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1. Plant Fucosyltransferases and the Emerging Biological Importance of Fucosylated Plant Structures

Author

Soto, MJ, Urbanowicz, BR, and Hahn, MG

Subjects
Arabinogalactan proteins, fucosyltransferase, glycosyltransferase, plant cell walls, xyloglucan, Plant Biology & Botany, Plant Biology, Crop and Pasture Production
Abstract

Plants frequently incorporate the monosaccharide l-fucose (Fuc; 6-deoxy-l-galactose) into glycans and glycopolymers located in diverse cellular locations. The incorporation of Fuc onto these varied glycans is carried out by fucosyltransferases (FUTs), that make up a protein superfamily with equally varied and diverse functions. The structures wherein Fuc is found have numerous proposed and validated functions, ranging from plant growth and development, cell expansion, adhesion, and signaling, to energy metabolism, among others. FUTs from several different plant species have been identified and described; however, very few of them have been extensively characterized biochemically and biologically. In this review, we summarize plant FUTs that have been biochemically characterized and biologically investigated for associated phenotypes, offering greater insight and understanding into the physiological importance of Fuc in plants and in plant cell wall structures, glycans, and proteins.

Published
2019

2. Functional genomics of Chlamydomonas reinhardtii

Author

Blaby, IK, Soto, MJ, and Blaby-Haas, CE

Abstract

Access to the Chlamydomonas reinhardtii genome provides the means to pursue fundamental genomics-based research of relevance to algae, land plants, and animal lineages. Of the 17,741 gene models, the function of most is only of limited knowledge, thus undermining our ability to truly understand the biology of this alga, and plants at large. Transcriptomes, proteomes, and phenomes can each provide clues by presenting a global snapshot image of the behavior of the cell under specific conditions. Herein we describe the history of functional genomics, how it is being applied to Chlamydomonas, and discuss the resources available for the experimental validation of function predictions.

Published
2023

3. Venous Thromboembolism in Patients With Autoimmune Disorders: Findings From the RIETE Registry

Author

Sada PR, López-Núñez JJ, Samperiz A, Soto MJ, Pedrajas JM, Porras JA, Peris ML, Olivé A, Debourdeau P, Pace F, Monreal M, and RIETE Investigators

Subjects
bleeding, anticoagulant therapy, autoimmune disorders, recurrences, venous thromboembolism
Abstract

Patients with autoimmune disorders are at an increased risk of venous thromboembolism (VTE), but this association has not been consistently evaluated. We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) database to compare the rates of VTE recurrences, major bleeding, and death during the course of anticoagulation, according to the presence or absence of autoimmune disorders. Of 71 625 patients with VTE recruited in February 2018, 1800 (2.5%) had autoimmune disorders. Median duration of anticoagulant therapy was slightly longer in patients with autoimmune disorders (median, 190 vs 182 days; P = .001). On multivariable analysis, patients with autoimmune disorders had a similar risk of VTE recurrences (hazard ratio [HR]: 0.93; 95% confidence interval [CI]: 0.68-1.27) or major bleeding (HR: 1.07; 95% CI: 0.82-1.40) and a lower risk to die (HR: 0.66; 95% CI: 0.54-0.81) than those without autoimmune disorders. Patients with giant cell arteritis had the highest rates of major bleeding (8.6 events per 100 patient-years) and the lowest rate of recurrences (zero). In other subgroups, the rates of both events were more balanced. During anticoagulation, patients with or without autoimmune disorders had similar rates of VTE recurrences or major bleeding. However, there were some differences between subgroups of patients with autoimmune disorders.

Published
2020

5. Prediction of early mortality in patients with cancer-associated thrombosis in the RIETE Database

Author

Fuentes, HE, Tafur, AJ, Caprini, JA, Alatri, A, Trujillo-santos, J, Farge-bancel, D, Rosa, V, Font, L, Vilaseca, A, Monreal, M, Adarraga, MD, Aibar, MA, Aibar, J, Amado, C, Aranda, C, Arcelus, JI, Ballaz, A, Barba, R, Barillari, G, Barron, M, Barron-Andres, B, Bascunana, J, Benzidia, I, Bertoletti, L, Blanco-Molina, A, Bilora, F, Bortoluzzi, C, Bosevski, M, Bounameaux, H, Braester, A, Brandolin, B, Brenner, B, Bucherini, E, Bui, HM, Bura-Riviere, A, Camon, AM, Carrasco, C, Castro, J, Cesta, A, Ciammaichella, M, Cruz, JA, de Ancos, C, del Toro, J, Demelo, P, Dentali, F, Diaz-pedroche, MD, Diaz-Peromingo, JA, Di Micco, P, Di Pangrazio, M, Ellis, M, Encabo, M, Falga, C, Falvo, N, Farfan, AI, Fernandez-Capitan, C, Fidalgo, MA, Font, C, Fresa, M, Furest, I, Garcia, MA, Garcia-Braoado, F, Garcia-Morillo, M, Garcia-Raso, A, Gavin, O, Gil-Diaz, A, Gomez, V, Gomez-Cuervo, C, Gonzalez-Martinez, J, Grandone, E, Grau, E, Guijarro, R, Gutierrez, J, Gutierrez, P, Hernandez-Blasco, L, Hu, A, Hirmerova, J, Imbalzano, E, Jara-Palomares, L, Jaras, MJ, Jimenez, D, Jou, I, Joya, MD, Krstevski, G, Lessiani, G, Lima, J, Llamas, P, Lobo, JL, Lopez-Jimenez, L, Lopez-Miguel, P, Lopez-Nunez, JJ, Lopez-Reyes, R, Lopez-Saez, JB, Lorente, MA, Lorenzo, A, Loring, M, Lumbierres, M, Mahe, I, Maida, R, Maly, R, Manrique-Abos, I, Marchena, PJ, Martin-Fernandez, M, Martin-Guerra, JM, Martin-Romero, M, Mastroiacovo, D, Mazzolai, L, Mellado, M, Merah, A, Morales, MD, Moustafa, F, Ney, B, Nieto, JA, Nunez, MJ, Olivares, MD, Otalora, S, Otero, R, Pace, F, Parisi, R, Pedrajas, JM, Pellejero, G, Perez-Ductor, C, Perez-Jacoiste, A, Perez-Rus, G, Peris, ML, Pesavento, R, Pesce, ML, Porras, JA, Prandoni, P, Quinta-Valla, R, Riesco, D, Rivas, A, Rocci, A, Rodriguez-Davila, MA, Rodriguez-Hernandez, A, Rubio, CM, Ruiz-Alcaraz, S, Ruiz-Artacho, P, Ruiz-Ruiz, J, Ruiz-Sada, P, Ruiz-Torregrosa, P, Sahuquillo, JC, Sala-Sainz, C, Salgado, E, Samperiz, A, Sanchez-Munoz-Torrero, JF, Sancho, T, Sanoja, ID, Siniscalchi, C, Skride, A, Soler, S, Sotgiu, P, Soto, MJ, Surinach, JM, Tiraferri, E, Tonello, D, Torres, MI, Tufano, A, Tzoran, I, Uresandi, F, Usandizaga, E, Valle, R, Vanassche, T, Vandenbriele, C, Vazquez, FJ, Verhamme, P, Villalobos, A, Visona, A, Hong, NV, Yoo, HH, and Zdraveska, M

Subjects
Neoplasms, Thrombosis, Mortality, premature
Abstract

Background: Proper risk stratification of patients for early mortality after cancer-associated thrombosis may lead to personalized anticoagulation protocols. Therefore, we aimed to derive and validate a scoring system to predict early mortality in this population. To this end, we selected patients with active cancer and thrombosis from the Computerized Registry of Patients with Venous Thromboembolism database. Methods: The main outcome was all cause mortality within the month following a thrombotic event. We used a simple random selection to split arc data in a derivation and a validation cohort. In the derivation cohort, we used recursive partitioning and binary logistic regression to identify groups at risk and to determine the likelihood of the primary outcome. The risk score was developed based on odds ratios from the final multivariate model, and then tested in the validation cohort. Results: In 10,025 eligible patients, we identified 6 predictors of 30-day mortality: leukocytosis >= 11.5x109/L; platelet count = 7). The AUC for the overall score was 0.74, and using a cutoff >= 7 points, the model had a negative predictive value of 94.4%, a positive predictive value of 23.1%, a sensitivity of 73.3%, and a specificity of 64.6% in the validation cohort. Conclusions: Our validated risk model may assist physicians in the selection of patients for outpatient management, and perhaps anticoagulant, considering expanding anticoagulation options.

Published
2019

6. Frequency and prognostic impact of acute kidney injury in patients with acute pulmonary embolism. Data from the RIETE registry

Author

Murgier, M, Darmon, M, Zeni, F, Valle, R, Del Toro, J, Llamas, P, Mazzolai, L, Villalobos, A, Monreal, M, Brenner, B, Farge-Bancel, D, Barba, R, Di Micco, P, Bertoletti, L, Tzoran, I, Reis, A, Bounameaux, H, Maly, R, Verhamme, P, Bosevski, M, Caprini, JA, Adarraga, MD, Aibar, MA, Aibar, J, Alfonso, M, Amado, C, Aranda, C, Arcelus, JI, Ballaz, A, Barron, M, Barron-Andres, B, Bascunana, J, Blanco-Molina, A, Camon, AM, Carrasco, C, Cruz, AJ, del Pozo, R, del Toro, J, Diaz-Pedroche, MC, Diaz-Peromingo, JA, Encabo, M, Falga, C, Fernandez-Capitan, C, Fidalgo, MA, Font, C, Font, L, Furest, I, Garcia, MA, Garcia-Bragado, F, Garcia-Morillo, M, Garcia-Raso, A, Gavin, O, Gomez, V, Gonzalez-Martinez, J, Grau, E, Guijarro, R, Gutierrez, J, Isern, V, Jara-Palomares, L, Jaras, MJ, Jimenez, D, Jimenez, J, Jou, I, Joya, MD, Lalueza, A, Lima, J, Lobo, JL, Lopez-Jimenez, L, Lopez-Miguel, P, Lopez-Reyes, R, Lopez-Saez, JB, Lorente, MA, Lorenzo, A, Loring, M, Lumbierres, M, Madridano, O, Marchena, PJ, Martin-Martos, F, Martin-Romero, M, Morales, MV, Nieto, JA, Nunez, A, Nunez, MJ, Olivares, MC, Otalora, S, Otero, R, Pedrajas, JM, Pellejero, G, Perez-Ductor, C, Peris, ML, Pesce, ML, Porras, JA, Riesco, D, Rivas, A, Rodriguez-Davila, MA, Rosa, V, Rubio, CM, Ruiz-Artacho, P, Sahuquillo, JC, Sala-Sainz, MC, Samperiz, A, Sanchez-Munoz-Torrero, JF, Sancho, T, Soler, S, Soto, MJ, Surinach, JM, Tolosa, C, Torres, MI, Trujillo-Santos, J, Uresandi, F, Usandizaga, E, Vela, J, Vidal, G, Gutierrez, P, Vazquez, FJ, Vilaseca, A, Vanassche, T, Vandenbriele, C, Hirmerova, J, Salgado, E, Benzidia, I, Bura-Riviere, A, Hij, A, Merah, A, Mahe, I, Moustafa, F, Braester, A, EllisM, Bilora, F, Bortoluzzi, C, Brandolin, B, Bucherini, E, Cattabiani, C, Ciammaichella, M, Dentali, F, DiMicco, P, Giorgi-Pierfranceschi, M, Grandone, E, Imbalzano, E, Maida, R, Mastroiacovo, D, Ngoc, V, Pace, F, Pallotti, G, Parisi, R, Pesavento, R, Prandoni, P, Quintavalla, R, Rocci, A, Romualdi, R, Siniscalchi, C, Sotgiu, P, Tiraferri, E, Tonello, D, Tufano, A, Visona, A, Skride, A, Krstevski, G, Zdraveska, M, and Caprini, J

Subjects
Risk, Pulmonary embolism, Bleeding, Mortality, Biomarkers, Acute kidney injury
Abstract

Rationale: Acute kidney injury (AKI) is associated with a poor outcome. Although pulmonary embolism(PE) may promote AKI through renal congestion and/or hemodynamic instability, its frequency and influence on outcome in patients with acute PE have been poorly studied. Methods: The frequency of AKI (defined according to the "Kidney Disease: Improving Global Outcomes" definition) at baseline and its influence on the 30-day mortality was evaluated in patients with acute PE from the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry. We used multivariate analysis to assess whether the presence of AKI influenced the risk for 30-day death. Results: The study included 21,131 patients, of whom 6222 (29.5%) had AKI at baseline: 4385 patients (21%) in stage 1, 1385 (6.5%) in stage 2 and 452 (2%) in stage 3. The proportion of patients with high-risk PE in those with no AKI, AKI stage 1, AKI stage 2 or AKI stage 3 was: 2.8%, 5.3%, 8.8% and 12%, respectively (p < 0.001). After 30 days, 1236 patients (5.9%) died. Overall mortality was 4% in patients with no AKI, 8.4% in AKI stage 1, 14% in AKI stage 2 and 17% in AKI stage 3 (all p < 0.001). AKI was independently associated with an increased risk of all-cause death at 30 days (odds ratio = 1.25; 95% CI: 1.02-1.54). Conclusions: One in every 3-4 patients with acute PE had AKI at baseline. The presence of AKI independently predicted 30-day mortality. This study suggests that AKI may deserve to be evaluated as a prognostic factor in patients with acute PE. (C) 2019 Elsevier B.V. All rights reserved.

