Laudio / Llodio, Spain
Laudio / Llodio, Spain

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Uribarri M.,Proteomika SLU | Hormaeche I.,Proteomika SLU | Zalacain R.,Cruces Hospital | Lopez-Vivanco G.,Cruces Hospital | And 3 more authors.
Journal of Thoracic Oncology | Year: 2014

Introduction: The enormous biological complexity and high mortality rate of lung cancer highlights the need for new global approaches for the discovery of reliable early diagnostic biomarkers. The study of bronchoalveolar lavage samples by proteomic techniques could identify new lung cancer biomarkers and may provide promising noninvasive diagnostic tools able to enhance the sensitivity of current methods. Methods: First, an observational prospective study was designed to assess protein expression differences in bronchoalveolar lavages from patients with (n = 139) and without (n = 49) lung cancer, using two-dimensional gel electrophoresis and subsequent protein identification by mass spectrometry. Second, validation of candidate biomarkers was performed by bead-based immunoassays with a different patient cohort (204 patients, 48 controls). Results: Thirty-two differentially expressed proteins were identified in bronchoalveolar lavages, 10 of which were confirmed by immunoassays. The expression levels of APOA1, CO4A, CRP, GSTP1, and SAMP led to a lung cancer diagnostic panel that reached 95% sensitivity and 81% specificity, and the quantification of STMN1 and GSTP1 proteins allowed the two main lung cancer subtypes to be discriminated with 90% sensitivity and 57% specificity. Conclusions: Bronchoalveolar lavage represents a promising noninvasive source of lung cancer specific protein biomarkers with high diagnostic accuracy. Measurement of APOA1, CO4A, CRP, GSTP1, SAMP, and STMN1 in this fluid may be a useful tool for lung cancer diagnosis, although a further validation in a larger clinical set is required for early stages. Copyright © 2014 by the International Association for the Study of Lung Cancer.


Andia D.,University of the Basque Country | Mozo De Rosales F.,University of the Basque Country | Villasante A.,University of the Basque Country | Rivero B.,University of the Basque Country | And 2 more authors.
International Journal of Gynecology and Obstetrics | Year: 2011

Objective: To examine the causal contribution of conization to premature delivery. Methods: This was a retrospective, case-control, multicenter study of women who underwent conization in 5 hospitals in the Basque Country (Spain) from 1998 to 2007. Three study groups were established: group A, post-conization infant deliveries; control group B, pre-conization infant deliveries; and control group C, infant deliveries without conization. Results: Comparing group A with group C, there was a higher rate of preterm delivery before 35 weeks (5.3% versus 1.6%), a lower mean birth weight (3156.2 g versus 3328.5 g), and a greater prevalence of infants under 2500 g (10.6% versus 3.7%). There were no significant differences between group A and group B: preterm delivery before 35 weeks (5.3% versus 4.8%), mean birth weight (3156.2 g versus 3119.4 g), and prevalence of infants under 2500 g (10.6% versus 10.6%). Conclusion: Pregnancy in women post-conization was associated with a risk of preterm delivery. However, there were no significant differences between women who underwent conization before and those who underwent conization after delivery. Cervical conization does not necessarily increase the risk of preterm delivery in subsequent pregnancy. Conization should be considered an indicator of such risk because it is associated with pregnancy complications arising from socio-epidemiologic factors present in women requiring conization that are also present in women who have premature delivery. © 2010 International Federation of Gynecology and Obstetrics.


