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1. An exploratory analysis of objective responses to neoadjuvant chemotherapy: results from a randomised phase III trial evaluating first-line carboplatin-paclitaxel regimens for ovarian, fallopian tube or primary peritoneal carcinoma (ICON8)

Author

McNeish, I, Morgan, RD, Cook, AD, James, EC, Lord, R, Dark, G, Glasspool, RM, Krell, J, Parkinson, C, Poole, CJ, Hall, M, Gallardo-Rincón, D, Lockley, M, Essapen, S, Summers, J, Anand, A, Zachariah, A, Williams, S, Jones, R, Scatchard, K, Walther, A, Kim, J-W, Sundar, S, Jayson, GC, Ledermann, JA, Clamp, AR, Imperial College Healthcare NHS Trust- BRC Funding, Ovarian Cancer Action, and Cancer Research UK

Subjects
1112 Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

BackgroundPlatinum-based neoadjuvant chemotherapy (NACT) followed by delayed primary surgery (DPS) is an established strategy for women with newly diagnosed, advanced stage epithelial ovarian cancer. Although this therapeutic approach has been validated in randomised, phase III trials,evaluation of response to NACT using Response Evaluation Criteria in Solid Tumours (RECIST)and CA125 was not reported. We describeRECIST and Gynecologic Cancer InterGroup (GCIG)CA125 responses in patients receiving platinum-based NACT followed by DPS in the phase III trial, ICON8.MethodsICON8 was an international, multicentre, randomised, phase III trial in which women ≥18 years old with an Eastern Cooperative Oncology Group performance status of 0-2, life expectancy >12 weeks and newly diagnosed International Federation of Gynecology and Obstetrics (FIGO;1988) stage IC-IIA high-grade serous, clear cell or any poorly differentiated/grade 3 histological subtype or any FIGO (1988) stage IIB-IV epithelial cancer of the ovary, fallopian tube or primary peritoneum were randomised (1:1:1) to receive either intravenous (IV) carboplatin (AUC5/6)and IV paclitaxel (175mg/m2by body surface area [BSA])on day 1 of every 21-day cycle(control arm)or IV carboplatin (AUC5/6)on day 1 and IV paclitaxel (80mg/m2by BSA)on days 1, 8 and 15 of every 21-day cycle(dose-fractionated paclitaxelarm) or IV carboplatin (AUC2)and IV paclitaxel (80mg/m2by BSA)on days 1, 8 and 15 of every 21-day cycle(dose-fractionated carboplatin and paclitaxelarm). Randomisation occurred using a minimisation method and patients where stratified according to GCIG group, disease stage and timing and outcome of cytoreductive surgery. Neither patients nor clinicians were masked to their allocated group. The scheduling of surgery and use of NACTwere determined by local multidisciplinary case review. In this post-hoc 5exploratory analysis of ICON8, progression-free survival (PFS) was analysed using the landmark method and defined as the time interval between the date of pre-surgical planning radiological tumour assessment to the date of investigator-assessed clinical or radiological progression or death, whichever occurred first. This is different to the intention-to-treat primary PFS efficacy analysis of ICON8, which definedPFS as the time from randomisation to the date of clinical or radiological progression or death, whichever occurred first. This post-hoc exploratory analysis includes only women recruited to ICON8thatwere planned for NACT followed by DPS and had RECIST v1.1 and/or GCIG CA125 evaluable disease. ICON8isclosed for enrolment and follow-up, and registered with ClinicalTrials.gov, number: NCT01654146. Findings: BetweenJune 6,2011 and November 28,2014,1,566 women were enrolled in ICON8.Seven hundred and seventy-nine women were planned forNACT followed by DPS(NACT-DPS). In the NACT-DPS population,94% had FIGO stage IIIC/IV disease. Five hundred and sixty-four women had RECIST evaluable disease at trial entry and the complete or partial response rate (CR/PR) was 62%(348/564). Seven hundred and twenty-seven women were evaluable by GCIG CA125 criteria at the time of diagnosis and 84%(610/727) had a CA125 response. The median PFS was 14.4 months (95% CI [confidence interval] 9.2-28.0months; 297 events) for RECIST CR/PR and 13.3 months (95% CI 8.1-20.1months; 171 events) for RECIST stable disease(SD). The median PFS for those women with a GCIG CA125 response was 13.8 months (95% CI 8.8-23.4months; 544 events) and 9.7 months (95% CI 5.8-14.5months; 111 events) for those without. Complete cytoreduction(R0) was achieved in 56% (187/335) of women with RECISTCR/PRand42% (73/172) with RECIST SD. Complete cytoreduction (R0) was achieved in50% (290/576) and 30% (30/101) of women 6with and without a GCIG CA125 response, respectively. The median follow-up was 29.5 months (interquartile range:15.6-54.3months) for the NACT-DPS population.InterpretationThe RECIST-defined radiological response was lower than frequently quoted to patients in the clinic. RECIST v1.1 and GCIGCA125 responses to NACT for epithelial ovarian cancer should not be used as individual predictive markers to stratify patients likely to benefit from DPS, but instead used in conjunction with the patient’s clinical capacity to undergo cytoreductive surgery. A patient should not be denied surgery based solely on the lack of a RECIST v1.1 or GCIG CA125 response.

Published
2020

2. Sengstaken Tube Removal under Direct Hemodynamic Monitoring after Post Transplantation Venous Occlusion

Author

Colón, A. L., Rodríguez-Bachiller, L., Velasco, E., Díaz-Zorita, B., Rincón, D., López-Baena, J. A., and Ferreiroa, J.

Subjects
Article Subject
Abstract

The surgical procedure for orthotopic liver transplantation (OLT) is well standardized, and most groups use the retrohepatic caval preservation or piggyback technique to improve hemodynamic tolerance. However, when a discrepancy between the site in the right upper quadrant of the liver recipient and a small graft is present, this technique can provoke a rotation on the axis of the vena cava and cause an occlusion of the suprahepatic vein drainage. This problem can be detected intraoperatively, and several methods have been described to resolve it by placing different devices to correct the position. Early withdrawal may cause the development of clinical hepatic congestion with ascites unresponsive to medical treatment. We present three cases of OLT who developed obstruction of the venous drainage solved intraoperatively with the placement of a Sengstaken-Blakemore tube. As a novelty, prior to the withdrawal of the device, a transjugular hemodynamic study was performed to ensure the correct position of the liver with adequate venous drainage.