Published
2019

7. Vena cava filters in patients presenting with major bleeding during anticoagulation for venous thromboembolism

Author

Mellado, M, Trujillo-Santos, J, Bikdeli, B, Jimenez, D, Nunez, MJ, Ellis, M, Marchena, PJ, Vela, JR, Clara, A, Moustafa, F, Monreal, M, Adarraga, MD, Aibar, MA, Alfonso, M, Arcelus, JI, Ballaz, A, Banos, P, Barba, R, Barron, M, Bascunana, J, Blanco-Molina, A, Camon, AM, Carrasco, C, Chasco, L, Cruz, AJ, Del, PR, Del, TJ, Diaz-Pedroche, MC, Diaz-Peromingo, JA, Encabo, M, Falga, C, Fernandez-Aracil, C, Fernandez-Capitan, C, Fidalgo, MA, Font, C, Font, L, Furest, I, Garcia, MA, Garcia-Bragado, F, Garcia-Morillo, M, Garcia-Raso, A, Garcia-Sanchez, I, Gavin, O, Gomez, C, Gomez, V, Gonzalez, J, Grau, E, Guijarro, R, Guirado, L, Gutierrez, J, Hernandez-Blasco, L, Hernando, E, Isern, V, Jara-Palomares, L, Jaras, MJ, Joya, MD, Lima, J, Llamas, P, Lobo, JL, Lopez-Jimenez, L, Lopez-Reyes, R, Lopez-Saez, JB, Lorente, MA, Lorenzo, A, Loring, M, Lumbierres, M, Madridano, O, Maestre, A, Martin, M, Martin-Martos, F, Morales, MV, Nieto, JA, Olivares, MC, Otalora, S, Otero, R, Pedrajas, JM, Pellejero, G, Perez-Ductor, C, Peris, ML, Pons, I, Porras, JA, Riera-Mestre, A, Rivas, A, Rodriguez-Davila, MA, Rodriguez-Galan, I, Rosa, V, Rubio, CM, Ruiz-Artacho, P, Sahuquillo, JC, Sala-Sainz, MC, Samperiz, A, Sanchez-Artola, B, Sanchez-Martinez, R, Sancho, T, Soler, S, Soto, MJ, Surinach, JM, Tolosa, C, Torres, MI, Uresandi, F, Usandizaga, E, Valero, B, Valle, R, Vela, J, Vidal, G, Villalobos, A, Xifre, B, Vazquez, FJ, Vilaseca, A, Vanassche, T, Vandenbriele, C, Verhamme, P, Yoo, HHB, Wells, P, Hirmerova, J, Maly, R, Salgado, E, Benzidia, I, Bertoletti, L, Bura-Riviere, A, Falvo, N, Farge-Bancel, D, Hij, A, Merah, A, Mahe, I, Quere, I, Braester, A, Brenner, B, Tzoran, I, Antonucci, G, Bilora, F, Bucherini, E, Cattabiani, C, Ciammaichella, M, Dentali, F, Di Micco, P, Doddi, M, Duce, R, Giorgi-Pierfranceschi, M, Grandone, E, Imbalzano, E, Lessiani, G, Maggi, F, Maida, R, Mastroiacovo, D, Pace, F, Pesavento, R, Poggio, R, Prandoni, P, Quintavalla, R, Rocci, A, Siniscalchi, C, Tiraferri, E, Tonello, D, Visona, A, Zalunardo, B, Gibietis, V, Skride, A, Vitola, B, Zdraveska, M, Bounameaux, H, Calanca, L, Fresa, M, and Mazzolai, L

Subjects
Male, medicine.medical_specialty, Vena Cava Filters, Inferior vena cava filter, Hemorrhage, 030204 cardiovascular system & hematology, Lower risk, Statistics, Nonparametric, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Thromboembolism, Anticoagulants, Bleeding, Mortality, Vena cava filter, Venous thromboembolism, Internal Medicine, medicine, Humans, Registries, 030212 general & internal medicine, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Mortality rate, Heparin, Middle Aged, Surgery, Clinical trial, Treatment Outcome, Propensity score matching, Emergency Medicine, Female, business, Major bleeding, medicine.drug
Abstract

The association between inferior vena cava filter (IVC) use and outcome in patients presenting with major bleeding during anticoagulation for venous thromboembolism (VTE) has not been thoroughly investigated. We used the RIETE registry to compare the 30-day outcomes (death, major re-bleeding or VTE recurrences) in VTE patients who bled during the first 3 months of therapy, regarding the insertion of an IVC filter. A propensity score matched (PSM) analysis was performed to adjust for potential confounders. From January 2001 to September 2016, 1065 VTE patients had major bleeding during the first 3 months of anticoagulation (gastrointestinal 370; intracranial 124). Of these, 122 patients (11%) received an IVC filter. Patients receiving a filter restarted anticoagulation later (median, 4 vs. 2 days) and at lower doses (95 +/- 52 IU/kg/day vs. 104 +/- 55 of low-molecular-weight heparin) than those not receiving a filter. During the first 30 days after bleeding (after excluding 246 patients who died within the first 24 h), 283 patients (27%) died, 63 (5.9%) had non-fatal re-bleeding and 19 (1.8%) had recurrent pulmonary embolism (PE). In PSM analysis, patients receiving an IVC filter (n = 122) had a lower risk for all-cause death (HR 0.49; 95% CI 0.31-0.77) or fatal bleeding (HR 0.16; 95% CI 0.07-0.49) and a similar risk for re-bleeding (HR 0.55; 95% CI 0.23-1.40) or PE recurrences (HR 1.57; 95% CI 0.38-6.36) than those not receiving a filter (n = 429). In VTE patients experiencing major bleeding during the first 3 months, use of an IVC filter was associated with reduced mortality rates. Clinical Trial Registration NCT02832245.

Published
2019

8. Mortality after pulmonary embolism in patients with diabetes. Findings from the RIETE registry

Author

de Miguel-Diez, J, Lopez-de-Andres, A, Jimenez-Trujillo, I, Hernandez-Barrera, V, Jimenez-Garcia, R, Lorenzo, A, Pedrajas, JM, Visona, A, Lopez-Miguel, P, Monreal, M, Adarraga, MD, Aibar, MA, Aibar, J, Alfonso, M, Amado, C, Aranda, C, Arcelus, JI, Ballaz, A, Barba, R, Barron, M, Barron-Andres, B, Bascunana, J, Blanco-Molina, A, Camon, AM, Carrasco, C, Cruz, AJ, del Toro, J, Diaz-Pedroche, MC, Diaz-Peromingo, JA, Falga, C, Fernandez-Capitan, C, Fidalgo, MA, Font, C, Font, L, Furest, I, Garcia, MA, Garcia-Bragado, F, Garcia-Morillo, M, Garcia-Ortega, A, Gavin, O, Gomez, V, Gonzalez-Martinez, J, Grau, E, Guijarro, R, Guirado, L, Gutierrez, J, Hernandez-Blasco, L, Isern, V, Jara-Palomares, L, Jaras, MJ, Jimenez, D, Jimenez, J, Jou, I, Joya, MD, Lalueza, A, Lima, J, Lobo, JL, Lopez-Jimenez, L, Lopez-Reyes, R, Lopez-Saez, JB, Lorente, MA, Loring, M, Lumbierres, M, Madridano, O, Marchena, PJ, Martin-Martos, Morales, MV, Nieto, JA, Nunez, A, Nunez, MJ, Olivares, MC, Otalora, S, Otero, R, Pellejero, G, Perez-Ductor, C, Perez-Jacoiste, A, Penis, ML, Pesce, ML, Porras, JA, Riesco, D, Rivas, A, Rodriguez-Davila, MA, Rosa, V, Rubio, CM, Ruiz-Artacho, P, Sahuquillo, JC, Sala-Sainz, MC, Samperiz, A, Sanchez-Munoz-Torrero, JF, Sancho, T, Soler, S, Soto, MJ, Surinach, JM, Tolosa, C, Torrents, A, Torres, MI, Trujillo-Santos, J, Uresandi, F, Usandizaga, E, Valle, R, Vela, J, Vidal, G, Villalobos, A, Gutierrez, P, Vazquez, FJ, Vilaseca, A, Vanasschc, T, Vandenbriele, C, Verhamme, P, Hirmerova, J, Maly, R, Salgado, E, Benzidia, I, Bertoletti, L, Bura-Riviere, A, Farge-Bancel, D, Hij, A, Merah, A, Mahe, I, Moustafa, F, Braester, A, Brenner, B, Ellis, M, Tzoran, I, Bilora, F, Bortoluzzi, C, Brandolin, B, Bucherini, E, Cattabiani, C, Ciammaichella, M, Dentali, F, Di Micco, P, Giorgi-Pierfranceschi, M, Grandone, E, Imbalzano, E, Maida, R, Mastroiacovo, D, Ngoc, V, Pace, F, Parisi, R, Pesavento, R, Prandoni, P, Quintavalla, R, Rocci, A, Siniscalchi, C, Sotgiu, P, Tiraferri, E, Tufano, A, Zalunardo, B, Kalejs, R, Skride, A, Vitola, B, Bosevski, M, Zdraveska, M, Ii, B, Fresa, M, Mazzolai, L, Caprini, J, and Bui, HM

Subjects
Cardiovascular events, Type 2 diabetes mellitus, Pulmonary embolism, Comorbidity, Mortality
Abstract

Background: Among patients presenting with pulmonary embolism (PE), those with diabetes are at increased risk to die than those without diabetes. The reasons have not been identified. We used the RIETE (Registro Informatizado Enfermedad Trombo Embolica) database to compare the mortality rate and the causes of death during anticoagulation in patients with PE according to the presence or absence of diabetes. Methods: A matched retrospective cohort study from consecutively enrolled patients in RIETE, from 179 hospitals in 24 countries. For each patient with diabetes we selected two patients with no diabetes matched by age, sex and year of diagnosis of the PE. Results: As of September 2017, there were 2010 PE patients with diabetes and two age-and-gender matched controls. Mean age was 74 +/- 11 years, 46% were men. Patients with diabetes were more likely to have comorbidities, to be using antiplatelets and to have more severe PE. During anticoagulation (median, 219 days), patients with diabetes had a higher mortality (hazard ratio [HR]: 1.45; 95% confidence intervals [CI]: 1.25-1.67) and a higher rate of arterial ischemic events (HR: 2.89; 95%CI: 1.71-4.94) than those without diabetes. On multivariable analysis, diabetes was not associated with an increased risk for death (HR: 1.26; 95%CI: 0.97-1.63). We also failed to find differences according to the use of antiplatelet drugs concomitantly. Conclusions: In our cohort of patients with PE, diabetes was not an independent predictor for death. The influence of arterial events or antiplatelet drugs (if any) was low.

Published
2019

9. Platelet count and outcome in patients with acute venous thromboembolism

Author

Di Micco, P., Ruiz Giménez, N., Nieto, J. A., Aujesky, D., del Molino, F., Valle, R., Barrón, M., Maestre, A., Monreal, M., Monreal, M, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Bertoletti, L, Schellong, S, Tzoran, I, Dr Abilio, R, Bosevski, M, Bounameaux, H, Malý, R, Andújar, V, Arcelus, Ji, Arroyo, M, Ballaz, A, Barrón, M, Barrón Andrés, B, Bascuñana, J, Bedate, P, Benítez, Jf, Blanco Molina, A, Boix, L, Bosco, J, Bueso, T, Casado, I, Chaves, E, Contra, A, de Ancos CL, de Miguel, J, del Molino, F, del Toro, J, Elías Hernández, T, Falgá, C, Farfán, A, Fernández Capitán, C, Fole, D, Font, C, Fuentes, Mi, Gallego, P, García Bragado, F, Gavín, O, Gómez, V, González, J, González Basch, E, González Nieto JA, Grau, E, Guil, M, Guijarro, R, Gutiérrez, J, Hernández, L, Hernández Huerta, S, Jara, L, Jaras, Mj, Jiménez, D, Lecumberri, R, Lobo, Jl, López Jiménez, L, López, L, Lorenzo, A, Luque, Jm, Macià, M, Madridano, O, Maestre, A, Marchena, Pj, Martín, M, Martín Villasclaras JJ, Muñoz, Fj, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Otero, R, Paul, He, Pedrajas, Jm, Peris, Ml, Quezada, Ca, Riera Mestre, A, Rivas, A, Rodríguez Dávila MA, Román, P, Rosa, V, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Toda, M, Todolí, Ja, Tolosa, C, Trujillo, J, Valdés, M, Valero, B, Valle, R, Vela, J, Vidal, G, Vilar, C, Villalobos, A, Villalta, J, Zorrilla, V, Gadelha, T, Hirmerova, J, Miklosovà, M, Salgado, E, Bura Riviere, A, Farge Bancel, D, Mahe, I, Merah, A, Quere, I, Faul, J, Braester, A, Zeltser, D, Barillari, G, Ciammaichella, M, Dalla Valle, F, Duce, R, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, P, Quintavalla, R, Rocci, A, Rota, L, Schenone, A, Tiraferri, E, Tonello, D, Tufano, A, Visonà, A, Zalunardo, B, Cardoso, C, Santos, M, Saraiva, M, Aujeski, D, Mazzolai, L, and Caprini, J.

Subjects
Blood Platelets, Male, Risk, medicine.medical_specialty, Cell Count, Hemorrhage, 030204 cardiovascular system & hematology, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Platelet, In patient, Registries, 030212 general & internal medicine, Mortality, Aged, Aged, 80 and over, Thrombocytosis, business.industry, Incidence, Mortality rate, Venous Thromboembolism, Hematology, Odds ratio, Middle Aged, medicine.disease, Thrombocytopenia, Thrombosis, Confidence interval, Surgery, Pulmonary embolism, Treatment Outcome, Acute Disease, Female, business, Venous thromboembolism
Abstract

SummaryThe relationship between platelet count and outcome in patients with acute venous thromboembolism (VTE) has not been consistently explored. RIETE is an ongoing registry of consecutive patients with acute VTE. We categorised patients as having very low- (450,000/μl) platelet count at baseline, and compared their three-month outcome. As of October 2012, 43,078 patients had been enrolled in RIETE: 21,319 presenting with pulmonary embolism and 21,759 with deep-vein thrombosis. In all, 502 patients (1.2%) had very low-; 5,472 (13%) low-; 28,386 (66%) normal-; 7,157 (17%) high-; and 1,561 (3.6%) very high platelet count. During the three-month study period, the recurrence rate was: 2.8%, 2.2%, 1.8%, 2.1% and 2.2%, respectively; the rate of major bleeding: 5.8%, 2.6%, 1.7%, 2.3% and 4.6%, respectively; the rate of fatal bleeding: 2.0%, 0.9%, 0.3%, 0.5% and 1.2%, respectively; and the mortality rate: 29%, 11%, 6.5%, 8.8% and 14%, respectively. On multivariate analysis, patients with very low-, low-, high- or very high platelet count had an increased risk for major bleeding (odds ratio [OR]: 2.70, 95% confidence interval [CI]: 1.85–3.95; 1.43 [1.18–1.72]; 1.23 [1.03–1.47]; and 2.13 [1.65–2.75]) and fatal bleeding (OR: 3.70 [1.92–7.16], 2.10 [1.48–2.97], 1.29 [0.88–1.90] and 2.49 [1.49–4.15]) compared with those with normal count. In conclusion, we found a U-shaped relationship between platelet count and the three-month rate of major bleeding and fatal bleeding in patients with VTE.

