81 results on '"Requena Tapia MJ"'
Search Results
2. Prospective study of diagnostic accuracy in the detection of high-grade prostate cancer in biopsy-naïve patients with clinical suspicion of prostate cancer who underwent the Select MDx test.
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Lendínez-Cano G, Ojeda-Claro AV, Gómez-Gómez E, Morales Jimenez P, Flores Martin J, Dominguez JF, Amores J, Cozar JM, Bachiller J, Juárez A, Linares R, Garcia Galisteo E, Alvarez Ossorio JL, Requena Tapia MJ, Moreno Jimenez J, and Medina Lopez RA
- Subjects
- Aged, Cohort Studies, Humans, Male, Middle Aged, Neoplasm Grading, Prospective Studies, Prostate diagnostic imaging, Prostate metabolism, Biomarkers, Tumor urine, Prostate-Specific Antigen urine, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms urine
- Abstract
Objectives: This study aimed to externally validate the diagnostic accuracy of the Select MDx test for Significant prostate cancer (Sig PCa) (ISUP > 1), in a contemporaneous, prospective, multicenter cohort with a prostate-specific antigen (PSA) between 3 and 10 ng/ml and a non-suspicious digital rectal examination., Methods and Participants: For all enrolled patients, the Select Mdx test, the risk calculator ERSPC3 + DRE, and a prostatic magnetic resonance imaging (MRI) were carried out. Subsequently, a systematic 12-core trans-rectal biopsy and a targeted biopsy, in the case of a prostate imaging-reporting and data system (PIRADS) > 2 lesion (max three lesions), were performed. To assess the accuracy of the Select MDx test in the detection of clinically Sig PCa, the test sensitivity was evaluated. Secondary objectives were specificity, negative predictive value (NPV), positive predictive value (PPV), and area under the curve (AUC). A direct comparison with the ERSPC + DRE risk calculator and MRI were also performed. We also studied the predictive ability to diagnose Sig PCa from the combination of the Select MDx test with MRI using clinical decision-curve analysis., Results: There were 163 patients enrolled after meeting the inclusion criteria and study protocol. The Select MDx test showed a sensitivity of 76.9% (95% CI, 63.2-87.5), 49.6% specificity (95% CI, 39.9-59.2), 82.09% (95% CI, 70.8-90.4) NPV, and 41.67% (95% CI, 31.7-52.2) PPV for the diagnosis of Sig PCa. COR analysis was also performed, which showed an AUC of 0.63 (95% CI, 0.56-0.71). There were no differences in the accuracy of Select MDx, ERSPC + DRE, or MRI. The combination of Select MDX + MRI showed the highest impact in the decision-curve analysis, with an NPV of 93%., Conclusion: Our study showed a worse performance for the SelectMdx test than previously reported, within a cohort of patients with a PSA 3-10 ng/ml and a normal DRE, with results similar to those from ERSPC + DRE RC and MRI, but with an improvement in the usual PSA pathway. A combination of the Select Mdx test and MRI could improve accuracy, but studies specifically evaluating this scenario with a cost-effective analysis are needed., (© 2021 Wiley Periodicals LLC.)
- Published
- 2021
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3. Telomere-based risk models for the early diagnosis of clinically significant prostate cancer.
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Rubio Galisteo JM, Fernández L, Gómez Gómez E, de Pedro N, Cano Castiñeira R, Pedregosa AB, Guler I, Carrasco Valiente J, Esteban L, González S, Castelló N, Otero L, García J, Segovia E, Requena Tapia MJ, and Najarro P
- Subjects
- Aged, Biomarkers, Tumor blood, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Grading, Prospective Studies, Prostate-Specific Antigen blood, Prostatic Neoplasms blood, Prostatic Neoplasms genetics, ROC Curve, Risk Factors, Early Diagnosis, Neoplasm Staging, Prostatic Neoplasms diagnosis, Risk Assessment methods, Telomere genetics
- Abstract
Background: The objective of this study was to explore telomere-associated variables (TAV) as complementary biomarkers in the early diagnosis of prostate cancer (PCa), analyzing their application in risk models for significant PCa (Gleason score > 6)., Methods: As part of a larger prospective longitudinal study of patients with suspicion of PCa undergoing prostate biopsy according to clinical practice, a subgroup of patients (n = 401) with PSA 3-10 ng/ml and no prior biopsies was used to evaluate the contribution of TAV to discern non-significant PCa from significant PCa. The cohort was randomly split for training (2/3) and validation (1/3) of the models. High-throughput quantitative fluorescence in-situ hybridization was used to evaluate TAV in peripheral blood mononucleated cells. Models were generated following principal component analysis and random forest and their utility as risk predictors was evaluated by analyzing their predictive capacity and accuracy, summarized by ROC curves, and their clinical benefit with decision curves analysis., Results: The median age of the patients was 63 years, with a median PSA of 5 ng/ml and a percentage of PCa diagnosis of 40.6% and significant PCa of 19.2%. Two TAV-based risk models were selected (TAV models 1 and 2) with an AUC ≥ 0.83 in the full study cohort, and AUC > 0.76 in the internal validation cohort. Both models showed an improvement in decision capacity when compared to the application of the PCPT-RC in the low-risk probabilities range. In the validation cohort, with TAV models 1 and 2, 33% /48% of biopsies would have been avoided losing 0/10.3% of significant PCa, respectively. The models were also tested and validated on an independent, retrospective, non contemporary cohort., Conclusions: Telomere analysis through TAV should be considered as a new risk-score biomarker with potential to increase the prediction capacity of significant PCa in patients with PSA between 3-10 ng/ml.
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- 2021
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4. Clinical, Cellular, and Molecular Evidence of the Additive Antitumor Effects of Biguanides and Statins in Prostate Cancer.
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Jiménez-Vacas JM, Herrero-Aguayo V, Montero-Hidalgo AJ, Sáez-Martínez P, Gómez-Gómez E, León-González AJ, Fuentes-Fayos AC, Yubero-Serrano EM, Requena-Tapia MJ, López M, Castaño JP, Gahete MD, and Luque RM
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- Adenocarcinoma diagnosis, Adenocarcinoma pathology, Adenocarcinoma surgery, Aged, Biguanides administration & dosage, Cell Line, Tumor, Cell Proliferation drug effects, Chemotherapy, Adjuvant, Cohort Studies, Combined Modality Therapy, Cross-Sectional Studies, Drug Synergism, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors administration & dosage, Male, Middle Aged, PC-3 Cells, Pilot Projects, Prostatectomy, Prostatic Neoplasms diagnosis, Prostatic Neoplasms pathology, Prostatic Neoplasms surgery, Retrospective Studies, Signal Transduction drug effects, Spain, Treatment Outcome, Adenocarcinoma drug therapy, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Biguanides pharmacology, Hydroxymethylglutaryl-CoA Reductase Inhibitors pharmacology, Prostatic Neoplasms drug therapy
- Abstract
Context: Prostate cancer (PCa) is one of the leading causes of cancer-related death among the male population worldwide. Unfortunately, current medical treatments fail to prevent PCa progression in a high percentage of cases; therefore, new therapeutic tools to tackle PCa are urgently needed. Biguanides and statins have emerged as antitumor agents for several endocrine-related cancers., Objective: To evaluate: (1) the putative in vivo association between metformin and/or statins treatment and key tumor and clinical parameters and (2) the direct effects of different biguanides (metformin/buformin/phenformin), statins (atorvastatin/simvastatin/lovastatin), and their combination, on key functional endpoints and associated signalling mechanisms., Methods: An exploratory/observational retrospective cohort of patients with PCa (n = 75) was analyzed. Moreover, normal and tumor prostate cells (normal [RWPE-cells/primary prostate cell cultures]; tumor [LNCaP/22RV1/PC3/DU145 cell lines]) were used to measure proliferation/migration/tumorsphere-formation/signalling pathways., Results: The combination of metformin+statins in vivo was associated to lower Gleason score and longer biochemical recurrence-free survival. Moreover, biguanides and statins exerted strong antitumor actions (ie, inhibition of proliferation/migration/tumorsphere formation) on PCa cells, and that their combination further decreased; in addition, these functional parameters compared with the individual treatments. These actions were mediated through modulation of key oncogenic and metabolic signalling pathways (ie, AR/mTOR/AMPK/AKT/ERK) and molecular mediators (MKI67/cMYC/androgen receptor/cell-cycle inhibitors)., Conclusions: Biguanides and statins significantly reduced tumor aggressiveness in PCa, with this effect being more potent (in vitro and in vivo) when both compounds are combined. Therefore, given the demonstrated clinical safety of biguanides and statins, our results suggest a potential therapeutic role of these compounds, especially their combination, for the treatment of PCa., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2021
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5. Unleashing the Diagnostic, Prognostic and Therapeutic Potential of the Neuronostatin/GPR107 System in Prostate Cancer.
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Sáez-Martínez P, Jiménez-Vacas JM, León-González AJ, Herrero-Aguayo V, Montero Hidalgo AJ, Gómez-Gómez E, Sánchez-Sánchez R, Requena-Tapia MJ, Castaño JP, Gahete MD, and Luque RM
- Abstract
Certain components of the somatostatin-system play relevant roles in Prostate Cancer (PCa), whose most aggressive phenotype (Castration-Resistant-PCa (CRPC)) remains lethal nowadays. However, neuronostatin and the G protein-coupled receptor 107 (GPR107), two novel members of the somatostatin-system, have not been explored yet in PCa. Consequently, we investigated the pathophysiological role of NST/GPR107-system in PCa. GPR107 expression was analyzed in well-characterized PCa patient's cohorts, and functional/mechanistic assays were performed in response to GPR107-silencing and NST-treatment in PCa cells (androgen-dependent (AD: LNCaP) and androgen-independent (AI: 22Rv1/PC-3), which are cell models of hormone-sensitive and CRPC, respectively), and normal prostate cells (RWPE-1 cell-line). GPR107 was overexpressed in PCa and associated with key clinical parameters (e.g., advance stage of PCa, presence of vascular invasion and metastasis). Furthermore, GPR107-silencing inhibited proliferation/migration rates in AI-PCa-cells and altered key genes and oncogenic signaling-pathways involved in PCa aggressiveness (i.e., KI67/CDKN2D/MMP9/PRPF40A, SST
5 TMD4/AR-v7/In1-ghrelin/EZH2 splicing-variants and AKT-signaling). Interestingly, NST treatment inhibited proliferation/migration only in AI-PCa cells and evoked an identical molecular response than GPR107-silencing. Finally, NST decreased GPR107 expression exclusively in AI-PCa-cells, suggesting that part of the specific antitumor effects of NST could be mediated through a GPR107-downregulation. Altogether, NST/GPR107-system could represent a valuable diagnostic and prognostic tool and a promising novel therapeutic target for PCa and CRPC.- Published
- 2020
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6. Update of the Andalusian Association of Urology protocol for the management of metastatic castration-resistant prostate cancer.
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Álvarez-Ossorio JL, Cozar-Olmo JM, Juárez-Soto Á, Medina-López R, Moreno-Jiménez J, and Requena-Tapia MJ
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- Algorithms, Clinical Protocols, Humans, Male, Neoplasm Metastasis, Practice Guidelines as Topic, Prostatic Neoplasms, Castration-Resistant pathology, Societies, Medical, Spain, Urology, Prostatic Neoplasms, Castration-Resistant therapy
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- 2020
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7. A Single-Center Experience With Third and Fourth Kidney Transplants and Second Kidney Transplant After Pancreas-Kidney Transplant: Surgical Aspects and Outcomes.
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Salguero Segura J, Valero Rosa J, Gomez E, Navarro Cabello MD, Ruiz Garcia J, Rodriguez Benot A, Robles Garcia JE, Requena Tapia MJ, and Campos Hernández JP
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- Adult, Female, Graft Survival, Humans, Male, Middle Aged, Postoperative Complications etiology, Retrospective Studies, Risk Assessment, Risk Factors, Spain, Time Factors, Treatment Outcome, Young Adult, Kidney Transplantation adverse effects, Pancreas Transplantation adverse effects, Reoperation adverse effects
- Abstract
Objectives: Overall, 25% to 33% of patients on kidney transplant wait lists present with prior graft loss. In addition, the number of patients who require a retransplant seems to be increasing. Here, we describe our experience with patients who had a second kidney transplant after a previous pancreas-kidney transplant or a third or fourth kidney transplant. We focused specifically on the technical aspects and outcomes related to this patient group., Materials and Methods: A single-center retrospective study was performed. The cohortincluded 15 patients > 18 years old who had received a second kidney graft after pancreas-kidney transplant or a second or greater kidney graft between 2013 and 2019., Results: Median age of recipients was 45 years (range, 20-58 y). In 10 patients, the transperitoneal approach was selected. In 5 patients, the retroperitoneal heterotopic kidney retransplant technique was used. Early surgical complications (≤ 30 days posttransplant) were reported in 4 patients. Three patients had late ureteral stenosis (> 90 days posttransplant). All grafts were functioning at time of patient discharge. Mean creatinine level was 2.69 mg/dL (range, 1.23-6.26 mg/dL). The 1-year and 2-year graft survivalrates were 85% and 75%, respectively. No grafts were lost because of surgical complications., Conclusions: Retransplant of a second graft after pancreas-kidney transplant or retransplant of a third or fourth renal graft is challenging but feasible, with evidence of reasonably positive outcomes after retransplant.