Published
2019
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3. Contribution of Altered Endocannabinoid System to Overactive mTORC1 Signaling in Focal Cortical Dysplasia

Author

García-Rincón D, Díaz-Alonso J, Paraíso-Luna J, Ortega Z, Aguareles J, de Salas-Quiroga A, Jou-Munoz C, de Prada I, Martínez-Cerdeño V, Aronica E, Guzmán M, Pérez-Jiménez MÁ, and Galve-Roperh I

Subjects
CB1 receptor, neural progenitor, malformation of cortical development, biological phenomena, cell phenomena, and immunity, cannabinoid, mTORC1, corticogenesis, mammalian target of rapamycin
Abstract

Alterations of the PI3K/Akt/mammalian target of rapamycin complex 1 (mTORC1) signaling pathway are causally involved in a subset of malformations of cortical development (MCDs) ranging from focal cortical dysplasia (FCD) to hemimegalencephaly and megalencephaly. These MCDs represent a frequent cause of refractory pediatric epilepsy. The endocannabinoid system -especially cannabinoid CB(1) receptor- exerts a neurodevelopmental regulatory role at least in part via activation of mTORC1 signaling. Therefore, we sought to characterize the possible contribution of endocannabinoid system signaling to FCD. Confocal microscopy characterization of the CB(1) receptor expression and mTORC1 activation was conducted in FCD Type II resection samples. FCD samples were subjected to single nucleotide polymorphism screening for endocannabinoid system elements, as well as CB(1) receptor gene sequencing. Cannabinoid CB(1) receptor levels were increased in FCD with overactive mTORC1 signaling. CB(1) receptors were enriched in phospho-S6-positive cells including balloon cells (BCs) that co-express aberrant markers of undifferentiated cells and dysplastic neurons. Pharmacological regulation of CB(1) receptors and the mTORC1 pathway was performed in fresh FCD-derived organotypic cultures. HU-210-evoked activation of CB(1) receptors was unable to further activate mTORC1 signaling, whereas CB(1) receptor blockade with rimonabant attenuated mTORC1 overactivation. Alterations of the endocannabinoid system may thus contribute to FCD pathological features, and blockade of cannabinoid signaling might be a new therapeutic intervention in FCD.

Published
2019

4. Real-world evidence of the effectiveness of ombitasvir-paritaprevir/r +/- dasabuvir +/- ribavirin in patients monoinfected with chronic hepatitis C or coinfected with human immunodeficiency virus-1 in Spain

Author

Sousa, J. M., Vergara, Mercedes, Pulido, F., Antolín, G. S., Hijona, L., Carnicer, F., Rincón, D., Salmerón, J., Mateos-Muñoz, B., Jou, A., Polo-Lorduy, B., Rubín, Á., Escarda, A., Aguilar, P., Aldámiz-Echevarría, T., García-Buey, L., Carrión, José A., Hernández-Guerra, M., Chimeno-Hernández, S., Espinosa, N., Morillas Cunill, Rosa Ma., Andrade, R. J., Delgado, M., Gallego, Adolfo, Magaz, M., Moreno-Planas, J. M., Estébanez, Á., Rico, M., Menéndez, F., Sampedro, B., Morano Amado, Luis Enrique, Izquierdo, S., Zozaya, J. M., Rodríguez, M., Morán-Sánchez, Senador, Lorente, S., Martín-Granizo, I., Von-Wichmann, M. Á., Manzanares, A., Universitat Autònoma de Barcelona, and AbbVie Pharmaceuticals

Subjects
Male, European People, modelos logísticos, Spanish People, HIV Infections, Hepacivirus, Gastroenterology, Geographical locations, 0302 clinical medicine, Immunodeficiency Viruses, ribavirina, 2-Naphthylamine, Ethnicities, mediana edad, education.field_of_study, Sulfonamides, farmacoterapia, Liver Diseases, virus diseases, Valine, Cirrhosis, Coinfection, Medicine, 030211 gastroenterology & hepatology, Drug Therapy, Combination, medicine.medical_specialty, Proline, Science, compuestos macrocíclicos, Gastroenterology and Hepatology, Tractament antiretroviral de gran activitat, Antiviral Agents, Microbiology, 03 medical and health sciences, Drug Therapy, VIH (Virus) -- Tractament, Humans, education, Uracil, Medicine and health sciences, Flaviviruses, anilidas, Organisms, medicine.disease, digestive system diseases, Logistic Models, chemistry, Paritaprevir, HIV-1, Population Groupings, Carbamates, People and places, Developmental Biology, Cyclopropanes, RNA viruses, antivíricos, Sustained Virologic Response, viruses, humanos, estudios de seguimiento, chemistry.chemical_compound, Anilides, 030212 general & internal medicine, Medicaments antivírics, Hispanic People, Pathology and laboratory medicine, Multidisciplinary, Dasabuvir, Hepatitis C virus, resultado del tratamiento, Hepatitis C, Middle Aged, Medical microbiology, Europe, Treatment Outcome, Infectious Diseases, carbamatos, Viruses, Female, Pathogens, VIH-1, medicine.drug, Research Article, Macrocyclic Compounds, Lactams, Macrocyclic, Population, Viral diseases, sulfonamidas, Internal medicine, Ribavirin, Retroviruses, medicine, análisis multifactorial, European Union, Biology and life sciences, business.industry, Lentivirus, Viral pathogens, HIV, Hepatitis C, Chronic, Fibrosis, Ombitasvir, Hepatitis viruses, Microbial pathogens, Spain, Co-Infections, Multivariate Analysis, Ritonavir, infecciones por VIH, business, uracilo, Follow-Up Studies
Abstract

[Aim] We describe the effectiveness and safety of the interferon-free regimen ombitasvir/paritaprevir/ritonavir plus dasabuvir with or without ribavirin (OBV/PTV/r ± DSV ± RBV) in a nationwide representative sample of the hepatitis C virus (HCV) monoinfected and human immunodeficiency virus-1/hepatitis C virus (HIV/HCV) coinfected population in Spain., [Material and methods] Data were collected from patients infected with HCV genotypes 1 or 4, with or without HIV-1 coinfection, treated with OBV/PTV/r ± DSV ± RBV at 61 Spanish sites within the initial implementation year of the first government-driven “National HCV plan.” Effectiveness was assessed by sustained virologic response at post-treatment week 12 (SVR12) and compared between monoinfected and coinfected patients using a non-inferiority margin of 5% and a 90% confidence interval (CI). Sociodemographic and clinical characteristics or patients and adverse events (AEs) were also recorded., [Results] Overall, 2,408 patients were included in the intention-to-treat analysis: 386 (16%) were patients with HIV/HCV. Patient selection reflected the real distribution of patients treated in each participating region in Spain. From the total population, 96.6% (95% CI, 95.8–97.3%) achieved SVR12. Noninferiority of SVR12 in coinfected patients was met, with a difference between monoinfected and coinfected patients of −2.2% (90% CI, −4.5% - 0.2%). Only genotype 4 was associated with non-response to OBV/PTV/r ± DSV ± RBV treatment (p, [Conclusions] Our results confirm that OBV/PTV/r ± DSV ± RBV is effective and generally well tolerated in a representative sample of the HCV monoinfected and HCV/HIV coinfected population in Spain within the experience of a national strategic plan to tackle HCV., The design, study conduct, and financial support for the study were provided by AbbVie (https://www.abbvie.com/).