Published
2013

10. Unsuspected pulmonary embolism in patients with cancer

Author

Silvia, Soler, Cristina, Delgado, Aitor, Ballaz, Elena, Cisneros, Radován, Malý, Dimitrios, Babalis, Manuel, Monréal, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Bertoletti, L, Papadakis, M, Bosevski, M, Bounameaux, H, Malý, R, Arcelus, Ji, Arcos, Mp, Ballaz, A, Barrón, M, Blanco Molina, A, Bosco, J, Chaves, E, Conget, F, Delgado, C, De Ancos, C, del Toro, J, Falgá, C, Farfán, A, Fernández Capitán, C, Gallego, P, García Bragado, F, Gómez del Olmo, V, Guijarro, J, Guillém, N, Gutiérrez, J, Hernández, L, Hernández Huerta, D, Jaras, Mj, Jiménez, D, Jiménez, S, Jiménez Gil, M, Lobo, Jl, López Jiménez, L, Lorenzo, A, Luque, Jm, Macia, M, Madridano, O, Maestre, A, Marchena, Pj, Martín Villasclaras JJ, Monreal, M, Morales, M, Nauffal, Md, Nieto, Ja, Ogea, Jl, Pedrajas, Jm, Riera Mestre, A, Rodríguez Dávila MA, Román, P, Román Bernal, B, Rosa, V, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Ruiz Ribó MD, Sahuquillo, Jc, Samperiz, A, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Todolí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valdés, V, Valle, R, Vidal, G, Villalta, J, Zorrilla, V, Bura Riviere, A, Debourdeau, P, Mahe, I, Babalis, D, Tzinieris, I, Barillari, A, Barillari, G, Ciammaichella, C, Dalla Valle, F, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, P, Quintavalla, R, Schenone, A, Tonello, D, Visonà, A, and Tomko, T.

Subjects
Male, medicine.medical_specialty, Colorectal cancer, Comorbidity, Risk Assessment, Prostate, Neoplasms, Internal medicine, Prevalence, medicine, Humans, In patient, Registries, business.industry, Incidence (epidemiology), Anticoagulants, Cancer, Hematology, Prognosis, medicine.disease, Pulmonary embolism, Europe, Natural history, Treatment Outcome, medicine.anatomical_structure, Female, Radiology, Pulmonary Embolism, business
Abstract

Background The natural history of unsuspected pulmonary embolism (PE) in patients with cancer has not been thoroughly studied. Methods We used the RIETE Registry data to compare the clinical characteristics, treatment strategies and outcome in cancer patients with unsuspected PE and in those presenting with symptomatic, acute PE. Results Up to December 2011, 78 cancer patients with unsuspected PE and 1,994 with symptomatic PE had been enrolled. Patients with unsuspected PE more likely had colorectal cancer than those with symptomatic PE (28% vs. 13%), and less likely had prostate (3.8% vs. 10%) or hematologic (1.3% vs. 6.4%) cancer, or prior venous thromboembolism (3.8% vs. 12%). While the patients were receiving anticoagulant therapy, the incidence of PE recurrences (0% vs. 1.9%) or major bleeding (2.6% vs. 4.8%) were similar. After completion of anticoagulation, recurrent PE developed in 2.6% vs. 1.4% of patients, and major bleeding in 0% vs. 0.4%, respectively. Conclusions Our findings suggest that the clinical characteristics and outcome in cancer patients with unsuspected PE are quite similar to those in patients with symptomatic PE.

Published
2012

11. Long-term therapy with low-molecular-weight heparin in cancer patients with venous thromboembolism

Author

Marchena, P. J., Nieto, J. A., Guil, M., García Bragado, F., Rabuñal, R., Boccalon, H., Trujillo Santos, J., Monreal, M., Akcalde, M, Arcelus, Ji, Barba, R, Blanco, A, Barrón, M, Casado, I, Casas, Jm, Cisneros, E, del Campo R., Ce, del Toro, J, Durán, M, Falgá, C, Fernández Capitán, C, Font, C, Gabriel, F, Gallego, P, García Bragado, F, Guijarro, R, Guil, M, Gutiérrez, J, Gutiérrez, Mr, Hermosa, Mj, Hernández, L, Hernández Huerta, D, Jiménez, M, Lobo, Jl, López, L, Lorenzo, A, Luque, Jm, Madridano, O, Marchena, Pj, Martín Villasclaras JJ, Montes, J, Monreal, M, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Oribe, M, Pedrajas, Jm, Rabuñal, R, Riera Mestre, A, Rodríguez, Ma, Roldán, V, Román, P, Rosa, V, Rubio, S, Ruiz Gamietea, A, Ruíz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Todolí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, V, Valle, R, Vidal, G, Villalta, J, Boccalon, H, Durant, C, Farge Bancel, D, Mahe, I, Rivron Guillot, K, Brenner, B, Barillari, A, Barillari, G, Ciammaichella, M, Di Micco, P, Dalla Valle, F, Duce, R, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Schenone, A, Tiraferri, E, Visonà, A, and Bosevski, M.

Subjects
Male, medicine.medical_specialty, medicine.drug_class, Low molecular weight heparin, Hemorrhage, 030204 cardiovascular system & hematology, Lower risk, Gastroenterology, Drug Administration Schedule, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Neoplasms, Internal medicine, medicine, Humans, Registries, Aged, business.industry, Incidence (epidemiology), Venous Thromboembolism, Hematology, Odds ratio, Heparin, Low-Molecular-Weight, Middle Aged, medicine.disease, Confidence interval, Pulmonary embolism, Surgery, Venous thrombosis, Treatment Outcome, 030220 oncology & carcinogenesis, Propensity score matching, Female, Pulmonary Embolism, business, Algorithms
Abstract

SummaryLong-term therapy with low-molecular-weight heparin (LMWH) is the treatment of choice for cancer patients with venous thromboembolism (VTE). However, the ideal doses of LMWH have not been thoroughly studied. We used the RIETE Registry data to assess the influence of the daily LMWH dosage on outcome during the first three months after VTE. We used propensity score-matching to compare patients who received

Published
2012

12. Clinical presentation and outcome of venous thromboembolism in COPD

Author

Bertoletti, L., Quenet, S., Mismetti, P., Hernandez, L., Martin Villasclaras, J. J., Tolosa, C., Valdes, M., Barron, M., Todoli, J. A., Monreal, M., Monreal, M, Pujol, I, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Bertoletti, L, Etienne, S, Papadakis, M, Bosevski, M, Bounameaux, H, Alcalde, M, Arcelus, Ji, Arcos, Mp, Barrón, M, Blanco Molina, A, Bosco, J, Cámara, T, Calvo, M, Casado, I, Casas, Jm, Cisneros, E, Chaves, E, Conget, F, Delgado, C, del Toro, J, Durán, M, Falgá, C, Fernández Capitán, C, Ferreiro, M, Font, C, Gabriel, F, Gallego, P, García Bragado, F, Guil, M, Guillém, N, Gutiérrez, J, Hermosa, Mj, Hernández, L, Hernández Huerta, D, Hernández Toboso, F, Jaras, Mj, Jiménez, D, Jiménez, S, Jiménez Gil, M, Lecumberri, R, Lobo, Jl, López Jiménez, L, Lorenzo, A, Luque, Jm, Madridano, O, Maestre, A, Manzano, V, Marchena, Pj, Martín Villasclaras JJ, Monte, R, Morales, M, Muñoz, S, Nauffal, Md, Nieto, Ja, Ogea, Jl, Oribe, M, Otero, R, Pedrajas, Jm, Rabuñal, R, Riera Mestre, A, Rodríguez Dávila MA, Román, M, Román, P, Román Bernal, B, Rosa, V, Rubio, S, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez, R, Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Tolodí, Ja, Tolosa, C, Torres, Mi, Trujillo, J, Uresandi, F, Valdés, M, Valdés, V, Valle, R, Vidal, G, Villalta, J, Zorrilla, V, Bura Riviere, A, Debourdeau, P, Mahe, I, Rivron Guillot, K, Zeltser, D, Barillari, A, Barillari, G, Ciammaichella, M, Valle, F, Duce, R, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, P, Quintavalla, R, Rocci, A, Schenone, A, Tiraferri, E, Tonello, D, Visonà, A, Zalunardo, B, and Righini, M.

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Vena Cava Filters, Pulmonary disease, Kaplan-Meier Estimate, Pulmonary Disease, Chronic Obstructive, Fibrinolytic Agents, Risk Factors, Internal medicine, Humans, Medicine, Registries, cardiovascular diseases, Risk factor, Aged, Aged, 80 and over, Venous Thrombosis, COPD, business.industry, Venous Thromboembolism, Middle Aged, Prognosis, medicine.disease, respiratory tract diseases, Surgery, Pulmonary embolism, Venous thrombosis, Treatment Outcome, Female, Risk of death, Presentation (obstetrics), Pulmonary Embolism, business, Venous thromboembolism
Abstract

Chronic obstructive pulmonary disease (COPD) is a moderate risk factor for venous thromboembolism (VTE), but neither the clinical presentation nor the outcome of VTE in COPD patients is well known. The clinical presentation of VTE, namely pulmonary embolism (PE) or deep venous thrombosis (DVT), and the outcome at 3 months (death, recurrent VTE or bleeding) were compared between 2,984 COPD patients and 25,936 non-COPD patients included in the RIETE (Registro Informatizado de la Enfermedad TromboEmbólica) registry. This ongoing international, multi-centre registry includes patients with proven symptomatic PE or DVT. PE was the more frequent VTE presentation in COPD patients (n = 1,761, 59%). PE presentation was more significantly associated with COPD patients than non-COPD patients (OR 1.64, 95% CI 1.49-1.80). During the 3-month follow-up, mortality (10.8% versus 7.6%), minor bleeding (4.5% versus 2.3%) or first VTE recurrences as PE (1.5% versus 1.1%) were significantly higher in COPD patients than in non-COPD patients. PE was the most common cause of death. COPD patients presented more frequently with PE than DVT. It may explain the worse prognosis of COPD patients, with a higher risk of death, bleeding or VTE recurrences as PE compared with non-COPD patients. Further therapeutic options are needed.

Published
2011

13. Thirty-day mortality rate in women with cancer and venous thromboembolism. Findings from the RIETE Registry

Author

Javier Trujillo Santos, José Manuel Casa, Ignacio, Casado, Ángel Luis Samperiz, Roberto, Quintavalla, Joan Carles Sahuquillo, Manuel, Monreal, Arcelus, Ji, Barba, R, Barrón, M, Blanco, A, Bosco, J, Casado, I, Casas, Jm, Cisneros, E, Chavez, E, del Campo, R, del Molino, F, del Toro, J, Durán, M, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, García Bragado, F, Guijarro, R, Guil, M, Gutiérrez, J, Gutiérrez, Mr, Hernández, L, Hernández Toboso, S, Jiménez, D, Jiménez Gil, M, Jordán, S, Lecumberri, R, Lobo, Jl, López Jiménez, L, Lorenzo, A, Luque, Jm, Madridano, O, Maestre, A, Marchena, Pj, Martín Villasclaras JJ, Montes, J, Monreal, M, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ochoa, F, Ogea, Jl, Oribe, M, Otero, R, Pedrajas, Jm, Ponce de León, L, Rabuñal, R, Riera Mestre, A, Rodríguez, Ma, Roldán, V, Román, P, Rosa, V, Rubio, S, Ruiz Gamietea, A, Ruíz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez, R, Muñoz Torrero SJ, Soler, S, Soto, Mj, Tiberio, G, Tolodí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valdés, V, Valdés, R, Vidal, G, Villalta, J, Boccalon, H, Debourdeau, P, Durant, C, Farge Bancel, D, Mahe, I, Rivron Guillot, K, Brenner, B, Barillari, A, Barillari, G, Ciammaichella, M, Di Micco, P, Dalla, Vf, Duce, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Schenone, A, Tiraferri, E, Visonà, A, Bosevski, M, and Bounameaux, H.

Subjects
Adult, medicine.medical_specialty, Hemorrhage, Neoplasms, Internal medicine, Pancreatic cancer, medicine, Carcinoma, Humans, Prospective Studies, Registries, Prospective cohort study, Aged, Aged, 80 and over, Gynecology, Lung, business.industry, Mortality rate, Anticoagulants, Cancer, Venous Thromboembolism, Hematology, Middle Aged, medicine.disease, Pulmonary embolism, Treatment Outcome, medicine.anatomical_structure, Female, Pulmonary Embolism, business, Ovarian cancer
Abstract

The influence of the site of cancer on outcome in cancer women with venous thromboembolism (VTE) is poorly understood. Reliable information on its influence might facilitate better use of prevention strategies. We assessed the 30-day outcome in all women with active cancer in the RIETE Registry, trying to identify if differences exist according to the tumor site. Up to May 2010, 2474 women with cancer and acute VTE had been enrolled. The most common sites were the breast (26%), colon (13%), uterus (9.3%), and haematologic (8.6%) cancers. During the 30-day study period, 329 (13%) patients died. Of them, 71 (2.9%) died of pulmonary embolism (PE), 22 (0.9%) died of bleeding. Fatal PE was more common in women with breast, colorectal, lung or pancreatic cancer (59% of the fatal PEs). Fatal bleeding was more frequent in women with colorectal, haematologic, ovarian cancer or carcinoma of unknown origin (55% of fatal bleedings).

