City 14080, Mexico;
| | - Pedro Barrios-Bernal
- Laboratorio de Medicina Personalizada, Instituto Nacional de Cancerología, S.S.A., San Fernando 22 Sección XVI, Tlalpan, Mexico City 14080, Mexico; (N.H.-P.); (P.B.-B.); (E.R.-N.)
| | - Eunice Romero-Nuñez
- Laboratorio de Medicina Personalizada, Instituto Nacional de Cancerología, S.S.A., San Fernando 22 Sección XVI, Tlalpan, Mexico City 14080, Mexico; (N.H.-P.); (P.B.-B.); (E.R.-N.)
| | - Victor A. Sosa-Hernandez
- Red de Apoyo a la Investigación, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (V.A.S.-H.); (J.L.M.-M.)
| | - Santiago Ávila-Ríos
- Centro de Investigación en Enfermedades Infecciosas (CIENI), Instituto Nacional de Enfermedades Respiratorias, Calzada de Tlalpan 4502, Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico;
| | - José Luis Maravillas-Montero
- Red de Apoyo a la Investigación, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (V.A.S.-H.); (J.L.M.-M.)
| | - Rogelio Pérez-Padilla
- Department of Research on Tobacco and COPD, Instituto Nacional de Enfermedades Respiratorias, Calzada de Tlalpan 4502, Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico;
| | - Diego de Miguel-Perez
- Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, New York, NY 11776, USA; (D.d.M.-P.); (C.R.)
| | - Christian Rolfo
- Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, New York, NY 11776, USA; (D.d.M.-P.); (C.R.)
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, S.S.A., San Fernando 22 Sección XVI, Tlalpan, Mexico City 14080, Mexico;
| |
Collapse
|
3
|
Lamot S, Viola L, Benitez S, Bacon L, Botero Zaccour JA, Martinez S, Arroyo-Hernández M, Bejarano A. PP.52 Current status of Lung Cancer Screening in Latin America. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2023.01.079] [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: 02/26/2023]
|
4
|
de Miguel-Perez D, Russo A, Gunasekaran M, Buemi F, Hester L, Fan X, Carter-Cooper BA, Lapidus RG, Peleg A, Arroyo-Hernández M, Cardona AF, Naing A, Hirsch FR, Mack PC, Kaushal S, Serrano MJ, Adamo V, Arrieta O, Rolfo C. Baseline extracellular vesicle TGF-β is a predictive biomarker for response to immune checkpoint inhibitors and survival in non-small cell lung cancer. Cancer 2023; 129:521-530. [PMID: 36484171 DOI: 10.1002/cncr.34576] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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: 07/25/2022] [Revised: 10/09/2022] [Accepted: 10/24/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Immune-checkpoint inhibitors (ICIs) are an effective therapeutic strategy, improving the survival of patients with lung cancer compared with conventional treatments. However, novel predictive biomarkers are needed to stratify which patients derive clinical benefit because the currently used and highly heterogenic histological PD-L1 has shown low accuracy. Liquid biopsy is the analysis of biomarkers in body fluids and represents a minimally invasive tool that can be used to monitor tumor evolution and treatment effects, potentially reducing biases associated with tumor heterogeneity associated with tissue biopsies. In this context, cytokines, such as transforming growth factor-β (TGF-β), can be found free in circulation in the blood and packaged into extracellular vesicles (EVs), which have a specific delivery tropism and can affect in tumor/immune system interaction. TGF-β is an immunosuppressive cytokine that plays a crucial role in tumor immune escape, treatment resistance, and metastasis. Thus, we aimed to evaluate the predictive value of circulating and EV TGF-β in patients with non-small-cell lung cancer receiving ICIs. METHODS Plasma samples were collected in 33 patients with advanced non-small-cell lung cancer before and during treatment with ICIs. EV were isolated from plasma by serial ultracentrifugation methods and circulating and EV TGF-β expression levels were evaluated by enzyme-linked immunosorbent assay. RESULTS Baseline high expression of TGF-β in EVs was associated with nonresponse to ICIs as well as shorter progression-free survival and overall survival, outperforming circulating TGF-β levels and tissue PD-L1 as a predictive biomarker. CONCLUSION If validated, EV TGF-β could be used to improve patient stratification, increasing the effectiveness of treatment with ICIs and potentially informing combinatory treatments with TGF-β blockade. PLAIN LANGUAGE SUMMARY Treatment with immune-checkpoint inhibitors (ICIs) has improved the survival of some patients with lung cancer. However, the majority of patients do not benefit from this treatment, making it essential to develop more reliable biomarkers to identify patients most likely to benefit. In this pilot study, the expression of transforming growth factor-β (TGF-β) in blood circulation and in extracellular vesicles was analyzed. The levels of extracellular vesicle TGF-β before treatment were able to determine which patients would benefit from treatment with ICIs and have a longer survival with higher accuracy than circulating TGF-β and tissue PD-L1, which is the currently used biomarker in clinical practice.