Published
2019

5. Harmonising clinical trials within the Gynecologic Cancer InterGroup: consensus and unmet needs from the Fifth Ovarian Cancer Consensus Conference

Author

Bookman, M. A., Okamoto, A., Stuart, G., Yanaihara, N., Aoki, D., Bacon, M., Fujiwara, K., González-Martín, A., Harter, P., Kim, J. W., Ledermann, J., Pujade-Lauraine, E., Quinn, M., Ochiai, K., Zeimet, A., Marth, C., du Bois, A., Hilpert, F., Pfisterer, J., Reuss, A., Friedlander, M., Wilson, M. K., Kridelka, F., Vergote, I., Berek, J., Dorig, Karam, A., Bekkers, R., Westermann, A., Gatsonis, C., Ng, C., Herráez, A. C., Ottevanger, N., Poveda, A., Redondo, A., Coleman, R., Lu, K., Gallardo-Rincón, D., Gomez-Garcia, E., Joly, F., Leary, A., Ray-Coquard, I., Burger, R., Moore, K. N., Fujiwara, H., Hasegawa, K., Gleeson, N., Levy, T., Rosengarten, O., Katsumata, N., Silverberg, S. G., Sugiyama, T., Chang, S. -J., Kim, B. -G., Nam, B. -H., Colombo, N., Ferrero, A, Lorusso, D., Scambia, G., Edmondson, R., Mcneish, I., Kohn, E., Hirte, H., Mcgee, J., Provencher, D., Sehouli, J., Wimberger, P., Maenpaa, J., Mirza, M. R., Oza, A., Welch, S., Gaffney, D., Small, W., Glasspool, R., Gourley, C., Millan, D., Zang, R., Zhu, J., Bookman, M, Okamoto, A, Stuart, G, Yanaihara, N, Aoki, D, Bacon, M, Fujiwara, K, Gonzalez-Martin, A, Harter, P, Kim, J, Ledermann, J, Pujade-Lauraine, E, Quinn, M, Ochiai, K, Zeimet, A, Marth, C, du Bois, A, Hilpert, F, Pfisterer, J, Reuss, A, Friedlander, M, Wilson, M, Kridelka, F, Vergote, I, Berek, J, Dorigo, O, Karam, A, Bekkers, R, Westermann, A, Gatsonis, C, Ng, C, Herraez, A, Ottevanger, N, Poveda, A, Redondo, A, Coleman, R, Lu, K, Gallardo-Rincon, D, Gomez-Garcia, E, Joly, F, Leary, A, Ray-Coquard, I, Burger, R, Moore, K, Fujiwara, H, Hasegawa, K, Gleeson, N, Levy, T, Rosengarten, O, Katsumata, N, Silverberg, S, Sugiyama, T, Chang, S, Kim, B, Nam, B, Colombo, N, Ferrero, A, Lorusso, D, Scambia, G, Edmondson, R, Mcneish, I, Kohn, E, Hirte, H, Mcgee, J, Provencher, D, Sehouli, J, Wimberger, P, Maenpaa, J, Mirza, M, Oza, A, Welch, S, Gaffney, D, Small, W, Glasspool, R, Gourley, C, Millan, D, Zang, R, and Zhu, J

Subjects
0301 basic medicine, medicine.medical_specialty, media_common.quotation_subject, Unmet needs, 03 medical and health sciences, 0302 clinical medicine, Documentation, Ovarian cancer, Voting, medicine, Humans, Mission statement, media_common, Randomized Controlled Trials as Topic, Ovarian Neoplasms, business.industry, Consensus conference, Hematology, medicine.disease, Clinical trial, Symposium Articles, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Family medicine, Consensus statement, Needs assessment, Female, business, Needs Assessment
Abstract

The Gynecologic Cancer InterGroup (GCIG) Fifth Ovarian Cancer Consensus Conference (OCCC) was held in Tokyo, Japan from 7 to 9 November 2015. It provided international consensus on 15 important questions in 4 topic areas, which were generated in accordance with the mission statement to establish ‘International Consensus for Designing Better Clinical Trials’. The methodology for obtaining consensus was previously established and followed during the Fifth OCCC. All 29 clinical trial groups of GCIG participated in program development and deliberations. Draft consensus statements were discussed in topic groups as well as in a plenary forum. The final statements were then presented to all 29 member groups for voting and documentation of the level of consensus. Full consensus was obtained for 11 of the 15 statements with 28/29 groups agreeing to 3 statements, and 27/29 groups agreeing to 1 statement. The high acceptance rate of the statements among trial groups reflects the fact that we share common questions, and recognise important unmet needs that will guide future research in ovarian cancer.

Published
2017

6. Effectiveness and safety of ombitasvir, paritaprevir, ritonavir ± dasabuvir ± ribavirin: An early access programme for Spanish patients with genotype 1/4 chronic hepatitis C virus infection

Author

Perelló C, Carrión JA, Ruiz-Antorán B, Crespo J, Turnes J, Llaneras J, Lens S, Delgado M, García-Samaniego J, García-Paredes F, Fernández I, Morillas RM, Rincón D, Porres JC, Prieto M, Lázaro Ríos M, Fernández-Rodríguez C, Hermo JA, Rodríguez M, Herrero JI, Ruiz P, Fernández JR, Macías M, Pascasio JM, Moreno JM, MONTON C, Arenas J, Real Y, Jorquera F, Calleja JL, and Spanish Collaborative Group for the Study of the Use of Hepatitis C Direct-Actin

Subjects
Male, Cirrhosis, Sustained Virologic Response, Hepacivirus, medicine.disease_cause, chemistry.chemical_compound, 0302 clinical medicine, severe fibrosis, dasabuvir, Medicine, Aged, 80 and over, Middle Aged, Infectious Diseases, Treatment Outcome, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Drug Therapy, Combination, Female, Viral load, medicine.drug, Adult, medicine.medical_specialty, Drug-Related Side Effects and Adverse Reactions, Genotype, Hepatitis C virus, compassionate use, Antiviral Agents, 03 medical and health sciences, Virology, Internal medicine, Humans, Adverse effect, Aged, Retrospective Studies, Hepatology, business.industry, Ribavirin, paritaprevir, Hepatitis C, Chronic, medicine.disease, digestive system diseases, Ombitasvir, Discontinuation, ombitasvir, chemistry, Paritaprevir, Spain, hepatitis C, business
Abstract

Over the last 5 years, therapies for hepatitis C virus (HCV) infection have improved significantly, achieving sustained virologic response (SVR) rates of up to 100% in clinical trials in patients with HCV genotype 1. We investigated the effectiveness and safety of ombitasvir/paritaprevir/ritonavir +/- dasabuvir in an early access programme. This was a retrospective, multicentre, national study that included 291 treatment-naive and treatment-experienced patients with genotype 1 or 4 HCV infection. Most patients (65.3%) were male, and the mean age was 57.5years. The mean baseline viral load was 6.1 log, 69.8% had HCV 1b genotype, 72.9% had cirrhosis and 34.7% were treatment-naive. SVR at 12 weeks posttreatment was 96.2%. Four patients had virological failure (1.4%), one leading to discontinuation. There were no statistical differences in virological response according to genotype or liver fibrosis. Thirty patients experienced serious adverse events (SAEs) (10.3%), leading to discontinuation in six cases. Hepatic decompensation was observed in five patients. Four patients died during treatment or follow-up, three of them directly related to liver failure. Multivariate analyses showed a decreased probability of achieving SVR associated with baseline albumin, bilirubin and Child-Pugh score B, and a greater probability of developing SAEs related to age and albumin. This combined therapy was highly effective in clinical practice with an acceptable safety profile and low rates of treatment discontinuation.

Published
2017

8. Ab initio and density functional study of a caffeic acid amide

Author

Edgar E. Daza C, David A. Rincón D, and M. Natália D. S. Cordeiro

Subjects
Hydrogen bond, Natural compound, Ab initio, Molecular systems, Condensed Matter Physics, Biochemistry, Potential energy, chemistry.chemical_compound, chemistry, Computational chemistry, Amide, Caffeic acid, Physical and Theoretical Chemistry, Conformational isomerism
Abstract

A series of ab initio and DFT calculations have been performed to study a natural compound often present in human diet, namely the amide of caffeic acid: 3-(3,4-dihydroxyphenyl)-2-propen-amide (ACA). Several molecular properties have been computed for this amide, such as potential energy profiles for internal rotation about different bonds, minimal conformer structures and corresponding vibrational frequencies. Twelve possible unlike conformations were found for ACA, adopting the amide group in all of them a non co-planar conformation. The conformational preferences of this amide are determined mainly by the degree of intra-molecular hydrogen bonding but non-bonding repulsions and conformational flexibility play also a key role. In all cases, the calculated properties are in good agreement with both experimental and theoretical data obtained for related molecular systems.