Published
2011

14. Clinical significance of a negative D‐dimer level in patients with confirmed venous thromboembolism. Findings from the RIETE Registry

Author

Soto, M. J., Grau, E., Gadelha, T., Palareti, G., Bounameaux, H., Villalta, J., Monreal, M., Arcelus, Ji, Barba, R, Blanco, A, Barrón, M, Casado, I, Casas, Jm, Cisneros, E, Chaves, E, del Toro, J, Durán, M, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, García Bragado, F, Gómez Zorilla, S, Grau, E, Guijarro, R, Guil, M, Gutiérrez, J, Gutiérrez, Mr, Hernández, L, Hernández Huerta, D, Jiménez, M, Jiménez, Mp, Lasso, Jm, Lobo, Jl, López, L, Lorenzo, A, Luque, Jm, Lladó, M, Madridano, O, Marchena, Pj, Martín Villasclaras JJ, Monreal, M, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Oribe, M, Pedrajas, Jm, Pérez Jiménez, L, Rabuñal, R, Riera Mestre, A, Rodríguez, Ma, Roldán, V, Román, P, Rosa, V, Rubio, S, Ruiz Gamietea, A, Ruíz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez Muñoz Torrero JF, Solanich, X, Soler, S, Soto, Mj, Tiberio, G, Todolí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, V, Valle, R, Vela, J, Vidal, G, Villalta, J, Gadelha, T, Boccalon, H, Farge Bancel, D, Mahe, I, Rivron Guillot, K, Brenner, B, Barillari, A, Barillari, G, Ciammaichella, M, Di Micco, P, Dalla Valle, F, Duce, R, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Schenone, A, Tiraferri, E, Visonà, A, and Bosevski, M

Subjects
ddc:616, medicine.medical_specialty, business.industry, Venous Thromboembolism/blood/pathology, Venous Thromboembolism, Hematology, Gastroenterology, Surgery, Fibrin Fibrinogen Degradation Products, Internal medicine, D-dimer, Humans, Medicine, Clinical significance, In patient, business, Venous thromboembolism, Fibrin Fibrinogen Degradation Products/metabolism
Published
2011

15. THU0651 Should we reduce the dose of biological therapy to all patients with inflammatory arthritis achieving sustained therapeutic goal?

Author

Gonzalez-Alvaro, I, primary, Sánchez-Piedra, C, additional, Almodovar, R, additional, Bachiller, J, additional, Balsa, A, additional, Blasco, AJ, additional, Caliz, R, additional, Candelas, G, additional, Fernández-Carballido, C, additional, García-Aparicio, A, additional, García-Magallόn, B, additional, García-Vicuña, R, additional, Gomez-Centeno, A, additional, Ortiz, AM, additional, Sanmartí, R, additional, Sanz, J, additional, Tejera, B, additional, Notario, I, additional, Soto, MJ, additional, Plasencia, C, additional, Hernández, V, additional, Espinosa, M, additional, Ramos, C, additional, and Lazaro, P, additional

Published
2017
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16. Pulmonary embolism and 3-month outcomes in 4036 patients with venous thromboembolism and chronic obstructive pulmonary disease: data from the RIETE registry

Author

Laurent, Bertoletti, Sara, Quenet, Silvy, Laporte, Joan, Sahuquillo, Francisco, Conget, José, Pedrajas, Mar, Martin, Ignacio, Casado, Antonio Riera Mestre, Manuel, Monreal, Arcelus, Ji, Arcos, Mp, Ballaz, A, Barba, R, Barrón, M, Barrón Andrés, B, Blanco Molina, A, Bosco, J, Chaves, E, Cañas, I, Casado, I, Contra, A, Conget, F, de Miguel, J, del Campo, R, del Toro, J, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, García Bragado, F, Gavín, O, Gómez, V, González, J, Gracia, V, Guil, M, Guillem, N, Gutiérrez, J, Hernández, L, Hernández Huerta, D, Jaras, Mj, Jiménez, D, Jiménez, S, Jiménez Gil, M, Lobo, Jl, Lecumberri, R, López Jiménez, L, Lorenzo, A, Macià, M, Madridano, O, Marchena, Pj, Martín, M, Martín Villasclaras JJ, Monreal, M, Morales, M, Morán, Lp, Nauffal, Md, Nieto, Ja, Núñez, Mj, Mascareño, Mc, Ogea, Jl, Otero, R, Pedrajas, Jm, Riera Mestre, A, Rodríguez Dávila MA, Román, P, Román Bernal, B, Roldán, V, Rosa, V, Royo, C, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valle, R, Vela, J, Vida, G, Villalta, J, Zorrilla, V, Bertoletti, L, Bura Riviere, A, Debourdeau, P, Farge Bancel, D, Lamuraglia, M, Mahe, I, Merah, A, Quere, I, Babalis, D, Papadakis, M, Brenner, B, Barillari, G, Ciammaichella, M, Di Micco, P, Dalla Valle, F, Duce, R, La Regina, M, Maida, R, Orlandini, F, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Rota, L, Schenone, A, Tonello, D, Visonà, A, Zalunardo, B, Bosevski, M, Bounameaux, H, Malý, R, Hirmerova, J, Salgado, E., BMC, Ed., Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), Service de Médecine Thérapeutique, CHU Saint-Etienne-Hôpital Nord - Saint Etienne, Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Saint Etienne, Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Internal Medicine, Hospital Municipal de Badalona, Department of Pneumonology, Hospital Clínico Universitario Lozano Blesa, Hospital Clínico San Carlos, Hospital Universitario Infanta Sofía, Hospital Universitario Virgen de las Nieves, Institut d'Investigació Biomèdica de Bellvitge [Barcelone] (IDIBELL)-Hospital Universitari de Bellvitge-Hospital Duran i Reynals, Hospital Universitari Germans Trias I Pujol, The RIETE Investigators, Universitat de Barcelona, [Bertoletti,L, Quenet,S, Laporte,S] Thrombosis Research Group, EA3065, University Saint-Etienne, Saint-Etienne, France. [Bertoletti,L, Laporte,S] CIE3, INSERM, Saint-Etienne, France. Department of Therapeutic Medicine, CHU Saint-Etienne, Hôpital Nord, Saint-Etienne, France. [Sahuquillo,JC] Department of Internal Medicine, Hospital Municipal de Badalona, Barcelona, Spain. [Conget,F] Department of Pneumonology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain. [Pedrajas,JM] Department of Internal Medicine, Hospital Clínico San Carlos, Madrid, Spain. [Martin,M] Department of Internal Medicine, Hospital Infanta Sofía, Madrid, Spain. [Casado,I] Department of Pneumonology, Hospital Universitario Virgen de las Nieves, Granada, Spain. [Riera-Mestre,A] Department of Internal Medicine, Hospital Univesitari de Bellvitge - IDIBELL, Barcelona, Spain. [Monreal,M] Department of Internal Medicine, Hospital Universitari Germans Trias I Pujol, Badalona, Spain., and Bayer Pharma AG for supporting this Registry. Bayer Pharma AG’s support was limited to the part of RIETE outside Spain

Subjects
Male, Internationality, Diseases::Respiratory Tract Diseases::Lung Diseases::Pulmonary Embolism [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Survival Analysis [Medical Subject Headings], Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Comorbidity, 030204 cardiovascular system & hematology, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Cohort Studies, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Comorbidity [Medical Subject Headings], Prevalence, Tasa de Supervivencia, Registries, Young adult, Pneumology, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence [Medical Subject Headings], Embòlia pulmonar, Aged, 80 and over, COPD, Venous Thromboembolism, Middle Aged, Prognosis, 3. Good health, Pulmonary embolism, Survival Rate, Embolia Pulmonar, Deep venous thrombosis, Female, Pneumologia, Venous thromboembolism, Cohort study, Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, Named Groups::Persons::Age Groups::Adult::Young Adult [Medical Subject Headings], Pronòstic mèdic, Análisis de Supervivencia, Check Tags::Male [Medical Subject Headings], Risk Assessment, 03 medical and health sciences, Young Adult, Internal medicine, Thromboembolism, medicine, Diseases::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive [Medical Subject Headings], Humans, cardiovascular diseases, Chronic obstructive pulmonary diseases, Intensive care medicine, Survival rate, Tromboembolisme, Survival analysis, Aged, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Survival Rate [Medical Subject Headings], Disciplines and Occupations::Social Sciences::Internationality [Medical Subject Headings], business.industry, Enfermedad Pulmonar Obstructiva Crónica, Research, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Assessment [Medical Subject Headings], equipment and supplies, medicine.disease, Survival Analysis, respiratory tract diseases, Check Tags::Female [Medical Subject Headings], 030228 respiratory system, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis [Medical Subject Headings], [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Registries [Medical Subject Headings], Estudios de Cohortes, Diseases::Cardiovascular Diseases::Vascular Diseases::Embolism and Thrombosis::Thromboembolism::Venous Thromboembolism [Medical Subject Headings], business, Medición de Riesgo
Abstract

Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) have a modified clinical presentation of venous thromboembolism (VTE) but also a worse prognosis than non-COPD patients with VTE. As it may induce therapeutic modifications, we evaluated the influence of the initial VTE presentation on the 3-month outcomes in COPD patients. METHODS COPD patients included in the on-going world-wide RIETE Registry were studied. The rate of pulmonary embolism (PE), major bleeding and death during the first 3 months in COPD patients were compared according to their initial clinical presentation (acute PE or deep vein thrombosis (DVT)). RESULTS Of the 4036 COPD patients included, 2452 (61%; 95% CI: 59.2-62.3) initially presented with PE. PE as the first VTE recurrence occurred in 116 patients, major bleeding in 101 patients and mortality in 443 patients (Fatal PE: first cause of death). Multivariate analysis confirmed that presenting with PE was associated with higher risk of VTE recurrence as PE (OR, 2.04; 95% CI: 1.11-3.72) and higher risk of fatal PE (OR, 7.77; 95% CI: 2.92-15.7). CONCLUSIONS COPD patients presenting with PE have an increased risk for PE recurrences and fatal PE compared with those presenting with DVT alone. More efficient therapy is needed in this subtype of patients. Yes

Published
2013

17. Factors associated with elevated pulmonary arterial pressure levels on the echocardiographic assessment in patients with prior pulmonary embolism

Author

Remedios, Otero, Teresa, Elías, Luis, Jara, Javier Trujillo Santos, Laurent, Bertoletti, Dolores, Nauffal, Justo Ruiz Ruiz, Ángeles Blanco Molina, Manuel, Monreal, Arcelus, Ji, Arcos, Mp, Ballaz, A, Barba, R, Barragán, Jm, Barrón, M, Barrón Andrés, B, Bascuñana, J, Blanco Molina, A, Boix, L, Bosco, J, Bueso, T, Campano, Fj, Cañas, I, Casado, I, Conget, F, Contra, A, Chaves, E, de Miguel, J, del Campo, R, del Toro, J, Falgá, C, Fernández Capitán, C, Font, C, Gabriel, F, Gallego, P, García Bragado, F, Gómez, V, González, J, Gracia, V, Guil, M, Guijarro, R, Gutiérrez, J, Hernández, L, Hernández Huerta, D, Jara, L, Jaras, Mj, Jiménez, D, Jiménez Gil, M, Lecumberri, R, Lobo, Jl, López Jiménez, L, Lorenzo, A, Macià, M, Madridano, O, Marchena, Pj, Martín, M, Martín Villasclaras JJ, Monreal, M, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Otero, R, Pedrajas, Jm, Riera Mestre, A, Rodríguez Dávila MA, Roldán, V, Román, P, Rodríguez, Em, Rosa, V, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Todolí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valero, B, Valle, R, Vidal, G, Villalobos, A, Villalta, J, Zamora, L, Zorrilla, V, Bertoletti, L, Bura Riviere, A, Farge Bancel, D, Mahe, I, Quere, I, Papadakis, M, Braester, A, Brenner, B, Zeltser, D, Barillari, G, Ciammaichella, M, Di Micco, P, Dalla Valle, F, Duce, R, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Rota, L, Schenone, A, Tiraferri, E, Tonello, D, Venturelli, U, Visonà, A, Zalunardo, B, Bosevski, M, Alatri, A, Aujeski, D, Bounameaux, H, Mazzolai, L, Malý, R, Tomko, T, Salgado, E, Schellong, S, and Caprini, J.

Subjects
Male, medicine.medical_specialty, Hypertension, Pulmonary, Background factors, Pulmonary arterial pressure, Risk Factors, Internal medicine, medicine.artery, medicine, Humans, In patient, Arterial Pressure, Aged, business.industry, Hematology, medicine.disease, Prognosis, Pulmonary embolism, stomatognathic diseases, Lung disease, Echocardiography, Heart failure, Pulmonary artery, Cardiology, Chronic thromboembolic pulmonary hypertension, Female, business, Pulmonary Embolism
Abstract

Factors associated with the detection of raised systolic pulmonary artery pressure (sPAP) levels in patients with a prior episode of pulmonary embolism (PE) are not well known.We used the RIETE Registry database to identify factors associated with the finding of sPAP levels ≥50 mm Hg on trans-thoracic echocardiography, in 557 patients with a prior episode of acute, symptomatic PE.Sixty-two patients (11.1%; 95% CI: 8.72-14.1) had sPAP levels ≥50 mm Hg. These patients were more likely women, older, and more likely had chronic lung disease, heart failure, renal insufficiency or leg varicosities than those with PAP levels50mm Hg. During the index PE event, they more likely had recent immobility, and more likely presented with hypoxemia, increased sPAP levels, atrial fibrillation, or right bundle branch block. On multivariate analysis, women aged ≥70 years (hazard ratio [HR]: 2.0; 95% CI: 1.0-3.7), chronic heart or chronic lung disease (HR: 2.4; 95% CI: 1.3-4.4), atrial fibrillation at PE presentation (HR: 2.8; 95% CI: 1.3-6.1) or varicose veins (HR: 1.8; 95% CI: 1.0-3.3) were all associated with an increased risk to have raised sPAP levels. Chronic heart disease, varicose veins, and atrial fibrillation were independent predictors in women, while chronic heart disease, atrial fibrillation, a right bundle branch block or an S1Q3T3 pattern on the electrocardiogram were independent predictors in men.Women aged ≥70 years more likely had raised sPAP levels than men after a PE episode. Additional variables influencing this risk seem to differ according to gender.