Collapse
Affiliation(s)
- Diego de Miguel-Perez
- Center for Thoracic Oncology, Tisch Cancer Institute, Mount Sinai Medical System & Icahn School of Medicine, Mount Sinai, New York, New York, USA.,Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Alessandro Russo
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Medical Oncology Unit, A.O. Papardo & Department of Human Pathology, University of Messina, Messina, Italy
| | - Muthukumar Gunasekaran
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Departments of Surgery and Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Francesco Buemi
- Medical Oncology Unit, A.O. Papardo & Department of Human Pathology, University of Messina, Messina, Italy
| | - Lisa Hester
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Xiaoxuan Fan
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Brandon A Carter-Cooper
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Rena G Lapidus
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Ariel Peleg
- Center for Thoracic Oncology, Tisch Cancer Institute, Mount Sinai Medical System & Icahn School of Medicine, Mount Sinai, New York, New York, USA
| | | | - Andres F Cardona
- Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC)/Foundation for Clinical and Applied Cancer Research (FICMAC)/Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogota, Colombia
| | - Aung Naing
- Departments of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Fred R Hirsch
- Center for Thoracic Oncology, Tisch Cancer Institute, Mount Sinai Medical System & Icahn School of Medicine, Mount Sinai, New York, New York, USA
| | - Philip C Mack
- Center for Thoracic Oncology, Tisch Cancer Institute, Mount Sinai Medical System & Icahn School of Medicine, Mount Sinai, New York, New York, USA
| | - Sunjay Kaushal
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Departments of Surgery and Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Maria Jose Serrano
- GENYO Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Vincenzo Adamo
- Medical Oncology Unit, A.O. Papardo & Department of Human Pathology, University of Messina, Messina, Italy
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Christian Rolfo
- Center for Thoracic Oncology, Tisch Cancer Institute, Mount Sinai Medical System & Icahn School of Medicine, Mount Sinai, New York, New York, USA.,Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
5
|
Ramos-Ramirez M, Hernandez-Pedro N, Arroyo-Hernández M, Aviles-Salas A, Cabrera Miranda L, Martinez-Perez K, Monraz-Perez S, Arrieta Rodriguez O. 1132P Prevalence of the synonymous EGFR Q787Q variant in Mexican patients with non-small cell lung cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
6
|
Arroyo-Hernández M, Alva-López LF, Rendón A, Barroso-Villafuerte FR, Báez-Saldaña R, Corona-Cruz JF, Farfán-Salazar G, Guerrero-Ixtlahuac J, Castillo-González P, Salmon-Demongin A, Zaldívar-Crosby G, Bolaño-Guerra LM, Zavala-Cruz GG, Sánchez-Gutiérrez A, Rendón-Ramírez EJ, Magdaleno-Maldonado GE, Olivares-Torres CA, López-Saucedo RA, Lizardo-Rodríguez AE, Ortiz-Vázquez S, Vázquez-García J, Montes-Narváez G, Pacheco-Juárez M, Arrieta-Rodríguez OG. Guía de Práctica Clínica para el diagnóstico temprano y la referencia oportuna del cáncer de pulmón. Salud Publica Mex 2022; 64:530-538. [PMID: 36130340 DOI: 10.21149/13919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/16/2022] [Indexed: 11/06/2022] Open
Abstract
OBJETIVO Proporcionar recomendaciones para la detección temprana de pacientes con alto riesgo de desarrollar cáncer de pulmón (CP) en el primer nivel de atención y su referencia oportuna. Material y métodos. Se realizó una búsqueda detallada de la evidencia científica disponible para responder las preguntas de investigación clínica y se utilizó el Panel Delphi modificado para lograr un consenso entre expertos. RESULTADOS Se generaron 14 recomendaciones siguiendo los estándares de una GPC. Conclusión. El CP representa un problema de salud pública en México; por ello, esta guía establece recomendaciones que apoyan la toma de decisiones sobre la detección precoz y la referencia de pacientes con sospecha de CP en el primer nivel de atención.
Collapse
Affiliation(s)
| | | | - Adrián Rendón
- Hospital Universitario Dr. José Eleuterio González. Nuevo León, México.
| | - Francisco Raúl Barroso-Villafuerte
- International Association of Medical Science Educators (IAMSE), Clínica de Especialidades Nuestra Señora de Guadalupe. Ciudad de México, México.
| | | | | | | | | | | | | | | | | | - Gad Gamed Zavala-Cruz
- Federación Mexicana de Especialistas y Residentes en Medicina Familiar. Ciudad de México, México.
| | | | | | | | | | | | | | - Sandra Ortiz-Vázquez
- Instituto de Seguridad Social de los Trabajadores del Estado de Chiapas. Chiapas, México.
