32 results on '"Serna, J."'
Search Results
2. Implication of general anaesthetic and sedation techniques in temporomandibular joint disorders - a systematic review
- Author
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Talavan-Serna J, Montiel-Company J, Bellot-Arcis C, and Almerich-Silla J
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Anaesthesia ,Disorders ,Joint ,Sedation ,Mandibular - Abstract
The purpose of this study was to conduct a systematic review of the literature on temporomandibular joint damage directly related to general anaesthesia and sedation. We searched MEDLINE, SCOPUS and the COCHRANE Library for titles and abstracts containing terms related to the subject. The search delimiters were analytical and descriptive studies with abstracts in Spanish, German, English or French, with no time limit. The search was updated in January 2015. Of the 398 articles found, 89 were duplicates and only 28 were of interest. Of these, 23 (82.14%) were case and case series reports, 4 (14.28%) were longitudinal studies and 1 (3.57%) was a cross-sectional study. General anaesthesia and sedation are risk factors for temporomandibular joint damage because of the drop in muscle tone caused by the drugs employed and because of airway management manoeuvres involving the joint. Joint complications have been described with spontaneous ventilation as well as with ventilation assisted by a face or laryngeal mask and with intubation. They are more frequent in women and/or patients with previous temporomandibular problems. Proper assessment is required both before and after anaesthesia or sedation in order to foresee and avoid or minimize temporomandibular complications. The data should be treated with caution, as the evidence of case and case series reports is not of a high standard and the small number of analytical studies is not entirely comparable. General anaesthesia and sedation techniques can influence the onset of temporomandibular joint disorders. More studies are needed to provide better clinical evidence. (C) 2016 Elsevier Masson SAS. All rights reserved.
- Published
- 2017
3. AIR POLLUTION IN MADRID, FROM 1964 TO 1970. STUDY CARRIED OUT IN THE SCHOOL OF PUBLIC HEALTH
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ANECHINA, P., primary, ROMERO, J., additional, SANCHEZ, B., additional, MURIAS, F., additional, and DE LA SERNA, J., additional
- Published
- 1971
- Full Text
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4. An example of simulation tools use for large injection moulds design: The CONTENUR™ 2400 l solid waste container
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Aisa, J., Javierre, Carlos, Serna, J. A. de la, Aisa, J., Javierre, Carlos, and Serna, J. A. de la
- Abstract
Large containers with volumes above 1100 l are usually produced using procedures such as rotomoulding process. These techniques have no part weight or dimensional limits. T.I.I.P., injection moulding plastic group of the Department of Mechanical Engineering of the Zaragoza University, developed with CONTENUR™ a new product under European norms for solid waste containers up to 2000 l volume; the result was a new main body up to 60 kg weight in one part. The design process combined several CAE tools (aesthetical design, mechanical design and rheological simulation) and, in last June, showed final result and passed different tests. Nowadays, more than 5000 samples are on the streets without basic modifications in the mould (more than 100 tonnes weight). The paper focuses on the methodology used to integrate tool and process design with product definition (i.e. injection pressure and clamp force versus thickness and part shape). Some parameters about process control in this particular mould (injection rate, temperature, viscosity, gate location, …) are detailed.
- Published
- 2006
5. A positron study of the defect structures in the D03 and B2 phases in the Fe–Al system
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Diego, N. de, Plazaola, F., Jiménez, José Antonio, Serna, J., Río del, J., Diego, N. de, Plazaola, F., Jiménez, José Antonio, Serna, J., and Río del, J.
- Abstract
The positron annihilation technique was used to identify the nature of the vacancy-type defects in the D03 and B2 phases of the Fe–Al system. Seven alloys with Al concentrations in the range 22.7–48 at.% Al and with different thermal treatments were examined. Positron lifetime calculations for the expected defects in the two phases were also performed in order to facilitate the defect identification. In the B2 phase, two types of defects were identified: a thermal complex formed by a Fe-divacancy and an Al antisite, and a Fe-vacancy. No constitutional vacancies were found in the D03 phase.
- Published
- 2005
6. Development of a Guide to Multidimensional Needs Assessment in the Palliative Care Initial Encounter (MAP).
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Goni-Fuste B, Pergolizzi D, Monforte-Royo C, Alonso-Babarro A, Belar A, Crespo I, Güell E, Julià-Torras J, Moreno-Alonso D, Nabal Vicuña M, Pascual A, Porta-Sales J, Rocafort J, Rodríguez-Prat A, Rodríguez D, Sala C, Serrano-Bermúdez G, Serna J, and Balaguer A
- Subjects
- Humans, Needs Assessment, Caregivers psychology, Qualitative Research, Palliative Care methods, Hospice and Palliative Care Nursing
- Abstract
Context: Ensuring patient-centered palliative care requires a comprehensive assessment of needs beginning in the initial encounter. However, there is no generally accepted guide for carrying out this multidimensional needs assessment as a first step in palliative intervention., Objectives: To develop an expert panel-endorsed interview guide that would enable proactive and systematic Multidimensional needs Assessment in the Palliative care initial encounter (MAP)., Methods: A preliminary version of the MAP guide was drafted based on a published literature review, published semistructured interviews with 20 patients, 20 family carers, and 20 palliative care professionals, and a nominal group process with palliative care professionals and a representative of the national patient's association. Consensus regarding its content was obtained through a modified Delphi process involving a panel of palliative care physicians from across Spain., Results: The published systematic literature review and qualitative study resulted in the identification of 55 needs, which were sorted and grouped by the nominal group. Following the Delphi process, the list of needs was reduced to 47, linked to six domains: Clinical history and medical conditions (n = 8), Physical symptoms (n = 17), Functional and cognitive status (n = 4), Psycho-emotional symptoms (n = 5), Social issues (n = 8), and Spiritual and existential concerns (n = 5)., Conclusion: MAP is an expert panel-endorsed semi-structured clinical interview guide for the comprehensive, systematic, and proactive initial assessment to efficiently assess multiple domains while adjusting to the needs of each patient. A future study will assess the feasibility of using the MAP guide within the timeframe of the palliative care initial encounter., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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7. The impact of e-cigarette exposure on different organ systems: A review of recent evidence and future perspectives.