Published
2012

18. A clinical prognostic model for the identification of low-risk patients with acute symptomatic pulmonary embolism and active cancer

Author

den Exter PL, Gómez, V, Jiménez, D, Trujillo Santos, J, Muriel, A, Huisman, Mv, Monreal, M, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Bertoletti, L, Papadakis, M, Bosevski, M, Bounameaux, H, Malý, R, Arcelus, Ji, Arcos, Mp, Ballaz, A, Barrón, M, Barrón Andrés, B, Blanco Molina, A, Boix, L, Bosco, J, Bueso, T, Campano, F, Cañas, I, Casado, I, Conget, F, de Miguel, J, del Campo, R, Chaves, E, del Toro, J, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, García Bragado, F, Gavín, O, González, J, Gracia, V, Guil, M, Guillem, N, Gutiérrez, J, Hernández, L, Hernández Huerta, D, Jaras, Mj, Jiménez, S, Jiménez Gil, M, Lobo, Jl, Lecumberri, R, López Jiménez, L, Lorenzo, A, Macià, M, Madridano, O, Marchena, Pj, Martín, M, Martín Villasclaras JJ, Mejías, I, Montero, L, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Otero, R, Pedrajas, Jm, Riera Mestre, A, Rodríguez Dávila MA, Román, P, Román Bernal, B, Roldán, V, Rosa, V, Royo, C, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Tirado, R, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valle, R, Vela, J, Vidal, G, Villalta, J, Zorrilla, V, Bura Riviere, A, Debourdeau, P, Farge Bancel, D, Lamuraglia, M, Mahe, I, Quere, I, Babalis, D, Barillari, G, Ciammaichella, M, Dalla Valle, F, Duce, R, La Regina, M, Maida, R, Orlandini, F, Pasca, S, Piovella, C, Poggio, R, Prandoni, P, Quintavalla, R, Rota, L, Schenone, A, Tonello, D, Visonà, A, Zalunardo, B, Alatri, A, Calanca, L, Mazzolai, L, Hirmerova, J, Tomko, T, Salgado, E., Bayer, and Sanofi España

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Clinical prediction rule, Critical Care and Intensive Care Medicine, Risk Assessment, Severity of Illness Index, Decision Support Techniques, Cohort Studies, Random Allocation, Risk Factors, Internal medicine, Neoplasms, medicine, Humans, Aged, Retrospective Studies, Aged, 80 and over, Framingham Risk Score, business.industry, Age Factors, Cancer, Reproducibility of Results, Retrospective cohort study, Middle Aged, medicine.disease, Prognosis, Surgery, Pulmonary embolism, Cohort, Multivariate Analysis, Female, Cardiology and Cardiovascular Medicine, Risk assessment, business, Pulmonary Embolism, Cohort study
Abstract

[Background] Physicians need a specific risk-stratification tool to facilitate safe and cost-effective approaches to the management of patients with cancer and acute pulmonary embolism (PE). The objective of this study was to develop a simple risk score for predicting 30-day mortality in patients with PE and cancer by using measures readily obtained at the time of PE diagnosis., [Methods] Investigators randomly allocated 1,556 consecutive patients with cancer and acute PE from the international multicenter Registro Informatizado de la Enfermedad TromboEmbólica to derivation (67%) and internal validation (33%) samples. The external validation cohort for this study consisted of 261 patients with cancer and acute PE. Investigators compared 30-day all-cause mortality and nonfatal adverse medical outcomes across the derivation and two validation samples., [Results] In the derivation sample, multivariable analyses produced the risk score, which contained six variables: age > 80 years, heart rate ≥ 110/min, systolic BP < 100 mm Hg, body weight < 60 kg, recent immobility, and presence of metastases. In the internal validation cohort (n = 508), the 22.2% of patients (113 of 508) classified as low risk by the prognostic model had a 30-day mortality of 4.4% (95% CI, 0.6%–8.2%) compared with 29.9% (95% CI, 25.4%–34.4%) in the high-risk group. In the external validation cohort, the 18% of patients (47 of 261) classified as low risk by the prognostic model had a 30-day mortality of 0%, compared with 19.6% (95% CI, 14.3%–25.0%) in the high-risk group., [Conclusions] The developed clinical prediction rule accurately identifies low-risk patients with cancer and acute PE., We are grateful to Sanofi Spain for supporting this registry with an unrestricted educational grant. We are also grateful to Bayer Pharma AG for supporting this registry. Bayer Pharma AG's support was limited to the part of RIETE outside Spain, which accounts for 15.53% of the total patients included in the RIETE Registry.

Published
2012

19. Influence of recent immobilization and recent surgery on mortality in patients with pulmonary embolism

Author

Nauffal, D., Ballester, M., LOPEZ REYES, R., Jiménez, D., Otero, R., Quintavalla, R., Monreal, M., Arcelus, J, Arcos, M, Ballaz, A, Barba, R, Barrón Andrés, B, Blanco Molina, A, Bosco, J, Chaves, E, Campano, F, Cañas, I, Casado, I, Cisneros, E, Conget, F, Delgado, C, de Miguel, J, del Campo, R, del Toro, J, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, Garcıá Bragado, F, Gavín, O, Gómez, V, González, J, Gracia, V, Gutiérrez, J, Hernández, L, Hernández Huerta, D, Jaras, Mj, Jiménez, D, Jiménez, S, Jiménez Gil, M, Lobo, Jl, Lecumberri, R, López Jiménez, L, Lorenzo, A, Luque, Jm, Macia, M, Madridano, O, Maestre, A, Marchena, Pj, Martín, M, Martín Villasclaras JJ, Monreal, M, Morales, M, Morán, Lp, Nauffal, Md, Nieto, Ja, Núnéz, Mj, Ogea, Jl, Otero, R, Pedrajas, Jm, Riera Mestre, A, Rodríguez Dávila MA, Román, P, Román Bernal, B, Roldán, V, Rosa, V, Royo, C, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Samperiz, Al, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Todolí, Ja, Tolosa, C, Trujillo, J, Uresandi, V, Valdés, M, Valle, R, Vela, J, Vidal, G, Villalta, J, Zorrilla, V, Bertoletti, L, Bura Riviere, A, Debourdeau, P, Mahe, I, Quere, I, Babalis, D, Papadakis, M, Brenner, B, Barillari, G, Ciammaichella, M, Dimicco, P, Dalla Valle, F, Duce, R, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Rota, L, Schenone, A, Bosevski, M, Bounameaux, H, Malý, R, Tomko, T, Decousus, H, Prandoni, P, Di Micco, P, and Malý, R.

Subjects
Male, medicine.medical_specialty, Immobilization, Risk Factors, Cause of Death, Medicine, Humans, In patient, Cause of death, Aged, Aged, 80 and over, business.industry, Mortality rate, Hematology, Surgical procedures, Middle Aged, medicine.disease, Confidence interval, Pulmonary embolism, Surgery, Increased risk, Surgical Procedures, Operative, Female, business, Pulmonary Embolism, Surgical patients
Abstract

Summary. Background: The influence of recent immobilization or surgery on mortality in patients with pulmonary embolism (PE) is not well known. Methods: We used the Registro Informatizado de Enfermedad TromboEmbolica (RIETE) data to compare the 3-month mortality rate in patients with PE, with patients categorized according to the presence of recent immobilization, recent surgery, or neither. Results: Of 18 028 patients with PE, 4169 (23%) had recent immobilization, 2212 (12%) had recent surgery, and 11 647 (65%) had neither. The all-cause mortality was 10.0% (95% confidence interval [CI] 9.5–10.4), and the PE-related mortality was 2.6% (95% CI 2.4–2.9). One in every two patients who died from PE had recent immobilization (43%) or recent surgery (6.7%). Only 25% of patients with immobilization had received prophylaxis, as compared with 65% of the surgical patients. Fatal PE was more common in patients with recent immobilization (4.9%; 95% CI 4.3–5.6) than in those with surgery (1.4%; 95% CI 1.0–2.0) or those with neither (2.1%; 95% CI 1.8–2.3). On multivariate analysis, patients with immobilization were at increased risk for fatal PE (odds ratio 2.2; 95% CI 1.8–2.7), with no differences being seen between patients immobilized in hospital or in the community. Conclusions: Forty-three per cent of patients dying from PE had recent immobilization for ≥ 4 days. Many of these deaths could have been prevented.

Published
2012

20. Low-molecular-weight or unfractionated heparin in venous thromboembolism: the influence of renal function

Author

Javier Trujillo Santos, Sebastian, Schellong, Conxita, Falga, Vanessa, Zorrilla, Pedro, Gallego, Manuel, Barrón, Manuel, Monreal, Arcelus, Ji, Ballaz, A, Barba, R, Barragán, Jm, Barrón, M, Barrón Andrés, B, Bascuñana, J, Blanco Molina, A, Bosco, J, Cañas, I, Casado, I, Conget, F, Chaves, E, de Miguel, J, del Campo, R, del Molino, F, del Toro, J, Falgá, C, Fernández, M, Fernández Capitán, C, Fuentes, L, Gabriel, F, Gallego, P, García Bragado, F, Gómez, V, González, J, Guil, M, Gutiérrez, J, Hernández, L, Hernández, Hd, Jaras, Mj, Jiménez, D, Jiménez, S, Lobo, Jl, López Jiménez, L, Lorenzo, A, Macià, M, Madridano, O, Marchena, Pj, Martín, M, Martín Villasclaras JJ, Monreal, M, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Otero, R, Pedrajas, Jm, Riera Mestre, A, Román, P, Rodríguez, Em, Román Bernal, B, Royo, C, Ruiz Martínez, C, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valle, R, Vela, J, Vidal, G, Villalta, J, Zorrilla, V, Barillari, G, Ciammaichella, M, Di Micco, P, Dalla Valle, F, Duce, R, Maida, R, Orlandini, F, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Rota, L, Schenone, A, Tiraferri, E, Tonello, D, Visonà, A, Zalunardo, B, Bertoletti, L, Bura Riviere, A, Debourdeau, P, Farge Bancel, D, Lamuraglia, M, Mahe, I, Quere, I, Brenner, B, Alatri, A, Bounameaux, H, Calanca, L, Mazzolai, L, Malý, R, Hirmerova, J, Tomko, T, Schellong, S, Papadakis, M, Bosevski, M, Salgado, E, La Regina, M, and Rodríguez Dávila MA

Subjects
Adult, Male, medicine.medical_specialty, medicine.drug_class, Low molecular weight heparin, Renal function, Kidney, Kidney Function Tests, Gastroenterology, Internal medicine, medicine, Humans, Renal Insufficiency, Intensive care medicine, Aged, business.industry, Heparin, General Medicine, Odds ratio, Venous Thromboembolism, Heparin, Low-Molecular-Weight, Middle Aged, medicine.disease, Confidence interval, Pulmonary embolism, Treatment Outcome, Propensity score matching, Female, business, Venous thromboembolism, medicine.drug, Follow-Up Studies
Abstract

In patients with acute venous thromboembolism and renal insufficiency, initial therapy with unfractionated heparin may have some advantages over low-molecular-weight heparin.We used the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) Registry data to evaluate the 15-day outcome in 38,531 recruited patients. We used propensity score matching to compare patients treated with unfractionated heparin with those treated with low-molecular-weight heparin in 3 groups stratified by creatinine clearance levels at baseline:60 mL/min, 30 to 60 mL/min, or30 mL/min.Patients initially receiving unfractionated heparin therapy (n = 2167) more likely had underlying diseases than those receiving low-molecular-weight heparin (n = 34,665). Propensity score-matched groups of patients with creatinine clearance levels60 mL/min (n = 1598 matched pairs), 30 to 60 mL/min (n = 277 matched pairs), and30 mL/min (n = 210 matched pairs) showed an increased 15-day mortality for unfractionated heparin compared with low-molecular-weight heparin (4.5% vs 2.4% [P = .001], 5.4% vs 5.8% [P = not significant], and 15% vs 8.1% [P = .02], respectively), an increased rate of fatal pulmonary embolism (2.8% vs 1.2% [P = .001], 3.2% vs 2.5% [P = not significant], and 5.7% vs 2.4% [P = .02], respectively), and a similar rate of fatal bleeding (0.3% vs 0.3%, 0.7% vs 0.7%, and 0.5% vs 0.0%, respectively). Multivariate analysis confirmed that patients treated with unfractionated heparin were at increased risk for all-cause death (odds ratio, 1.8; 95% confidence interval, 1.3-2.4) and fatal pulmonary embolism (odds ratio, 2.3; 95% confidence interval, 1.5-3.6).In comparison with low-molecular-weight heparin, initial therapy with unfractionated heparin was associated with a higher mortality and higher rate of fatal pulmonary embolism in patients with creatinine clearance levels60 mL/min or30 mL/min, but not in those with levels between 30 and 60 mL/min.

Published
2012

21. Silent pulmonary embolism in patients with proximal deep vein thrombosis in the lower limbs

Author

Tzoran, I., Saharov, G., Brenner, B., Delsart, D., Román, P., Visoná, A., Jiménez, D., Monreal, M., Arcelus, Ji, Arcos, Mp, Ballaz, A, Barba, R, Barrón, M, Blanco Molina, A, Bosco, J, Chaves, E, Conget, F, Delgado, C, De Ancos, C, del Toro, J, Falgá, C, Farfán, A, Fernández Capitán, C, Gallego, P, García Bragado, F, Gómez del Olmo, V, Guijarro, J, Guillém, N, Gutiérrez, J, Hernández, L, Hernández Huerta, D, Jaras, Mj, Jiménez, D, Jiménez, S, Jiménez Gil, M, Lobo, Jl, López Jiménez, L, Lorenzo, A, Luque, Jm, Macia, M, Madridano, O, Maestre, A, Marchena, Pj, Martín Villasclaras JJ, Monreal, M, Morales, M, Nauffal, Md, Nieto, Ja, Ogea, Jl, Pedrajas, Jm, Riera Mestre, A, Rodríguez Dávila MA, Román, P, Román Bernal, B, Rosa, V, Ruíz, J, Ruiz Gamietea, A, Ruiz Giménez, N, Ruiz Ribó MD, Sahuquillo, Jc, Samperiz, A, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Todolí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valdés, V, Valle, R, Vidal, G, Villalta, J, Zorrilla, V, Bertoletti, L, Bura Riviere, A, Debourdeau, P, Mahe, I, Papadakis, M, Babalis, D, Tzinieris, I, Brenner, B, Barillari, A, Barillari, G, Ciammaichella, M, Di Micco, P, Dalla Valle, F, Maida, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Schenone, A, Tonello, D, Visonà, A, Bosevski, M, Bounameaux, H, Malý, R, and Tomko, T.