| | | | | | | | | |
Collapse
|
7
|
Arroyo-Hernández M, Casas-Ramos P, Saldaña-Díaz A, Mellado-Romero M, Puertas-García-Sandoval J, Ortiz-Cruz E. [Translated article] The computer application “SCAE” in the early diagnosis of musculoskeletal cancer in the healthcare area of the “Hospital Universitario 12 de Octubre”. Analysis of its effectiveness and proposals for improvement. Rev Esp Cir Ortop Traumatol (Engl Ed) 2022. [DOI: 10.1016/j.recot.2021.05.010] [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: 11/28/2022] Open
|
8
|
Arroyo-Hernández M, Maldonado F, Lozano-Ruiz F, Muñoz-Montaño W, Nuñez-Baez M, Arrieta O. Radiation-induced lung injury: current evidence. BMC Pulm Med 2021; 21:9. [PMID: 33407290 PMCID: PMC7788688 DOI: 10.1186/s12890-020-01376-4] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 12/14/2020] [Indexed: 02/07/2023] Open
Abstract
Chemo-radiotherapy and systemic therapies have proven satisfactory outcomes as standard treatments for various thoracic malignancies; however, adverse pulmonary effects, like pneumonitis, can be life-threatening. Pneumonitis is caused by direct cytotoxic effect, oxidative stress, and immune-mediated injury. Radiotherapy Induced Lung Injury (RILI) encompasses two phases: an early phase known as Radiation Pneumonitis (RP), characterized by acute lung tissue inflammation as a result of exposure to radiation; and a late phase called Radiation Fibrosis (RF), a clinical syndrome that results from chronic pulmonary tissue damage. Currently, diagnoses are made by exclusion using clinical assessment and radiological findings. Pulmonary function tests have constituted a significant step in evaluating lung function status during radiotherapy and useful predictive tools to avoid complications or limit toxicity. Systemic corticosteroids are widely used to treat pneumonitis complications, but its use must be standardized, and consider in the prophylaxis setting given the fatal outcome of this adverse event. This review aims to discuss the clinicopathological features of pneumonitis and provide practical clinical recommendations for prevention, diagnosis, and management.
Collapse
Affiliation(s)
- Marisol Arroyo-Hernández
- Head of Thoracic Oncology Unit, Unidad Funcional de Oncología Torácica, Instituto Nacional de Cancerología (INCan), Av. San Fernando #22, Sección XVI, Tlalpan, 14080, México City, CDMX, México
| | - Federico Maldonado
- Head of Thoracic Oncology Unit, Unidad Funcional de Oncología Torácica, Instituto Nacional de Cancerología (INCan), Av. San Fernando #22, Sección XVI, Tlalpan, 14080, México City, CDMX, México
| | - Francisco Lozano-Ruiz
- Head of Thoracic Oncology Unit, Unidad Funcional de Oncología Torácica, Instituto Nacional de Cancerología (INCan), Av. San Fernando #22, Sección XVI, Tlalpan, 14080, México City, CDMX, México
| | - Wendy Muñoz-Montaño
- Head of Thoracic Oncology Unit, Unidad Funcional de Oncología Torácica, Instituto Nacional de Cancerología (INCan), Av. San Fernando #22, Sección XVI, Tlalpan, 14080, México City, CDMX, México
| | - Mónica Nuñez-Baez
- Departamento de Radioncología, Hospital Universitario HM Sanchinarro, Caracas, Venezuela
| | - Oscar Arrieta
- Head of Thoracic Oncology Unit, Unidad Funcional de Oncología Torácica, Instituto Nacional de Cancerología (INCan), Av. San Fernando #22, Sección XVI, Tlalpan, 14080, México City, CDMX, México.
| |
Collapse
|
9
|
Barrón F, Sánchez R, Arroyo-Hernández M, Blanco C, Zatarain-Barrón ZL, Catalán R, Ramos-Ramírez M, Cardona AF, Flores-Estrada D, Arrieta O. Risk of Developing Checkpoint Immune Pneumonitis and Its Effect on Overall Survival in Non-small Cell Lung Cancer Patients Previously Treated With Radiotherapy. Front Oncol 2020; 10:570233. [PMID: 33117699 PMCID: PMC7550759 DOI: 10.3389/fonc.2020.570233] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 09/03/2020] [Indexed: 12/29/2022] Open
Abstract
Introduction Immune checkpoint inhibitor-related pneumonitis (ICIP) is a potentially life threatening immune-related adverse event (irAE), especially in non-small cell lung cancer (NSCLC) patients. Currently, the potential for increased irAE in patients who receive radiotherapy is scarcely known, although a connection between antitumor immune responses and irAEs has been suggested. In this study, we evaluated the development of ICIP in non-small cell lung cancer patients with prior radiotherapy, treated with immunotherapy in the second-line. Methods In this retrospective trial, we included patients treated with second-line immunotherapy at the National Cancer Institute in Mexico City from February 2015 to February 2018. Clinical, radiological and treatment variables were evaluated according to the presence of ICIP as defined by the Common Terminology Criteria for Adverse Events (4.0) in patients with or without a previous (≥months) history of radiotherapy. Results Among 101 NSCLC patients who received treatment with ICIs, 22 patients (21.8%) were diagnosed with ICIP, of which 73% (16/22) had a history of radiotherapy (OR 6.04, 95% CI 2.03-18.0, p < 0.001). Median progression free survival and overall survival were similar in patients who developed ICIP compared with those who did not, however, patients who presented grade ≥ 2 ICIP had an increased risk of mortality (HR 2.54, 95% CI 1.20-5.34, p = 0.014). Conclusion In this real-world cohort of NSCLC patients treated with ICI, the history of prior radiotherapy was associated with increased risk for ICIP development. Unlike other irAEs, grade ≥ 2 ICIP is an independent prognostic factor for decreased survival in NSCLC patients.