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Ali N, Xavier J, Engur M, Pv M, and Bernardino de la Serna J
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- Animals, Humans, Prospective Studies, Electronic Nicotine Delivery Systems, Smoking Cessation
- Abstract
The use of electronic cigarettes (e-cigs) is rapidly increasing worldwide and is promoted as a smoking cessation tool. The impact of traditional cigs on human health has been well-defined in both animal and human studies. In contrast, little is known about the adverse effects of e-cigs exposure on human health. This review summarizes the impact of e-cigs exposure on different organ systems based on the rapidly expanding recent evidence from experimental and human studies. A number of growing studies have shown the adverse effects of e-cigs exposure on various organ systems. The summarized data in this review indicate that while e-cigs use causes less adverse effects on different organs compared to traditional cigs, its long-term exposure may lead to serious health effects. Data on short-term organ effects are limited and there is no sufficient evidence on long-term organ effects. Moreover, the adverse effects of secondhand and third hand e-cigs vapour exposure have not been thoroughly investigated in previous studies. Although some studies demonstrated e-cigs used as a smoking cessation tool, there is a lack of strong evidence to support it. While some researchers suggested e-cigs as a safer alternative to tobacco smoking, their long-term exposure health effects remain largely unknown. Therefore, more epidemiological and prospective studies including mechanistic studies are needed to address the potential adverse health effects of e-cigs to draw a firm conclusion about their safe use. A wide variation in e-cigs products and the lack of standardized testing methods are the major barriers to evaluating the existing data. Specific regulatory guidelines for both e-cigs components and the manufacturing process may be effective to protect consumer health., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)
- Published
- 2023
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8. Enduring undetectable MRD and updated outcomes in relapsed/refractory CLL after fixed-duration venetoclax-rituximab.
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Seymour JF, Kipps TJ, Eichhorst BF, D'Rozario J, Owen CJ, Assouline S, Lamanna N, Robak T, de la Serna J, Jaeger U, Cartron G, Montillo M, Mellink C, Chyla B, Panchal A, Lu T, Wu JQ, Jiang Y, Lefebure M, Boyer M, and Kater AP
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- Antineoplastic Combined Chemotherapy Protocols adverse effects, Bendamustine Hydrochloride adverse effects, Bridged Bicyclo Compounds, Heterocyclic adverse effects, Humans, Neoplasm, Residual drug therapy, Neoplasm, Residual etiology, Recurrence, Rituximab adverse effects, Sulfonamides, Leukemia, Lymphocytic, Chronic, B-Cell
- Abstract
The MURANO trial (A Study to Evaluate the Benefit of Venetoclax Plus Rituximab Compared With Bendamustine Plus Rituximab in Participants With Relapsed or Refractory Chronic Lymphocytic Leukemia [CLL]; ClinicalTrials.gov identifier #NCT02005471) reported superior progression-free survival (PFS) and overall survival (OS) with venetoclax-rituximab (VenR) vs bendamustine-rituximab (BR) in relapsed/refractory (R/R) CLL. Patients were randomized to 2 years of VenR (n = 194; rituximab for the first 6 months) or 6 months of BR (n = 195). Although undetectable minimal residual disease (uMRD) was achieved more often with VenR, the long-term implications of uMRD with this fixed-duration, chemotherapy-free regimen have not been explored. We report MRD kinetics and updated outcomes with 5 years' follow-up. Survival benefits with VenR vs BR were sustained (median PFS [95% confidence interval]: 53.6 [48.4, 57.0] vs 17.0 [15.5, 21.7] months, respectively, P < .0001; 5-year OS [95% confidence interval]: 82.1% [76.4, 87.8] vs 62.2% [54.8, 69.6], P < .0001). VenR was superior to BR, regardless of cytogenetic category. VenR-treated patients with uMRD at end of treatment (EOT; n = 83) had superior OS vs those with high-MRD+ (n = 12): 3-year post-EOT survival rates were 95.3% vs 72.9% (P = .039). In those with uMRD at EOT, median time to MRD conversion was 19.4 months. Of 47 patients with documented MRD conversion, 19 developed progressive disease (PD); median time from conversion to PD was 25.2 months. A population-based logistic growth model indicated slower MRD median doubling time post-EOT with VenR (93 days) vs BR (53 days; P = 1.2 × 10-7). No new safety signals were identified. Sustained survival, uMRD benefits, and durable responses support 2-year fixed-duration VenR treatment in R/R CLL., (© 2022 by The American Society of Hematology.)
- Published
- 2022
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9. Oocyte vitrification for elective fertility preservation: a SWOT analysis.
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Gil-Arribas E, Blockeel C, Pennings G, Nekkebroeck J, Velasco JAG, Serna J, and De Vos M
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- Cryopreservation methods, Female, Fertility, Humans, Oocytes, Fertility Preservation methods, Vitrification
- Abstract
Oocyte vitrification, also known as egg freezing, is increasingly being used by women as a precautionary measure against the anticipated decline in fertility. In countries where this procedure is allowed, elective oocyte vitrification has become an integral part of the treatment portfolio of fertility clinics. The widespread tendency towards the postponement of motherhood and the advances in laboratory technologies are encouraging women to consider oocyte vitrification and, by doing so, increase their reproductive autonomy. However, elective oocyte vitrification, or elective egg freezing (EEF), still elicits controversy, not only when EEF is appraised from a cost-efficiency point of view, but also in terms of medical and ethical concerns. In general, although the laboratory tool of vitrification has revolutionized the treatment of infertility, the pros and cons need to be clarified when considering EEF., (Copyright © 2022 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2022
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10. B-cell acute lymphoblastic leukemia in patients with chronic lymphocytic leukemia treated with lenalidomide.
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Fürstenau M, Fink AM, Schilhabel A, Weiss J, Robrecht S, Eckert R, de la Serna J, Crespo M, Coscia M, Vitale C, Böttcher S, Weppner G, Ritgen M, Stilgenbauer S, Tausch E, Fischer K, Hallek M, Eichhorst B, Brüggemann M, and Herling CD
- Subjects
- B-Lymphocytes drug effects, B-Lymphocytes pathology, Female, Humans, Immunologic Factors adverse effects, Incidence, Lenalidomide adverse effects, Leukemia, Lymphocytic, Chronic, B-Cell pathology, Male, Precursor Cell Lymphoblastic Leukemia-Lymphoma pathology, Risk Factors, Immunologic Factors therapeutic use, Lenalidomide therapeutic use, Leukemia, Lymphocytic, Chronic, B-Cell complications, Leukemia, Lymphocytic, Chronic, B-Cell drug therapy, Precursor Cell Lymphoblastic Leukemia-Lymphoma etiology
- Published
- 2021
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11. [Diagnosis of a late-onset congenital diaphragmatic hernia using bedside ultrasound].
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Oulego-Erroz I, Pradillos-Serna J, and Ardela-Díaz E
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- Humans, Infant, Ultrasonography, Hernias, Diaphragmatic, Congenital diagnostic imaging
- Published
- 2021
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12. Chemical compounds causing severe acute toxicity in heavy liquids used for intraocular surgery.