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- 2020
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8. Dysregulation of the splicing machinery is directly associated to aggressiveness of prostate cancer.
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Jiménez-Vacas JM, Herrero-Aguayo V, Montero-Hidalgo AJ, Gómez-Gómez E, Fuentes-Fayos AC, León-González AJ, Sáez-Martínez P, Alors-Pérez E, Pedraza-Arévalo S, González-Serrano T, Reyes O, Martínez-López A, Sánchez-Sánchez R, Ventura S, Yubero-Serrano EM, Requena-Tapia MJ, Castaño JP, Gahete MD, and Luque RM
- Subjects
- Aged, Benzamides, Carcinogenesis drug effects, Carcinogenesis genetics, Cell Line, Tumor, Cell Proliferation drug effects, Gene Expression Regulation, Neoplastic drug effects, Gene Silencing drug effects, Humans, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Proteins genetics, Neoplasm Proteins metabolism, Nitriles, Phenylthiohydantoin analogs & derivatives, Phenylthiohydantoin pharmacology, Phenylthiohydantoin therapeutic use, Prostatic Neoplasms drug therapy, RNA Splicing drug effects, Signal Transduction drug effects, Signal Transduction genetics, Spliceosomes metabolism, Prostatic Neoplasms genetics, Prostatic Neoplasms pathology, RNA Splicing genetics
- Abstract
Background: Dysregulation of splicing variants (SVs) expression has recently emerged as a novel cancer hallmark. Although the generation of aberrant SVs (e.g. AR-v7/sst5TMD4/etc.) is associated to prostate-cancer (PCa) aggressiveness and/or castration-resistant PCa (CRPC) development, whether the molecular reason behind such phenomena might be linked to a dysregulation of the cellular machinery responsible for the splicing process [spliceosome-components (SCs) and splicing-factors (SFs)] has not been yet explored., Methods: Expression levels of 43 key SCs and SFs were measured in two cohorts of PCa-samples: 1) Clinically-localized formalin-fixed paraffin-embedded PCa-samples (n = 84), and 2) highly-aggressive freshly-obtained PCa-samples (n = 42)., Findings: A profound dysregulation in the expression of multiple components of the splicing machinery (i.e. 7 SCs/19 SFs) were found in PCa compared to their non-tumor adjacent-regions. Notably, overexpression of SNRNP200, SRSF3 and SRRM1 (mRNA and/or protein) were associated with relevant clinical (e.g. Gleason score, T-Stage, metastasis, biochemical recurrence, etc.) and molecular (e.g. AR-v7 expression) parameters of aggressiveness in PCa-samples. Functional (cell-proliferation/migration) and mechanistic [gene-expression (qPCR) and protein-levels (western-blot)] assays were performed in normal prostate cells (PNT2) and PCa-cells (LNCaP/22Rv1/PC-3/DU145 cell-lines) in response to SNRNP200, SRSF3 and/or SRRM1 silencing (using specific siRNAs) revealed an overall decrease in proliferation/migration-rate in PCa-cells through the modulation of key oncogenic SVs expression levels (e.g. AR-v7/PKM2/XBP1s) and alteration of oncogenic signaling pathways (e.g. p-AKT/p-JNK)., Interpretation: These results demonstrate that the spliceosome is drastically altered in PCa wherein SNRNP200, SRSF3 and SRRM1 could represent attractive novel diagnostic/prognostic and therapeutic targets for PCa and CRPC., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2019 The Author(s). Published by Elsevier B.V. All rights reserved.)
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- 2020
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9. Clinical Utility of Ghrelin-O-Acyltransferase (GOAT) Enzyme as a Diagnostic Tool and Potential Therapeutic Target in Prostate Cancer.
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Jiménez-Vacas JM, Gómez-Gómez E, Montero-Hidalgo AJ, Herrero-Aguayo V, L-López F, Sánchez-Sánchez R, Guler I, Blanca A, Méndez-Vidal MJ, Carrasco J, Lopez-Miranda J, Requena-Tapia MJ, Castaño JP, Gahete MD, and Luque RM
- Abstract
Recent data suggested that plasma Ghrelin O-Acyl Transferase enzyme (GOAT) levels could represent a new diagnostic biomarker for prostate cancer (PCa). In this study, we aimed to explore the diagnostic and prognostic/aggressiveness capacity of GOAT in urine, as well as to interrogate its putative pathophysiological role in PCa. We analysed urine/plasma levels of GOAT in a cohort of 993 patients. In vitro (i.e., cell-proliferation) and in vivo (tumor-growth in a xenograft-model) approaches were performed in response to the modulation of GOAT expression/activity in PCa cells. Our results demonstrate that plasma and urine GOAT levels were significantly elevated in PCa patients compared to controls. Remarkably, GOAT significantly outperformed PSA in the diagnosis of PCa and significant PCa in patients with PSA levels ranging from 3 to 10 ng/mL (the so-called PSA grey-zone). Additionally, urine GOAT levels were associated to clinical (e.g., Gleason-score, PSA levels) and molecular (e.g., CDK2 / CDK6 / CDKN2A expression) aggressiveness parameters. Indeed, GOAT overexpression increased, while its silencing/blockade decreased cell-proliferation in PCa cells. Moreover, xenograft tumors derived from GOAT-overexpressing PCa (DU145) cells were significantly higher than those derived from the mock-overexpressing cells. Altogether, our results demonstrate that GOAT could be used as a diagnostic and aggressiveness marker in urine and a therapeutic target in PCa.
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- 2019
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10. Observational study comparing the accuracy/variability between the ERSPC and the PCPT risk calculators for the prediction of significant prostate cancer in patients with PSA <10 ng/mL.
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Gomez Gomez E, Salamanca Bustos JJ, Carrasco Valiente J, Fernandez Rueda JL, Blanca A, Valero Rosa J, Bravo Arrebola I, Marquez López J, Jimenez Vacas JM, Luque R, and Requena Tapia MJ
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- Aged, Biopsy methods, Humans, Male, Middle Aged, Predictive Value of Tests, Retrospective Studies, Risk Assessment, Decision Support Techniques, Early Detection of Cancer methods, Prostate-Specific Antigen blood, Prostatic Neoplasms diagnosis
- Abstract
Introduction: Risk calculators (RCs) are easy-to-use tools considering available clinical variables that could help to select those patients with risk of prostate cancer (PCa) who should undergo a prostate biopsy., Objective: To perform a comparison for the prediction of significant PCa (SigPCa) between the European Randomised Study of Screening for PCa (ERSPC) and the PCa Prevention Trial (PCPT) RCs in patients with prostate-specific antigen (PSA) between 3 and 10 ng/mL through an evaluation of the accuracy/variability between two consecutive PSA values., Setting: An observational study in a major university hospital in the south of Spain., Methods and Participants: An observational study was performed in patients who underwent a prostate biopsy. SigPCa probabilities were calculated with the two PSA measures using ERSPC3/4+digital rectal examination and PCPT v2+free PSA RCs. The prediction of SigPCa was determined by the area under the receiver operating characteristic curve (AUC). Calibration, discrimination and decision curve analysis were studied. The variability between both RCs' agreement was compared using Cohen's kappa coefficient., Results: 510 patients were analysed (87 diagnosed with SigPCa). The median PSA values were 5.3 and 5 ng/mL for PSA1 and PSA2, respectively. Both RCs overestimated the risk in the case of high-risk probabilities. Discriminative ability for SigPCa was similar between models with an AUC=0.73 (0.68-0.79) for ERSPC-RC versus 0.73 (0.67-0.79) for PCPT-RC. ERSPC-RC showed less variability than PCPT-RC, with a constant agreement (k=0.7-0.8) for usual range of clinical decision-making. Remarkably, a higher number of biopsies would be avoided using the ERSPC-RC, but more SigPCa would be missed along all the risk probabilities., Conclusions: Both RCs performed similar in the prediction of SigPCa. However, ERSPC-RC seems to be more stable for intraindividual PSA variations., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2019
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11. Spliceosome component SF3B1 as novel prognostic biomarker and therapeutic target for prostate cancer.
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Jiménez-Vacas JM, Herrero-Aguayo V, Gómez-Gómez E, León-González AJ, Sáez-Martínez P, Alors-Pérez E, Fuentes-Fayos AC, Martínez-López A, Sánchez-Sánchez R, González-Serrano T, López-Ruiz DJ, Requena-Tapia MJ, Castaño JP, Gahete MD, and Luque RM
- Subjects
- Aged, Cell Line, Tumor, Cell Proliferation, Cohort Studies, Drug Delivery Systems, Gene Expression Regulation, Neoplastic, Humans, Male, Middle Aged, Phosphoproteins genetics, Prognosis, Prostatic Neoplasms drug therapy, RNA Splicing Factors genetics, Spliceosomes chemistry, Antineoplastic Agents pharmacology, Biomarkers, Tumor blood, Phosphoproteins metabolism, Prostatic Neoplasms metabolism, RNA Splicing Factors metabolism
- Abstract
Prostate cancer (PCa) is one of the most common cancers types among men. Development and progression of PCa is associated with aberrant expression of oncogenic splicing-variants (eg, AR-v7), suggesting that dysregulation of the splicing process might represent a potential actionable target for PCa. Expression levels (mRNA and protein) of SF3B1, one of the main components of the splicing machinery, were analyzed in different cohorts of PCa patients (clinically localized [n = 84], highly aggressive PCa [n = 42], and TCGA dataset [n = 497]). Functional and mechanistic assays were performed in response to pladienolide-B in nontumor and tumor-derived prostate cells. Our results revealed that SF3B1 was overexpressed in PCa tissues and its levels were associated with clinically relevant PCa-aggressive features (eg, metastasis/AR-v7 expression). Moreover, inhibition of SF3B1 activity by pladienolide-B reduced functional parameters of aggressiveness (proliferation/migration/tumorspheres-formation/apoptosis) in PCa cell lines, irrespective of AR-v7 expression, and reduced viability of primary PCa cells. Antitumor actions of pladienolide-B involved: (1) inhibition of PI3K/AKT and JNK signaling pathways, (2) modulation of tumor markers and splicing variants (AR-v7/In1-ghrelin), and (3) regulation of key components of mRNA homeostasis-associated machineries (spliceosome/SURF/EJC). Altogether, our results demonstrated that SF3B1 is overexpressed and associated with malignant features in PCa, and its inhibition reduces PCa aggressiveness, suggesting that SF3B1 could represent a novel prognostic biomarker and a therapeutic target in PCa., (Copyright © 2019 Elsevier Inc. All rights reserved.)
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- 2019
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12. Oncogenic Role of Secreted Engrailed Homeobox 2 (EN2) in Prostate Cancer.
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Gómez-Gómez E, Jiménez-Vacas JM, Pedraza-Arévalo S, López-López F, Herrero-Aguayo V, Hormaechea-Agulla D, Valero-Rosa J, Ibáñez-Costa A, León-González AJ, Sánchez-Sánchez R, González-Serrano T, Requena-Tapia MJ, Castaño JP, Carrasco-Valiente J, Gahete MD, and Luque RM
- Abstract
Engrailed variant-2 (EN2) has been suggested as a potential diagnostic biomarker; however, its presence and functional role in prostate cancer (PCa) cells is still controversial or unknown. Here, we analyzed 1) the expression/secretion profile of EN2 in five independent samples cohorts from PCa patients and controls (prostate tissues and/or urine) to determine its utility as a PCa biomarker; and 2) the functional role of EN2 in normal (RWPE1) and tumor (LNCaP/22Rv1/PC3) prostate cells to explore its potential value as therapeutic target. EN2 was overexpressed in our two cohorts of PCa tissues compared to control and in tumor cell lines compared with normal-like prostate cells. This profile was corroborated in silico in three independent data sets [The Cancer Genome Atlas(TCGA)/Memorial Sloan Kettering Cancer Center (MSKCC)/Grasso]. Consistently, urine EN2 levels were elevated and enabled discrimination between PCa and control patients. EN2 treatment increased cell proliferation in LNCaP/22Rv1/PC3 cells, migration in RWPE1/PC3 cells, and PSA secretion in LNCaP cells. These effects were associated, at least in the androgen-sensitive LNCaP cells, with increased AKT and androgen-receptor phosphorylation levels and with modulation of key cancer-associated genes. Consistently, EN2 treatment also regulated androgen-receptor activity (full-length and splicing variants) in androgen-sensitive 22Rv1 cells. Altogether, this study demonstrates the potential utility of EN2 as a non-invasive diagnostic biomarker for PCa and provides novel and valuable information to further investigate its putative utility to develop new therapeutic tools in PCa.