Collapse
Affiliation(s)
- Feliciano Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, México City, Mexico
| | - Roberto Sánchez
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, México City, Mexico
| | | | | | | | - Rodrigo Catalán
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, México City, Mexico
| | | | - Andrés F Cardona
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Clinical Research and Biology Systems Department, Universidad el Bosque, Bogotá, Colombia
| | | | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, México City, Mexico
| |
Collapse
|
10
|
Arrieta O, Cardona AF, Lara-Mejía L, Heredia D, Barrón F, Zatarain-Barrón ZL, Lozano F, de Lima VC, Maldonado F, Corona-Cruz F, Ramos M, Cabrera L, Martin C, Corrales L, Cuello M, Arroyo-Hernández M, Aman E, Bacon L, Baez R, Benitez S, Botero A, Burotto M, Caglevic C, Ferraris G, Freitas H, Kaen DL, Lamot S, Lyons G, Mas L, Mata A, Mathias C, Muñoz A, Patane AK, Oblitas G, Pino L, Raez LE, Remon J, Rojas L, Rolfo C, Ruiz-Patiño A, Samtani S, Viola L, Viteri S, Rosell R. Recommendations for detection, prioritization, and treatment of thoracic oncology patients during the COVID-19 pandemic: the THOCOoP cooperative group. Crit Rev Oncol Hematol 2020; 153:103033. [PMID: 32650215 PMCID: PMC7305738 DOI: 10.1016/j.critrevonc.2020.103033] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/13/2020] [Indexed: 12/16/2022] Open
Abstract
The world currently faces a pandemic due to SARS-CoV-2. Relevant information has emerged regarding the higher risk of poor outcomes in lung cancer patients. As such, lung cancer patients must be prioritized in terms of prevention, detection and treatment. On May 7th, 45 experts in thoracic cancers from 11 different countries were invited to participate. A core panel of experts regarding thoracic oncology care amidst the pandemic gathered virtually, and a total of 60 initial recommendations were drafted based on available evidence, 2 questions were deleted due to conflicting evidence. By May 16th, 44 experts had agreed to participate, and voted on each of the 58 recommendation using a Delphi panel on a live voting event. Consensus was reached regarding the recommendations (>66 % strongly agree/agree) for 56 questions. Strong consensus (>80 % strongly agree/agree) was reached for 44 questions. Patients with lung cancer represent a particularly vulnerable population during this time. Special care must be taken to maintain treatment while avoiding exposure.
Collapse
Affiliation(s)
- Oscar Arrieta
- Instituto Nacional de Cancerología, Mexico City, Mexico.
| | - Andrés F Cardona
- Thoracic Oncology Clinic, Clínica del Country, Bogotá, Colombia; Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | | | - David Heredia
- Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | | | | | | | | | | | - Maritza Ramos
- Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Luis Cabrera
- Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Claudio Martin
- Thoracic Oncology Unit, Alexander Fleming Institute, Buenos Aires, Argentina; Hospital Maria Ferrer, Buenos Aires, Argentina
| | - Luis Corrales
- Oncology Department, Hospital San Juan de Dios, San José Costa Rica, Costa Rica; Oncología Médica, Centro de Investigación y Manejo del Cáncer (CIMCA), San José, Costa Rica
| | - Mauricio Cuello
- Department of Oncology, Hospital de Clínicas, Universidad de la República - UDELAR, Montevideo, Uruguay
| | | | - Enrique Aman
- Clinical Oncology Unit, Swiss Medical Group, Buenos Aires, Argentina
| | - Ludwing Bacon
- Centro de Oncología, Hospital Vivián Pellas, Nicaragua
| | - Renata Baez
- National Institute for Respiratory Diseases, Mexico City, Mexico
| | - Sergio Benitez
- Coordinador de la sección Oncología, asociación Argentina de Medicina Respiratoria, Argentina
| | | | - Mauricio Burotto
- Clínica Universidad de los Andes, Centro de Estudios Clínicos Bradford Hill, Chile
| | - Christian Caglevic
- Departamento de Investigación del Cáncer- Fundación Arturo López Pérez, Santiago, Chile
| | - Gustavo Ferraris
- Centro Médico Dean Funes, Radioterapia Oncológica, Córdoba, Argentina
| | - Helano Freitas
- Departamento de Oncologia Clínica - A C Camargo Cancer Center, São Paulo, Brazil
| | | | - Sebastián Lamot
- CONCIENCIA, Instituto Oncohematológico de la Patagonia, Chile
| | - Gustavo Lyons
- Department of Thoracic Surgery, Hospital Británico, Buenos Aires, Argentina
| | - Luis Mas
- Medical Oncology Department, National Institute for Neoplastic Diseases - INEN, Lima, Peru
| | - Andrea Mata
- Hospital La Católica Goicoechea, San José, Costa Rica
| | | | | | - Ana Karina Patane
- Hospital de Rehabilitacion Respiratoria María Ferrer, Buenos Aires, Argentina
| | | | - Luis Pino