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Srivastava GK, Andrés-Iglesias C, Coco RM, Fernandez-Bueno I, Medina J, García-Serna J, Dueñas A, Rull F, and Pastor JC
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- Cell Line, Epithelial Cells drug effects, Humans, Retina cytology, Drug Contamination, Fluorocarbons toxicity, Ophthalmologic Surgical Procedures, Trialkyltin Compounds toxicity
- Abstract
Perfluorocarbon liquids (PFCLs) have been considered safe for intraocular manipulation of the retina, but since 2013 many cases of acute eye toxicity cousing blindness have been reported in various countries when using various commercial PFCLs. All these PFCLs were CE marked (Conformité Européenne), which meant they had been subjected to evaluation complying with the International Organization for Standardization (ISO) guidelines. These dramatic events raised questions about the safety of PFCLs and the validity of some cytotoxicity tests performed under ISO guidelines. Samples from toxic batches were analyzed by gas chromatography-mass spectrometry combined with Raman and infrared spectrometry. Perfluorooctanoic acid, dodecafluoro-1-heptanol, ethylbenzene and tributyltin bromide were identified and evaluated by a direct contact cytotoxicity test using ARPE-19 cell line, patented by our group (EP 3467118 A1). Perfluorooctanoic acid at a concentration of >0.06 mM and tributyltin bromide at a concentration of ≥0.016 mM were shown to be toxic, whereas the concentration found in the toxic samples reached 0.48 mM, and 0.111 mM, respectively. These finding emphasized the idea that determination of partially fluorinated compounds are not enough to guarantee the safety of these medical devices., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2020
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13. Significance of Aspergillus niger aggregate species as contaminants of food products in Spain regarding their occurrence and their ability to produce mycotoxins.
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Gil-Serna J, García-Díaz M, Vázquez C, González-Jaén MT, and Patiño B
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- Aspergillus classification, Aspergillus genetics, Aspergillus niger classification, Aspergillus niger genetics, Aspergillus niger isolation & purification, Aspergillus niger metabolism, DNA, Fungal genetics, Food Contamination analysis, Fumonisins metabolism, Gene Expression, Genome, Fungal genetics, Multigene Family, Mycotoxins genetics, Ochratoxins metabolism, Phylogeny, Sequence Analysis, DNA, Spain, Aspergillus isolation & purification, Aspergillus metabolism, Food Microbiology, Mycotoxins metabolism
- Abstract
The Aspergillus niger aggregate contains 15 morphologically indistinguishable species which presence is related to ochratoxin A (OTA) and fumonisin B
2 (FB2 ) contamination of foodstuffs. The taxonomy of this group was recently reevaluated and there is a need of new studies regarding the risk that these species might pose to food security. 258 isolates of A. niger aggregate obtained from a variety of products from Spain were classified by molecular methods being A. tubingensis the most frequently occurring (67.5%) followed by A. welwitschiae (19.4%) and A. niger (11.7%). Their potential ability to produce mycotoxins was evaluated by PCR protocols which allow a rapid detection of OTA and FB2 biosynthetic genes in their genomes. OTA production is not widespread in A. niger aggregate since only 17% of A. niger and 6% of A. welwitschiae isolates presented the complete biosynthetic cluster whereas the lack of the cluster was confirmed in all A. tubingensis isolates. On the other hand, A. niger and A. welwitschiae seem to be important FB2 producers with 97% and 29% of the isolates, respectively, presenting the complete cluster. The genes involved in OTA and FB2 were overexpressed in producing isolates and their expression was related to mycotoxin synthesis., (Copyright © 2019 Elsevier Ltd. All rights reserved.)- Published
- 2019
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14. Prevalence of wild type ATTR assessed as myocardial uptake in bone scan in the elderly population.
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Mohamed-Salem L, Santos-Mateo JJ, Sanchez-Serna J, Hernández-Vicente Á, Reyes-Marle R, Castellón Sánchez MI, Claver-Valderas MA, Gonzalez-Vioque E, Haro-Del Moral FJ, García-Pavía P, and Pascual-Figal DA
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- Aged, Aged, 80 and over, Bone Density physiology, Female, Follow-Up Studies, Humans, Male, Prevalence, Retrospective Studies, Amyloid Neuropathies, Familial diagnostic imaging, Amyloid Neuropathies, Familial epidemiology, Heart diagnostic imaging, Population Surveillance, Radionuclide Imaging methods, Radiopharmaceuticals
- Abstract
Background: Myocardial uptake of bone tracers has emerged as useful tool for the early detection of transthyretin amyloidosis (ATTR). The prevalence of wild-type ATTR (ATTRwt) in individuals remains to be established., Methods: All whole body bone scans performed in individuals ≥ 75 years with no previous clinical suspicion of ATTR were revised in a population-based university hospital over a 7-year period (1509 studies corresponding to 1114 patients; 80.5 ± 4.1 years, 65% males). Positive cardiac uptake was defined according to Perugini score as grade 2 or 3. Heart failure (HF) hospitalizations during the follow-up were obtained from regional administrative databases., Results: Thirty-one patients ≥ 75 years (2.78%) showed cardiac uptake; compared with those without uptake, these patients were older (85 ± 5 vs. 80 ± 4, p < 0.001) and predominantly males (90% vs. 64%, p = 0.005). The prevalence of cardiac uptake was 3.88% in males and 0.77% in females, and increased with age, reaching 13.9% in males≥85 years (2.7% among females). The estimated prevalence for the European standard population ≥ 75 years was 4.15% in males, 1.03% in females and 2.59% in the general population. HF hospitalizations rates were 14% in patients without uptake and 29% in those with cardiac uptake (p = 0.034). After adjusting for age and gender, cardiac uptake was associated with a higher risk of HF hospitalization (OR 2.60, 95%CI 1.09-5.74, p = 0.022)., Conclusions: Myocardial uptake in bone scan is very prevalent with ageing, mainly affects males and is associated with an increased risk of HF hospitalization. These findings reinforce ATTRwt as a relevant cause of HF in the elderly., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2018
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15. Ellagic acid protects from myelin-associated sphingolipid loss in experimental autoimmune encephalomyelitis.
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Busto R, Serna J, Perianes-Cachero A, Quintana-Portillo R, García-Seisdedos D, Canfrán-Duque A, Paino CL, Lerma M, Casado ME, Martín-Hidalgo A, Arilla-Ferreiro E, Lasunción MA, and Pastor Ó
- Subjects
- Animals, Cell Line, Tumor, Ceramides biosynthesis, Cerebral Cortex drug effects, Cerebral Cortex metabolism, Cerebral Cortex pathology, Coumarins metabolism, Coumarins pharmacology, Encephalomyelitis, Autoimmune, Experimental metabolism, Encephalomyelitis, Autoimmune, Experimental pathology, Female, Freund's Adjuvant administration & dosage, Gene Expression, Guinea Pigs, Mycobacterium tuberculosis chemistry, Myelin Basic Protein agonists, Myelin Basic Protein genetics, Myelin Basic Protein metabolism, Myelin Sheath metabolism, Myelin Sheath pathology, Neuroglia drug effects, Neuroglia metabolism, Neuroglia pathology, Oligodendroglia drug effects, Oligodendroglia metabolism, Oligodendroglia pathology, Rats, Rats, Inbred Lew, Spinal Cord drug effects, Spinal Cord metabolism, Spinal Cord pathology, Anti-Inflammatory Agents pharmacology, Ceramides agonists, Ellagic Acid pharmacology, Encephalomyelitis, Autoimmune, Experimental drug therapy, Myelin Sheath drug effects, Neuroprotective Agents pharmacology
- Abstract
Experimental autoimmune encephalomyelitis (EAE), the most common model for multiple sclerosis, is characterized by inflammatory cell infiltration into the central nervous system and demyelination. Previous studies have demonstrated that administration of some polyphenols may reduce the neurological alterations of EAE. In this work, we show that ellagic acid, a polyphenolic compound, is beneficial in EAE, most likely through stimulation of ceramide biosynthesis within the brain. EAE was induced in Lewis rats by injection of guinea-pig spinal cord tissue along with Freund's complete adjuvant containing Mycobacterium tuberculosis. Clinical signs first appeared at day 8 post-immunization and reached a peak within 3 days, coincident with reduction of myelin basic protein (MBP) in the cortex. Sphingolipids, the other major components of myelin, also decreased at the acute phase of EAE, both in the cerebral cortex and in the spinal cord. In rats receiving ellagic acid in the drinking water from 2 days before immunization, the onset of the disease was delayed and clinical signs were reduced. This amelioration of clinical signs was accompanied by sustained levels of both MBP and sphingolipid in the cortex, without apparent changes in infiltration of inflammatory CD3+ T-cells, microglial activation, or weight loss, which together suggest a neuroprotective effect of ellagic acid. Finally, in glioma and oligodendroglioma cells we demonstrate that urolithins, the ellagic acid metabolites that circulate in plasma, stimulate the synthesis of ceramide. Together these data suggest that ellagic acid consumption protects against demyelination in rats with induced EAE, likely by a mechanism involving sphingolipid synthesis., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2018
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16. Aspergillus steynii and Aspergillus westerdijkiae as potential risk of OTA contamination in food products in warm climates.