Larrea B.A.,Cruces University Hospital | Iztueta M.G.,Cruces University Hospital | Iztueta M.G.,Instituto Clinico Quirurgico Oftalmologico ICQO | Indart L.M.,Cruces Hospital | Alday N.M.,Cruces University Hospital
Graefe's Archive for Clinical and Experimental Ophthalmology | Year: 2014

Purpose: To investigate the ability of ganglion cell complex (GCC) analysis by optical coherence tomography (OCT) to detect early axonal damage in nonarteritic anterior ischaemic optic neuropathy (NAION), and to assess the relationship of GCC measurements with visual field defects and function parameters.Methods: Twenty-two patients with NAION participated in this retrospective case-series study. Patients underwent spectral-domain OCT measurement of retinal nerve fibre layer (RNFL) and GCC average and minimum thicknesses, best-corrected visual acuity, Ishihara test and Humphrey visual field (SITA Standard 24–2). These measurements were recorded in the acute (2–6 weeks after the ischaemic episode) and chronic (≥6 months later) phases. Spearman’s coefficients were used to assess the relationship between GCC thickness and visual field defects.Results: In the acute phase, none of the patients showed atrophy of the optic disc, while early damage was observed in the GCC average and minimum thickness in 54.54 % and 77.27 % of patients. At 6 months, the rate of patients with RNFL below normal limits increased to 90 % in the RNFL, and 92.85 % and 100 % in the GCC average and minimum GCC respectively. Spearman’s coefficients indicated significant relationships of GCC in the acute phase with visual field index and mean deviation in both acute and chronic phases. A significant correlation was also found with location of the defects.Conclusions: GCC thickness measurement by OCT is capable of detecting early axonal damage in NAION eyes in the acute phase that cannot be detected by RNFL. GCC defects are significantly correlated with visual field globally and the defect location. © 2014, Springer-Verlag Berlin Heidelberg.


Ruiz J.C.,University of Cantabria | Sanchez-Fructuoso A.,San Carlos Hospital | Zarraga S.,Cruces Hospital
Transplantation Reviews | Year: 2012

Proteinuria is a marker of poor prognosis in kidney transplant recipients as well as in nontransplant patients with chronic kidney disease. It negatively influences the rate of deterioration of graft renal function, graft survival, and more importantly, patient survival. This review analyzes the current knowledge on the management of this crucial aspect in kidney transplantation.The reduction of proteinuria has demonstrated a beneficial effect on kidney function and also on patient survival in nontransplant patients with chronic kidney disease, but unfortunately, to date, it has not been possible to demonstrate the same benefit in the kidney transplant population (although it probably exists). Nevertheless, the appearance of proteinuria in a renal transplant patient must always be followed by an investigation on its etiology, and many times, it should include a graft biopsy to adequately categorize the underlying process responsible for the proteinuria and to establish a correct therapy. Furthermore, in spite of the cause of proteinuria, it should be treated to reduce to normal or near-normal levels with the objective to eliminate or reduce its negative effects on the graft and the cardiovascular system of the patient. The drugs that interfere with the renin-angiotensin-aldosterone system, angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, are the cornerstone of the management of this complication, and recently, direct renin inhibitors have added to the armamentarium. Mono-, dual-, and triple-therapy modalities are discussed, as well as other therapies and nonpharmacologic measures. © 2012 Elsevier Inc..


Gomez B.,Cruces Hospital | Mintegi S.,Cruces Hospital | Benito J.,Cruces Hospital | Egireun A.,Cruces Hospital | And 2 more authors.
Pediatric Infectious Disease Journal | Year: 2010

OBJECTIVES: (1) To assess the rate of bacteremia in febrile infants less than 3 months of age admitted to a pediatric emergency department at a tertiary hospital; (2) to describe the bacteria isolated; and (3) to analyze factors related to increased probability of having a positive blood culture. Methods: A retrospective, cross-sectional, 5-year descriptive study that includes all infants less than 3 months of age who presented with fever without source (FWS) and had a blood culture performed. Results: A blood culture was performed in 1018 (91.5%) of 1125 infants admitted, and a bacterial pathogen was grown in 23 (2.2%) of these; 8 were associated with a positive urine culture. The most frequently isolated pathogen was Escherichia coli (9), followed by Streptococcus pneumoniae (4). The risk factors detected by multivariate analysis were: (a) being classified as "not well-appearing" (12.5% vs. 1.8%; odds ratio: 8.37) and (b) leukocyturia and/or nitrituria in a urine dipstick test (5.6% vs. 1.6%; odds ratio: 3.73). C-reactive protein value was higher than white blood cell count and absolute neutrophil count in detecting bacteremia; a 70 g/L cut-off had a specificity of 93.8%, but sensitivity of only 69.6%. Conclusions: A positive blood culture rate of 2.2% was found in infants less than 3 months of age with FWS. C-reactive protein, white blood cell count, and absolute neutrophil count were not good bacteremia predictors. We recommend obtaining a blood culture in infants less than 3 months of age with FWS, particularly those patients considered "not well-appearing" and those with leukocyturia and/or nitrituria. © 2009 by Lippincott Williams & Wilkins.