- Medical Oncology Group, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Luis E Raez
- Thoracic Oncology Program Memorial Cancer Institute, Memorial Healthcare System, Pembroke Pines, FL, United States
| | - Jordi Remon
- Medical Oncology Department, Centro Integral Oncología Clara Campal Bacelona, HM-Delfos, Barcelona, Spain
| | - Leonardo Rojas
- Medical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Christian Rolfo
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | | | - Suraj Samtani
- Medical Oncology Department, Clínica Bradford Hill, Santiago, Chile
| | - Lucia Viola
- Fundación neumológica colombiana, Bogotá, Colombia
| | - Santiago Viteri
- Instituto Oncológico Dr. Rosell. Centro Médico Teknon. Grupo QuironSalud. Barcelona, España
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| |
Collapse
|
11
|
Arroyo-Hernández M, Zinser-Sierra JW, Vázquez-García JC. Detección temprana de cáncer de pulmón en México. Salud Publica Mex 2019; 61:347-351. [DOI: 10.21149/10326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 03/06/2019] [Indexed: 11/06/2022] Open
Abstract
La detección temprana de cáncer pulmonar (CP) en población de alto riesgo tiene el potencial de diagnosticar la enfermedad en estadios tempranos y facilitar el tratamiento oportuno con el fin de disminuir la tasa de mortalidad. En México, como en otros países en vías de desarrollo, además del tabaquismo, la exposición al humo de leña se posiciona como uno de los principales factores de riesgo para desarrollar CP, lo cual no se ha considerado en estudios de tamizaje previamente publicados. Distintas interrogantes surgen en relación con quiénes son las personas que presentan un alto riesgo de desarrollar CP en América Latina, cuál es el costo-beneficio de poner en marcha un programa de detección oportuna de CP en México y cuáles son los obstáculos que los países de la región enfrentan para su implementación.
Collapse
|
12
|
Torre-Bouscoulet L, Arroyo-Hernández M, Martínez-Briseño D, Muñoz-Montaño WR, Gochicoa-Rangel L, Bacon-Fonseca L, Pérez-Padilla R, Vergara E, García-Sancho C, Lozano-Ruiz F, Fernández-Plata R, Guzmán-Barragán A, Arrieta O. Longitudinal Evaluation of Lung Function in Patients With Advanced Non-Small Cell Lung Cancer Treated With Concurrent Chemoradiation Therapy. Int J Radiat Oncol Biol Phys 2018; 101:910-918. [DOI: 10.1016/j.ijrobp.2018.04.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 02/27/2018] [Accepted: 04/04/2018] [Indexed: 12/22/2022]
|
13
|
Torre-Bouscoulet L, Muñoz-Montaño WR, Martínez-Briseño D, Lozano-Ruiz FJ, Fernández-Plata R, Beck-Magaña JA, García-Sancho C, Guzmán-Barragán A, Vergara E, Blake-Cerda M, Gochicoa-Rangel L, Maldonado F, Arroyo-Hernández M, Arrieta O. Abnormal pulmonary function tests predict the development of radiation-induced pneumonitis in advanced non-small cell lung Cancer. Respir Res 2018; 19:72. [PMID: 29690880 PMCID: PMC5937833 DOI: 10.1186/s12931-018-0775-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 04/10/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Radiation pneumonitis (RP) is a frequent complication of concurrent chemoradiotherapy (CCRT) and is associated with severe symptoms that decrease quality of life and might result in pulmonary fibrosis or death. The aim of this study is to identify whether pulmonary function test (PFT) abnormalities may predict RP in non-small cell lung cancer (NSCLC) patients. METHODS A prospective multi-institutional study was conducted with locally advanced and oligometastatic NSCLC patients. All participants were evaluated at baseline, end of CCRT, week 6, 12, 24, and 48 post-CCRT. They completed forced spirometry with a bronchodilator, body plethysmography, impulse oscillometry, carbon monoxide diffusing capacity (DLCO), molar mass of CO2, six-minute walk test and exhaled fraction of nitric oxide (FeNO). Radiation pneumonitis was assessed with RTOG and CTCAE. The protocol was registered in www.clinicaltrials.gov (NCT01580579), registered April 19, 2012. RESULTS Fifty-two patients were enrolled; 37 completed one-year follow-up. RP ≥ Grade 2 was present in 11/37 (29%) for RTOG and 15/37 (40%) for CTCAE. Factors associated with RP were age over 60 years and hypofractionated dose. PFT abnormalities at baseline that correlated with the development of RP included lower forced expiratory volume in one second after bronchodilator (p = 0.02), DLCO (p = 0.02) and FeNO (p = 0.04). All PFT results decreased after CCRT and did not return to basal values at follow-up. CONCLUSIONS FEV1, DLCO and FeNO prior to CCRT predict the development of RP in NSCLC. This study suggests that all patients under CCRT should be assessed by PFT to identify high-risk patients for close follow-up and early treatment.