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Gil-Serna J, Patiño B, Cortes L, Gonzalez-Jaen MT, and Vazquez C
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- Aspergillus classification, Aspergillus growth & development, Aspergillus isolation & purification, Climate, Culture Media metabolism, Spores, Fungal classification, Spores, Fungal growth & development, Spores, Fungal isolation & purification, Spores, Fungal metabolism, Aspergillus metabolism, Food Contamination analysis, Food Microbiology, Ochratoxins metabolism
- Abstract
Aspergillus steynii and Aspergillus westerdijkiae are the main ochratoxin A (OTA) producing species of Aspergillus section Circumdati. Due to its recent description, few data are available about the influence of ecophysiological factors on their growth and OTA production profiles. In this work, the effect of temperature (20, 24 and 28 °C) and water activity (aw) (0.928, 0.964 and 0.995) on growth, sporulation and OTA production by these fungi was examined in CYA and media prepared from paprika, green coffee, anise, grapes, maize and barley. Growth was positively affected by the highest temperature and aw values indicating that both species might be expected in warm climates or storage conditions. However, optimal growth conditions showed differences depending on the medium. OTA production was markedly affected by substrate and showed qualitative and quantitative differences. Both species, especially A. steynii, represent a great potential risk of OTA contamination due to their high production in a variety of conditions and substrates, in particular in barley and paprika-based media. Additionally, neither growth nor sporulation did result good indicators of OTA production by A. steynii or A. westerdijkiae; therefore, specific and highly-sensitive detection methods become essential tools for control strategies to reduce OTA risk by these species., (Copyright © 2014 Elsevier Ltd. All rights reserved.)
- Published
- 2015
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17. Clinical Utility of the Collect Scale To Assess Comorbidities In Patients With Chronic Lymphocytic Leukemia.
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De LS, Carbonell F, Giraldo P, Lopez A, González I, García C, Orofino J, Roset M, Perulero N, and Rios E
- Published
- 2014
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18. Health outcomes of children born after IVF/ICSI: a review of current expert opinion and literature.
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Fauser BC, Devroey P, Diedrich K, Balaban B, Bonduelle M, Delemarre-van de Waal HA, Estella C, Ezcurra D, Geraedts JP, Howles CM, Lerner-Geva L, Serna J, and Wells D
- Subjects
- Child, Female, Fertilization in Vitro adverse effects, Humans, Incidence, Oocytes cytology, Pregnancy, Sperm Injections, Intracytoplasmic adverse effects, Child Development physiology, Congenital Abnormalities epidemiology, Fertilization in Vitro statistics & numerical data, Genetic Diseases, Inborn epidemiology, Infertility therapy, Sperm Injections, Intracytoplasmic statistics & numerical data
- Abstract
The Sixth Evian Annual Reproduction (EVAR) Workshop Group Meeting was held to evaluate the impact of IVF/intracytoplasmic sperm injection on the health of assisted-conception children. Epidemiologists, reproductive endocrinologists, embryologists and geneticists presented data from published literature and ongoing research on the incidence of genetic and epigenetic abnormalities and congenital malformations in assisted-conception versus naturally conceived children to reach a consensus on the reasons for potential differences in outcomes between these two groups. IVF-conceived children have lower birthweights and higher peripheral fat, blood pressure and fasting glucose concentrations than controls. Growth, development and cognitive function in assisted-conception children are similar to controls. The absolute risk of imprinting disorders after assisted reproduction is less than 1%. A direct link between assisted reproduction and health-related outcomes in assisted-conception children could not be established. Women undergoing assisted reproduction are often older, increasing the chances of obtaining abnormal gametes that may cause deviations in outcomes between assisted-conception and naturally conceived children. However, after taking into account these factors, it is not clear to what extent poorer outcomes are due to the assisted reproduction procedures themselves. Large-scale, multicentre, prospective epidemiological studies are needed to investigate this further and to confirm long-term health consequences in assisted-conception children. Assisted reproduction treatment is a general term used to describe methods of achieving pregnancy by artificial means and includes IVF and sperm implantation. The effect of assisted reproduction treatment on the health of children born using these artificial methods is not fully understood. In April 2011, fertility research experts met to give presentations based on research in this area and to look carefully at the evidence for the effects of assisted reproduction treatment on children's health. The purpose of this review was to reach an agreement on whether there are differences in the health of assisted-conception children with naturally conceived children. The researchers discovered no increased risk in birth defects in assisted-conception children compared with naturally conceived children. They found that IVF-conceived children have lower birth weights and higher fat under the skin, higher blood pressure and higher fasting glucose concentrations than naturally conceived children; however, growth, development and cognitive function are similar between groups. A very low risk of disorders of genetic control was observed in assisted-conception children. Overall, there did not appear to be a direct link between assisted reproduction treatment and children's health. The researchers concluded that the cause of some differences in the health of children conceived using assisted reproduction treatment may be due to the age of the woman receiving treatment. Large-scale, research studies are needed to study the long-term health of children conceived using assisted reproduction treatment., (Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2014
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19. Clinical significance of CD56 expression in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline-based regimens.