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- 2019
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13. CE-MS-based urinary biomarkers to distinguish non-significant from significant prostate cancer.
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Frantzi M, Gomez Gomez E, Blanca Pedregosa A, Valero Rosa J, Latosinska A, Culig Z, Merseburger AS, Luque RM, Requena Tapia MJ, Mischak H, and Carrasco Valiente J
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- Aged, Algorithms, Case-Control Studies, Humans, Image-Guided Biopsy, Male, Middle Aged, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms pathology, Support Vector Machine, Ultrasonography, Interventional, Biomarkers, Tumor urine, Electrophoresis, Capillary methods, Mass Spectrometry methods, Prostatic Neoplasms urine
- Abstract
Background: Prostate cancer progresses slowly when present in low risk forms but can be lethal when it progresses to metastatic disease. A non-invasive test that can detect significant prostate cancer is needed to guide patient management., Methods: Capillary electrophoresis/mass spectrometry has been employed to identify urinary peptides that may accurately detect significant prostate cancer. Urine samples from 823 patients with PSA (<15 ng/ml) were collected prior to biopsy. A case-control comparison was performed in a training set of 543 patients (n
Sig = 98; nnon-Sig = 445) and a validation set of 280 patients (nSig = 48, nnon-Sig = 232). Totally, 19 significant peptides were subsequently combined by a support vector machine algorithm., Results: Independent validation of the 19-biomarker model in 280 patients resulted in a 90% sensitivity and 59% specificity, with an AUC of 0.81, outperforming PSA (AUC = 0.58) and the ERSPC-3/4 risk calculator (AUC = 0.69) in the validation set., Conclusions: This multi-parametric model holds promise to improve the current diagnosis of significant prostate cancer. This test as a guide to biopsy could help to decrease the number of biopsies and guide intervention. Nevertheless, further prospective validation in an external clinical cohort is required to assess the exact performance characteristics.- Published
- 2019
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14. Clinical association of metabolic syndrome, C-reactive protein and testosterone levels with clinically significant prostate cancer.
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Gómez-Gómez E, Carrasco-Valiente J, Campos-Hernández JP, Blanca-Pedregosa AM, Jiménez-Vacas JM, Ruiz-García J, Valero-Rosa J, Luque RM, and Requena-Tapia MJ
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- Aged, Biopsy methods, Humans, Inflammation metabolism, Inflammation pathology, Male, Middle Aged, Neoplasm Grading methods, Odds Ratio, Prospective Studies, Prostate metabolism, Prostate pathology, Risk Factors, C-Reactive Protein metabolism, Metabolic Syndrome metabolism, Metabolic Syndrome pathology, Prostatic Neoplasms metabolism, Prostatic Neoplasms pathology, Testosterone metabolism
- Abstract
Recently, the influence that metabolic syndrome (MetS), hormonal alterations and inflammation might have on prostate cancer (PCa) risk has been a subject of controversial debate. Herein, we aimed to investigate the association between MetS-components, C-reactive protein (CRP) and testosterone levels, and the risk of clinically significant PCa (Sig-PCa) at the time of prostate biopsy. For that, men scheduled for transrectal ultrasound guided biopsy of the prostate were studied. Clinical, laboratory parameters and criteria for MetS characterization just before the biopsy were collected. A total of 524 patients were analysed, being 195 (37.2%) subsequently diagnosed with PCa and 240 (45.8%) meet the diagnostic criteria for MetS. Among patients with PCa, MetS-diagnosis was present in 94 (48.2%). Remarkably, a higher risk of Sig-PCa was associated to MetS, greater number of MetS-components and higher CRP levels (odds-ratio: 1.83, 1.30 and 2.00, respectively; P < 0.05). Moreover, higher circulating CRP levels were also associated with a more aggressive Gleason score in PCa patients. Altogether, our data reveal a clear association between the presence of MetS, a greater number of MetS-components or CRP levels >2.5 mg/L with an increased Sig-PCa diagnosis and/or with aggressive features, suggesting that MetS and/or CRP levels might influence PCa pathophysiology., (© 2018 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.)
- Published
- 2019
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15. Plasma ghrelin O-acyltransferase (GOAT) enzyme levels: A novel non-invasive diagnosis tool for patients with significant prostate cancer.
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Gómez-Gómez E, Jiménez-Vacas JM, Carrasco-Valiente J, Herrero-Aguayo V, Blanca-Pedregosa AM, León-González AJ, Valero-Rosa J, Fernández-Rueda JL, González-Serrano T, López-Miranda J, Gahete MD, Castaño JP, Requena-Tapia MJ, and Luque RM
- Subjects
- Cohort Studies, Humans, Male, Middle Aged, Neoplasm Grading, Prostate-Specific Antigen, Prostatic Neoplasms pathology, Acyltransferases blood, Biomarkers, Tumor blood, Prostate pathology, Prostatic Neoplasms blood
- Abstract
Early detection of PCa faces severe limitations as PSA displays poor-specificity/sensitivity. As we recently demonstrated that plasma ghrelin O-acyltransferase (GOAT)-enzyme is significantly elevated in PCa-patients compared with healthy-controls, using a limited patients-cohort, we aimed to further explore the potential of GOAT to improve PCa diagnosis using an ample patients-cohort (n = 312) and defining subgroups (i.e. significant PCa/metastatic patients, etc.) that could benefit from this biomarker. Plasma GOAT-levels were evaluated by ELISA in patients with (n = 183) and without (n = 129) PCa. Gleason Score ≥ 7 was considered clinically significant PCa. GOAT-levels were higher in PCa patients vs control patients, and in those with significant PCa vs non-significant PCa. GOAT-levels association with the diagnoses of significant PCa was independent from traditional clinical variables (i.e. PSA/age/DRE). Remarkably, GOAT outperformed PSA in patients with PSA-levels ranging 3-20 ng/mL for the significant PCa diagnosis [GOAT-AUC = 0.612 (0.531-0.693) vs PSA-AUC = 0.494 (0.407-0.580)]. A panel of key variables including GOAT/age/DRE/testosterone also outperformed the same panel but with PSA [AUC = 0.720 (0.710-0.730) vs AUC = 0.705 (0.695-0.716), respectively]. Notably, GOAT-levels could also represent a novel predictive biomarker of aggressiveness, as its levels are positively associated with Gleason Score and the presence of metastasis at the time of diagnoses. Altogether, our data reveal that GOAT-levels can be used as a non-invasive biomarker for significant PCa diagnosis in patients at risk of PCa (with PSA: 3-20 ng/mL)., (© 2018 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.)
- Published
- 2018
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16. New Approach to Guide Target Prostate Biopsy: Technique and Initial Experience.
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Gómez Gómez E, Valero Rosa J, Carrasco Valiente J, Triviño Tarradas F, Anglada Curado F, López Ruiz D, and Requena Tapia MJ
- Abstract
Objective: To describe the technique of transrectal biopsy with a new device that fuses multiparametric magnetic resonance (mpMRI) and ultrasound images in real time to guide target biopsies and to evaluate our initial experience., Methods: Patients with persistent suspicion of prostate cancer despite a previous negative biopsy and who had an mpMRI before the biopsy were selected. All patients underwent target biopsy plus standard systematic biopsy. Significant prostate cancer (sig PCa) was defined according to the Epstein criteria for standard biopsy and Gleason grade of ≥7 and a positive core length of ≥5 mm for target biopsy., Results: The first 40 patients were evaluated. The median age was 65 years old. In a sagittal isotropic sequence, the fusion process was started. The fusion can be improved by using different tools such as concordant points and Global Positioning System corrections tools. In the target biopsy, a median of 4 cores was taken, whereas in the standard biopsy, 12 cores were taken. Twenty-two patients were diagnosed with prostate cancer; of these patients, 17 were diagnosed with sig PCa. The fusion target biopsy diagnosed more sig PCa than the standard biopsy; however, it was not statistically significant (37.5% vs 25%, P=.08). The probability of being diagnosed with cancer increased in correlation with the Prostate Imaging Reporting and Data System score, without reaching statistical significance (k=0.45, P=.08)., Conclusions: This new device is a useful tool to guide biopsy in patients with target lesions in an mpMRI to increase the detection of sig PCa. A larger cohort would be required to show significant differences., (Copyright © 2018 Elsevier Ltd. All rights reserved.)
- Published
- 2018
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17. Initial Experience in the Use of Novel Auto-expandable Metal Ureteral Stent in the Treatment of Ureter Stenosis in Kidney Transplanted Patients.
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Salamanca-Bustos JJ, Gomez-Gomez E, Campos-Hernández JP, Carrasco-Valiente J, Ruiz-García J, Márquez-López FJ, Zurera-Tendero L, and Requena-Tapia MJ
- Subjects
- Adult, Aged, Constriction, Pathologic etiology, Constriction, Pathologic surgery, Female, Follow-Up Studies, Humans, Male, Middle Aged, Postoperative Complications etiology, Republic of Korea, Treatment Outcome, Ureter pathology, Ureteral Obstruction etiology, Ureteral Obstruction pathology, Young Adult, Kidney Transplantation adverse effects, Postoperative Complications surgery, Self Expandable Metallic Stents, Ureter surgery, Ureteral Obstruction surgery
- Abstract
Introduction: Ureter stenosis in renal transplantation patients is a relatively frequent complication that negatively conditions graft evolution. The use of ureteral stents is a valid treatment alternative to the use of double-J catheters in patients for whom surgery is not contemplated or after surgical recurrence. We present our initial experience with five patients treated using this technique., Materials and Methods: We describe a total of five patients with ureteral stenosis after renal transplantation who were treated using ureteral stent model UVENTA (Taewoong Medical, Seoul, Korea) in our center. The median follow-up was 18 months (range, 4 to 38 months). We describe the clinical history of patients and previous treatments on ureteral stenosis. The technical procedure of placement is described. The clinical course is analyzed by measurement of renal function and imaging tests, as well as post-stent complications. Survival of the renal graft is evaluated., Results: The procedure could be completed in all patients without complications. The technique was effective in all patients, with correction of creatinine value and hydronephrosis during the renal ultrasound test. One patient suffered a urinary tract infection episode associated with the use of the ureteral stent. One patient suffered the loss of the renal graft secondary to the development of cryoglobulins. One hundred percent of the ureteral stents are functioning as of the writing of this article., Conclusions: In renal transplantation patients with ureter stenosis, metallic stents are a useful technique with low morbidity and associated complications., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2018
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18. What Is the Influence of Both Risk Donor and Risk Receiver on Simultaneous Pancreas-Kidney Transplantation?
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Sánchez-Hidalgo JM, Salamanca-Bustos JJ, Arjona-Sánchez Á, Campos-Hernández JP, Ruiz Rabelo J, Rodríguez-Benot A, Requena-Tapia MJ, and Briceño-Delgado J
- Subjects
- Adult, Female, Humans, Kaplan-Meier Estimate, Kidney Transplantation adverse effects, Male, Middle Aged, Multivariate Analysis, Pancreas Transplantation methods, Postoperative Complications etiology, Retrospective Studies, Risk Factors, Survival Analysis, Graft Survival, Kidney Transplantation methods, Pancreas Transplantation adverse effects, Postoperative Complications epidemiology, Tissue Donors
- Abstract
Introduction: Some factors affect the pancreas of a marginal donor, and although their influence on graft survival has been determined, there is an increasing consensus to accept marginal organs in a controlled manner to increase the pool of organs. Certain factors related to the recipient have also been proposed as having negative influence on graft prognosis. The objective of this study was to analyze the influence of these factors on the results of our simultaneous pancreas-kidney (SPK) transplantation series., Materials and Methods: Retrospective analysis of 126 SPK transplants. Donors and recipients were stratified in an optimal group (<2 expanded donor criteria) and a risk group (≥2 criteria). A pancreatic graft survival analysis was performed using a Kaplan-Meier test and log-rank test. Prognostic variables on graft survival were studied by Cox regression. Postoperative complications (graded by Clavien classification) were compared by χ
2 test or Fisher test., Results: Median survival of pancreas was 66 months, with no significant difference between groups (P > .05). Multivariate analysis showed risk factors to be donor age, cold ischemia time, donor body mass index, receipt body mass index, and receipt panel-reactive antibody., Conclusions: In our series, the use of pancreatic grafts from donors with expanded criteria is safe and has increased the pool of grafts. Different variables, both donor and recipient, influence the survival of the pancreatic graft and should be taken into account in organ distribution systems., (Copyright © 2017 Elsevier Inc. All rights reserved.)- Published
- 2018
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19. [Oligometastatic prostate cancer. concept and implications.]