Collapse
Affiliation(s)
- L Torre-Bouscoulet
- Subdirección de Investigación Clínica, INER, Calz. de Tlalpan 4502, Tlalpan, Sección XVI, C.P. 14080, Ciudad de México, México
- Departamento de Fisiología Respiratoria INER, México city, México
| | - W R Muñoz-Montaño
- Unidad Funcional de Oncología Torácica, Instituto Nacional de Cancerología (INCAN), Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080, Ciudad de México, CP, Mexico
| | - D Martínez-Briseño
- Departamento de Investigación en Epidemiología y Ciencias Sociales en Salud, Instituto Nacional de Enfermedades Respiratorias (INER), México city, Mexico
| | | | - R Fernández-Plata
- Departamento de Investigación en Epidemiología y Ciencias Sociales en Salud, Instituto Nacional de Enfermedades Respiratorias (INER), México city, Mexico
| | - J A Beck-Magaña
- Unidad Funcional de Oncología Torácica, Instituto Nacional de Cancerología (INCAN), Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080, Ciudad de México, CP, Mexico
| | - C García-Sancho
- Departamento de Investigación en Epidemiología y Ciencias Sociales en Salud, Instituto Nacional de Enfermedades Respiratorias (INER), México city, Mexico
| | - A Guzmán-Barragán
- Departamento de Investigación en Epidemiología y Ciencias Sociales en Salud, Instituto Nacional de Enfermedades Respiratorias (INER), México city, Mexico
| | - E Vergara
- Unidad Funcional de Oncología Torácica, Instituto Nacional de Cancerología (INCAN), Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080, Ciudad de México, CP, Mexico
| | - M Blake-Cerda
- Departamento de Radio-Oncología, INCAN, México city, Mexico
| | - L Gochicoa-Rangel
- Subdirección de Investigación Clínica, INER, Calz. de Tlalpan 4502, Tlalpan, Sección XVI, C.P. 14080, Ciudad de México, México
- Departamento de Fisiología Respiratoria INER, México city, México
| | - F Maldonado
- Departamento de Radio-Oncología, INCAN, México city, Mexico
| | - M Arroyo-Hernández
- Unidad Funcional de Oncología Torácica, Instituto Nacional de Cancerología (INCAN), Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080, Ciudad de México, CP, Mexico
| | - O Arrieta
- Unidad Funcional de Oncología Torácica, Instituto Nacional de Cancerología (INCAN), Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080, Ciudad de México, CP, Mexico.
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Ciudad de México, México.
| |
Collapse
|
14
|
Páramo-Díaz P, Arroyo-Hernández M, Rodríguez Vega V, Aroca-Peinado M, León-Baltasar JL, Caba-Doussoux P. Surgical treatment of extra-articular distal-third diaphyseal fractures of the humerus using a modified posterior approach and an extra-articular plate. Rev Esp Cir Ortop Traumatol (Engl Ed) 2017; 61:404-411. [PMID: 28890121 DOI: 10.1016/j.recot.2017.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 06/17/2017] [Accepted: 07/03/2017] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To evaluate the clinical and radiological outcomes of these fractures treated through a modified posterior approach with a distal humerus plate. MATERIAL AND METHODS Between 2013 and 2015 we performed a retrospective study of these fractures surgically treated in our centre. INCLUSION CRITERIA older than 18 years old, no pathological fractures, follow up 1 year at least. 23 patients underwent surgery, mean age 45 years old, with an average follow-up of 18 months. Patient characteristics, aetiology and type of fractures were recorded. The surgery was performed using Gerwin modified posterior approach with a posterolateral distal humerus plate. Clinical results were evaluated using Quick DASH, MEPS, VAS. Radiological results were also evaluated. Complications associated with treatment and radial nerve palsy incidence were recorded as well. RESULTS Type of fracture according AO/OTA: six 12-A, seven 12-B, ten 12-C. 23 patients progressed to union. After one year: QD 6.43, VAS 0.66, MEPS 88.88. No failure of internal fixation. Two superficial infections. 15 excellent results, 5 good, and 3 fair, with no poor results. CONCLUSION Surgical fixation of these fractures through a modified posterior approach with a posterolateral plate minimises iatrogenic nerve injury, provides better visualisation of the proximal humerus, provides stable fixation of these injuries and results in high union rates and overall excellent functional results.