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Montesinos P, Rayón C, Vellenga E, Brunet S, González J, González M, Holowiecka A, Esteve J, Bergua J, González JD, Rivas C, Tormo M, Rubio V, Bueno J, Manso F, Milone G, de la Serna J, Pérez I, Pérez-Encinas M, Krsnik I, Ribera JM, Escoda L, Lowenberg B, and Sanz MA
- Subjects
- Adolescent, Adult, Anthracyclines administration & dosage, Female, Humans, Leukemia, Promyelocytic, Acute blood, Male, Middle Aged, Prognosis, Recurrence, Risk Factors, Tretinoin administration & dosage, Young Adult, Antineoplastic Combined Chemotherapy Protocols therapeutic use, CD56 Antigen blood, Leukemia, Promyelocytic, Acute drug therapy, Leukemia, Promyelocytic, Acute immunology
- Abstract
The expression of CD56 antigen in acute promyelocytic leukemia (APL) blasts has been associated with short remission duration and extramedullary relapse. We investigated the clinical significance of CD56 expression in a large series of patients with APL treated with all-trans retinoic acid and anthracycline-based regimens. Between 1996 and 2009, 651 APL patients with available data on CD56 expression were included in 3 subsequent trials (PETHEMA LPA96 and LPA99 and PETHEMA/HOVON LPA2005). Seventy-two patients (11%) were CD56(+) (expression of CD56 in ≥ 20% leukemic promyelocytes). CD56(+) APL was significantly associated with high white blood cell counts; low albumin levels; BCR3 isoform; and the coexpression of CD2, CD34, CD7, HLA-DR, CD15, and CD117 antigens. For CD56(+) APL, the 5-year relapse rate was 22%, compared with a 10% relapse rate for CD56(-) APL (P = .006). In the multivariate analysis, CD56 expression retained the statistical significance together with the relapse-risk score. CD56(+) APL also showed a greater risk of extramedullary relapse (P < .001). In summary, CD56 expression is associated with the coexpression of immaturity-associated and T-cell antigens and is an independent adverse prognostic factor for relapse in patients with APL treated with all-trans-retinoic acid plus idarubicin-derived regimens. This marker may be considered for implementing risk-adapted therapeutic strategies in APL. The LPA2005 trial is registered at http://www.clinicaltrials.gov as NCT00408278.
- Published
- 2011
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20. Does microgranular variant morphology of acute promyelocytic leukemia independently predict a less favorable outcome compared with classical M3 APL? A joint study of the North American Intergroup and the PETHEMA Group.
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Tallman MS, Kim HT, Montesinos P, Appelbaum FR, de la Serna J, Bennett JM, Deben G, Bloomfield CD, Gonzalez J, Feusner JH, Gonzalez M, Gallagher R, Miguel JD, Larson RA, Milone G, Paietta E, Rayon C, Rowe JM, Rivas C, Schiffer CA, Vellenga E, Shepherd L, Slack JL, Wiernik PH, Willman CL, and Sanz MA
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Cytarabine administration & dosage, Daunorubicin administration & dosage, Female, Follow-Up Studies, Humans, Infant, Leukemia, Promyelocytic, Acute classification, Male, Middle Aged, Remission Induction, Survival Rate, Treatment Outcome, Tretinoin administration & dosage, Young Adult, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Leukemia, Promyelocytic, Acute drug therapy, Leukemia, Promyelocytic, Acute pathology, Neoplasm Recurrence, Local drug therapy, Neoplasm Recurrence, Local pathology
- Abstract
Few studies have examined the outcome of large numbers of patients with the microgranular variant (M3V) of acute promyelocytic leukemia (APL) in the all-trans retinoic acid era. Here, the outcome of 155 patients treated with all-trans retinoic acid-based therapy on 3 clinical trials, North American Intergroup protocol I0129 and Programa para el Estudio de la Terapéutica en Hemopatía Maligna protocols LPA96 and LPA99, are reported. The complete remission rate for all 155 patients was 82%, compared with 89% for 748 patients with classical M3 disease. The incidence of the APL differentiation syndrome was 26%, compared with 25% for classical M3 patients, and the early death rate was 13.6% compared with 8.4% for patients with classical M3 morphology. With a median follow-up time among survivors of 7.6 years (range 3.6-14.5), the 5-year overall survival, disease-free survival, and cumulative incidence of relapse for patients with M3V were 70%, 73%, and 24%, respectively. With a median follow-up time among survivors of 7.6 years (range 0.6-14.3), the 5-year overall survival, disease-free survival, and cumulative incidence of relapse among patients with classical M3 morphology were 80% (P = .006 compared with M3V), 81% (P = .07), and 15% (P = .005), respectively. When outcomes were adjusted for the white blood cell count or the relapse risk score, none of these outcomes were significantly different between patients with M3V and classical M3 APL.
- Published
- 2010
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21. Risk-adapted treatment of acute promyelocytic leukemia based on all-trans retinoic acid and anthracycline with addition of cytarabine in consolidation therapy for high-risk patients: further improvements in treatment outcome.
- Author
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Sanz MA, Montesinos P, Rayón C, Holowiecka A, de la Serna J, Milone G, de Lisa E, Brunet S, Rubio V, Ribera JM, Rivas C, Krsnik I, Bergua J, González J, Díaz-Mediavilla J, Rojas R, Manso F, Ossenkoppele G, González JD, and Lowenberg B
- Subjects
- Adolescent, Adult, Aged, Anthracyclines administration & dosage, Anthracyclines adverse effects, Antineoplastic Combined Chemotherapy Protocols adverse effects, Cytarabine administration & dosage, Cytarabine adverse effects, Disease-Free Survival, Female, Humans, Male, Middle Aged, Risk Adjustment, Risk Factors, Survival Rate, Tretinoin administration & dosage, Tretinoin adverse effects, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Leukemia, Myeloid, Acute drug therapy, Leukemia, Myeloid, Acute mortality
- Abstract
A risk-adapted strategy based on all-trans retinoic acid (ATRA) and anthracycline monochemotherapy (PETHEMA LPA99 trial) has demonstrated a high antileukemic efficacy in acute promyelocytic leukemia. We designed a new trial (LPA2005) with the objective of achieving stepwise improvements in outcome. Between July 2005 and April 2009, low- and intermediate-risk patients (leukocytes < 10 x 10(9)/L) received a reduced dose of mitoxantrone for the second consolidation course, whereas high- risk patients younger than 60 years of age received cytarabine combined with ATRA and idarubicin in the first and third consolidation courses. Of 372 patients attaining complete remission after ATRA plus idarubicin (92.5%), 368 proceeded to consolidation therapy. For low- and intermediate-risk patients, duration of neutropenia and thrombocytopenia and hospital stay were significantly reduced without sacrificing antileukemic efficacy, compared with the previous LPA99 trial. For high-risk patients, the 3-year relapse rate was significantly lower in the LPA2005 trial (11%) than in the LPA99 (26%; P = .03). Overall disease-free survival was also better in the LPA2005 trial (P = .04). In conclusion, the lower dose of mitoxantrone resulted in a significant reduction of toxicity and hospital stay while maintaining the antileukemic activity, and the combination of ATRA, idarubicin, and cytarabine for high-risk acute promyelocytic leukemia significantly reduced the relapse rate in this setting. Registered at http://www.clinicaltrials.gov as NCT00408278.
- Published
- 2010
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22. Differentiation syndrome in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline chemotherapy: characteristics, outcome, and prognostic factors.