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Carrasco Valiente J, Ruiz García JM, and Requena Tapia MJ
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- Humans, Male, Neoplasm Metastasis, Prostatic Neoplasms therapy, Prostatic Neoplasms pathology
- Abstract
Oligometastatic prostate cancer has been proposed as an intermediate stage between localized and extensively disseminated disease. Oligometastatic disease is being diagnosed more frequently due to the advances in imaging tests. Nevertheless, there is no consensus definition yet of oligometastatic prostate cancer. The importance of this entity is that several studies have pointed out that local and metastasis directed treatment may improve survival in selected patients. However, we need the results of well controlled prospective randomized clinical trials to help a better understanding and management of oligometastatic prostate cancer.
- Published
- 2018
20. Comorbidity and socio-demographic factors associated with renal lithiasis in persons aged 40 to 65: A cross-sectional study.
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Arias Vega R, Pérula de Torres LA, Jiménez García C, Carrasco Valiente J, Requena Tapia MJ, Cano Castiñeira R, and Silva Ayçaguer LC
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- Adult, Age Distribution, Aged, Climate, Comorbidity, Cross-Sectional Studies, Female, Humans, Hypercholesterolemia epidemiology, Hypertension epidemiology, Hyperuricemia epidemiology, Male, Middle Aged, Obesity epidemiology, Risk Factors, Sampling Studies, Socioeconomic Factors, Spain epidemiology, Temperature, Kidney Calculi epidemiology
- Abstract
Background and Objective: Renal lithiasis is one of the most important urological diseases. It seems to be related to different socio-demographic and climatic factors, lifestyle and pre-existing comorbidity. The aim of this study was to examine the relationship between socio-demographic variables, certain risk factors and chronic diseases and the renal lithiasis., Patients and Method: A cross-sectional population-based study was carried out, selecting the Spanish population aged from 40 to 65 years, combining 2 random samples (PreLiRenA and PreLiRenE studies). Data were collected by personal telephone surveys, gathering information on socio-demographic variables and perceived morbidity. Data on annual average temperatures in each Spanish region were also collected. A bivariate and multivariate analysis was performed., Results: A total of 4,894 subjects were surveyed; 51.3% were women; 25% were aged 40-45 years, 36% had primary school education and 31.4% were of low social class. The overall prevalence of renal lithiasis was 15.0% (95% confidence interval [95% CI] 14.5-15.5). By means of multivariate analysis, the variables that showed a strong statistical relationship with the presence of renal lithiasis were: older age (61-65 years; OR=1.39; 95% CI 1.06-1.80), high social class (OR=1.98; 95% CI 1.29-2.62), family history of renal lithiasis (OR=2.22; 95% CI 1.88-2.65), high blood pressure (OR=1.68; 95% CI 1.39-2.02) and overweight/obesity (OR=1.31; 95% CI 1.12-1.54). A correlation was observed between renal lithiasis and average annual temperatures in the Spanish regions (r=0.59; P=.013)., Conclusions: A relationship was observed between renal lithiasis and older age, belonging to higher social classes, the existence of a family history of urolithiasis, and hypertension and overweight or obesity. The prevalence of renal lithiasis is greater in warmer climate zones., (Copyright © 2017 Elsevier España, S.L.U. All rights reserved.)
- Published
- 2017
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21. Expression of proteins FGFR3, PI3K, AKT, p21Waf1/Cip1 and cyclins D1 and D3 in patients with T1 bladder tumours: clinical implications and prognostic significance.
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Blanca Pedregosa AM, Sánchez-González Á, Carrasco Valiente J, Ruiz García JM, Gómez Gómez E, López Beltrán A, and Requena Tapia MJ
- Subjects
- Aged, Aged, 80 and over, Cyclin D1 biosynthesis, Cyclin D2 biosynthesis, Cyclin-Dependent Kinase Inhibitor p21 biosynthesis, Female, Humans, Male, Middle Aged, Neoplasm Staging, Oncogene Protein v-akt biosynthesis, Phosphatidylinositol 3-Kinases biosynthesis, Prognosis, Prospective Studies, Receptor, Fibroblast Growth Factor, Type 3 biosynthesis, Survival Analysis, Urinary Bladder Neoplasms pathology, Urinary Bladder Neoplasms surgery, Urinary Bladder Neoplasms metabolism, Urinary Bladder Neoplasms mortality
- Abstract
Objective: To determine the differential protein expression of biomarkers FGFR3, PI3K (subunits PI3Kp110α, PI3KClassIII, PI3Kp85), AKT, p21Waf1/Cip1 and cyclins D1 and D3 in T1 bladder cancer versus healthy tissue and to study their potential role as early recurrence markers., Material and Method: This is a prospective study that employed a total of 67 tissue samples (55 cases of T1 bladder tumours that underwent transurethral resection and 12 cases of adjacent healthy mucosa). The protein expression levels were assessed using Western blot, and the means and percentages were compared using Student's t-test and the chi-squared test. The survival analysis was conducted using the Kaplan-Meier method and the log-rank test., Results: Greater protein expression was detected for FGFR3, PI3Kp110α, PI3KClassIII, cyclins D1 and D3 and p21Waf1/Cip1 in the tumour tissue than in the healthy mucosa. However, these differences were not significant for PI3Kp85 and AKT. We observed statistically significant correlations between early recurrence and PI3Kp110α, PI3KClassIII, PI3Kp85 and AKT (P=.003, P=.045, P=.050 and P=.028, respectively), between the tumour type (primary vs. recurrence) and cyclin D3 (P=.001), between the tumour size and FGFR3 (P=.035) and between multifocality and cyclin D1 (P=.039). The survival analysis selected FGFR3 (P=.024), PI3Kp110α (P=.014), PI3KClassIII (P=.042) and AKT (P=.008) as markers of early-recurrence-free survival., Conclusions: There is an increase in protein expression levels in bladder tumour tissue. The overexpression of FGFR3, PI3Kp110α, PI3KClassIII and AKT is associated with increased early-recurrence-free survival for patients with T1 bladder tumours., (Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2017
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22. European Randomized Study of Screening for Prostate Cancer Risk Calculator: External Validation, Variability, and Clinical Significance.
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Gómez-Gómez E, Carrasco-Valiente J, Blanca-Pedregosa A, Barco-Sánchez B, Fernandez-Rueda JL, Molina-Abril H, Valero-Rosa J, Font-Ugalde P, and Requena-Tapia MJ
- Subjects
- Aged, Europe, Humans, Male, Middle Aged, Risk Assessment, Early Detection of Cancer, Prostatic Neoplasms diagnosis, Randomized Controlled Trials as Topic
- Abstract
Objective: To externally validate the European Randomized Study of Screening for Prostate Cancer (ERSPC) risk calculator (RC) and to evaluate its variability between 2 consecutive prostate-specific antigen (PSA) values., Materials and Methods: We prospectively catalogued 1021 consecutive patients before prostate biopsy for suspicion of prostate cancer (PCa). The risk of PCa and significant PCa (Gleason score ≥7) from 749 patients was calculated according to ERSPC-RC (digital rectal examination-based version 3 of 4) for 2 consecutive PSA tests per patient. The calculators' predictions were analyzed using calibration plots and the area under the receiver operating characteristic curve (area under the curve). Cohen kappa coefficient was used to compare the ability and variability., Results: Of 749 patients, PCa was detected in 251 (33.5%) and significant PCa was detected in 133 (17.8%). Calibration plots showed an acceptable parallelism and similar discrimination ability for both PSA levels with an area under the curve of 0.69 for PCa and 0.74 for significant PCa. The ERSPC showed 226 (30.2%) unnecessary biopsies with the loss of 10 significant PCa. The variability of the RC was 16% for PCa and 20% for significant PCa, and a higher variability was associated with a reduced risk of significant PCa., Conclusion: We can conclude that the performance of the ERSPC-RC in the present cohort shows a high similitude between the 2 PSA levels; however, the RC variability value is associated with a decreased risk of significant PCa. The use of the ERSPC in our cohort detects a high number of unnecessary biopsies. Thus, the incorporation of ERSPC-RC could help the clinical decision to carry out a prostate biopsy., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2017
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23. [Epidemiology of urinary lithiasis in Spain: New scenarios.]
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Carrasco Valiente J, Gómez Gómez E, and Requena Tapia MJ
- Subjects
- Age Distribution, Diet, Female, Humans, Male, Middle Aged, Risk Factors, Sex Distribution, Spain epidemiology, Urolithiasis etiology, Urolithiasis epidemiology
- Abstract
Renal lithiasis is one of the most common disorders in modern society, constituting an important health problem that associates a great economic burden. The nature of stone disease varies according to age and sex, being also influenced by dietary and lifestyle factors, and climatic variations among others. In spite of the advances made in the management of this pathology, it continues being a disease with a high recurrence rate. In recent years, several studies have pointed out that its prevalence is rising especially in developed countries. This increase seems to be fundamentally due to changes in dietary habits and lifestyle, although other factors such as migratory flows from rural areas to major cities, and a rise in global temperatures may also be involved. In the present article, we discuss the main factors that seem to influence today the epidemiology of urinary litiasis, as well as the aforementioned increase of prevalence.
- Published
- 2017
24. Prostate Cancer Patients-Negative Biopsy Controls Discrimination by Untargeted Metabolomics Analysis of Urine by LC-QTOF: Upstream Information on Other Omics.
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Fernández-Peralbo MA, Gómez-Gómez E, Calderón-Santiago M, Carrasco-Valiente J, Ruiz-García J, Requena-Tapia MJ, Luque de Castro MD, and Priego-Capote F
- Subjects
- Aged, Aged, 80 and over, Biopsy, Humans, Male, Middle Aged, Prostatic Neoplasms pathology, Biomarkers, Tumor urine, Kallikreins urine, Metabolomics methods, Prostate-Specific Antigen urine, Prostatic Neoplasms urine
- Abstract
The existing clinical biomarkers for prostate cancer (PCa) diagnosis are far from ideal (e.g., the prostate specific antigen (PSA) serum level suffers from lack of specificity, providing frequent false positives leading to over-diagnosis). A key step in the search for minimum invasive tests to complement or replace PSA should be supported on the changes experienced by the biochemical pathways in PCa patients as compared to negative biopsy control individuals. In this research a comprehensive global analysis by LC-QTOF was applied to urine from 62 patients with a clinically significant PCa and 42 healthy individuals, both groups confirmed by biopsy. An unpaired t-test (p-value < 0.05) provided 28 significant metabolites tentatively identified in urine, used to develop a partial least squares discriminant analysis (PLS-DA) model characterized by 88.4 and 92.9% of sensitivity and specificity, respectively. Among the 28 significant metabolites 27 were present at lower concentrations in PCa patients than in control individuals, while only one reported higher concentrations in PCa patients. The connection among the biochemical pathways in which they are involved (DNA methylation, epigenetic marks on histones and RNA cap methylation) could explain the concentration changes with PCa and supports, once again, the role of metabolomics in upstream processes.
- Published
- 2016
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25. Partial thrombosis of the corpus cavernosum: should we dig deeper into coagulopathy disorders?
- Author
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Gomez Gomez E, Campos Hernandez JP, Cazalilla M, Triviño F, Barbudo J, Prieto R, and Requena Tapia MJ
- Subjects
- Anticoagulants therapeutic use, Aspirin therapeutic use, Drug Therapy, Combination, Enoxaparin therapeutic use, Humans, Magnetic Resonance Imaging, Male, Priapism drug therapy, Priapism genetics, Thrombosis drug therapy, Thrombosis genetics, Treatment Outcome, Ultrasonography, Young Adult, Factor V genetics, Priapism diagnostic imaging, Thrombosis diagnostic imaging
- Abstract
Partial thrombosis of the corpus cavernosum, also known as partial priapism is a rare condition. The condition is known to be unilateral, and its aetiology is not well known. Usually, symptoms are pain and perineal mass and Magnetic Resonance is needed to confirm the diagnosis. In most cases the treatment is conservative with anticoagulation therapy. We present a case of partial thrombosis of the corpus cavernosum with a Factor V Leyden mutation., (© 2016 Blackwell Verlag GmbH.)