Jimenez U.,Cruces Hospital | Marina N.,Cruces Hospital | de Santamaria E.L.,Cruces Hospital | Pac J.J.,Cruces Hospital | Galdiz J.B.,Cruces Hospital
European Journal of Cardio-thoracic Surgery | Year: 2010

Background and objectives: A variety of methods have been used to evaluate patients with lung cancer to define a patient cohort at high risk for postoperative mortality and respiratory complications associated with lung resection surgery. Our aim was to evaluate the utility of vibration response imaging (VRI XP) Operation Planning Software (O-Plan) in assessing suitability for surgical resection and for the prediction of postoperative forced expiratory volume in 1 s (ppoFEV 1). Methods: A total of 58 subjects with lung cancer underwent evaluation prior to lung resection surgery and postoperative lung function after surgery. Results: Preoperative pulmonary function tests and quantitative breath sound measurements by VRI were performed in all patients to estimate postoperative lung function. In addition, 20 patients underwent perfusion scan prior to surgery. VRI XP O-Plan predictions (12 pneumonectomies and 46 lobectomies) showed good correlation and concordance (Lin's coefficient) with postoperative FEV 1 (l) (r = 0.865, Lin's coefficient 0.858) and FEV 1 (%) (r = 0.877, Lin's coefficient 0.861) 4-6 weeks after surgery. Predicted and postoperative measured FEV 1 showed no significant differences (p > 0.05). Average lung function predicted postoperative values were similar for perfusion and VRI XP O-Plan calculations with a correlation of 0.74 and concordance of 0.700. Conclusions: VRI XP O-Plan has shown high accuracy in predicting postoperative FEV 1 after lung resection surgery. Given its simplicity of operation and the non-invasive nature of VRI XP and O-Plan, it could be a good alternative to perfusion scan in pre-surgery assessment. © 2009 European Association for Cardio-Thoracic Surgery.


Prieto J.A.,Cruces Hospital | Andrade F.,Cruces Hospital | Lage S.,Cruces Hospital | Aldamiz-Echevarria L.,Cruces Hospital
Journal of Chromatography B: Analytical Technologies in the Biomedical and Life Sciences | Year: 2011

Tyrosinemia is an inborn error of metabolism characterized by the accumulation of tyrosine as well as toxic by-products. NTBC or nitisinone is a drug currently used for the treatment of tyrosinemia that avoids the formation of these toxic substances. This paper presents the determination of NTBC in plasma and dry blood spots by high-performance liquid chromatography (HPLC) coupled to tandem mass spectrometry. The concentration of NTBC in matched plasma-dry blood spots was compared and the study of degradation of NTBC in plasma and dry spots at different temperatures is presented. Method: For sample preparation, plasma proteins were precipitated with acetonitrile and 3-mm discs were extracted with methanol. ESI(+) was used as inozation method and the analytes were detected by multiple reaction monitoring using the transitions 330>218 for NTBC and 340>228 for mesotrione, used as internal standard. Results: There is good correlation between concentrations obtained in dry blood spots and plasma (r2=0.83), although values are 2.4 times higher in plasma samples. NTBC in plasma is stable at least for 45 days frozen at -30°C and refrigerated at 4°C. However, it shows slow decomposition at room temperature, approximately 30% after 45 days. The method shows good precision, accuracy and linearity and the detection limit is 50nmol/L and paper samples are appropriate for the monitorization of NTBC. © 2011 Elsevier B.V.