Collapse
Affiliation(s)
- P Páramo-Díaz
- Unidad de Traumatología, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España.
| | - M Arroyo-Hernández
- Unidad de Traumatología, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - V Rodríguez Vega
- Unidad de Traumatología, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - M Aroca-Peinado
- Unidad de Traumatología, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - J L León-Baltasar
- Unidad de Traumatología, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - P Caba-Doussoux
- Unidad de Traumatología, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España
| |
Collapse
|
15
|
Arroyo-Hernández M, Mellado-Romero M, Páramo-Díaz P, García-Lamas L, Vilà-Rico J. Chronic ankle instability: Arthroscopic anatomical repair. Rev Esp Cir Ortop Traumatol (Engl Ed) 2016; 61:104-110. [PMID: 27939181 DOI: 10.1016/j.recot.2016.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 03/05/2016] [Revised: 10/09/2016] [Accepted: 10/18/2016] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Ankle sprains are one of the most common injuries. Despite appropriate conservative treatment, approximately 20-40% of patients continue to have chronic ankle instability and pain. In 75-80% of cases there is an isolated rupture of the anterior talofibular ligament. MATERIAL AND METHOD A retrospective observational study was conducted on 21 patients surgically treated for chronic ankle instability by means of an arthroscopic anatomical repair, between May 2012 and January 2013. There were 15 men and 6 women, with a mean age of 30.43 years (range 18-48). The mean follow-up was 29 months (range 25-33). All patients were treated by arthroscopic anatomical repair of anterior talofibular ligament. Four (19%) patients were found to have varus hindfoot deformity. Associated injuries were present in 13 (62%) patients. There were 6 cases of osteochondral lesions, 3 cases of posterior ankle impingement syndrome, and 6 cases of peroneal pathology. All these injuries were surgically treated in the same surgical time. RESULTS A clinical-functional study was performed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. The mean score before surgery was 66.12 (range 60-71), and after surgery it increased up to a mean of 96.95 (range 90-100). All patients were able to return to their previous sport activity within a mean of 21.5 weeks (range 17-28). Complications were found in 3 (14%) patients. CONCLUSIONS Arthroscopic anatomical ligament repair technique has excellent clinical-functional results with a low percentage of complications, and enables patients to return to their previous sport activity within a short period of time.
Collapse
Affiliation(s)
- M Arroyo-Hernández
- Unidad de Artroscopia, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España.
| | - M Mellado-Romero
- Unidad de Artroscopia, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - P Páramo-Díaz
- Unidad de Artroscopia, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - L García-Lamas
- Unidad de Artroscopia, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - J Vilà-Rico
- Unidad de Artroscopia, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España; Departamento de Cirugía, Universidad Complutense de Madrid, Madrid, España
| |
Collapse
|
16
|
Arroyo-Hernández M, Mellado-Romero MA, Páramo-Díaz P, Martín-López CM, Cano-Egea JM, Vilá Y Rico J. [Comparative study of the repair of full thickness tear of the supraspinatus by means of "single row" or "suture bridge" techniques]. Acta Ortop Mex 2015; 29:288-294. [PMID: 27403515] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE The purpose of this study is to analyze if there is any difference between the arthroscopic reparation of full-thickness supraspinatus tears with simple row technique versus suture bridge technique. MATERIAL AND METHODS We accomplished a retrospective study of 123 patients with full-thickness supraspinatus tears between January 2009 and January 2013 in our hospital. There were 60 simple row reparations, and 63 suture bridge ones. RESULTS The mean age in the simple row group was 62.9, and in the suture bridge group was 63.3 years old. There were more women than men in both groups (67%). All patients were studied using the Constant test. The mean Constant test in the suture bridge group was 76.7, and in the simple row group was 72.4. We have also accomplished a statistical analysis of each Constant item. Strength was higher in the suture bridge group, with a significant statistical difference (p 0.04). The range of movement was also greater in the suture bridge group, but was not statistically significant. CONCLUSIONS Suture bridge technique has better clinical results than single row reparations, but the difference is not statistically significant (p = 0.298).