Published
2007
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9. The CB₁ cannabinoid receptor signals striatal neuroprotection via a PI3K/Akt/mTORC1/BDNF pathway

Author

Blázquez, C, Chiarlone, A, Bellocchio, L, Resel, E, Pruunsild, P, García-Rincón, D, Sendtner, M, Timmusk, T, Lutz, B, Galve-Roperh, I, and Guzmán, M

Subjects
musculoskeletal, neural, and ocular physiology, Brain-Derived Neurotrophic Factor, TOR Serine-Threonine Kinases, Mechanistic Target of Rapamycin Complex 1, Corpus Striatum, Neuroprotection, Disease Models, Animal, Mice, Phosphatidylinositol 3-Kinases, Huntington Disease, nervous system, Receptor, Cannabinoid, CB1, Multiprotein Complexes, Animals, lipids (amino acids, peptides, and proteins), Transgenes, Promoter Regions, Genetic, Proto-Oncogene Proteins c-akt, Signal Transduction
Abstract

The CB1 cannabinoid receptor, the main molecular target of endocannabinoids and cannabis active components, is the most abundant G protein-coupled receptor in the mammalian brain. In particular, the CB1 receptor is highly expressed in the basal ganglia, mostly on terminals of medium-sized spiny neurons, where it plays a key neuromodulatory function. The CB1 receptor also confers neuroprotection in various experimental models of striatal damage. However, the assessment of the physiological relevance and therapeutic potential of the CB1 receptor in basal ganglia-related diseases is hampered, at least in part, by the lack of knowledge of the precise mechanism of CB1 receptor neuroprotective activity. Here, by using an array of pharmacological, genetic and pharmacogenetic (designer receptor exclusively activated by designer drug) approaches, we show that (1) CB1 receptor engagement protects striatal cells from excitotoxic death via the phosphatidylinositol 3-kinase/Akt/mammalian target of rapamycin complex 1 pathway, which, in turn, (2) induces brain-derived neurotrophic factor (BDNF) expression through the selective activation of BDNF gene promoter IV, an effect that is mediated by multiple transcription factors. To assess the possible functional impact of the CB1/BDNF axis in a neurodegenerative-disease context in vivo, we conducted experiments in the R6/2 mouse, a well-established model of Huntington's disease, in which the CB1 receptor and BDNF are known to be severely downregulated in the dorsolateral striatum. Adeno-associated viral vector-enforced re-expression of the CB1 receptor in the dorsolateral striatum of R6/2 mice allowed the re-expression of BDNF and the concerted rescue of the neuropathological deficits in these animals. Collectively, these findings unravel a molecular link between CB1 receptor activation and BDNF expression, and support the relevance of the CB1/BDNF axis in promoting striatal neuron survival.

Published
2015

10. Acute respiratory distress syndrome sub-phenotypes according to histological findings

Author

Cardinal Fernández, Pablo, Muñoz Rincón, D. A., Thille, Arnaud W., Jaramillo, C., Ballén Barragán, A., Herrero, Raquel, Nin, Nicolás, Cal, Miguel A. de la, Esteban, Andrés, and Lorente Balanza, José Ángel

Subjects
Síndrome de dificultad respiratoria aguda, Aparato respiratorio
Abstract

The objective is to demonstrate that among patients with the clinical diagnosis of ARDS, the presence of diffuse alveolar damage (DAD) at histological examination, as compared to its absence, defines a clinical sub-phenotype. We studied patients that died in our ICU from 2000 to 2012 with the diagnosis of ARDS according to the Berlin definition and had autopsy. We excluded patients dying [14 days after the diagnosis of ARDS. The diagnosis of DAD required the presence of hyaline membranes plus at least one of the following: intra-alveolar edema, alveolar type I cell necrosis, alveolar type II cell proliferation, interstitial proliferation of fibroblasts or organizing interstitial fibrosis. 7.214 JCR (2014) Q1, 3/27 Critical care medicine UEM

Published
2014

11. Antifungal stewardship in a tertiary-care institution: a bedside intervention

Author

Valerio, M, Muñoz, P, Rodríguez, C G, Caliz, B, Padilla, B, Fernández-Cruz, A, Sánchez-Somolinos, M, Gijón, P, Peral, J, Gayoso, J, Frias, I, Salcedo, M, Sanjurjo, M, Bouza, E, Bouza, E., Bustinza, A., Cáliz, B., Escribano, P., Fernández-Cruz, A., Fernández-Quero, J., Frias, I., Gayoso, J., Gijón, P., Guinea, J., Kestler, M., de Lorenzo, A., Martínez, M. C., Menárguez, M. C., Muñoz, P., Navarro, M., Padilla, B., Peláez, T., Peral, J., Rincón, D., Rodríguez, C. G., Salcedo, M., Sánchez, C., Sánchez-Somolinos, M., Sanjurjo, M., Serrano, D., Valerio, M., Vena, Antonio, Verde, E., and Zamora, and E.

Subjects
Male, Posaconazole, Pediatrics, Antifungals, candidaemia, cost savings, invasive aspergillosis, stewardship, Adolescent, Adult, Aged, Aged, 80 and over, Antifungal Agents, Child, Child, Preschool, Costs and Cost Analysis, Drug Prescriptions, Drug Utilization, Female, Humans, Infant, Infant, Newborn, Middle Aged, Mycoses, Survival Analysis, Tertiary Care Centers, Treatment Outcome, Young Adult, Organizational Policy, Antifungal drug, Tertiary care, 80 and over, Incidence (epidemiology), General Medicine, Infectious Diseases, medicine.drug, Antifungal, Microbiology (medical), medicine.medical_specialty, medicine.drug_class, Intensive care, Intervention (counseling), medicine, Preschool, Voriconazole, business.industry, Newborn, Emergency medicine, business
Abstract

Antifungal stewardship (AFS) programmes are needed in tertiary-care hospitals. Our aim is to describe a bedside non-restrictive AFS programme, and to evaluate its economic impact. During the first year of the AFS a bundle of non-interventional measures were implemented. During the second year an infectious diseases specialist visited 453 patients receiving candins, liposomal amphotericin B, voriconazole or posaconazole. Monthly costs were studied with an interrupted time series (ITS) analysis. The main prescribing departments were haematology (35%), medical departments (23%), and intensive care units (20%). Reasons to start antifungal therapy were: targeted therapy (36%), prophylaxis (32%), empirical therapy (20%) and pre-emptive therapy (12%). At the initial visit, diagnostic advice was provided in 40% of cases. The most common therapeutic recommendations were to de-escalate the antifungal drug (17%) or to suspend it (7%). Annual total antifungal expenditure was reduced from US$3.8 million to US$2.9 million over the first 2 years, generating net savings of US$407,663 and US$824,458 per year after considering the cost of additional staff required. The ITS analyses showed a significant economic impact after the first 12 months of the intervention (p 0.042 at month 13), which was enhanced in the following 24 months (p 0.006 at month 35). The number of defined daily doses decreased from 66.4 to 54.8 per 1000 patient-days. Incidence of candidaemia was reduced from 1.49 to 1.14 (p 0.08) and related mortality was reduced from 28% to 16% (p 0.1). A collaborative and non-compulsory AFS program based on bedside intervention is an efficacious and cost-effective approach that optimizes the use of AF drugs.