- Published
- 2016
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26. Graft Survival in Patients Who Received Second Allograft, Comparing Those With or Without Previous Failed Allograft Nephrectomy.
- Author
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Sánchez-González Á, Carrasco-Valiente J, Arenas-Bonilla AJ, Campos-Hernández JP, Blanca-Pedregosa A, Ruíz-García JM, Valero-Rosa J, Gómez-Gómez E, Salamanca-Bustos JJ, Navarro-Cabello D, and Requena-Tapia MJ
- Subjects
- Adult, Delayed Graft Function mortality, Delayed Graft Function physiopathology, Female, Graft Rejection immunology, Graft Rejection physiopathology, Humans, Immunosuppressive Agents therapeutic use, Kaplan-Meier Estimate, Kidney Failure, Chronic mortality, Kidney Failure, Chronic surgery, Male, Middle Aged, Multivariate Analysis, Renal Dialysis mortality, Reoperation, Retrospective Studies, Time Factors, Tissue Donors, Transplantation, Homologous mortality, Allografts physiology, Graft Rejection mortality, Graft Survival physiology, Kidney Transplantation mortality, Nephrectomy mortality
- Abstract
Introduction: Nowadays, the number of patients receiving a second graft is growing, and the management of failed grafts is still controversial., Objective: Our objective was to analyze the influence of graft nephrectomy on graft and patient survival., Materials and Methods: We retrospectively evaluated the demographic features and graft outcomes of 63 recipients who received second allografts between August 1985 and April 2013. They were divided into two groups: group A, those who underwent nephrectomy of failed graft (n = 21, 33.3%), and group B, those whose failed graft was retained (n = 42, 66.6%). χ
2 and Mann-Whitney U tests were used to compare demographic characteristics and graft features in both groups. Kaplan-Meier test was used to analyze graft and patient survival. Finally, univariate and multivariate analysis was done using Cox regression., Results: Demographic characteristics of donor and receptors were similar in both groups. Overall panel-reactive antibody (P = .040) showed statistically significant differences between groups (72.0 ± 25.3 in group A and 54.8 ± 30.0 in group B). Hemodialysis duration was longer in group A (P = .023, 112.2 ± 72.8 vs 70.9 ± 66.9 months). The percentage of patients who had delayed graft function was higher in group A (58.8% vs 27.3%, P = .029). Kaplan-Meier test found no differences between groups (P = .344); group A, 107.4 months (95% confidence interval [CI] 74.0 to 140.8) and group B, 82.7 months (95% CI 62.5 to 102.8). We found no differences in terms of patient survival (P = .798) with the Kaplan-Meier test. In group A, patient survival was 164.5 months (CI 137.7 to 191.31) and in group B, 152.0 months (95% CI 125.5 to 178.5)., Conclusions: Failed graft nephrectomy did not show a negative impact on graft and patient survival., (Copyright © 2016 Elsevier Inc. All rights reserved.)- Published
- 2016
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27. Validation of the Pancreatic Donor Risk Index in Simultaneous Pancreas-Kidney Transplantation Performed in Córdoba Hospital From 2000 to 2015.
- Author
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Salamanca-Bustos JJ, Campos-Hernandez JP, Sánchez-Hidalgo JM, Arjona-Sánchez A, Sánchez-González A, Arenas-Bonilla AJ, Ruiz-Rabelo J, Carrasco-Valiente J, Ruiz-García J, Regueiro-López JC, Briceño-Delgado J, and Requena-Tapia MJ
- Subjects
- Adult, Female, Graft Survival physiology, Hospitals statistics & numerical data, Humans, Kaplan-Meier Estimate, Kidney Transplantation methods, Kidney Transplantation mortality, Male, Pancreas Transplantation methods, Pancreas Transplantation mortality, Regression Analysis, Retrospective Studies, Risk Assessment methods, Risk Factors, United States, Young Adult, Kidney Transplantation adverse effects, Pancreas Transplantation adverse effects, Tissue Donors statistics & numerical data
- Abstract
Background: The Pancreatic Donor Risk Index (PDRI) was developed in 2010 in the United States to predict graft survival after pancreas transplantation, based on donor characteristics and logistical and technical conditions. The aim of the study was to validate the utility of PDRI as a pancreas allograft survival predictor in simultaneous pancreas-kidney transplantation (SPK) transplants performed in our hospital between 2000 and 2015., Methods: This retrospective analysis of 126 SPK transplants was performed by the same surgical team from the years 2000 to 2015. Donor variables that are integrated in the PDRI were calculated (age, sex, race, creatinine serum levels, body mass index, height, cold ischemia time, cause of death, type of pancreas transplant). Pancreatic graft survival at 1 and 5 years was calculated by use of the Kaplan-Meier test. Comparison of survival curves between PDRI risk quartiles was calculated by use of the log-rank test. Association between graft survival and variables integrating the PDRI was calculated by use of univariate Cox regression analysis., Results: Log-rank analysis found no statistically significant association between global graft survival and PDRI quartiles. Univariate Cox regression analysis showed a statistically significant association between graft survival and cold ischemia time (P < .05)., Conclusions: PDRI was not a useful tool to predict pancreatic graft outcomes in a Spanish reference population., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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28. Influence of Donor and Recipient Ages in Survival of Simultaneous Pancreas-Kidney Transplantation.
- Author
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Arenas-Bonilla AJ, Campos-Hernández JP, Carrasco-Valiente J, Márquez-López FJ, Ruiz-García JM, Sánchez-Gónzalez A, Salamanca-Bustos JJ, Regueiro-López JC, Navarro-Cabello MD, and Requena-Tapia MJ
- Subjects
- Adolescent, Adult, Age Factors, Diabetes Mellitus, Type 1 surgery, Female, Humans, Kidney Failure, Chronic surgery, Male, Middle Aged, Postoperative Complications etiology, Retrospective Studies, Graft Survival physiology, Kidney Transplantation, Pancreas Transplantation, Tissue Donors, Transplant Recipients
- Abstract
Introduction: Simultaneous pancreas-kidney transplantation (SPKT) is a well treatment for patients with insulin-dependent diabetes and end-stage renal disease. Donor age is a barrier to the acceptance of organs. Age matching has been extensively studied in kidney transplantation; however, there are no studies in graft survival after SPKT. We aimed to study the combined influence of the ages of the donors and recipients in graft survival after SPKT., Material and Methods: Donors and recipients are classified as younger (age <40 years) or older (age ≥40 years). There were four study groups (young-young, young-old, old-young, and old-old). They were evaluated retrospectively for demographic and clinical characteristics of donors and recipients and the long-term survival between 2001 and 2012 of kidney pancreas transplantation patients at our center., Results: A total of 115 transplantations were performed. The four groups had 55 young-young, 40 young-old, 10 old-young, and 10 old-old patients. Serious complications occurred in 32%, 42%, 30%, and 40%, respectively, and deaths were 2%, 5%, 0%, and 20%, respectively, in the groups. Pancreas graft survival at 3 years for each group was 80%, 87, 5%, 90%, and 60%, respectively, and kidney graft survival was 92.7%, 90%, 90%, and 70%, respectively. Panel-reactive antibodies (PRAs) >30% were associated with poor graft survival, and serious postoperative complications associated with poor pancreas-kidney graft survival., Conclusions: In conclusion, both younger and older recipients show excellent long-term graft and patient survival after SPKTs from younger donors. We recommended that older-recipient SPKT be transplanted from younger donors because older recipients who have been transplanted from older donors had decreased survival., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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29. Prognostic value of penile colour doppler ultrasonography for recovering erectile function after radical prostatectomy.
- Author
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Valero-Rosa J, Campos-Hernández JP, Carrasco-Valiente J, Gómez-Gómez E, Márquez-López FJ, Ruiz-García J, García-Rubio JH, Requena-Tapia MJ, and Prieto-Castro R
- Subjects
- Adenocarcinoma surgery, Humans, Male, Middle Aged, Predictive Value of Tests, Prognosis, Prostatic Neoplasms surgery, Recovery of Function, Retrospective Studies, Alprostadil administration & dosage, Erectile Dysfunction diagnostic imaging, Erectile Dysfunction drug therapy, Penile Erection, Penis diagnostic imaging, Postoperative Complications drug therapy, Prostatectomy methods, Ultrasonography, Doppler, Color
- Abstract
Objective: To analyse the predictive utility of penile colour Doppler ultrasonography after the injection of vasoactive agents for recovering erectile function after radical prostatectomy., Material and Methods: A retrospective study was conducted on patients with erectile dysfunction after radical prostatectomy who were treated with intracavernous injections of prostaglandins E1 between January 1, 2006 and December 31, 2012. The study included patients with no history of erectile dysfunction prior to the surgery and who did not respond to medical treatment. Colour Doppler was performed on all patients after the intracavernous injection. A peak systolic velocity ≥30cm/sec and an end diastolic velocity ≤5cm/sec were considered normal haemodynamic values. We assessed the result of the treatment during the follow-up using the International Index of Erectile Function-5., Results: We included 197 patients. The mean age was 60.8 (±6.3). The pathological diagnosis for all patients was adenocarcinoma, 74.1% of which were confined to the organ (T1-T2/Nx-N0). Treatment with injections after the surgery was started after a mean duration of 6.8 months (+3.5). The Doppler ultrasonography results were normal for 53 patients (26.9%). During the follow-up, 113 patients (57.4%) maintained functional erections; 55 of these patients (28%) did not require injections. Normal Doppler ultrasonography results were associated with a favourable response to treatment (p<.01)., Conclusions: The prostaglandin E1 test will help provide a diagnosis in erectile dysfunction for patients who have undergone prostatectomies. The test helps provide information on the vascular condition of the penis and useful prognostic information for the follow-up of these patients., (Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2016
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30. [Prevalence of urolithiasis in the 40 to 65 year old Spanish population: The PreLiRenE study].
- Author
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Arias Vega MR, Pérula de Torres LA, Carrasco Valiente J, Requena Tapia MJ, Jiménez García C, and Silva Ayçaguer LC
- Subjects
- Adult, Aged, Cross-Sectional Studies, Female, Health Surveys, Humans, Male, Middle Aged, Prevalence, Spain epidemiology, Urolithiasis epidemiology
- Abstract
Background and Objective: Urolithiasis is a common urologic condition with increasing incidence in the population worldwide. In Andalusia (Spain), the PreLiRenA study showed a high prevalence (16.4%; 95% confidence interval [95% CI] 14.8-17.8) of this condition in population aged between 40 and 65 years. The interesting results reported in that study encouraged us to further investigate the magnitude of this condition at a national level. We aimed to estimate the prevalence of urolithiasis in the Spanish population aged between 40 and 65 years., Patients and Method: This is an observational, cross-sectional, prevalence, stratified sampling study by Spanish region, sex and age. A total of 2,444 telephone interviews were conducted using a questionnaire that covered several sociodemographic and clinical variables. Bivariate, descriptive statistical study was performed. The prevalence ratio (PR) with the 95% CI was calculated., Results: Of the 2,444 subjects interviewed, 51.2% (n=1,251) were women. The prevalence and incidence of urolithiasis were 14.6% (95% CI 13.1-15.9) and 2.9% (95% CI 2.2-3.6), respectively. Significant differences were found by age, with a higher prevalence in 46-50 years (PR 1.58; 95% CI 1.12-2.21; P<.001) and 61-65 years (PR 1.47; 95% CI 1.02-2.13), and upper-class subjects (PR 1.75; 95% CI 1.07-2.86; P<.024). Of respondents, 52.8% had experienced more than one episode of urolithiasis. A total of 46.9% passed the calculus spontaneously, and 51.1% were diagnosed in the Emergency Unit., Conclusions: The prevalence of urolithiasis in the Spanish population aged between 40 and 65 years is high; especially among upper-class subjects and in middle-aged. A high recurrence rate is also observed., (Copyright © 2016 Elsevier España, S.L.U. All rights reserved.)
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- 2016
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31. Graft Survival in Patients With Polycystic Kidney Disease With Nephrectomy of Native Kidney Pretransplant.