Subjects
Male, medicine.medical_specialty, Time Factors, Deep vein, Hemorrhage, Risk Assessment, Risk Factors, medicine, Odds Ratio, Humans, Clinical significance, Prospective Studies, Registries, Israel, Prospective cohort study, Aged, Aged, 80 and over, Venous Thrombosis, Chi-Square Distribution, business.industry, Incidence (epidemiology), Incidence, Anticoagulants, Hematology, Odds ratio, Middle Aged, medicine.disease, Thrombosis, Survival Analysis, Surgery, Pulmonary embolism, Europe, medicine.anatomical_structure, Logistic Models, Treatment Outcome, Lower Extremity, Asymptomatic Diseases, Multivariate Analysis, Female, business, Pulmonary Embolism, Chi-squared distribution
Abstract

Summary. Background: One in every three patients with deep vein thrombosis (DVT) in the lower limbs may have silent pulmonary embolism (PE), but its clinical relevance has not been thoroughly studied. Methods: We used the RIETE Registry data to study patients with proximal DVT and no PE symptoms, but with a systematic search for PE. We compared the outcome of DVT patients with silent PE and those with no PE. Results: Of 2375 patients with DVT, 842 (35%) had silent PE and 1533 had no PE. During the first 15 days of anticoagulation, patients presenting with silent PE had a higher incidence of symptomatic PE events than those with no PE (0.95% vs. 0.13%; P = 0.015), with a similar incidence of major bleeding (0.95% vs. 1.63%; P = 0.09). In patients with silent PE, the incidence of PE events during the first 15 days was equal to the incidence of major bleeding (eight events each), but in those with no PE the incidence of PE events was eight times lower (3 vs. 25 bleeding events). Multivariate analysis confirmed that DVT patients with silent PE had a higher incidence of symptomatic PE events during the first 15 days than those with no PE (odds ratio, 4.80; 95% CI, 1.27–18.1), with no differences in bleeding. Conclusions: DVT patients with silent PE at baseline had an increased incidence of symptomatic PE events during the first 15 days of anticoagulant therapy. This effect disappeared after 3 months of anticoagulation.

Published
2012

22. Venous thromboembolism in immobilized patients with dementia. Findings from the RIETE registry

Author

Nuñez, Mj, Villalba, Jc, Cebrián, E, Visoná, A, Lopez Jimenez, L, Núñez, M, Szwebel, Ta, Luque, Jm, Jaras, Mj, Monreal, M, Arcelus, Ji, Barba, R, Barrón, M, Blanco, A, Boix, L, Bosco, J, Calvo, M, Casado, I, Casas, Jm, Cisneros, E, Chavez, E, del Campo, R, del Toro, J, Durán, M, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, García Bragado, F, Guil, M, Gutiérrez, J, Hernández, L, Hernández Huerta, D, Jiménez Gil, M, Lecumberri, R, Lobo, Jl, López Jiménez, L, Lorenzo, A, Madridano, O, Manzano, V, Maestre, A, Marchena, Pj, Martín Villasclaras JJ, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Oribe, M, Otero, R, Pedrajas, Jm, Provenza, M, Rabuñal, R, Riera Mestre, A, Rodríguez, Ma, Roldán, V, Román, B, Román, P, Rosa, V, Royo, C, Rubio, S, Ruíz, C, Ruíz, J, Ruiz Gamietea, A, Ruíz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Timiraos, J, Tolodí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valdés, V, Valle, R, Vidal, G, Villalta, J, Zorrilla, V, Bura Riviere, A, Debourdeau, P, Durant, C, Farge Bancel, D, Mahe, A, Mismetti, P, Rivron Guillot, K, Szwebel, T, Brenner, B, Barillari, A, Barillari, G, Ciammaichella, M, Di Micco, P, Dalla Valle, F, Duce, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, Paolo, Quintavalla, R, Maida, R, Schenone, A, Tiraferri, E, Tonello, D, Visonà, A, Bosevski, M, and Papadakis, M.

Subjects
Male, medicine.medical_specialty, Deep vein, Hemorrhage, Internal medicine, medicine, Dementia, Humans, Registries, Aged, Aged, 80 and over, business.industry, Incidence (epidemiology), Incidence, Anticoagulants, Hematology, Odds ratio, Venous Thromboembolism, Heparin, Low-Molecular-Weight, Middle Aged, medicine.disease, Thrombosis, Surgery, Pulmonary embolism, Natural history, Clinical trial, medicine.anatomical_structure, Treatment Outcome, Female, business, Pulmonary Embolism
Abstract

Background The natural history of venous thromboembolism (VTE) in patients with dementia has not been thoroughly studied. Methods We used the RIETE Registry data to assess the clinical characteristics, treatment strategies and outcome during the first 3 months after acute VTE in all immobilized patients with dementia. Results As of August 2011, 37988 patients had been enrolled, of whom 1316 (3.5%) had dementia. Most patients in both subgroups were initially treated with low-molecular-weight heparin (LMWH). Then, 48% of patients with dementia and 25% of those without dementia received LMWH as long-term therapy. During the first 3 months of anticoagulant therapy, patients with dementia had a higher incidence of fatal pulmonary embolism (PE): 4.0% vs. 1.2% (odds ratio: 3.3; 95% CI: 2.5-4.4) and fatal bleeding: 1.4% vs. 0.5% (odds ratio: 2.9; 95% CI: 1.8-4.6) than those without dementia. In demented patients initially presenting with PE, the incidence of fatal PE during the first week outweighed that of fatal bleeding (42 vs. 4 deaths), but from Day 8, the incidence of fatal PE was similar to the incidence of fatal bleeding. In patients initially presenting with deep vein thrombosis (DVT), there were 4 fatal PE and 8 fatal bleeding events. Conclusions VTE patients with dementia had a high incidence of fatal PE and fatal bleeding. In those initially presenting with PE, the risk of dying of PE far outweighed that of fatal bleeding. In patients presenting with DVT alone, the risk of fatal PE was lower than that of fatal bleeding.

Published
2012

23. Venous thromboembolism in patients with intracranial haemorrhage

Author

Lobo, J. L., Nieto, J. A., Zorrilla, V., Garrido, N., Madridano, O., Ruiz, J., Farge Bancel, D., Tiberio, G., Uresandi, F., Monreal, M., Monreal, M, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Rivron Guillot, K, Bosevski, M, Arcelus, Ji, Barrón, M, Blanco, A, Bosco, J, Casado, I, Casas, Jm, Cisneros, E, Chavez, E, del Campo, R, del Molino, F, del Toro, J, Durán, M, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, García Bragado, F, González, Jp, Guijarro, R, Guil, M, Gutiérrez, J, Gutiérrez, Mr, Hernández, L, Hernández Huerta, D, Hernández Toboso, S, Jiménez, D, Jiménez Gil, M, Lecumberri, R, Lobo, Jl, López Jiménez, L, Lorenzo, A, Luque, Jm, Madridano, O, Maestre, A, Marchena, Pj, Martín Villasclaras JJ, Montes, J, Montaña, M, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Oribe, M, Otero, R, Pedrajas, Jm, Provenza, M, Rabuñal, R, Riera Mestre, A, Rodríguez, Ma, Roldán, V, Román, P, Rosa, V, Rubio, S, Ruíz, C, Ruíz, J, Ruiz Gamietea, A, Ruíz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez, R, Sánchez, Mt, Soler, S, Soto, Mj, Tiberio, G, Timiraos, J, Tolodí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valdés, V, Valle, R, Vidal, G, Villalta, J, Boccalon, H, Debourdeau, P, Durant, C, Farge Bancel, D, Mahe, I, Mismetti, P, Szwebel, T, Barillari, G, Ciammaichella, Bb, Ciammaichella, M, Dalla, Vf, Duce, R, Piovella, C, Poggio, R, Prandoni, P, Quintavalla, R, Schenone, A, Tiraferri, E, Tonello, D, Visonà, A, and Bosevski, M.

Subjects
Male, Risk, 0301 basic medicine, medicine.medical_specialty, Intracranial haemorrhage, Hemorrhage, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Drug Dosage Calculations, In patient, Aged, business.industry, General surgery, Vascular biology, Anticoagulants, Hematology, Heparin, Low-Molecular-Weight, Middle Aged, Survival Analysis, Surgery, 030104 developmental biology, Spain, Female, Pulmonary Embolism, business, Intracranial Hemorrhages, Venous thromboembolism, Follow-Up Studies, Pneumonology
Abstract

Jose Luis Lobo1; Jose Antonio Nieto2; Vanesa Zorrilla1; Noelia Garrido2; Olga Madridano3; Justo Ruiz4; Dominique Farge-Bancel5; Gregorio Tiberio6; Fernando Uresandi7; Manuel Monreal8; the RIETE Investigators* 1Department of Pneumonology, Hospital de Txagorritxu, Vitoria, Spain; 2Department of Internal Medicine, Hospital Virgen de la Luz, Cuenca, Spain; 3Department of Internal Medicine, Hospital Infanta Sofia, Madrid, Spain; 4Department of Internal Medicine, Hospital de Fuenlabrada, Madrid, Spain; 5Department of Internal Medicine, Hopital SaintLouis, Paris, France; 6Department of Internal Medicine, Hospital Virgen del Camino, Pamplona, Navarra, Spain; 7Department of Pneumonology, Hospital de Cruces, Barakaldo, Vizcaya, Spain; 8Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain

Published
2011

24. Acute venous thromboembolism after non-major orthopaedic surgery or post-traumatic limb immobilisation

Author

Bertoletti, L., Righini, M., Bounameaux, H., López Jiménez, L., Tiraferri, E., Visonà, A., Monreal, M., Monreal, M, Decousus, H, Prandoni, Paolo, Brenner, B, Barba, R, Di Micco, P, Rivron Guillot, K, Bosevski, M, Bounameaux, H, Arcelus, Ji, Barrón, M, Blanco, A, Bosco, J, Casado, I, Casas, Jm, Cisneros, E, Chavez, E, del Campo, R, del Molino, F, del Toro, J, Durán, M, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, García Bragado, F, Guijarro, R, Guil, M, Gutiérrez, J, Gutiérrez, Mr, Hernández, L, Hernández Toboso, S, Jiménez, D, Jiménez Gil, M, Jordán, S, Lecumberri, R, Lobo, Jl, López Jiménez, L, Lorenzo, A, Luque, Jm, Madridano, O, Maestre, A, Marchena, Pj, Martín Villasclaras JJ, Montes, J, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ochoa, F, Ogea, Jl, Oribe, M, Otero, R, Pedrajas, Jm, Ponce de León, L, Rabuñal, R, Riera Mestre, A, Rodríguez, Ma, Roldán, V, Román, P, Rosa, V, Rubio, S, Ruiz Gamietea, A, Ruíz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Tolodí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valdés, V, Valle, R, Vidal, G, Villalta, J, Boccalon, H, Debourdeau, P, Durant, C, Farge Bancel, D, Mahe, I, Barillari, A, Barillari, G, Ciammaichella, M, Dalla Valle, F, Duce, R, Pasca, S, Piovella, C, Poggio, R, Prandoni, P, Quintavalla, R, Schenone, A, Tiraferri, E, and Visonà, A

Published
2011

35. Natural history of patients developing thrombocytopenia while receiving anticoagulant therapy for venous thromboembolism

Author

Di Micco, P, Fontanella, A, Falvo, N, Bonithon Kopp, C, Decousus, H, Riera Mestre, A, Monreal, M, Prandoni, Paolo, Brenner, B, Barba, R, Rivron Guillot, K, Bosevski, M, Alcalde, M, Arcelus, Ji, Barrón, M, Blanco, A, Boix, L, Bosco, J, Bruscas, Mj, Casado, I, Casas, Jm, Chavez, E, del Campo, R, del Molino, F, del Toro, J, Durán, M, Falgá, C, Fernández Capitán, C, Gabriel, F, Gallego, P, García Bragado, F, Guijarro, R, Guil, M, Gutiérrez, J, Gutiérrez, Mr, Hermosa, Mj, Hernández, L, Hernández Juerta, D, Jiménez, M, Jordán, S, Lecumberri, R, Lobo, Jl, López, L, Lorenzo, A, Luque, Jm, Madridano, O, Maestre, A, Marchena, Pj, Martín Villasclaras JJ, Montes, J, Morales, M, Nauffal, Md, Nieto, Ja, Núñez, Mj, Ogea, Jl, Oribe, M, Otero, R, Pedrajas, Jm, Rabuñal, R, Rodríguez, Ma, Roldán, V, Román, P, Rosa, V, Rubio, S, Ruiz Gamietea, A, Ruiz Giménez, N, Sahuquillo, Jc, Samperiz, A, Sánchez, R, Sánchez Muñoz Torrero JF, Soler, S, Soto, Mj, Tiberio, G, Tolodí, Ja, Tolosa, C, Trujillo, J, Uresandi, F, Valdés, M, Valdés, V, Valle, R, Villalta, J, Boccalon, H, Farge Bancel, D, Mahe, I, Szwebel, Ta, Barillari, A, Barillari, G, Ciammaichella, M, Dalla Valle, F, Duce, R, Marconi, M, Pasca, S, Piovaccari, Gc, Piovella, C, Poggio, R, Prandoni, P, Quintavalla, R, Schenone, A, Tiraferri, E, Tonello, D, Visonà, A, Zalunardo, B, and Bosevski, M.

Subjects
Aged, 80 and over, Male, Time Factors, Platelet Count, Anticoagulants, Hemorrhage, Venous Thromboembolism, Middle Aged, Risk Assessment, Thrombocytopenia, Europe, Risk Factors, Disease Progression, Secondary Prevention, Humans, Female, Registries, Aged, Retrospective Studies

36. Chronic liver disease and cirrhosis mortality and social deprivation: a spatial analysis in small areas of Madrid region.