Published
2015
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12. Análisis de los modelos institucionales de la evaluación de centros de Cataluña

Author

Bartolomé, M., Bisquerra Alzina, Rafael, Borrell, Núria, Cabrera, F., Espín López, Julia Victoria, Figuera, P., Jiménez, A., Mateo Andrés, Juan, Rincón, D. del, Rodríguez, M., Sans, A., Tomás, M., and Tort, L.

Subjects
3 - Ciencias sociales::37 - Educación. Enseñanza. Formación. Tiempo libre [CDU]
Abstract

Este trabajo supone una síntesis del esfuerzo conjunto de dos departamentos de la Universidad de Barcelona (MIDE y DOE) Y de la Inspección de Cataluña, a fin de presentar y analizar críticamente los modelos evaluativos más usados en el ámbito de Cataluña, añadiendo a modo de referencia y contraste externo, para ser también incluidos en el análisis, tres modelos foráneos (ECIS, GRIDS y DELAWARE). Como aportaciones más interesantes señalamos la difusión de dichos modelos en un foco tan autorizado como lo fue el del IV Seminario del área celebrado en Santiago en 1988, un esquema facilitador del análisis comparativo entre ellos y las consiguientes conclusiones. This paper presents a synthesis of the endeavors of two Barcelona University Educational Departments (MIDE and DOE) and the Catalonian Educational Supervision Department, in order to show an analyze the school evaluation models more used in Catalonia. We add to the analysis three foreign models (ECIS, GRIDS and DELA W ARE) as an external points of reference. We can point out as the more interesting findings, the public presentation of al these models to the well prepared audience of Santiago Symposium (celebrated in july 1988), the schemes developed to facilitate the comparative analysis among them, and their conclusions.

Published
1991

13. The Third National Ovarian Cancer Consensus 2011. Grupo de Investigacion en Cancer de Ovario y Tumores Ginecologicos de Mexico 'GICOM' | Tercer Consenso Nacional de Cáncer de Ovario 2011. Grupo de Investigación en Cáncer de Ovario y Tumores Ginecológicos de México 'GICOM'

Author

Gallardo-Rincón, D., David Cantu-de Leon, Alanís-López, P., Álvarez-Avitia, M. Á, Bañuelos-Flores, J., Herbert-Núñez, G. S., Oñate-Ocaña, L. F., Pérez-Montiel, M. D., Rodríguez-Trejo, A., Ruvalcaba-Limón, E., Serrano-Olvera, A., Ortega-Rojo, A., Cortés-Esteban, P., Erazo-Valle, A., Gerson-Cwilich, R., De-La-Garza-Salazar, J., Green-Renner, D., León-Rodríguez, E., Morales-Vásquez, F., Poveda-Velasco, A., Aguilar-Ponce, J. L., Alva-López, L. F., Alvarado-Aguilar, S., Alvarado-Cabrero, I., Aquino-Mendoza, C. A., Aranda-Flores, C. E., Bandera-Delgado, A., Barragán-Curiel, E., Barrón-Rodríguez, P., Brom-Valladares, R., Cabrera-Galeana, P. A., Calderillo-Ruiz, G., Camacho-Gutiérrez, S., Capdeville-García, D., Cárdenas-Sánchez, J., Carlón-Zárate, E., Carrillo-Garibaldi, Ó, Castorena-Roji, G., Cervantes-Sánchez, G., Coronel-Martínez, J. A., Chanona-Vilchis, J. G., Díaz-Hernández, V., Escudero-De-Los Ríos, P., Garibay-Cerdenares, O., Gómez-García, E., Herrera-Montalvo, L. A., Hinojosa-García, L. M., Isla-Ortiz, D., Jiménez-López, J., Lavín-Lozano, A. J., Limón-Rodríguez, J. A., López-Basave, H. N., López-García, S. C., Maffuz-Aziz, A., Martínez-Cedillo, J., Martínez-López, D. M., Medina-Castro, J. M., Melo-Martínez, C., Méndez-Herrera, C., Montalvo-Esquivel, G., Morales-Palomares, M. Á, Morán-Mendoza, A., Morgan-Villela, G., Mota-García, A., Muñoz-González, D. E., Ochoa-Carrillo, F. J., Pérez-Amador, M., Recinos-Money, E., Rivera-Rivera, S., Robles Flores, J. U., Rojas-Castillo, E., Rojas-Marín, C., Salas-Gonzáles, E., Sámano-Nateras, L., Santibañez-Andrade, M., Santillán-Gómez, A., Silva-García, A., Silva, J. A., Solorza-Luna, G., Tabarez-Ortiz, A. R., Talamás-Rohana, P., Tirado-Gómez, L. L., Torres-Lobatón, A., and Quijano-Castro, F.

14. The first Mexican consensus of endometrial cancer | Primer consenso Mexicano de cáncer de endometrio: Grupo de Investigación en Cáncer de Ovario y Tumores Ginecológicos de México 'GICOM'

Author

Ruvalcaba-Limón, E., David Cantu-de Leon, León-Rodríguez, E., Cortés-Esteban, P., Serrano-Olvera, A., Morales-Vásquez, F., Sosa-Sánchez, R., Poveda-Velasco, A., Crismatt-Zapata, A., Santillán-Gómez, A., Aguilar-Jiménez, C., Alanís-López, P., Alfaro-Ramírez, P., Álvarez-Avitia, M. Á, Aranda-Flores, C. E., Arias-Ceballos, J. H. R., Arrieta-Rodríguez, O., Barragán-Curiel, E., Botello-Hernández, D., Brom-Valladares, R., Cabrera-Galeana, P. A., Cantón-Romero, J. C., Capdeville-García, D., Cárdenas-Sánchez, J., Castorena-Roji, G., Cepeda-López, F. R., Cervantes-Sánchez, G., Cetina-Pérez, L. D. C., Coronel-Martínez, J. A., Cortés-Cárdenas, S. A., Cruz-López, J. C., La Garza-Salazar, J. G., Díaz-Romero, C., Dueñas-González, A., Valle-Solís, A. E., Escudero-De Los Ríos, P., Flores-Álvarez, E., García-Matus, R., Gerson-Cwilich, R., González-Enciso, A., González-De-León, C., Guevara-Torres, A. G., Herbert-Núñez, G. S., Hernández-Hernández, C., Hernández-Hernández, D. M., Isla-Ortiz, D., Jesús-Sandoval, R., Jiménez-Cervantes, C., Kuri-Exsome, R., López-Obispo, J. L., Maffuz-Aziz, A., Martínez-Barrera, L. M., Medina-Castro, J. M., Montalvo-Esquivel, G., Mora-Aguilar, V. H., Morales-Palomares, M. Á, Morán-Mendoza, A., Morgan-Villela, G., Mota-García, A., Muñoz-González, D. E., Murillo-Cruz, D. A., Novoa-Vargas, A., Ochoa-Carrillo, F. J., Oñate-Ocaña, L. F., Ortega-Rojo, A., Palacios-Martínez, A. G., Palomeque-López, A., Pérez-Montiel, M. D., Quijano-Castro, F., Rivera-Rivera, S., Rivera-Rubí, L. M., Robles-Flores, J. U., Rodríguez-Trejo, A., Salas-Gonzáles, E., Silva, J. A., Solorza-Luna, G., Souto-Del-Bosque, R., Tirado-Gómez, L. L., Torrescano-González, S., Torres-Lobatón, A., Trejo-Durán, E., Villavicencio-Valencia, V., and Gallardo-Rincón, D.