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García-Rubio JH, Carrasco Valiente J, Campos Hernández JP, Ruiz García J, Márquez López J, Regueiro López JC, Cano Castiñeira R, Pendón Ruiz de Mier MV, and Requena Tapia MJ
- Subjects
- Female, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Graft Survival, Kidney Transplantation, Nephrectomy, Polycystic Kidney, Autosomal Dominant surgery
- Abstract
Introduction: Autosomal-dominant polycystic disease (ADPKD) represents 5%-10% of cases of end-stage renal failure. However, management of these patients in terms of whether or not to perform a transplant and optimal timing remains controversial. The objective of our analysis was to evaluate graft survival in patients with ADPKD in which we conduct pretransplant nephrectomy., Methods: This retrospective study including renal transplant patients secondary to ADPKD in our hospital between January 2000 and December 2012. Pretransplant native kidney nephrectomy was indicated in cases of need for space or repeated complications (cysts). We compared the initial function and graft survival between groups of transplanted based on whether nephrectomy had been performed or not., Results: Eighty-seven patients underwent a kidney transplant owing to ADPKD; 62% (n = 54) were male, with an average age of 55.22 years. Twenty-seven patients (30%) underwent nephrectomy native kidneys before transplantation. There were no serious postoperative complications. Patients who underwent nephrectomy (group 1) showed values of creatinine of 1.57 and 1.50 mg/dL at 3 and 6 months, respectively. In the no nephrectomy group, these values were 2.03 and 1.83 mg/dL, respectively. Graft survival after the first year was of 98% for group 1 and 95% for group 2. The 5-year implant survival was 95% and 80%, respectively., Conclusions: Native kidney nephrectomy before transplantation in ADPKD is safe in an experienced center, both in terms of surgery-related morbidity and mortality and graft survival and function., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
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32. Assessment and clinical factors associated with pain in patients undergoing transrectal prostate biopsy.
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Gómez-Gómez E, Ramírez M, Gómez-Ferrer A, Rubio-Briones J, Iborra I, J Carrasco-Valiente, Campos JP, Ruiz-García J, Requena-Tapia MJ, and Solsona E
- Subjects
- Adult, Aged, Aged, 80 and over, Humans, Image-Guided Biopsy adverse effects, Image-Guided Biopsy methods, Male, Middle Aged, Prostate diagnostic imaging, Prostatic Neoplasms diagnostic imaging, Rectum, Retrospective Studies, Ultrasonography, Interventional, Urologic Surgical Procedures adverse effects, Anesthesia, Local, Pain etiology, Pain Measurement, Prostate pathology, Prostatic Neoplasms pathology
- Abstract
Objectives: To quantify the degree of pain experienced by patients who undergo ultrasound-guided transrectal prostate biopsy in standard clinical practice and assess the clinical factors associated with increased pain., Material and Methods: Analysis of a multicenter series of patients with prostate biopsy according to standard clinical practice. The biopsy was performed transrectally with a protocol of local anesthesia on the posterolateral nerve bundle. The pain was assessed at 20minutes into the procedure using the visual analog scale (0-10). The degree of pain was analyzed, and the association was studied using a univariate/multivariate analysis of selected clinical variables and the degree of pain., Results: A total of 1188 patients with a median age of 64 years were analyzed. Thirty percent of the biopsies were diagnosed with a tumor. The median pain score was 2, with 65% of the patients reporting a pain score ≤2. The multivariate analysis showed that the prostate volume (RR, 1.34; 95% CI 1.01-1.77; P=.04), having a previous biopsy (RR, 2.25; 95% CI 1.44-3.52; P<.01), age (RR, .63; 95% CI .47-.85; P<.01) and feel palpation (RR, 1.95; 95% CI 1.28-2.96; P<.01) were factors independently associated with greater pain during the procedure., Conclusions: Transrectal biopsy with local anesthesia is a relatively painless technique. Factors such as age, a previous biopsy, pain on being touched and prostate volume were associated with the presence of greater pain during the procedure., (Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2015
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33. Impact of 3D vision on mental workload and laparoscopic performance in inexperienced subjects.
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Gómez-Gómez E, Carrasco-Valiente J, Valero-Rosa J, Campos-Hernández JP, Anglada-Curado FJ, Carazo-Carazo JL, Font-Ugalde P, and Requena-Tapia MJ
- Subjects
- Clinical Competence, Cross-Over Studies, Female, Headache etiology, Humans, Laparoscopy methods, Male, Mental Fatigue etiology, Prospective Studies, Psychomotor Performance, Surveys and Questionnaires, Vision Disorders etiology, Young Adult, Imaging, Three-Dimensional adverse effects, Laparoscopy psychology, Simulation Training, Surgeons psychology, Urologic Surgical Procedures
- Abstract
Objective: To assess the effect of vision in three dimensions (3D) versus two dimensions (2D) on mental workload and laparoscopic performance during simulation-based training., Materials and Methods: A prospective, randomized crossover study on inexperienced students in operative laparoscopy was conducted. Forty-six candidates executed five standardized exercises on a pelvitrainer with both vision systems (3D and 2D). Laparoscopy performance was assessed using the total time (in seconds) and the number of failed attempts. For workload assessment, the validated NASA-TLX questionnaire was administered., Results: 3D vision improves the performance reducing the time (3D = 1006.08 ± 315.94 vs. 2D = 1309.17 ± 300.28; P < .001) and the total number of failed attempts (3D = .84 ± 1.26 vs. 2D = 1.86 ± 1.60; P < .001). For each exercise, 3D vision also shows better performance times: "transfer objects" (P = .001), "single knot" (P < .001), "clip and cut" (P < .05), and "needle guidance" (P < .001). Besides, according to the NASA-TLX results, less mental workload is experienced with the use of 3D (P < .001). However, 3D vision was associated with greater visual impairment (P < .01) and headaches (P < .05)., Conclusion: The incorporation of 3D systems in laparoscopic training programs would facilitate the acquisition of laparoscopic skills, because they reduce mental workload and improve the performance on inexperienced surgeons. However, some undesirable effects such as visual discomfort or headache are identified initially., (Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2015
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34. [When should we perform a bone scintigraphy in patients with new diagnosis of asymptomatic prostate cancer in order to detect bone metastasis?].
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Márquez-López J, Gómez-Gómez E, Anaya-Henares F, Robles-Casilda R, and Requena-Tapia MJ
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- Adult, Aged, Aged, 80 and over, Asymptomatic Diseases, Early Detection of Cancer, Humans, Male, Middle Aged, Neoplasm Grading, Prostate-Specific Antigen blood, Prostatic Neoplasms blood, Radionuclide Imaging, Retrospective Studies, Bone Neoplasms diagnostic imaging, Bone Neoplasms secondary, Prostatic Neoplasms pathology
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Objective: To define, based on PSA value, Gleason score (GS), clinical stage and age, those patients diagnosed with asymptomatic prostate cancer whose cases warrant further study of bone metastasis (BMet)., Methods: From January 2006 to May 2010, we evaluated 263 patients diagnosed with prostate cancer who were chosen for further study of bone scintigraphy following the consensus protocol accepted by the Ministry of Health of Andalusia (Integrated Andalusian Process Prostate Cancer-BPH). All selected studies met the criteria defined in the test indications: PSA >10 or Gleason score (GS) ≥7 or positive biopsy of seminal vesicles, all without symptoms of bone pain. A multivariate analysis of potential predictive factors for positive bone scintigraphy was performed and cutoffs were determined by calculating the following diagnostic rates: sensitivity, specificity and positive and negative predictive values with their respective confidence intervals at 95% certainty., Results: BMet were detected in 29 cases (11%). The average age of the patients with a positive bone scan was 65.5 and 68.4 years in those with a negative result (p=0.03). Multivariate analysis showed that GS OR: 2.08 [95% CI (1.34 - 3.18)] (p<0.001) and PSA level 21-200 ng/ml OR: 3.68 [95% CI (1.13-1.02)] (p<0.05) were independent predictive variables for positive bone scan. The cutoffs were estimated by ROC curve analysis, resulting in a cutoff of 16.18 ng/ml for PSA value and 7 for GS (larger area under the curve: 0.864 with a sensitivity of 94.5% and specificity of 47%)., Conclusions: In the group of patients defined in our study, diagnosed with asymptomatic prostate cancer, the assessment of BMet using a bone scan should be carried out with a PSA level ≥ 16.18 ng/ml and GS ≥7 as reference points.
- Published
- 2015
35. Short-term evolution of renal transplant with grafts from donation after cardiac death: Type III Maastricht category.
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Salmeron-Rodriguez MD, Navarro-Cabello MD, Agüera-Morales ML, Lopez-Andreu M, Rodriguez-Benot A, Robles-Arista JC, Dueñas-Jurado JM, Campos-Hernandez JP, Requena-Tapia MJ, and Aljama-Garcia P
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- Adult, Aged, Cold Ischemia, Delayed Graft Function epidemiology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Renal Dialysis, Treatment Outcome, Warm Ischemia, Donor Selection, Heart Arrest, Kidney Failure, Chronic therapy, Kidney Transplantation
- Abstract
Background: Kidney transplantation from donors after cardiac death (Type III Maastricht category) is a therapeutic option for patients with terminal renal failure., Materials and Methods: We present a cohort of 8 patients who received a kidney transplant from donors after cardiac death (DCD). We analyzed the analytical results for the first 6 months after transplantation., Results: We included 8 cases of kidney transplants with organs from DCD (Type III Maastricht category). The mean age of donors was 58.40 ± 4.39 years and 3 (60%) were male. The mean creatinine (Cr) level prior to death was 1.10 ± 0.36 mg/dL. The mean age of recipients was 59.88 ± 10.58 years and 7 (87.5%) were male. Seven patients (87.5%) were on hemodialysis, whereas only 1 (12.5%) was on peritoneal dialysis. The median time on renal replacement therapy was 18 months (range, 2-76). Mean total warm ischemia time (WIT) was 24.88 ± 6.72 minutes, whereas the mean real WIT was 20.13 ± 4.51 minutes. The mean cold ischemia time (CIT) was 6 hours and 12 minutes ± 2 hours. Preimplantation biopsy showed acute tubular necrosis (extensive 40%). Tubular atrophy was mild in 100% of cases. After transplantation, 6 patients (75%) had delayed graft function requiring dialysis sessions whereas 2 patients (25%) did not require renal replacement therapy. Mean Cr level at 1, 3, and 6 months after transplantation was 2.37, 1.75, and 1.17 mg/dL, respectively., Conclusion: Kidney transplantation with grafts from donors after cardiac arrest Maastricht Type III evolves favorably in the short term. According to preliminary results, controlled asystole donation could be an effective alternative to transplantation., (Copyright © 2015 Elsevier Inc. All rights reserved.)
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- 2015
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36. Influence of surgical complications on kidney graft survival in recipients of simultaneous pancreas kidney transplantation.
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Campos Hernández JP, Gómez Gómez E, Carrasco Valiente J, Márquez López FJ, Ruiz García J, Anglada Curado FJ, Prieto Castro R, Ruiz Rabelo J, Navarro Cabello ML, and Requena Tapia MJ
- Subjects
- Adult, Aged, Diabetes Mellitus, Type 1 complications, Female, Humans, Incidence, Kaplan-Meier Estimate, Kidney Failure, Chronic etiology, Male, Middle Aged, Multivariate Analysis, Proportional Hazards Models, Retrospective Studies, Risk Factors, Severity of Illness Index, Treatment Outcome, Diabetes Mellitus, Type 1 surgery, Graft Survival, Kidney Failure, Chronic surgery, Kidney Transplantation methods, Pancreas Transplantation methods, Postoperative Complications diagnosis, Postoperative Complications epidemiology
- Abstract
Purpose: Simultaneous pancreas-kidney transplantation is the gold standard treatment for patients with end-stage renal failure secondary to insulin-dependent diabetes mellitus. This kind of transplantation is a complex operation associated with a high incidence of surgical complications and mortality risk which could influence graft survival. The aim of this study was to establish the influence of different grades of postoperative complications, classified according to Clavien-Dindo, on the rate of kidney graft loss., Methods: We performed an observational retrospective review of all simultaneous transplantations performed between February 1989 and May 2012. Factors examined were related to recipient and donor characteristics, surgical procedures, and postoperative outcomes. For this purpose, Kaplan-Meier analyses and Cox-Regression tests are used., Results: One hundred thirty-nine transplantations were performed. Complications grades I, II, and IIIa were experienced in 81 (58.3%) patients, and grades IIIb and IVa-b in 55 (39.6%). Multivariate analysis showed an influence of panel reactive antibody (hazard ratio [HR]: 10.79; P = .003), incidence of acute rejection (HR: 2.55; P = .03), and complications grouped into grades IIIb and IVa-b (HR: 3.63; P = .02). Kaplan Meier analysis showed worse kidney graft survival rate in groups grades IIIb and IVa-b compared to grades I, II, and IIIa (86.6% vs 98.7% at 1 year and 81.8% vs 97.3% at 5 years; P = .001)., Conclusions: Despite being the gold standard treatment for these patients, pancreas and kidney transplantations have numerous complications which could influence the prognosis of graft kidney survival., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
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37. Index high insulin resistance in pancreas-kidney transplantation contributes to poor long-term survival of the pancreas graft.