- Author
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Montesinos P, Bergua JM, Vellenga E, Rayón C, Parody R, de la Serna J, León A, Esteve J, Milone G, Debén G, Rivas C, González M, Tormo M, Díaz-Mediavilla J, González JD, Negri S, Amutio E, Brunet S, Lowenberg B, and Sanz MA
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Disease-Free Survival, Drug Therapy, Combination, Female, Humans, Leukemia, Promyelocytic, Acute complications, Male, Middle Aged, Prognosis, Recurrence, Risk Factors, Syndrome, Time Factors, Anthracyclines therapeutic use, Leukemia, Promyelocytic, Acute drug therapy, Leukemia, Promyelocytic, Acute pathology, Tretinoin therapeutic use
- Abstract
Differentiation syndrome (DS) can be a life-threatening complication in patients with acute promyelocytic leukemia (APL) undergoing induction therapy with all-trans retinoic acid (ATRA). Detailed knowledge about DS has remained limited. We present an analysis of the incidence, characteristics, prognostic factors, and outcome of 739 APL patients treated with ATRA plus idarubicin in 2 consecutive trials (Programa Español de Tratamientos en Hematología [PETHEMA] LPA96 and LPA99). Overall, 183 patients (24.8%) experienced DS, 93 with a severe form (12.6%) and 90 with a moderate form (12.2%). Severe but not moderate DS was associated with an increase in mortality. A bimodal incidence of DS was observed, with peaks occurring in the first and third weeks after the start of ATRA therapy. A multivariate analysis indicated that a WBC count greater than 5 x 10(9)/L and an abnormal serum creatinine level correlated with an increased risk of developing severe DS. Patients receiving systematic prednisone prophylaxis (LPA99 trial) in contrast to those receiving selective prophylaxis with dexamethasone (LPA96 trial) had a lower incidence of severe DS. Patients developing severe DS showed a reduced 7-year relapse-free survival in the LPA96 trial (60% vs 85%, P = .003), but this difference was not apparent in the LPA99 trial (86% vs 88%).
- Published
- 2009
- Full Text
- View/download PDF
23. Risk-adapted treatment of acute promyelocytic leukemia with all-trans retinoic acid and anthracycline monochemotherapy: long-term outcome of the LPA 99 multicenter study by the PETHEMA Group.
- Author
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Sanz MA, Montesinos P, Vellenga E, Rayón C, de la Serna J, Parody R, Bergua JM, León A, Negri S, González M, Rivas C, Esteve J, Milone G, González JD, Amutio E, Brunet S, García-Laraña J, Colomer D, Calasanz MJ, Chillón C, Barragán E, Bolufer P, and Lowenberg B
- Subjects
- Adolescent, Adult, Aged, Cohort Studies, Disease-Free Survival, Female, Humans, Male, Middle Aged, Recurrence, Treatment Outcome, Anthracyclines therapeutic use, Antineoplastic Agents therapeutic use, Leukemia, Promyelocytic, Acute drug therapy, Tretinoin therapeutic use
- Abstract
A previous report of the Programa de Estudio y Tratamiento de las Hemopatías Malignas (PETHEMA) Group showed that a risk-adapted strategy combining all-trans retinoic acid (ATRA) and anthracycline monochemotherapy for induction and consolidation in newly diagnosed acute promyelocytic leukemia results in an improved outcome. Here we analyze treatment outcome of an enlarged series of patients who have been followed up for a median of 65 months. From November 1999 through July 2005 (LPA99 trial), 560 patients received induction therapy with ATRA plus idarubicin. Patients achieving complete remission received 3 courses of consolidation followed by maintenance with ATRA and low-dose chemotherapy. The 5-year cumulative incidence of relapse and disease-free survival were 11% and 84%, respectively. These results compare favorably with those obtained in the previous LPA96 study (P = .019 and P = .04, respectively). This updated analysis confirms the high antileukemic efficacy, low toxicity, and high degree of compliance of a risk-adapted strategy combining ATRA and anthracycline monochemotherapy for consolidation therapy.
- Published
- 2008
- Full Text
- View/download PDF
24. Causes and prognostic factors of remission induction failure in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and idarubicin.
- Author
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de la Serna J, Montesinos P, Vellenga E, Rayón C, Parody R, León A, Esteve J, Bergua JM, Milone G, Debén G, Rivas C, González M, Tormo M, Díaz-Mediavilla J, González JD, Negri S, Amutio E, Brunet S, Lowenberg B, and Sanz MA
- Subjects
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Blast Crisis blood, Blast Crisis drug therapy, Blast Crisis mortality, Child, Child, Preschool, Creatinine blood, Disease-Free Survival, Female, Hemorrhage blood, Hemorrhage chemically induced, Humans, Idarubicin administration & dosage, Idarubicin adverse effects, Infections blood, Infections etiology, Leukemia, Promyelocytic, Acute blood, Leukemia, Promyelocytic, Acute drug therapy, Male, Middle Aged, Remission Induction, Risk Factors, Sex Factors, Survival Rate, Syndrome, Treatment Failure, Tretinoin administration & dosage, Tretinoin adverse effects, Antineoplastic Combined Chemotherapy Protocols adverse effects, Hemorrhage mortality, Infections mortality, Leukemia, Promyelocytic, Acute mortality
- Abstract
An understanding of the prognostic factors associated with the various forms of induction mortality in patients with acute promyelocytic leukemia (APL) has remained remarkably limited. This study reports the incidence, time of occurrence, and prognostic factors of the major categories of induction failure in a series of 732 patients of all ages (range, 2-83 years) with newly diagnosed APL who received all-trans retinoic acid (ATRA) plus idarubicin as induction therapy in 2 consecutive studies of the Programa de Estudio y Tratamiento de las Hemopatias Malignas (PETHEMA) Group. Complete remission was attained in 666 patients (91%). All the 66 induction failures were due to induction death. Hemorrhage was the most common cause of induction death (5%), followed by infection (2.3%) and differentiation syndrome (1.4%). Multivariate analysis identified specific and distinct pretreatment characteristics to correlate with an increased risk of death caused by hemorrhage (abnormal creatinine level, increased peripheral blast counts, and presence of coagulopathy), infection (age>60 years, male sex, and fever at presentation), and differentiation syndrome (Eastern Cooperative Oncology Group [ECOG] score>1 and low albumin levels), respectively. These data furnish clinically relevant information that might be useful for designing more appropriately risk-adapted treatment protocols aimed at reducing the considerable problem of induction mortality in APL.
- Published
- 2008
- Full Text
- View/download PDF
25. Treatment of newly diagnosed acute promyelocytic leukemia (APL): a comparison of French-Belgian-Swiss and PETHEMA results.