15. National Consensus of Diagnosis and treatment of non-small cell lung cancer

Author

Arrieta O, Guzmán-de Alba E, Lf, Alba-López, Acosta-Espinoza A, Alatorre-Alexander J, Jf, Alexander-Meza, Sr, Allende-Pérez, Alvarado-Aguilar S, Me, Araujo-Navarrete, Lm, Argote-Greene, Ca, Aquino-Mendoza, Am, Astorga-Ramos, Austudillo-de la Vega H, Avilés-Salas A, Lj, Barajas-Figueroa, Barroso-Quiroga N, Blake-Cerda M, Pa, Cabrera-Galeana, Calderillo-Ruíz G, Ad, Campos-Parra, Am, Cano-Valdez, Capdeville-García D, Castillo-Ortega G, Casillas-Suárez C, Castillo-González P, Jf, Corona-Cruz, Me, Correa-Acevedo, Ss, Cortez-Ramírez, Ja, La Cruz-Vargas, Jg, La Garza-Salazar, Md, La Mata-Moya, Me, Domínguez-Flores, Hr, Domínguez-Malagón, Lm, Domínguez-Parra, Domínguez-Peregrina A, Durán-Alcocer J, Mi, Enríquez-Aceves, Elizondo-Ríos A, Md, Escobedo-Sánchez, Pe, Villafranca, Flores-Cantisani A, Jp, Flores-Gutiérrez, Franco-Marina F, Ee, Franco-González, Ra, Franco-Topete, Fuentes-de la Peña H, Galicia-Amor S, Gallardo-Rincón D, Gamboa-Domínguez A, García-Andreu J, Cm, García-Cuéllar, Mc, García-Sancho-Figueroa, García-Torrentera R, Gerson-Cwilich R, Gómez-González A, Green-Schneeweiss L, Guillén-Núñez Mdel R, Gutiérrez-Velázquez H, Ibarra-Pérez C, Jiménez-Fuentes E, Juárez-Sánchez P, Juárez-Ramiro A, Kelly-García J, Kuri-Exsome R, Jm, Lázaro-León, León-Rodríguez E, Llanos-Osuna S, Loyola-García U, Js, López-González, Antuñano Fj, López Y., Ma, Loustaunau-Andrade, Eo, Macedo-Pérez, Machado-Villarroel L, Magallanes-Maciel M, Martínez-Barrera L, Martínez-Cedillo J, Martínez-Martínez G, Medina-Esparza A, Meneses-García A, Mohar-Betancourt A, Morales Blanhir J, Morales-Gómez J, Motola-Kuba D, Mp, Nájera-Cruz, Núñez-Valencia Cdel C, Ma, Ocampo-Ocampo, Md, Ochoa-Vázquez, Ca, Olivares-Torres, Palomar-Lever A, Patiño-Zarco M, Pérez-Padilla R, Yr, Peña-Alonso, Ar, Pérez-Romo, Aquilino Pérez M, Pm, Pinaya-Ruíz, Ma, Pointevin-Chacón, Jj, Poot-Braga, Posadas-Valay R, Ramirez-Márquez M, Reyes-Martínez I, Robledo-Pascual J, Rodríguez-Cid J, Ce, Rojas-Marín, Romero-Bielma E, Je, Rubio-Gutiérrez, Ja, Sáenz-Frías, Ma, Salazar-Lezama, Sánchez-Lara K, Sansores Martínez R, Santillán-Doherty P, Alejandro-Silva J, Jl, Téllez-Becerra, Toledo-Buenrostro V, Luis Torre-Bouscoulet, Torecillas-Torres L, Torres M, Tovar-Guzmán V, Jg, Turcott-Chaparro, Jj, Vázquez-Cortés, Me, Vázquez-Manríquez, Vilches-Cisneros N, Jf, Villegas-Elizondo, Mm, Zamboni, Zamora-Moreno J, and Jw, Zinser-Sierra

Subjects
Lung Neoplasms, Carcinoma, Non-Small-Cell Lung, Decision Trees, Smoking, Humans, Mexico, Algorithms, Neoplasm Staging
Abstract

Mexican specialists in oncology, oncologic surgery, thoracic surgery, pneumology, pathology, molecular biology, anesthesiology, algology, psychology, nutrition, and rehabilitation (all of them experts in lung cancer treatment) in order to develop the National Consensus on Lung Cancer. The consensus has been developed as an answer to the need of updated Mexican guidelines for the optimal treatment of the disease, as well as to the requirements that such guidelines be established by multidisciplinary panel, depicting the current attention given to cancer lung cases in Mexico. Thus, this paper analyses the epidemiological review, screening, diagnosis, staging, pathology, translational medicine, and the suitable therapies for early, locally advanced, and metastatic disease in the first, second, and third lines of management, as well as rehabilitation and palliative measures.

16. The Third National Ovarian Cancer Consensus 2011. Grupo de Investigacion en Cancer de Ovario y Tumores Ginecologicos de Mexico 'GICOM',Tercer Consenso Nacional de Cáncer de Ovario 2011. Grupo de Investigación en Cáncer de Ovario y Tumores Ginecológicos de México 'GICOM'

Author

Gallardo-Rincón, D., Cantú-De-León, D., Alanís-López, P., Álvarez-Avitia, M. Á, Bañuelos-Flores, J., Herbert-Núñez, G. S., Oñate-Ocaña, L. F., Pérez-Montiel, M. D., Rodríguez-Trejo, A., Ruvalcaba-Limón, E., Serrano-Olvera, A., Ortega-Rojo, A., Cortés-Esteban, P., Erazo-Valle, A., Gerson-Cwilich, R., De-La-Garza-Salazar, J., Green-Renner, D., León-Rodríguez, E., Morales-Vásquez, F., Poveda-Velasco, A., Aguilar-Ponce, J. L., Alva-López, L. F., Alvarado-Aguilar, S., Alvarado-Cabrero, I., Aquino-Mendoza, C. A., Aranda-Flores, C. E., Bandera-Delgado, A., Barragán-Curiel, E., Barrón-Rodríguez, P., Brom-Valladares, R., Cabrera-Galeana, P. A., Calderillo-Ruiz, G., Camacho-Gutiérrez, S., Capdeville-García, D., Cárdenas-Sánchez, J., Carlón-Zárate, E., Carrillo-Garibaldi, Ó, Castorena-Roji, G., Cervantes-Sánchez, G., Coronel-Martínez, J. A., Chanona-Vilchis, J. G., Díaz-Hernández, V., Escudero-De-Los Ríos, P., Garibay-Cerdenares, O., Gómez-García, E., Herrera-Montalvo, L. A., Hinojosa-García, L. M., Isla-Ortiz, D., Jiménez-López, J., Lavín-Lozano, A. J., Limón-Rodríguez, J. A., López-Basave, H. N., López-García, S. C., Maffuz-Aziz, A., Martínez-Cedillo, J., Martínez-López, D. M., Medina-Castro, J. M., Melo-Martínez, C., Méndez-Herrera, C., Montalvo-Esquivel, G., Morales-Palomares, M. Á, Morán-Mendoza, A., Morgan-Villela, G., Mota-García, A., Muñoz-González, D. E., Ochoa-Carrillo, F. J., Pérez-Amador, M., Recinos-Money, E., Rivera-Rivera, S., Robles Flores, J. U., Rojas-Castillo, E., Rojas-Marín, C., Salas-Gonzáles, E., Sámano-Nateras, L., Santibañez-Andrade, M., Santillán-Gómez, A., Silva-García, A., Silva, J. A., Solorza-Luna, G., Tabarez-Ortiz, A. R., Patricia Talamás-Rohana, Tirado-Gómez, L. L., Torres-Lobatón, A., and Quijano-Castro, F.