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Pendón-Ruiz de Mier V, Navarro Cabello MD, Martínez Vaquera S, Lopez-Andreu M, Aguera Morales ML, Rodriguez-Benot A, Ruiz Rabelo J, Campos Hernandez P, Requena Tapia MJ, and Aljama Garcia P
- Subjects
- Adult, Blood Glucose analysis, Body Mass Index, Female, Glucose Tolerance Test, Glycated Hemoglobin analysis, Humans, Insulin blood, Insulin-Secreting Cells metabolism, Kidney Failure, Chronic surgery, Male, Middle Aged, Pancreas metabolism, Peptides analysis, Proteinuria, Glycemic Index physiology, Graft Survival, Insulin Resistance, Kidney Transplantation, Pancreas Transplantation
- Abstract
Background: Pancreas-kidney transplantation (PKT) is the best therapeutic option for diabetic patients with end-stage renal failure. Peripheral insulin resistance and the percentage of remaining β-cells in the PKT have been little studied in medical literature., Methods: We analyzed PKT performed in our hospital from January 1992 to January 2014, with follow-up for 5 years. Metabolic values related to glycemic were studied, namely, proteinuria, peptide C, glucose, insulin, and glycosylated hemoglobin. We analyzed insulin resistance (homeostatic model assessment [HOMA]-IR), the percentage of remaining β-cells (HOMA-β), and the influence of these variables on the glycemic profile and graft survival., Results: In the study period, 156 simultaneous PKT were performed in our center. At 2 years posttransplantation, the median value of HOMA-IR kidney-pancreas was 4. We compared transplantation with lower HOMA-IR (<4) and higher HOMA-IR (>4). HOMA-β (36 [26-67] vs 29 [14-42]; P = .04), glucose (86 [80-90] vs 81 [74-89]; P = .018), and body mass index (BMI; 24 [21-27] vs 21 [19-24]; P = .013) were greater in the group HOMA-IR>4 versus HOMA-IR<4 group, respectively, after 3 months. These differences in glycemic profile were maintained until the first year after transplantation. At 2 and 5 years of follow-up, the HOMA-IR>4 group showed higher glucose levels and greater BMI, but not differences in HOMA-β. At 1 and 5 years posttransplantation, pancreatic graft survival in the HOMA-IR>4 group (82.9% vs 92.5%) was lower compared with the HOMA-IR<4 group (67% vs 87.5%; P = .016)., Conclusions: PKT exhibit an altered glycemic profile in the posttransplantation follow-up associated with the percentage of remaining β-cells and peripheral insulin resistance. PKT patients with peripheral insulin resistance showed decreased pancreatic graft survival., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
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38. Prevalence of renal stones in Andalusian population: results of PreLiRenA study.
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Cano-Castiñeira R, Carrasco-Valiente J, Pérula-de-Torres LA, Jiménez-García C, Olaya-Caro I, Criado-Larumbe M, and Requena-Tapia MJ
- Subjects
- Adult, Aged, Cross-Sectional Studies, Humans, Incidence, Middle Aged, Prevalence, Risk Factors, Spain epidemiology, Kidney Calculi epidemiology
- Abstract
Introduction: Urolithiasis is a disease having a high recurrence rate and associated morbidity. A not well quantified increase is being seen in recent years that could be related with various factors. The main purpose of our study has been to estimate urolithiasis prevalence and incidence in the region of Andalusia, determining which factors are associated., Material and Methods: We performed an observational and cross-sectional study. Using a multistage randomized procedure, we selected a sample of 2439 subjects, aging from 40 to 65 years old, who currently lived in Andalusia. Data was collected through phone interviews, questioning the chosen subjects about their kidney stones history, comorbidity and socio-demographic characteristics. We conducted a descriptive, bivariate and multivariate analysis with logistic regression., Results: A total of 2439 subjects were surveyed. Subjects had mean age of 51.1±7.61 years - standard deviation; (95% confidence interval - 95% CI: 50.70-51.30), 48.7% of whom were male. Prevalence of urolithiasis obtained was 16.4% (95% CI: 14.87-17.85%) and an incidence of 1.2 (95% CI: .74-1.64). Variables significantly associated with the presence of urolithiasis found in the multivariate study were: presence of a family history of kidney stones (odds ratio -OR: 1.91; 95% CI: 1.51-2.40, P<.001), hypertension (OR:1.58; 95% CI:1.24-2.02; P<.001), gout (OR:1.98; 95% CI: 1.26-3,12; P=.003) and a high BMI (OR: 1.60; 95% CI 1.19-2.17; p=.008)., Conclusions: A significant increase in the prevalence and incidence of urolithiasis is observed in the environment in regards to the previously available figures. The presence of a family history of urolithiasis, hypertension, gout as well as having a high BMI could influence the observed epidemiological changes in renal lithiasis., (Copyright © 2013 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2015
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39. Pre-chemotherapy abiraterone acetate. A proposal of a treatment algorithm in castration resistant prostate cancer.
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Arrabal-Martín M, Anglada-Curado F, Cózar-Olmo JM, Soler-Martínez J, Moreno-Jiménez J, Castiñeiras-Fernández J, Ledo-Cepero MJ, Beardo-Villar P, Requena-Tapia MJ, and Zuluaga-Gómez A
- Subjects
- Drug Therapy, Combination, Humans, Male, Steroid 17-alpha-Hydroxylase antagonists & inhibitors, Abiraterone Acetate therapeutic use, Algorithms, Antineoplastic Agents therapeutic use, Prostatic Neoplasms, Castration-Resistant drug therapy
- Abstract
Context: Prostate cancer treatment remains a challenge for the urologist. Medical control in locally advanced or metastatic prostate cancer is usually performed with LHRH analogues and/or antiandrogens. Different treatments have been proposed when there is biochemical and clinical progression of the disease and other new ones have changed the patients' perspective and life expectancy., Objective: This review has aimed to establish the current role of Abiraterone Acetate in the treatment of castration-resistant prostate cancer and facilitate decision-making by the Urologist by means of a Treatment Algorithm., Acquisition of the Evidence: A search of current evidence on Abiraterone treatment in patients with castration- resistant metastatic prostate cancer was performed in PubMed, mainly analyzing those studies designed as clinical trials. In addition, we reviewed and updated the role of hormone therapy and androgen receptors in prostate cancer., Evidence Synthesis: There are currently basically two clinical trials that demonstrate the effectiveness of Abiraterone in metastatic prostate cancer compared to placebo. The study COU-AA 302 shows a clear benefit with Abiraterone prior to chemotherapy in patients with castration-resistant prostate cancer, this making it possible to establish an algorithm for initial treatment that facilitates decision-making by the urologist., Conclusion: Abiraterone is a pre-chemotherapy treatment option in selected patients with castration resistant metastatic prostate cancer, although it is necessary to improve the cost and to design more multicenter clinical trials to optimize the cost/benefit ratio., (Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.)
- Published
- 2014
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40. Bladder cancer in Spain 2011: population based study.
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Miñana B, Cózar JM, Palou J, Unda Urzaiz M, Medina-Lopez RA, Subirá Ríos J, de la Rosa-Kehrmann F, Chantada-Abal V, Lozano F, Ribal MJ, Rodríguez Fernández E, Castiñeiras Fernández J, Concepción Masip T, Requena-Tapia MJ, Moreno-Sierra J, Hevia M, Gómez Rodríguez A, Martínez-Ballesteros C, Ramos M, Amón Sesmero JH, Pizá Reus P, Bohorquez Barrientos A, Rioja Sanz C, Gomez-Pascual JA, Hidalgo Zabala E, Parra Escobar JL, and Serrano O
- Subjects
- Administration, Intravesical, Adult, Aged, Aged, 80 and over, Antibiotics, Antineoplastic administration & dosage, Comorbidity, Female, Hematuria epidemiology, Humans, Incidence, Male, Middle Aged, Mitomycin administration & dosage, Neoplasm Invasiveness, Neoplasm Staging, Population Surveillance, Smoking epidemiology, Spain epidemiology, Urinary Bladder Neoplasms drug therapy, Urinary Bladder Neoplasms pathology, Urinary Bladder Neoplasms surgery, Young Adult, Urinary Bladder Neoplasms epidemiology
- Abstract
Purpose: We estimate the annual incidence of bladder cancer in Spain and describe the clinical profile of patients with bladder cancer enrolled in a population based study., Materials and Methods: Using the structure of the Spanish National Health System as a basis, in 2011 the AEU (Spanish Association of Urology) conducted this study with a representative sample from 26 public hospitals and a reference population of 10,146,534 inhabitants, comprising 21.5% of the Spanish population., Results: A total of 4,285 episodes of bladder cancer were diagnosed, of which 2,476 (57.8%) were new cases and 1,809 (42.2%) were cases of recurrence, representing an estimated 11,539 new diagnoses annually in Spain. The incidence of bladder cancer in Spain, age adjusted to the standard European population, was 20.08 cases per 100,000 inhabitants (95% CI 13.9, 26.3). Of patients diagnosed with a first episode of bladder cancer 84.3% were male, generally older than 59 years (81.7%) with a mean ± SD age of 70.5 ± 11.4 years. Of these patients 87.5% presented with some type of clinical symptom, with macroscopic hematuria (90.8%) being the most commonly detected. The majority of primary tumors were nonmuscle invasive (76.7%) but included a high proportion of high grade tumors (43.7%). According to the ISUP (International Society of Urologic Pathology)/WHO (2004) classification 51.1% was papillary high grade carcinoma. Carcinoma in situ was found in 2.2% of primary and 5.8% of recurrent cases., Conclusions: The incidence of bladder cancer in Spain, age adjusted to the standard European population, confirms that Spain has one of the highest incidences in Europe. Most primary nonmuscle invasive bladder cancer corresponded to high risk patients but with a low detected incidence of carcinoma in situ., (Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
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41. Palliative surgery for rare cases of anterior urethral metastasis in prostate cancer.
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Gómez Gómez E, Carrasco Aznar JC, Moreno Rodríguez Mdel M, Valero Rosa J, and Requena Tapia MJ
- Abstract
Penis metastasis from prostate cancer is very rare, and its management varies from case to case as there are very few cases reported in the literature. We describe a patient with prostate cancer treated with radiotherapy and androgen deprivation therapy who presented with urethral bleeding as a symptom of anterior urethral metastasis during followup. We propose a way to manage this and review the literature.
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- 2014
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42. Prognostic value of microvascular invasion in predicting survival in renal cell carcinoma.
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Santiago-Agredano B, Álvarez-Kindelán J, Font-Ugalde P, Blanca-Pedregosa A, López-Beltrán A, and Requena-Tapia MJ
- Subjects
- Adult, Carcinoma, Renal Cell surgery, Disease-Free Survival, Female, Humans, Kidney Neoplasms surgery, Male, Middle Aged, Neoplasm Invasiveness, Prognosis, Retrospective Studies, Survival Rate, Carcinoma, Renal Cell mortality, Carcinoma, Renal Cell pathology, Kidney Neoplasms mortality, Kidney Neoplasms pathology, Microvessels, Vascular Neoplasms mortality, Vascular Neoplasms pathology
- Abstract
Objective: To assess microvascular tumor invasion and other clinical and histological parameters as potential prognostic factors in surgically treated renal cell carcinoma., Materials and Methods: Surgical specimens from 238 consecutive patients who underwent radical or partial surgery between 1990 and 2006 were retrospectively evaluated. The series included clinically localized or metastatic renal cell carcinoma (pT1-4; N0-1; M0-1). Disease-free and cancer-specific survival assessments were the end points with median follow-up of 75 months (range 1-189 months). Variables studied included: age, sex, tumor size, TNM 2010 classification, Fuhrman grade, histological subtype and microvascular tumor invasion., Results: Microvascular tumor invasion was observed in 79 patients (33,2%) and was significantly associated with age (P=.010), tumor size (P=.000), Fuhrman grade (P=.000), pT stage 2010 (P=.000),N stage 2010 (P=.000) and M stage 2010 (P=.000). Multivariate analyses determined that sex, Fuhrman grade, pT stage 2010 and histological subtipe were independent prognostic factors of disease-free survival, while sex, Fuhrman grade, pT stage 2010, M stage 2010, histological subtype and microvascular invasion were prognostic factors for cancer-specific survival., Conclusions: Our study shows that microvascular tumor invasion is an independent prognostic factor for cancer-specific survival in surgically treated patients with renal cell carcinoma., (Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.)