- Author
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Adès L, Sanz MA, Chevret S, Montesinos P, Chevallier P, Raffoux E, Vellenga E, Guerci A, Pigneux A, Huguet F, Rayon C, Stoppa AM, de la Serna J, Cahn JY, Meyer-Monard S, Pabst T, Thomas X, de Botton S, Parody R, Bergua J, Lamy T, Vekhoff A, Negri S, Ifrah N, Dombret H, Ferrant A, Bron D, Degos L, and Fenaux P
- Subjects
- Adult, Clinical Trials as Topic, Female, Humans, Male, Middle Aged, Risk Factors, Treatment Outcome, Leukemia, Promyelocytic, Acute diagnosis, Leukemia, Promyelocytic, Acute drug therapy
- Abstract
All-trans retinoic acid (ATRA) plus anthracycline chemotherapy is the reference treatment of newly diagnosed acute promyelocytic leukemia (APL), whereas the role of cytosine arabinoside (AraC) remains disputed. We performed a joint analysis of patients younger than 65 years included in Programa para el Estudio de la Terapéutica en Hemopatía Maligna (PETHEMA) LPA 99 trial, where patients received no AraC in addition to ATRA, high cumulative dose idarubicin, and mitoxantrone, and APL 2000 trial, where patients received AraC in addition to ATRA and lower cumulative dose daunorubicin. In patients with white blood cell (WBC) count less than 10 x 10(9)/L, complete remission (CR) rates were similar, but 3-year cumulative incidence of relapse (CIR) was significantly lower in LPA 99 trial: 4.2% versus 14.3% (P = .03), although 3-year survival was similar in both trials. This suggested that AraC is not required in APL with WBC count less than 10 x 10(9)/L, at least in trials with high-dose anthracycline and maintenance treatment. In patients with WBC of 10 x 10(9)/L or more, however, the CR rate (95.1% vs 83.6% P = .018) and 3-year survival (91.5% vs 80.8%, P = .026) were significantly higher in APL 2000 trial, and there was a trend for lower 3-year CIR (9.9% vs 18.5%, P = .12), suggesting a beneficial role for AraC in those patients.
- Published
- 2008
- Full Text
- View/download PDF
26. All-trans retinoic acid and anthracycline monochemotherapy for the treatment of elderly patients with acute promyelocytic leukemia.
- Author
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Sanz MA, Vellenga E, Rayón C, Díaz-Mediavilla J, Rivas C, Amutio E, Arias J, Debén G, Novo A, Bergua J, de la Serna J, Bueno J, Negri S, Beltrán de Heredia JM, and Martín G
- Subjects
- Aged, Aged, 80 and over, Anthracyclines administration & dosage, Antineoplastic Combined Chemotherapy Protocols toxicity, Female, Humans, Idarubicin administration & dosage, Leukemia, Promyelocytic, Acute mortality, Male, Middle Aged, Patient Compliance, Recurrence, Remission Induction, Sex Factors, Survival Analysis, Tretinoin administration & dosage, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Leukemia, Promyelocytic, Acute drug therapy
- Abstract
Therapeutic results in elderly patients with acute promyelocytic leukemia (APL) have been generally reported as less effective than for younger patients. Patients 60 years or older with APL who were enrolled in 2 successive multicenter PETHEMA studies received induction therapy with all-trans retinoic acid (ATRA) and idarubicin, consolidation with 3 anthracycline monochemotherapy courses with or without ATRA, and maintenance with ATRA and low-dose chemotherapy. Eighty-seven of 104 patients achieved complete remission (84%). Eighty-six proceeded to consolidation therapy (2 withdrew after the first and second courses). Deaths in remission occurred during consolidation and maintenance therapy in 3 and 4 patients, respectively. One patient showed molecular persistence after consolidation and 5 had a relapse. The 6-year cumulative incidence of relapse, leukemia-free survival, and disease-free survival were 8.5%, 91%, and 79%, respectively. A significantly higher incidence of low-risk patients found among the elderly, as compared to younger patients, may partially account for the low relapse rate observed. This study confirms the high antileukemic efficacy, low toxicity, and high degree of compliance of protocols using ATRA and anthracycline monochemotherapy for induction and consolidation therapy in elderly patients.
- Published
- 2004
- Full Text
- View/download PDF
27. A new system for localization of nonpalpable breast lesions with adhesive marker plate.
- Author
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Berná-Serna JD, Nieves J, Madrigal M, and Berná-Mestre JD
- Subjects
- Adult, Aged, Biopsy, Needle methods, Female, Humans, Middle Aged, Breast Neoplasms diagnostic imaging, Breast Neoplasms surgery, Mammography methods
- Abstract
The objective of this article is to present a new method of preoperative localization of nonpalpable breast lesions by means of an adhesive marker plate that makes an anteroposterior approach to the thoracic wall possible. Between January 2000 and September 2002, 41 consecutive mammographic localizations were performed with the adhesive marker plate. In most cases (n = 34) the lesions were microcalcifications. The mean age of the patients was 54.7 years. The device used consists of a square plate made of highly flexible plastic with an adhesive film on the back for firm attachment to the area of the breast surface corresponding to the approximate location of the lesion. This plate contains a network of holes and a system of radiopaque coordinates. The technique for its use is described step by step. All 41 lesions were localized: to within 5 mm or by transfixation of the lesion in 95.1% of cases (39/41) and to within 1 cm in the remaining 2 cases. Surgical excision of the breast lesions was carried out successfully in all cases, and in 56% (23/41) it was possible to use a periareolar incision. Histological findings revealed 24 benign and 17 malignant lesions. This new technique permits the localization of nonpalpable breast lesions accurately, simply, and with very little discomfort to the patient. The anteroposterior approach simplifies the surgeon's task in the management of these lesions.
- Published
- 2004
- Full Text
- View/download PDF
28. Risk-adapted treatment of acute promyelocytic leukemia with all-trans-retinoic acid and anthracycline monochemotherapy: a multicenter study by the PETHEMA group.
- Author
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Sanz MA, Martín G, González M, León A, Rayón C, Rivas C, Colomer D, Amutio E, Capote FJ, Milone GA, De La Serna J, Román J, Barragán E, Bergua J, Escoda L, Parody R, Negri S, Calasanz MJ, and Bolufer P
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Antibiotics, Antineoplastic adverse effects, Antineoplastic Agents adverse effects, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Antineoplastic Combined Chemotherapy Protocols adverse effects, Female, Humans, Idarubicin adverse effects, Incidence, Leukemia, Promyelocytic, Acute epidemiology, Male, Middle Aged, Recurrence, Remission Induction, Risk Factors, Tretinoin adverse effects, Antibiotics, Antineoplastic administration & dosage, Antineoplastic Agents administration & dosage, Idarubicin administration & dosage, Leukemia, Promyelocytic, Acute drug therapy, Tretinoin administration & dosage
- Abstract
All-trans-retinoic acid (ATRA) increases the efficacy of chemotherapy when used for induction and maintenance treatment of acute promyelocytic leukemia (APL), but its role in consolidation is unknown. Since November 1996, 426 patients with newly diagnosed APL have received induction therapy with ATRA and idarubicin. Before November 1999 (LPA96 study), consolidation therapy consisted of 3 courses of anthracycline monochemotherapy. After November 1999 (LPA99 study), patients with intermediate and high risks of relapse received consolidation therapy with ATRA and increased doses of anthracyclines. Of the 384 patients who achieved complete remission (90%), 382 proceeded to consolidation therapy. Seven patients died in remission (1.8%). The 3-year cumulative incidence of relapse for patients in the LPA96 and LPA99 studies was 17.2% and 7.5%, respectively (P =.008). Patients treated with ATRA in consolidation therapy showed an overall reduction in the relapse rate from 20.1% to 8.7% (P =.004). In intermediate-risk patients the rate decreased from 14.0% to 2.5% (P =.006). This improved antileukemic efficacy also translated into significantly better disease-free and overall survival. A risk-adapted strategy combining anthracycline monochemotherapy and ATRA for induction and consolidation therapy of newly diagnosed APL results in improved antileukemic efficacy and a high degree of compliance.