Author

Segura del Pozo J, Gandarillas A, Domínguez Berjón F, Soto MJ, López L, Marta I, Abad I, Zorrilla B, and Duque I

Abstract

OBJECTIVES: To study census-tract distribution of chronic liver disease and cirrhosis mortality in the Madrid Region and its association with socio-economic deprivation. METHODS: Cross-sectional, ecological (3906 census-tract) study, using mortality data for 1996-2003 and a deprivation index drawn up on the basis of 2001 census data. Standardised mortality ratios were calculated taking Spanish rates for 2001 as reference. Smoothed census-tract relative risks were computed using the Besag-York-Mollie model. Relative risks (RRs) of dying and their 95% credibility intervals (95% CIs) were calculated according to quartiles of the deprivation index (with the fourth quartile -Q- of the indicator being the most unfavourable situation). Maps were plotted depicting the distribution of the posterior probability of RR > 1. RESULTS: Census tracts with a high risk of mortality were detected, mostly located in the centre and on the eastern, south-eastern and south-western fringes of the city of Madrid. Mortality increased with deprivation. RRs of mortality according to quartíles of the deprivation index were: Q2 = 1.5 (CI: 1.3-1.6), Q3 = 1.9 (CI:1.7-2.2) and Q4 = 2.5 (CI:2.2-2.8) for men; and Q2 = 1.3 (CI:1.1-1.5), Q3 = 1.5 (CI:1.3-1.7) and Q4 = 1.6 (CI:1.3-1.8) for women. CONCLUSIONS: This small-area study enabled census tracts with excess mortality eligible for a special public health intervention to be identified, and their association with socio-economic deprivation to be confirmed. [ABSTRACT FROM AUTHOR]

Published
2010
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37. Clinical presentation and time-course of postoperative venous thromboembolism: Results from the RIETE Registry

Author

Arcelus, Juan Ignacio, Monreal, Manuel, Caprini, Joseph A, Guisado, Javier Gutiérrez, Soto, Maria José, Núñez, Manuel Jesús, Alvárez, Juan Carlos, Renseigné, Non, Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance (UMR 3192) (Lab-STICC), Université européenne de Bretagne - European University of Brittany (UEB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Télécom Bretagne-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS), Asociación de Investigación y Desarrollo en la Industria del Mueble y Afines (AIDIMA), AIDIMA, DEPARTAMENTO DE QUIMICA ORGANICA, Universidad de Concepción [Chile], RIETE investigators, [Arcelus,JI] Departamento de Cirugía de la Universidad de Granada y Hospital Virgen de las Nieves, Granada, Spain. [Monreal,M] Servicio de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. [Caprini,JA] Department of Surgery, Evanston Northwestern Healthcare, Evanston, Illinois,USA. [Gutiérrez Guisado,J] Servicio de Medicina Interna, Hospital Asepeyo Coslada, Madrid, Spain. [Soto,MJ] Servicio de Medicina Interna, Hospital Universitario Puerta del Mar, Cádiz, Spain. [Núñez,MJ] Servicio de Medicina Interna, Hospital Comarcal de Salnés, Pontevedra, Spain.[Alvárez,JC] Servicio de Medicina Interna, Hospital Virgen de Macarena, Sevilla, Spain., and The project has been partially supported by Red Respira from the Instituto Carlos III (RedRespira-ISCiii-RTIC-03/11). We express our gratitude to Sanofi-Aventis Spain for supporting this Registry with an unrestricted educational grant and the Registry Coordinating Center, S & H Medical Science Service, for their logistic and administrative support.

Subjects
Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Recurrence [Medical Subject Headings], Male, Diseases::Respiratory Tract Diseases::Lung Diseases::Pulmonary Embolism [Medical Subject Headings], Phenomena and Processes::Physical Phenomena::Time::Time Factors [Medical Subject Headings], medicine.medical_treatment, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 0302 clinical medicine, Hemorragia, Estudios prospectivos, Procedimientos quirúrgicos, Prospective Studies, MESH: Incidence, Masculino, Hip fracture, MESH: Middle Aged, Incidence, Geographicals::Geographic Locations::Europe [Medical Subject Headings], Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Fibrin Modulating Agents::Fibrinolytic Agents [Medical Subject Headings], Humanos, 3. Good health, Embolia pulmonar, Sistema de registros, Geographicals::Geographic Locations::Asia::Asia, Western::Middle East::Israel [Medical Subject Headings], MESH: Hemorrhage, Venous thromboembolism, medicine.medical_specialty, Argentina, Check Tags::Male [Medical Subject Headings], Hemorrhage, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Hemorrhage [Medical Subject Headings], MESH: Orthopedic Procedures, MESH: Surgical Procedures, Operative, 03 medical and health sciences, Fibrinolytic Agents, Humans, Aged, Mediana edad, MESH: Humans, medicine.disease, Check Tags::Female [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Orthopedic Procedures [Medical Subject Headings], Orthopedic surgery, Surgery, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Registries [Medical Subject Headings], Pulmonary Embolism, MESH: Female, MESH: Pulmonary Embolism, Time Factors, MESH: Registries, Geographicals::Geographic Locations::Americas::South America::Argentina [Medical Subject Headings], 030204 cardiovascular system & hematology, MESH: Venous Thromboembolism, Recurrence, Neoplasms, MESH: Fibrinolytic Agents, Orthopedic Procedures, MESH: Neoplasms, Registries, 030212 general & internal medicine, Israel, Prospective cohort study, Recurrencia local de neoplasia, MESH: Aged, Incidence (epidemiology), Femenino, MESH: Argentina, MESH: Israel, Venous Thromboembolism, Hematology, Diseases::Neoplasms [Medical Subject Headings], Middle Aged, Neoplasias, Pulmonary embolism, Europe, Venous thrombosis, Surgical Procedures, Operative, Female, Fibrinolíticos, Incidencia, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Incidence [Medical Subject Headings], medicine, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative [Medical Subject Headings], Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Procedimientos ortopédicos, business.industry, Vascular disease, MESH: Time Factors, Arthroplasty, MESH: Prospective Studies, MESH: Male, MESH: Recurrence, Factores de tiempo, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, MESH: Europe, Europa ( Continente), Diseases::Cardiovascular Diseases::Vascular Diseases::Embolism and Thrombosis::Thromboembolism::Venous Thromboembolism [Medical Subject Headings], business, Ancianos, Tromboembolia venosa
Abstract

Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; There is little literature about the clinical presentation and time-course of postoperative venous thromboembolism (VTE) in different surgical procedures. RIETE is an ongoing, prospective registry of consecutive patients with objectively confirmed, symptomatic acute VTE. In this analysis, we analysed the baseline characteristics, thromboprophylaxis and therapeutic patterns, time-course, and three-month outcome of all patients with postoperative VTE. As of January 2006, there were 1,602 patients with postoperative VTE in RIETE: 393 (25%) after major orthopaedic surgery (145 elective hip arthroplasty, 126 knee arthroplasty, 122 hip fracture); 207 (13%) after cancer surgery; 1,002 (63%) after other procedures. The percentage of patients presenting with clinically overt pulmonary embolism (PE) (48%, 48%, and 50% respectively), the average time elapsed from surgery to VTE (22 +/- 16, 24 +/- 16, and 21 +/- 15 days, respectively), and the three-month incidence of fatal PE (1.3%, 1.4%, and 0.8%, respectively), fatal bleeding (0.8%, 1.0%, and 0.2%, respectively), or major bleeding (2.3%, 2.9%, and 2.8%, respectively) were similar in the three groups. However, the percentage of patients who had received thromboprophylaxis (96%, 76% and 52%, respectively), the duration of prophylaxis (17 +/- 9.6, 13 +/- 8.9, and 12 +/- 11 days, respectively) and the mean daily doses of low-molecular-weight heparin (4,252 +/- 1,016, 3,260 +/- 1,141, and 3,769 +/- 1,650 IU, respectively), were significantly lower in those undergoing cancer surgery or other procedures. In conclusion, the clinical presentation, time-course, and three-month outcome of VTE was similar among the different subgroups of patients, but the use of prophylaxis in patients undergoing cancer surgery or other procedures was suboptimal. Yes

Published
2008

38. Supplemental Nutrition Assistance Program issuance timing is associated with sugar-sweetened beverage marketing in the USA.

Author

Dai J, Kenney EL, Soto MJ, Zhong A, Moran AJ, Broad Leib EM, and Bleich SN

Subjects
Humans, United States, Longitudinal Studies, Time Factors, Food Assistance statistics & numerical data, Sugar-Sweetened Beverages statistics & numerical data, Supermarkets, Marketing methods, Marketing statistics & numerical data
Abstract

Objective: Prior research has shown that there are more supermarket displays of sugar-sweetened beverages (SSB) during times when Supplemental Nutrition Assistance Program (SNAP) benefits are distributed ('issuance periods'). This may contribute to inequitable purchasing and consumption. This study examines whether SSB marketing in weekly supermarket circulars, which retailers use to advertise products, is more prevalent during issuance periods compared to non-issuance periods., Design: We conducted longitudinal, difference-in-differences analyses of data extracted from weekly supermarket circulars of randomly selected SNAP-authorised retailers in six states. Analyses tested whether SSB advertisements ('ads') were more prevalent during SNAP issuance periods compared to non-issuance periods within states with distinct issuance periods (3, 5, 10 or 15 d), compared to one state with continuous benefit issuance (28 d; the 'control' state)., Setting: Weekly online supermarket circulars collected from August to September 2019 were analysed in 2021., Participants: The study sample included 5152 circulars from 563 SNAP-authorised retailers in the states California, Connecticut, Nebraska, New Jersey and Texas (distinct issuance period states) as well as Florida ('control' state)., Results: The estimated mean percentage of beverage ads classified as SSB ads during issuance days was 51·5 % compared to 48·4 % during non-issuance days ( P < 0·001). In difference-in-differences analyses comparing to the 'control' state with continuous issuance, SSB ad counts were 2·9 % higher (95 % CI 1·9 %, 3·9 %) during SNAP issuance relative to non-issuance., Conclusions: SSB ads are slightly more prevalent in weekly supermarket circulars during SNAP issuance periods. Future research should explore the linkages between circular ads and SSB purchasing and consumption.

Published
2024
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39. Variation in tiered network health plan penetration and local provider market characteristics.

Author

Sinaiko AD, Curto VE, Bambury E, Soto MJ, and Rosenthal MB

Subjects
Massachusetts, Health Benefit Plans, Employee statistics & numerical data
Abstract

Objective: To understand variation in enrollment in tiered network health plans (TNPs) and the local provider market characteristics associated with TNP penetration., Data Sources and Study Setting: We used 2013-2017 Massachusetts three-digit ZIP code level employer-sponsored health insurance enrollment data, data on physician horizontal and vertical affiliations from the Massachusetts Provider Database, state hospital reports in 2013, 2015, and 2017, and the 2013-2017 Massachusetts All-Payer Claims database., Study Design: Linear regressions were used to estimate associations between TNP and local provider market characteristics., Data Extraction: We constructed measures of TNP penetration and local provider market characteristics and linked these data using three-digit ZIP code., Principal Findings: TNP penetration was at least 10% in all employer market sectors and highest among jumbo sized employers. All state employee health plan enrollees were in a tiered network health plan. Among enrollees not in the state employee health plan, TNP penetration varied from 6.0% to 19.6% across three-digit ZIP codes in Massachusetts. TNP penetration was higher in areas with less horizontal and vertical physician market concentration., Conclusions: Market competition, rather than the absolute quantity of physicians in an area, is associated with TNP penetration., (© 2023 Health Research and Educational Trust.)

Published
2024
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40. Layered Double Hydroxides (LDH) as Delivery Vehicles of a Chimeric Protein Carrying Epitopes from the Porcine Reproductive and Respiratory Syndrome Virus.

Author

Alonso-Cerda MJ, García-Soto MJ, Miranda-López A, Segura-Velázquez R, Sánchez-Betancourt JI, González-Ortega O, and Rosales-Mendoza S

Abstract

The Porcine Reproductive and Respiratory Syndrome Virus (PRRSV) causes reproductive failure and respiratory symptoms, leading to huge economic losses for the pig farming industry. Although several vaccines against PRRSV are available in the market; they show an overall low efficacy, and several countries have the need for vaccines covering the local, circulating variants. This project aims at developing a new chimeric antigen targeting specific epitopes from PRRSV and evaluating two test adjuvants to formulate a vaccine candidate. The test antigen was called LTB-PRRSV, which was produced recombinantly in Escherichia coli and consisted of the heat labile enterotoxin B subunit from E. coli (LTB) and four epitopes from PRRSV. LTB-PRRSV was rescued as inclusion bodies and methods for its solubilization, IMAC-based purification, and refolding were standardized, leading to mean yields of 18 mg of pure protein per liter culture. Layered double hydroxides (LDH) have been used as vaccine adjuvants given their biocompatibility, low cost, and positive surface charge that allows an efficient adsorption of negatively charged biomolecules. Therefore, LDH were selected as delivery vehicles of LTB-PRRSV. Pure LTB-PRRSV was adsorbed onto LDH by incubation at different LDH:LTB-PRRSV mass ratios (1:0.25, 1:0.5, 1:1, and 1:2) and at pH 9.5. The best adsorption occurred with a 1:2 mass ratio, and in a sucrose-tween solution. The conjugates obtained had a polydispersity index of 0.26, a hydrodynamic diameter of 192 nm, and a final antigen concentration of 64.2 μg/mL. An immunogenicity assessment was performed by injecting mice with LDH:LTB-PRRSV, Alum/LTB-PRRSV, or LTB-PRRSV in a scheme comprising three immunizations at two-week intervals and two dose levels (1 and 5 μg). LTB-PRRSV was capable of inducing strong humoral responses, which lasted for a longer period when LDH was used as the delivery vehicle/adjuvant. The potential of LDH to serve as an attractive carrier for veterinary vaccines is discussed.

Published
2024
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41. Clinical Features and Therapeutic Outcomes Comparing Primary Mediastinal Large B-cell Lymphoma to Mediastinal Hodgkin Disease.

Author

Cruz-Chamorro RJ, Rodríguez-López JL, González-Soto MJ, Arroyo-Suárez R, Ortiz-Sánchez C, Encarnación-Medina J, and Cabanillas F

Subjects
Humans, Retrospective Studies, Male, Female, Adult, Middle Aged, Young Adult, Aged, Cohort Studies, Treatment Outcome, Follow-Up Studies, Prognosis, Adolescent, Superior Vena Cava Syndrome etiology, Progression-Free Survival, Survival Rate, Mediastinal Neoplasms pathology, Mediastinal Neoplasms diagnosis, Mediastinal Neoplasms therapy, Hodgkin Disease pathology, Hodgkin Disease diagnosis, Hodgkin Disease therapy, Lymphoma, Large B-Cell, Diffuse pathology, Lymphoma, Large B-Cell, Diffuse diagnosis, Lymphoma, Large B-Cell, Diffuse therapy
Abstract

Currently, there is limited data available comparing Primary Mediastinal Large B-cell Lymphoma (PMBL) and mediastinal Hodgkin disease, nodular sclerosis type (HDNS). This is a retrospective cohort study that compares the clinical features, histology through immunohistochemistry (IHC) and treatment outcomes of 19 cases of PMBL and 39 cases of HDNS diagnosed over 13 years at a single institution in San Juan, PR. Superior Vena Cava syndrome (SVCS) and elevated Lactate Dehydrogenase (LDH) levels were more frequently seen in the PMBL cohort. At the median follow-up visit, of 74 months, no significant difference was seen in overall survival or progression free survival between PMBL and HDNS. Almost all of the relapses in the PMBL group occurred within 12 months of diagnosis. Our data suggests that PMBL and HDNS differ in their clinical presentation and have a favorable prognosis.