- Published
- 2013
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43. Extracorporeal shock wave lithotripsy for distal ureteral calculi: improved efficacy using low frequency.
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Anglada-Curado FJ, Campos-Hernández P, Carrasco-Valiente J, Anaya-Henares F, Carazo-Carazo JL, Alvarez-Kindelán J, Regueiro-López JC, and Requena-Tapia MJ
- Subjects
- Adult, Female, Follow-Up Studies, Humans, Lithotripsy adverse effects, Male, Middle Aged, Pain Measurement, Pain, Postoperative physiopathology, Prospective Studies, Radio Waves, Reference Values, Risk Assessment, Severity of Illness Index, Treatment Outcome, Young Adult, Lithotripsy methods, Ureteral Calculi diagnosis, Ureteral Calculi therapy
- Abstract
Objectives: To compare low versus high frequency for lithotripsy in the management of distal ureteral calculi., Methods: A total of 154 patients with radio-opaque calculi (0.5-1 cm diameter) in the distal ureter were randomized to be given either lithotripsy at 80 or 60 pulses per min (high frequency or low frequency groups, respectively). The number of waves and sessions received, and time to total resolution were measured. A Dornier Compact Delta lithotripter was used., Results: A total of 72 patients were assigned to the high frequency group and 78 to the low frequency group. Four patients were excluded from the study because of intolerance of the procedure. The size was slightly lower in low frequency group, whereby an analysis of covariance was carried out to eliminate the size factor, with the limit established as 0.7 cm. The low frequency group received 2980 ± 1211 waves, and the high frequency group received 5752 ± 3121 (P<0.001). The success rate was higher in the low frequency group (100%) than in the high frequency group (92.9%; P=0.02). If adjusted to the size of the calculus with a threshold of 0.7 cm, there was a difference, although it was not statistically significant. The time to elimination of the fragments was higher in the high frequency group (17.68 days) than in the low frequency group (7.15 days; P<0.001). The number of sessions necessary for resolution was higher in the high frequency group (1.56) than in the low frequency group (1.14; P<0.001)., Conclusions: Lithotripsy at 60 pulses provides better outcomes than lithotripsy at 80 pulses for the treatment of distal ureteral calculi., (© 2012 The Japanese Urological Association.)
- Published
- 2013
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44. [State of acute phase markers and oxidative stress in patients with kidney stones in the urinary tract].
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Carrasco-Valiente J, Anglada-Curado FJ, Aguilar-Melero P, González-Ojeda R, Muntané-Relat J, Padillo-Ruiz FJ, and Requena-Tapia MJ
- Subjects
- Adult, Biomarkers blood, Female, Humans, Kidney Calculi blood, Male, Middle Aged, Prospective Studies, Acute-Phase Proteins analysis, Kidney Calculi metabolism, Oxidative Stress
- Abstract
Objective: This present study has aimed to assess the state of acute phase markers and oxidative stress in patients with kidney stones., Material and Methods: A prospective study was carried out on 100 patients with kidney stones and 25 healthy controls. Albumin, ß2 microglobulin, Gamma-glutamyl transpepsidase, Lactate dehydrogenase, Tumor necrosis factor alpha, Interleukin 1 and Interleukin-6 were evaluated as acute phase markers and lipid peroxidation products, Superoxide dismutase and Glutathione peroxidase levels acted as oxidative stress markers., Results: An increase in renal cell damage markers as expressed by the ß2 microglobulin (p=0.04), albumin (p=0.004), Lactate dehydrogenase (p=0.001) and Gamma glutamyl transpepsidasa (p=0.01) was observed in the patient group. There was a direct correlation between levels of ß2 microglobulin and stone size (r=0.3, p=0.03). The association between stone size and cytokine activation was observed to be stronger in patients with staghorn calculi. In these patients, Tumor necrosis factor alpha (p=0.011), Interleukin 1 (p=0.004) and Interleukin 6 (p=0.004) were significantly higher. Patients with stones in the urinary tract showed data of significantly higher oxidative stress, expressed as an increase in levels of lipid peroxidation products (p=0.03) and a decrease in the antioxidant activity of Superoxide dismutase (p=0.03) and Glutathione peroxidase (p=0.002)., Conclusions: Patients undergoing urolithiasis showed an elevation of acute phase markers, associated with oxidative stress as expressed by an increase in lipid peroxidation products and a decrease in the antioxidant enzyme activity., (Copyright © 2011 AEU. Published by Elsevier Espana. All rights reserved.)
- Published
- 2012
- Full Text
- View/download PDF
45. Hand metastasis from renal carcinoma.
- Author
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Anglada-Curado FJ, De Haro-Padilla J, Carrasco-Valiente J, Alvarez-Kindelan J, Ruiz-Garcia J, and Requena-Tapia MJ
- Subjects
- Aged, Brain Neoplasms secondary, Carcinoma, Renal Cell diagnosis, Carcinoma, Renal Cell surgery, Female, Hand Injuries complications, Humans, Kidney Neoplasms surgery, Nephrectomy, Skin Neoplasms diagnosis, Skin Neoplasms surgery, Carcinoma, Renal Cell secondary, Hand pathology, Kidney Neoplasms pathology, Skin Neoplasms secondary
- Abstract
Renal carcinoma may develop metachronous distant metastases without evidence of regional or local disease recurrence. These lesions may be misdiagnosed because of its benign-like appearance and lack of evidence of other disease spread., (Copyright © 2010 Elsevier Inc. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
46. [New epidemiologic patterns and risk factors in renal cancer].
- Author
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Anglada Curado FJ, Campos Hernández P, Prieto Castro R, Carazo Carazo JL, Regueiro López JC, Vela Jiménez F, and Requena Tapia MJ
- Subjects
- Humans, Kidney Neoplasms etiology, Risk Factors, Spain epidemiology, Kidney Neoplasms epidemiology
- Abstract
Incidence of renal carcinoma, one of the most fatal solid neoplasms, has steadily increased in Western society. Moreover, these tumors are being increasingly detected in their early stages. As with most cancers, the underlying causes of the disease remain unknown. However, understanding of pathogenesis of this tumor is rapidly advancing, and will allow for new treatments for advanced disease. Understanding of the influence of easily avoidable risk factors may allow for prevention of thousands of deaths caused by renal cancer.
- Published
- 2009
- Full Text
- View/download PDF
47. [The 2004 WHO classification of bladder tumors: a summary and commentary].
- Author
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Alvarez Kindelán J, Campos Hernández JP, López Beltrán A, and Requena Tapia MJ
- Subjects
- Humans, Urothelium pathology, World Health Organization, Urinary Bladder Neoplasms classification, Urinary Bladder Neoplasms pathology
- Abstract
The Key points of the latest World Health Organization (WHO) classification of non-invasive urothelial tumors are the following: the description of the categories has been expanded to improve their recognition: a tumor with particularly good prognosis (papillary urothelial neoplasm of low malignant potential) no longer carries the label of "cancer"; it avoids the use of ambiguous grading as grade 1/2 o 2/3 (as done in the 1973 WHO classification); the group of non-invasive high-grade carcinoma is large enough to virtually contain all those tumors having biological properties similar to those seen in invasive urothelial carcinoma, and a similarly high level of genetic instability. This scheme is meant to replace the 1973 WHO classification, but the use of both the 1973 and the latest WHO classification is recommended until the latter is sufficiently validated.
- Published
- 2007
- Full Text
- View/download PDF
48. Urinary bladder cancer risk factors in men: a Spanish case-control study.
- Author
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Baena AV, Allam MF, Del Castillo AS, Díaz-Molina C, Requena Tapia MJ, Abdel-Rahman AG, and Navajas RF
- Subjects
- Age Factors, Aged, Case-Control Studies, Confounding Factors, Epidemiologic, Diet Surveys, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Retrospective Studies, Risk Factors, Smoking adverse effects, Spain epidemiology, Urinary Bladder Neoplasms epidemiology, Urinary Bladder Neoplasms etiology
- Abstract
The rising incidence of urinary bladder cancer is alarming and potential relationships with different risk factors have been postulated. The purpose of this study was to examine the possible relationship between different environmental risk factors and urinary bladder cancer. All men with urinary bladder cancer who were admitted to the Department of Urology of Reina Sofia University Hospital of Cordoba, Spain over 1 year were included in our study. Men were administered an interview questionnaire, which included data on history of known urinary bladder cancer risk factors. Comparisons between men with urinary bladder cancer (cases) and those with nonmalignant urological disease (controls) were made. The study included 74 cases and 89 controls. The variables associated with malignant lesions on univariate analysis were age, smoking and drinking alcohol. Meanwhile, fish, poultry and beef consumption were proved to be protective factors. The risk factors identified by the logistic regression analysis were age, smoking and fluid intake. The independent protective factors on the multivariate analysis were fish and poultry consumptions. Smoking was found to be the principal independent risk factors for urinary bladder cancer. Our results call for further investigation of urinary bladder cancer risk factors; future studies should preferably be performed on large prospective cohorts, to increase their validity.
- Published
- 2006
- Full Text
- View/download PDF
49. [Determination of free prostatic specific antigen cut point for the selection of patients in first prostate biopsy].
- Author
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López Luque A, Gómez Bermudo J, Márquez López J, Leva Vallejo M, Regueiro López JC, and Requena Tapia MJ
- Subjects
- Biopsy, Humans, Male, Middle Aged, Prospective Studies, Patient Selection, Prostate-Specific Antigen blood, Prostatic Neoplasms blood, Prostatic Neoplasms pathology
- Abstract
Objectives: Determine the cut point of free PSA rate for optimize the first prostate biopsy indication., Material and Methods: Prospective trial between june 2002-september 2004, We included patients in first prostate biopsy with normal rectal digital examen, total PSA between 3-10 ng/ml and normal transrectal prostate ultrasound. We realize descriptive stadistic analisis of variables age, total PSA, prostate volume and % free PSA and analitic stadistic analisis with ROC curves of variables total PSA and % free PSA for determine as of her predicts the best one rate of prostate cancer., Results: We reclute 727 men with a mean age 62.91 years, total PSA mean 6.12 ng/ml, prostate volume mean 42.78 cc and % free PSA mean 15.22%. We had 106 prostate cancer, the prostate cancer rate in first biopsy was 14.6%; 77 cases had 1 lobe prostate cancer and 29 in 2 lobes. The most frecuent gleason was 6 (46 cases 43.4%) and the second gleason 7 (43 cases 40.6%). In the ROC curves analysis, total PSA had area under the curve 0.476 (p=0.3) and 0.611 (p=0.023) for % free PSA. The optime cut point for % free PSA in our trial was 19% (Sensibility 91.4% and Specificity 20%). The use of this cut point had allowed the saving us 138 biopsies (19.11%) with the lost one of diagnose of 10 cases of cancer of prostate., Conclusions: The use of the % free PSA is useful and allows in our region the best indication of the patients who are going to first biopsy of prostate, avoiding the accomplishment of unnecessary biopsies.
- Published
- 2006
- Full Text
- View/download PDF
50. [Multilocular cystic renal carcinoma: pathologic study of 14 cases].
- Author
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Romero Ortiz A, López-Beltrán A, Pérez Luque A, and Requena Tapia MJ
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Carcinoma pathology, Kidney Neoplasms pathology, Polycystic Kidney Diseases pathology
- Abstract
Objectives: The article focuses on the multilocular cystic renal carcinoma, the most frequent of the renal cystic carcinomas. The importance of performing a separate analysis of these cystic tumors comes from their better prognosis some authors have suggested. Moreover, they are frequently difficult to differentiate from multilocular benign cysts and other benign lesions by radiological studies, cytology or even during surgery. Pathologic study is essential for a definitive diagnosis of the lesion., Methods and Results: We reviewed 14 cases of multilocular cystic renal carcinoma obtained from the series of 191 renal cell carcinomas diagnosed in our hospital in the period 1995-2002. Inclusion criteria were existence of a multicystic complex mass, in which clear cells partially or completely covered the cystic walls and accumulate within the septa., Conclusions: The lack of well-documented cases of multilocular cystic renal carcinoma with metastases supports the fact that they are tumors with a very good prognosis. In conclusion, data from both literature and our series support that multilocular cystic renal carcinoma should be considered a low-grade neoplasia, and its treatment should be conservative.
- Published
- 2005
- Full Text
- View/download PDF
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