- Published
- 2004
- Full Text
- View/download PDF
29. Evidence of a high percentage of intersex in the Mediterranean swordfish (Xiphias gladius L.).
- Author
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De Metrio G, Corriero A, Desantis S, Zubani D, Cirillo F, Deflorio M, Bridges CR, Eicker J, de la Serna JM, Megalofonou P, and Kime DE
- Subjects
- Animals, Animals, Wild, Endocrine System drug effects, Estrogens, Female, Immunohistochemistry, Male, Oocytes, Testis abnormalities, Vitellogenins analysis, Disorders of Sex Development, Perciformes physiology, Water Pollutants adverse effects
- Abstract
The first evidence of the presence of intersexuality in a wild population of Mediterranean swordfish (Xiphias gladius L.) is reported. Forty of 162 specimens (25%) macroscopically classified as males, showed the presence of female germ cells within the testes. In two specimens grouped previtellogenic oocytes were present; all the other specimens possessed single scattered previtellogenic oocytes. The presence of vitellogenin was demonstrated immunohistochemically in the liver of both intersex and normal males. These findings could be due to the exposure to oestrogen-mimicking substances.
- Published
- 2003
- Full Text
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30. Incidence, clinical features, and outcome of all trans-retinoic acid syndrome in 413 cases of newly diagnosed acute promyelocytic leukemia. The European APL Group.
- Author
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De Botton S, Dombret H, Sanz M, Miguel JS, Caillot D, Zittoun R, Gardembas M, Stamatoulas A, Condé E, Guerci A, Gardin C, Geiser K, Makhoul DC, Reman O, de la Serna J, Lefrere F, Chomienne C, Chastang C, Degos L, and Fenaux P
- Subjects
- Acute Kidney Injury chemically induced, Adult, Aged, Antibiotics, Antineoplastic administration & dosage, Antineoplastic Agents therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Cardiovascular Diseases chemically induced, Cytarabine administration & dosage, Dexamethasone therapeutic use, Disease-Free Survival, Female, Humans, Incidence, Leukocyte Count drug effects, Life Tables, Male, Middle Aged, Pericardial Effusion chemically induced, Pleural Effusion chemically induced, Proportional Hazards Models, Remission Induction, Respiration Disorders chemically induced, Survival Rate, Syndrome, Treatment Outcome, Tretinoin therapeutic use, Antineoplastic Agents adverse effects, Leukemia, Promyelocytic, Acute drug therapy, Tretinoin adverse effects
- Abstract
All trans-retinoic acid (ATRA) syndrome is a life-threatening complication of uncertain pathogenesis that can occur during the treatment of acute promyelocytic leukemia (APL) by ATRA. Since its initial description, however, no large series of ATRA syndrome has been reported in detail. We analyzed cases of ATRA syndrome observed in an ongoing European trial of treatment of newly diagnosed APL. In this trial, patients 65 years of age or less with an initial white blood cell count (WBC) less than 5,000/microL were initially randomized between ATRA followed by chemotherapy (CT) (ATRA-->CT group) or ATRA with CT started on day 3; patients with WBC greater than 5,000/microL received ATRA and CT from day 1; patients aged 66 to 75 received ATRA-->CT. In patients with initial WBC less than 5, 000/microL and allocated to ATRA-->CT, CT was rapidly added if WBC was greater than 6,000, 10,000, 15,000/microL by days 5, 10, and 15 of ATRA treatment. A total of 64 (15%) of the 413 patients included in this trial experienced ATRA syndrome during induction treatment. Clinical signs developed after a median of 7 days (range, 0 to 35 days). In two of them, they were in fact present before the onset of ATRA. In 11 patients, they occurred upon recovery from the phase of aplasia due to the addition of CT. Respiratory distress (89% of the patients), fever (81%), pulmonary infiltrates (81%), weight gain (50%), pleural effusion (47%), renal failure (39%), pericardial effusion (19%), cardiac failure (17%), and hypotension (12%) were the main clinical signs, and 63 of the 64 patients had at least three of them. Thirteen patients required mechanical ventilation and two dialysis. A total of 60 patients received CT in addition to ATRA as per protocol or based on increasing WBC; 58 also received high dose dexamethasone (DXM); ATRA was stopped when clinical signs developed in 30 patients. A total of 55 patients (86%) who experienced ATRA syndrome achieved complete remission (CR), as compared with 94% of patients who had no ATRA syndrome (P = .07) and nine (14%) died of ATRA syndrome (5 cases), sepsis (2 cases), leukemic resistance (1 patient), and central nervous system (CNS) bleeding (1 patient). None of the patients who achieved CR and received ATRA for maintenance had ATRA syndrome recurrence. No significant predictive factors of ATRA syndrome, including pretreatment WBC, could be found. Kaplan Meier estimates of relapse, event-free survival (EFS), and survival at 2 years were 32% +/- 10%, 63% +/- 8%, and 68% +/- 7% in patients who had ATRA syndrome as compared with 15% +/- 3%, 77% +/- 2%, and 80% +/- 2% in patients who had no ATRA syndrome (P = .05, P = .003, and P = .03), respectively. In a stepwise Cox model that also included pretreatment prognostic variables, ATRA syndrome remained predictive for EFS and survival. In conclusion, in this multicenter trial where CT was rapidly added to ATRA in case of high or increasing WBC counts and DXM generally also used at the earliest clinical sign, the incidence of ATRA syndrome was 15%, but ATRA syndrome was responsible for death in only 1.2% of the total number of patients treated. However, occurrence of ATRA syndrome was associated with lower EFS and survival., (Copyright 1998 by The American Society of Hematology.)
- Published
- 1998
31. Flow cytometric analysis of whole organs and embryos.
- Author
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Serna J, Pimentel B, and de la Rosa EJ
- Subjects
- Animals, Organ Culture Techniques methods, Embryo, Nonmammalian cytology, Flow Cytometry methods
- Published
- 1998
- Full Text
- View/download PDF
32. Sequential administration of cronolone and prostaglandin F2alpha for estrus synchronization in goats.
- Author
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Serna JA, Bosu WT, and Barker CA
- Subjects
- Animals, Female, Goats, Pregnancy, Time Factors, Estrus drug effects, Flurogestone Acetate pharmacology, Pregnenediones pharmacology, Prostaglandins F pharmacology
- Published
- 1978
- Full Text
- View/download PDF
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