Published
2024

42. Addressing Chagas disease from a One Health perspective: risk factors, lessons learned and prevention of oral transmission outbreaks in Colombia.

Author

Olivera MJ, Rincón Acevedo CY, Olivera AJ, Mendez-Cardona S, and Vera Soto MJ

Abstract

Background: Chagas disease (CD) is transmitted by vectors but can also be transmitted orally through contaminated food, drinks, or meat. The One Health perspective aims to understand the complex interaction between human, animal, and environmental health in controlling disease. This study analyzed risk factors and drew lessons from past outbreaks of orally transmitted CD to develop effective preventive strategies., Methods: A simultaneous mixed methods study was conducted. The study consisted of two phases: an ecological epidemiological analysis at the municipal level using secondary data spanning from 1992 to 2023, and semistructured interviews with health providers and policymakers at the national level in Colombia. The results from both phases were triangulated to gain a comprehensive understanding of the topic., Results: A total of 64 outbreaks, infecting 302 individuals, were reported. Most of these outbreaks (89.2%) were classified as family-related, and they occurred most frequently during the months of April to June (46.6%). It is worth noting that a significant number of these outbreaks took place in municipalities that lacked vector control plans. Risk factors for oral transmission included the location of food preparation, poor housing quality, food preparation water source, the presence of vectors/marsupials, forest type, and climatic variables. Interviews conducted emphasized the importance of implementing outbreak plans and providing staff training to effectively address the issue., Conclusion: A One Health approach strengthening prevention, surveillance, case management and cross-sectoral collaboration is needed to control outbreaks and reduce transmission in Colombia. Preparedness plans and education of health professionals are also important. This study identified modifiable risk factors to guide public health interventions., Competing Interests: The authors declare no known competing financial interests or personal relationships that could have influenced the work reported in this paper., (© 2024 The Authors.)

Published
2024
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43. Sinorhizobium meliloti GR4 Produces Chromosomal- and pSymA-Encoded Type IVc Pili That Influence the Interaction with Alfalfa Plants.

Author

Carvia-Hermoso C, Cuéllar V, Bernabéu-Roda LM, van Dillewijn P, and Soto MJ

Abstract

Type IVc Pili (T4cP), also known as Tad or Flp pili, are long thin microbial filaments that are made up of small-sized pilins. These appendages serve different functions in bacteria, including attachment, biofilm formation, surface sensing, motility, and host colonization. Despite their relevant role in diverse microbial lifestyles, knowledge about T4cP in bacteria that establish symbiosis with legumes, collectively referred to as rhizobia, is still limited. Sinorhizobium meliloti contains two clusters of T4cP-related genes: flp-1 and flp-2 , which are located on the chromosome and the pSymA megaplasmid, respectively. Bundle-forming pili associated with flp-1 are involved in the competitive nodulation of alfalfa plants, but the role of flp-2 remains elusive. In this work, we have performed a comprehensive bioinformatic analysis of T4cP genes in the highly competitive S. meliloti GR4 strain and investigated the role of its flp clusters in pilus biogenesis, motility, and in the interaction with alfalfa. Single and double flp -cluster mutants were constructed on the wild-type genetic background as well as in a flagellaless derivative strain. Our data demonstrate that both chromosomal and pSymA flp clusters are functional in pili biogenesis and contribute to surface translocation and nodule formation efficiency in GR4. In this strain, the presence of flp-1 in the absence of flp-2 reduces the competitiveness for nodule occupation.

Published
2024
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44. Siderophores and competition for iron govern myxobacterial predation dynamics.

Author

Contreras-Moreno FJ, Moraleda-Muñoz A, Marcos-Torres FJ, Cuéllar V, Soto MJ, Pérez J, and Muñoz-Dorado J

Subjects
Soil Microbiology, Microbial Interactions, Rhizosphere, Symbiosis, Siderophores metabolism, Iron metabolism, Myxococcus xanthus metabolism, Myxococcus xanthus genetics, Myxococcus xanthus physiology, Sinorhizobium meliloti metabolism, Sinorhizobium meliloti genetics
Abstract

Bacterial predators are decisive organisms that shape microbial ecosystems. In this study, we investigated the role of iron and siderophores during the predatory interaction between two rhizosphere bacteria: Myxococcus xanthus, an epibiotic predator, and Sinorhizobium meliloti, a bacterium that establishes nitrogen-fixing symbiosis with legumes. The results show that iron enhances the motility of the predator and facilitates its predatory capability, and that intoxication by iron is not used by the predator to prey, although oxidative stress increases in both bacteria during predation. However, competition for iron plays an important role in the outcome of predatory interactions. Using combinations of predator and prey mutants (nonproducers and overproducers of siderophores), we have investigated the importance of competition for iron in predation. The results demonstrate that the competitor that, via the production of siderophores, obtains sufficient iron for growth and depletes metal availability for the opponent will prevail in the interaction. Consequently, iron fluctuations in soils may modify the composition of microbial communities by altering the activity of myxobacterial predators. In addition, siderophore overproduction during predation can alter soil properties, affecting the productivity and sustainability of agricultural operations., (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Society for Microbial Ecology.)

Published
2024
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45. Methods for Studying Swimming and Surface Motilities in Rhizobia.

Author

Fuentes-Romero F, Alías-Villegas C, Navarro-Gómez P, Acosta-Jurado S, Bernabéu-Roda LM, Cuéllar V, Soto MJ, and Vinardell JM

Subjects
Swimming, Vegetables, Flagella, Rhizobium, Fabaceae
Abstract

Rhizobia are soil proteobacteria able to establish a nitrogen-fixing interaction with legumes. In this interaction, rhizobia must colonize legume roots, infect them, and become hosted inside new organs formed by the plants and called nodules. Rhizobial motility, not being essential for symbiosis, might affect the degree of success of the interaction with legumes. Because of this, the study of rhizobial motility (either swimming or surface motility) might be of interest for research teams working on rhizobial symbiotic performance. In this chapter, we describe the protocols we use in our laboratories for studying the different types of motilities exhibited by Sinorhizobium fredii and Sinorhizobium meliloti, as well as for analyzing the presence of flagella in these bacteria. All these protocols might be used (or adapted) for studying bacterial motility in rhizobia., (© 2024. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)

Published
2024
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46. Ensuring access to essential health products: Lessons from Colombia's leishmaniasis control and elimination initiative.

Author

Vlassoff C, Giron N, Vera Soto MJ, Maia-Elkhoury ANS, Lal A, Castellanos LG, Almeida G, and Lim C

Subjects
Humans, Colombia epidemiology, Poverty, Sustainable Development, Leishmaniasis, Visceral drug therapy, Leishmaniasis, Visceral epidemiology, Leishmaniasis, Visceral prevention & control, Leishmaniasis drug therapy, Leishmaniasis epidemiology, Leishmaniasis prevention & control
Abstract

Background: This paper identifies opportunities and challenges for leishmaniasis control and elimination in Colombia, emphasizing the role of pooled procurement of essential medicines and supplies. Colombia is among the countries most affected by leishmaniasis globally, and also faces the dual challenge of procuring critically needed medicines in the context of limited national resources. It recently renewed its commitment to the control and elimination of leishmaniasis under its 2022-2031 Public Health Plan (PDSP) through a comprehensive public health approach., Methodology/principal Findings: The methodology comprises a comprehensive literature review and key informant interviews with leishmaniasis experts from the Colombian national control program and PAHO/WHO, focusing on cutaneous, mucocutaneous, and visceral leishmaniasis. Leishmaniasis is endemic throughout Colombia, with over 11 million people at risk, many of whom live in poverty-stricken, remote and isolated rural areas with limited access to health services. Leishmaniasis care, including medicines, is provided free of charge, but many barriers were nonetheless identified at environmental, population, and health system levels, including the supply of quality-assured medicines. Opportunities to alleviate these barriers were identified, including the support of the PAHO Strategic Fund. Within the context of the sustainable development goals and international leishmaniasis control and elimination targets, Colombian officials have established their own priorities, the highest of which is the reduction of deaths from visceral leishmaniasis., Conclusions/significance: The elimination of leishmaniasis as a public health problem presents significant challenges, given its biological complexity and diversity, physical and clinical manifestations, social and economic impacts, frequently burdensome treatment regimens, and insufficient supply of necessary medicines. However, rigorous prevention and control efforts through strong political commitment and a highly motivated workforce can dramatically reduce its burden. Colombia's new PDSP, which highlights leishmaniasis control, is an opportunity for a revitalized health system response through committed leadership, intersectoral actions, and partnerships with international organizations that share a common vision., Competing Interests: The authors declare no competing interest, (Copyright: © 2023 Vlassoff et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Published
2023
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48. Absolute quantification of myocardial uptake of 99m Tc-DPD in patients with cardiac amyloidosis due to transthyretin deposits (ATTR).

Author

Sebastián Palacid F, Álvarez Mena N, Del Carmen Zambrano Infantino R, García Aragón M, Alonso Rodríguez M, Pérez López B, Gamazo Laherrán C, González Soto MJ, and Ruano Pérez R

Subjects
Humans, Organotechnetium Compounds, Heart diagnostic imaging, Myocardium, Prealbumin, Amyloidosis diagnostic imaging
Abstract

Purpose: To determine the diagnostic contribution of the absolute quantification of the myocardial deposit of 99m Tc-DPD in patients with cardiac amyloidosis due to transthyretin deposits (ATTR)., Materials and Methods: SPECT/CT was performed in 41 patients with positive scintigraphic results for ATTR cardiac amyloidosis. The patients were divided into two groups (Perugini grades 2 and 3) and the SUVmax at the level of the bone and both ventricles and the percentage of dose calculated in these areas were calculated. The Student's t-test was used to compare results and the area under the curve (AUC) was calculated to assess differential efficacy and establish discriminatory cut-off points between both groups of patients., Results: Statistically significant differences were observed in all the study variables, with the exception of bone SUV max . The differences with the greatest statistical power were observed in the variables SUV maxRV and the percentage of dose in both ventricles (p < 0.001). The cut-off point obtained for the variable SUVm axLV was 8.620 (sensitivity 87.9% and specificity 100%; AUC 0.966), while that of the variable SUV maxRV was 6.195 (sensitivity 81.8% and specificity 100%; AUC 0.955)., Conclusions: The absolute quantification of myocardial uptake of 99m Tc-DPD in the SPECT/CT images of patients with suspected cardiac amyloidosis due to transthyretin deposits represents a new diagnostic tool that allows adequate classification of patients according to the Perugini visual grading scale., (Copyright © 2023 Sociedad Española de Medicina Nuclear e Imagen Molecular. Published by Elsevier España, S.L.U. All rights reserved.)

Published
2023
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49. Assessing the Adjuvant Effect of Layered Double Hydroxides (LDH) on BALB/c Mice.

Author

Govea-Alonso DO, García-Soto MJ, Mendoza-Pérez ES, Farfán-Castro S, Fuente D, González-Ortega O, and Rosales-Mendoza S

Abstract

The discovery and validation of new adjuvants are critical areas for vaccinology. Mineral materials (e.g., alum microparticles) have been used for a long time as adjuvants in human vaccine formulations. Nonetheless, the use of nanosized materials is a promising approach to diversify the properties of adjuvants. Nanoclays are potential adjuvants proposed by some research groups. However, their adjuvant mechanisms and safety have not been fully elucidated. Herein, we aimed at expanding the knowledge on the potential adjuvanticity of layered double hydroxide (LDH) nanoparticles by reporting a detailed method for the synthesis and characterization of LDHs and the adsorption of a model antigen (bovine serum albumin, BSA). LDHs varying in diameter (from 56 to 88 nm) were obtained, and an in vitro evaluation revealed that the LDHs are not inherently toxic. BSA was passively adsorbed onto the LDHs, and the immunogenicity in mice of the conjugates obtained was compared to that of free BSA and BSA co-administered with alum (Alum-BSA). The LDH-BSA conjugates induced a higher humoral response that lasted for a longer period compared with that of free BSA and Alum-BSA, confirming that LDH exerts adjuvant effects. The 56 nm LDH particles were deemed as the more efficient carrier since they induced a higher and more balanced Th1/Th2 response than the 88 nm particles. This study is a contribution toward expanding the characterization and use of nanoclays in vaccinology and justifies further studies with pathogen-specific antigens.

Published
2023
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50. HPV infection in oral cancer, our experience: prevalence, clinical implications, and current vaccination program in Spain.

Author

Aragón-Niño Í, Cuesta-Urquía C, González-Martín-Moro J, Morán-Soto MJ, Pozo-Kreilinger JJ, Pampín-Martinez MM, Del Castillo-Pardo-de Vera JL, and Cebrián-Carretero JL

Abstract

Background: Oral cancer is the 11th most common type of cancer in the world, with established major risk factors as tobacco and alcohol, and recently included high-risk human papillomavirus types 16 and 18. HPV types 16 and 18 are the etiologic agents of cervical cancers and a proportion of oropharyngeal cancers. However, the picture of HPV and the clinical implications of oral cancers are not clear with most reports combining oral cancer data with head and neck cancers. It has been confirmed as a favorable prognostic factor in oropharyngeal cancer. However, the prognostic value of HPV in oral squamous cell carcinoma is still unclear., Material and Methods: The main objective of this article is to present the evidence encountered following a bibliographical review of recent publications specifically related to oral cancer and its differences from oropharyngeal cancer. The secondary goals are to present the findings of a five-year retrospective observational study of the prevalence of HPV infection in oral cancer patients treated by the Oral and Maxillofacial Surgery Department at La Paz University Hospital (Madrid, Spain), and finally, we to evaluate and compare our country's HPV prevention program in comparison to other European countries., Results: According to the review of the literature, HPV positive oral squamous cell carcinoma is associated with significantly decreased overall survival and distant control. Bibliographic review suggest HPV infection can be used as a negative prognostic factor in oral squamous cell carcinoma., Conclusions: As regards diagnostic testing for HPV, it should be extended to as many cases of oral cavity squamous cell carcinoma as possible, especially in those with risk factors. The current vaccination program in Spain does not have adequate coverage and is significantly under the level of other European Union countries; it should be expanded and catch-up strategies should be included. Key words: HPV, OSSC, Papillomavirus, oral carcinoma, prevention., Competing Interests: Conflicts of interest The authors have no conflicts of interest to declare., (Copyright: © 2023 Medicina Oral S.L.)

Published
2023
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