Collapse
Affiliation(s)
- M Arroyo-Hernández
- Unidad de Artroscopía. Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario 12 de Octubre de Madrid. España
| | - M A Mellado-Romero
- Unidad de Artroscopía. Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario 12 de Octubre de Madrid. España
| | - P Páramo-Díaz
- Unidad de Artroscopía. Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario 12 de Octubre de Madrid. España
| | - C M Martín-López
- Unidad de Artroscopía. Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario 12 de Octubre de Madrid. España
| | - J M Cano-Egea
- Unidad de Artroscopía. Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario 12 de Octubre de Madrid. España
| | - J Vilá Y Rico
- Unidad de Artroscopía. Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario 12 de Octubre de Madrid. España
- Universidad Complutense de Madrid. Departamento de Cirugía. España
| |
Collapse
|
17
|
Arroyo-Hernández M, Tamayo J, Costa-Krämer JL. Stress and DNA assembly differences on cantilevers gold coated by resistive and e-beam evaporation techniques. Langmuir 2009; 25:10633-10638. [PMID: 19694416 DOI: 10.1021/la900696f] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Changes in the sign of differential surface stress of gold-coated cantilevers produced by thiol-derivatized single-stranded DNA immobilization are observed, depending on the method used to deposit the gold. While the DNA immobilization on e-beam gold-coated cantilevers produces a compressive differential surface stress in the metallic layer, the opposite is observed for resistively coated cantilevers under the same immobilization conditions. The gold films exhibit quite a similar morphology, and the immobilization differences seem to be related to the charge state of the metallic layer surface. This in turn produces a different distribution of the orientation of the DNA strands on the gold layer. A tentative explanation for the observed effect is proposed.
Collapse
Affiliation(s)
- M Arroyo-Hernández
- Instituto de Microelectrónica de Madrid, IMM-CNM-CSIC, Isaac Newton 8, PTM, 28760 Tres Cantos, Madrid, Spain.
| | | | | |
Collapse
|
18
|
Arroyo-Hernández M, Manso-Silvan M, López-Elvira E, Muñoz A, Climent A, Duart JMM. One step processing of aminofunctionalized gate oxides. Biosens Bioelectron 2007; 22:2786-9. [PMID: 17229567 DOI: 10.1016/j.bios.2006.10.039] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2006] [Revised: 09/06/2006] [Accepted: 10/25/2006] [Indexed: 10/23/2022]
Abstract
A plasma discharge process has been developed that allows the growth of biosensor gate oxides with adapted surface properties for the direct application of biomolecular immobilization cascades. The process involves an accurate selection of processing conditions, mainly, low temperature evaporation of (3-aminopropyl)triethoxysilane (APTS) and dynamic power and flow conditions. Room temperature evaporation of APTS was achieved by designing a vessel with an internal capillary network. The initial high power (100 W) plasma conditions were replaced by milder molecular fragmentation (50 W, 25 W) in a pure Ar discharge. Under these conditions the thin SiO(2) layers presented graded properties with a denser layer at the Si (100) interface and a hybrid organic-inorganic structure at the surface. The chemistry of the films was analysed by Fourier transformed infrared spectroscopy (FTIR) and Rutherford backscattering spectroscopy combined with elastic recoil detection analysis (RBS, ERDA), which confirmed the presence of the SiO(2) and organic phases. Contact angle measurements indicate the higher contribution of the basic polar component to the surface free energy. Furthermore, the higher affinity of the surface towards biomolecular immobilization was confirmed by fluorescence microscopy. Finally, penetration of nitrobenzaldehyde was obtained by application of a molecular permeation method evaluated by UV-vis spectroscopy onto fused silica substrates.
Collapse
Affiliation(s)
- M Arroyo-Hernández
- Applied Physics Department, Faculty of Science, Universidad Autónoma de Madrid, 28049 Madrid, Spain.
| | | | | | | | | | | |
Collapse
|
19
|
Manso-Silván M, Rodríguez-Navas C, Arroyo-Hernández M, López-Elvira E, Gago R, Vázquez L, Agulló-Rueda F, Climent A, Martínez-Duart JM, García-Ruiz JP. Hybrid titania–aminosilane platforms evaluated with human mesenchymal stem cells. J Biomed Mater Res B Appl Biomater 2007; 83:232-9. [PMID: 17385221 DOI: 10.1002/jbm.b.30788] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The properties of hybrid aminopropyltriethoxysilane-tetraisopropylorthotitanate (APTS-TIPT) platforms prepared by a sol-gel route have been explored, and their biocompatibility was assayed after culture of human mesenchymal stem cells (hMSCs). The organic content of this material was observed to be preferably surface-oriented as indicated by microanalytical techniques. Furthermore, the surface showed characteristic amino-silane bands when explored by Raman spectroscopy as well as indications of silane and titanate condensation. Surface activity of the amino groups was probed by ultraviolet-visible spectroscopy imine derivatization and chemical force spectroscopy, showing a pH-dependent surface charge-induced potential. hMSCs cultured onto these surfaces showed relevant differences with respect to their behavior on gelatin-coated glass plates. Even if with a lower proliferative rate than controls, the cells develop long cytosolic prolongations in osteogenic differentiation medium, thus, supporting the idea of an APTS-TIPT stimulated process.
Collapse
Affiliation(s)
- M Manso-Silván
- Departamento de Física Aplicada C-XII-104, Universidad Autónoma de Madrid, 28049 Madrid, Spain.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Arroyo-Hernández M, Pérez-Rigueiro J, Martínez-Duart J. Formation of amine functionalized films by chemical vapour deposition. Materials Science and Engineering: C 2006. [DOI: 10.1016/j.msec.2005.09.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|