17. Profiles and clinical management of hepatitis C patients in Spain: DisHCovery study,Perfil clínico y seguimiento de los pacientes con hepatitis C crónica en hospitales españoles: Estudio disHCovery

Author

Buti, M., Franco, A., Carmona, I., Sánchez-Ruano, J. J., Sansó, A., Berenguer, M., García-Buey, L., Hernández-Guerra, M., Morillas, R. M., Ledesma, F., Esteban, R., Aguilera, V., Alonso, M. J., Alonso, S., Alonso-Burgal, M., Andrade, R., Antón, S., Aparcero, R., Artaza, T., Bárcena, R., Barrera, P., Blas, J. M., Calleja, J. L., Casas, M., Casado, M., Costan, G., Cuaresma, M., Cuenca, F., Dalmau, B., Daponte, S., Vaquer, P., Delgado, M., La Bandera, M., La Fuente, E., La Mata, M., Devesa, M. J., Diago, M., Eraña, L. F., Escudero, M., Estevez, M., Fernández-Bermejo, M., Fernández, A., Fernández-Castroagudín, J., Fernández, I., Forns, X., Fraga, E., Gallego, A., Gallego, R., García-Buey, M. L., García, I., García-Samaniego, J., Gely, C., Gila, A., González, L., Gómez-Alonso, M., Gomez-Rubio, M., González, M., González, M. L., Gutiérrez, M. L., Hombrados, M., Jimenez, M., Jor­dán, T., Jorquera, F., Sabela Lens, Linares, P., López, G., López-Cepero, J., López, C., Lorente, S., Manzano, M. L., Maraver, A., Mera, J., Miquel, M., Molina, C., Molina, E., Montero, J. L., Montoliu, S., Moreno, J., Moreno, I., Morillas, R., Olcoz, J. L., Olveira, A., Palau, A., Pardo, A., Pascasio, J. M., Pérez, J., Peláez, G., Pérez-Moreno, J., Pérez-Tristancho, M. R., Planas, R., Pons, J. A., Porcel, A., Povato, A., Primo, J., Puertas-Montenegro, Quer, J. C., Rincón, D., Rivás, L., Rodríguez, M., Romero, M., Salmerón, J., Sánchez, J., Sánchez-Ru­ano, J. J., Sanso, A., Santamaría, G., Serra, M. A., Serrano, T., Solá, R., Torras, J., Turnes, J., Urquijo, J. J., Vergara, M., Vilella, A., and Viñolo, C.

19. Profiles and clinical management of hepatitis C patients in Spain: DisHCovery study,Perfil clínico y seguimiento de los pacientes con hepatitis C crónica en hospitales españoles: Estudio disHCovery

Author

Buti, M., Franco, A., Carmona, I., Sánchez-Ruano, J. J., Sansó, A., Berenguer, M., García-Buey, L., Hernández-Guerra, M., Morillas, R. M., Ledesma, F., Esteban, R., Aguilera, V., Alonso, M. J., Alonso, S., Alonso-Burgal, M., Andrade, R., Antón, S., Aparcero, R., Artaza, T., Bárcena, R., Barrera, P., Blas, J. M., Calleja, J. L., Casas, M., Casado, M., Costan, G., Cuaresma, M., Cuenca, F., Dalmau, B., Daponte, S., Vaquer, P., Delgado, M., La Bandera, M., La Fuente, E., La Mata, M., Devesa, M. J., Diago, M., Eraña, L. F., Escudero, M., Estevez, M., Fernández-Bermejo, M., Fernández, A., Fernández-Castroagudín, J., Fernández, I., Forns, X., Fraga, E., Gallego, A., Gallego, R., García-Buey, M. L., García, I., Javier García-Samaniego, Gely, C., Gila, A., González, L., Gómez-Alonso, M., Gomez-Rubio, M., González, M., González, M. L., Gutiérrez, M. L., Hombrados, M., Jimenez, M., Jor­dán, T., Jorquera, F., Lens, S., Linares, P., López, G., López-Cepero, J., López, C., Lorente, S., Manzano, M. L., Maraver, A., Mera, J., Miquel, M., Molina, C., Molina, E., Montero, J. L., Montoliu, S., Moreno, J., Moreno, I., Morillas, R., Olcoz, J. L., Olveira, A., Palau, A., Pardo, A., Pascasio, J. M., Pérez, J., Peláez, G., Pérez-Moreno, J., Pérez-Tristancho, M. R., Planas, R., Pons, J. A., Porcel, A., Povato, A., Primo, J., Puertas-Montenegro, Quer, J. C., Rincón, D., Rivás, L., Rodríguez, M., Romero, M., Salmerón, J., Sánchez, J., Sánchez-Ru­ano, J. J., Sanso, A., Santamaría, G., Serra, M. A., Serrano, T., Solá, R., Torras, J., Turnes, J., Urquijo, J. J., Vergara, M., Vilella, A., and Viñolo, C.

20. [New treatments of hepatic encephalopathy]

Author

Rafael Bañares, Ja, Carneros, and Rincón D

Subjects
Flumazenil, Male, Clinical Trials as Topic, Benzoic Acid, Benzoates, Lactulose, Rats, Electrocardiography, Zinc, Gastrointestinal Agents, Hepatic Encephalopathy, Animals, Humans, Female, Magnesium, GABA Modulators, Amino Acids, Branched-Chain

22. [The first Mexican consensus of endometrial cancer. Grupo de Investigación en Cáncer de Ovario y Tumores Ginecológicos de México]. | Primer consenso Mexicano de cancer de endometrio

Author

Ruvalcaba-Limón, E., David Cantu-de Leon, León-Rodríguez, E., Cortés-Esteban, P., Serrano-Olvera, A., Morales-Vásquez, F., Sosa-Sánchez, R., Poveda-Velasco, A., Crismatt-Zapata, A., Santillán-Gómez, A., Aguilar-Jiménez, C., Alanís-López, P., Alfaro-Ramírez, P., Alvarez-Avitia, M. A., Aranda-Flores, C. E., Arias-Ceballos, J. H., Arrieta-Rodríguez, O., Barragán-Curiel, E., Botello-Hernández, D., Brom-Valladares, R., Cabrera-Galeana, P. A., Cantón-Romero, J. C., Capdeville-García, D., Cárdenas-Sánchez, J., Castorena-Roji, G., Cepeda-López, F. R., Cervantes-Sánchez, G., Cetina-Pérez, L. C., Coronel-Martínez, J. A., Cortés-Cárdenas, S. A., Cruz-López, J. C., La Garza-Salazar, J. G., Díaz-Romero, C., Dueñas-González, A., Valle-Solís, A. E., Escudero-De Los Ríos, P., Flores-Alvarez, E., García-Matus, R., Gerson-Cwilich, R., González-Enciso, A., González-De-León, C., Guevara-Torres, A. G., Herbert-Núñez, G. S., Hernández-Hernández, C., Hernández-Hernández, D. M., Isla-Ortiz, D., Jesús-Sandoval, R., Jiménez-Cervantes, C., Kuri-Exsome, R., López-Obispo, J. L., Maffuz-Aziz, A., Martínez-Barrera, L. M., Medina-Castro, J. M., Montalvo-Esquivel, G., Mora-Aguilar, V. H., Morales-Palomares, M. A., Morán-Mendoza, A., Morgan-Villela, G., Mota-García, A., Muñoz-González, D. E., Murillo-Cruz, D. A., Novoa-Vargas, A., Ochoa-Carrillo, F. J., Oñate-Ocaña, L. F., Ortega-Rojo, A., Palacios-Martínez, A. G., Palomeque-López, A., Pérez-Montiel, M. D., Quijano-Castro, F., Rivera-Rivera, S., Rivera-Rubí, L. M., Robles-Flores, J. U., Rodríguez-Trejo, A., Salas-Gonzáles, E., Silva, J. A., Solorza-Luna, G., Souto-Del-Bosque, R., Tirado-Gómez, L. L., Torrescano-González, S., Torres-Lobatón, A., Trejo-Durán, E., Villavicencio-Valencia, V., Gallardo-Rincón, D., and Tumores Ginecologicos Mexico, Grupo Investigacion En Cancer Ovario Y.

23. [Percutaneous intrahepatic portosystemic shunting as a treatment for refractory hepatic hydrothorax]

Author

Núñez O, García A, Rincón D, Alonso S, Echenagusía A, and Rafael Bañares

Subjects
Hydrothorax, Humans, Middle Aged, Portasystemic Shunt, Transjugular Intrahepatic, Aged
Abstract

Hepatic hydrothorax is an infrequent complication of portal hypertension in liver cirrhosis. Treatment with saline restriction and diuretics is usually effective but when this fails, the therapeutic approach is difficult and multiple complications occur. Transjugular percutaneous intrahepatic portosystemic shunt (IPS) is associated with a marked decrease in portal pressure and consequently this technique has been used in the treatment of refractory ascites. The aim of this study was to analyze the efficacy, safety and outcome of refractory hepatic hydrothorax treated by IPS. The procedure was performed in 5 patients who were all grade B or C in the Child-Pugh classification. Three patients showed complete response to the treatment, of whom 1 underwent transplantation 20 days later. The fourth patient showed partial response with a reduction in the need to perform thoracocentesis and the fifth patient showed no response to IPS and died after 17 days of follow-up. Albumin levels and Child classification remained unchanged. Two patients presented recurrence with reappearance of hydrothorax due to shunt dysfunction and 2 patients presented hepatic encephalopathy that responded to medical treatment. Refractory hepatic hydrothorax can be controlled by IPS in a large number of patients but its efficacy is restricted by shunt dysfunction, the risk of encephalopathy and by its limited effect on survival.

24. National consensus of diagnosis and treatment of non-small cell lung cancer,Consenso nacional de diagnóstico y tratamiento del cáncer de pulmón de células no pequeñas

Author

Arrieta, O., Guzmán-De Alba, E., Alba-López, L. F., Acosta-Espinoza, A., Alatorre-Alexander, J., Alexander-Meza, J. F., Allende-Pérez, S. R., Alvarado-Aguilar, S., Araujo-Navarrete, M. E., Argote-Greene, L. M., Aquino-Mendoza, C. A., Astorga-Ramos, A. M., Astudillo-De La Vega, H., Avilés-Salas, A., Barajas-Figueroa, L. J., Barroso-Quiroga, N., Blake-Cerda, M., Cabrera-Galeana, P. A., Calderillo-Ruíz, G., Campos-Parra, A. D., Cano-Valdez, A. M., Capdeville-García, D., Castillo-Ortega, G., Casillas-Suárez, C., Castillo-González, P., Corona-Cruz, J. F., Correa-Acevedo, M. E., Cortez-Ramírez, S. S., Jhony A. De La Cruz-Vargas, La Garza-Salazar, J. G., La Mata-Moya, M. D., La Peña-Hinojosa, C., Domínguez-Flores, M. E., Domínguez-Malagón, H. R., Domínguez-Parra, L. M., Domínguez-Peregrina, A., Durán-Alcocer, J., Enríquez-Aceves, M. I., Elizondo-Ríos, A., Escobedo-Sánchez, M. D., Villafranca, P. E. -M, Flores-Cantisani, A., Flores-Gutiérrez, J. P., Franco-Marina, F., Franco-González, E. E., Franco-Topete, R. A., Fuentes-De La Peña, H., Galicia-Amor, S., Gallardo-Rincón, D., Gamboa-Domínguez, A., García-Andreu, J., García-Cuéllar, C. M., García-Sancho-Figueroa, M. C., García-Torrentera, R., Gerson-Cwilich, R., Gómez-González, A., Green-Schneeweiss, L., Del Rocío Guillén-Núñez, M., Gutiérrez-Velázquez, H., Ibarra-Pérez, C., Jiménez-Fuentes, E., Juárez-Sánchez, P., Juárez-Ramiro, A., Kelly-García, J., Kuri-Exsome, R., Lázaro-León, J. M., León-Rodríguez, E., Llanos-Osuna, S., Loyola-García, U., López-González, J. S., López Yde Antuñano, F. J., Loustaunau-Andrade, M. A., Macedo-Pérez, E. O., Machado-Villarroel, L., Magallanes-Maciel, M., Martínez-Barrera, L., Martínez-Cedillo, J., Martínez-Martínez, G., Medina-Esparza, A., Meneses-García, A., Mohar-Betancourt, A., Blanhir, J. M., Morales-Gómez, J., Motola-Kuba, D., Nájera-Cruz, M. P., Del Carmen Núñez-Valencia, C., Ocampo-Ocampo, M. A., Ochoa-Vázquez, M. D., Olivares-Torres, C. A., Palomar-Lever, A., Patiño-Zarco, M., Pérez-Padilla, R., Peña-Alonso, Y. R., Pérez-Romo, A. R., Pérez, M. A., Pinaya-Ruíz, P. M., Pointevin-Chacón, M. A., Poot-Braga, J. J., Posadas-Valay, R., Ramírez-Márquez, M., Reyes-Martínez, I., Robledo-Pascual, J., Rodríguez-Cid, J., Rojas-Marín, C. E., Romero-Bielma, E., Rubio-Gutiérrez, J. E., Sáenz-Frías, J. A., Salazar-Lezama, M. Á, Sánchez-Lara, K., Martínez, R. S., Santillán-Doherty, P., Alejandro-Silva, J., Téllez-Becerra, J. L., Toledo-Buenrostro, V., Torre-Bouscoulet, L., Torecillas-Torres, L., Torres, M., Tovar-Guzmán, V., Turcott-Chaparro, J. G., Vázquez-Cortés, J. J., Vázquez-Manríquez, M. E., Vilches-Cisneros, N., Villegas-Elizondo, J. F., Zamboni, M. M., Zamora-Moreno, J., and Zinser-Sierra, J. W.

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