Azkunaga B.,Cruces Hospital | Mintegi S.,Cruces Hospital | Bizkarra I.,Cruces Hospital | Fernandez J.,Cruces Hospital
European Journal of Emergency Medicine | Year: 2011

We aim to describe the characteristics and the management of the paediatric poisonings registered in the Toxicology Surveillance System created by the Intoxications Working Group of the Spanish Society of Paediatric Emergencies. We reviewed 130 episodes registered during 1 year. The main involved substances were drugs (73, 56.2%), household products (24,18.5%) and ethanol (16, 12.3%). Most common mechanisms were accidental poisonings at home in children of less than 5 years (91, 70%; principally, paracetamol or anticatharrals) and patients of 12-18 years (24.6%), with recreational alcohol consumption or suicide attempt. Approximately 10% received prehospital treatment and 56.9% received treatment in the paediatric emergency department (PED), which mainly activated charcoal. Approximately 50% were managed as outpatients, and all did well. Although intoxications are infrequent in PED and the short-term prognosis is good, the consumption of healthcare resources is high. Copyright © Lippincott Williams & Wilkins.


Prats Vinas J.M.,Cruces Hospital | Suinaga Errasti I.,Cruces Hospital | Blanco Lago R.,Cruces Hospital
Pediatric Neurology | Year: 2011

We report on a girl with cutaneous angioma and hydrocephalus who presented the characteristics of the condition described by Shapiro and Shulman. At birth, she manifested extensive pink discoloration on her face, scalp, and back. During infancy, she developed hydrocephalus, which later stabilized. Magnetic resonance angiography revealed anomalous intracranial venous drainage, which led to development of her hydrocephalus. Various authors described such a process in the 1970s and 1980s, interpreting it as a variant of Sturge-Weber syndrome, and listing it with other neurocutaneous syndromes associated with vascular nevi, but few references to this condition appear in the recent literature. We think it exists as a syndrome, and that it is not a variant of Sturge-Weber syndrome. The cutaneous anomaly has characteristics closer to those of vascular birthmarks that fade than those of the port wine stain itself, and seems a direct consequence of abnormal venous drainage rather than a primarily capillary malformation. © 2011 Elsevier Inc. All rights reserved.


Rajakumar K.,University of Pittsburgh | De Las Heras J.,Childrens Hospital of Pittsburgh | De Las Heras J.,Cruces Hospital | Chen T.C.,Boston University | And 4 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2011

Objective: The aim of the study was to examine the relationship between vitamin D status, total and abdominal adiposity, and lipids in black and white children. Methods: Plasma 25-hydroxyvitamin D [25(OH)D], adiposity [body mass index (BMI), percentage of total body fat, visceral adipose tissue (VAT), sc adipose tissue (SAT)], and fasting lipids were assessed in healthy obese and nonobese 8- to 18-yr-old black and white children. Results: We studied 237 children (mean ± SD age, 12.7 ± 2.2 yr; 47% black, 47% obese, and 43% male). Mean 25(OH)D concentration for the entire cohort was 19.4 ± 7.4 ng/ml. The majority of the children were vitamin D deficient [25(OH)D < 20 ng/ml; 73% blacks, 40% whites]. Plasma 25(OH)D was associated inversely with BMI, BMI percentile, percentage of total body fat, VAT, and SAT and positively with HDL cholesterol in the entire cohort. VAT was higher in vitamin D-deficient whites, and SAT was higher in vitamin D-deficient blacks compared with their respective vitamin D-non-deficient counterparts. Race, season, pubertal status, and VAT were independent significant predictors of 25(OH)D status. Conclusions: In black and white youth examined together, lower levels of 25(OH)D are associated with higher adiposity measures and lower HDL. Furthermore, vitamin D deficiency is associated with higher VAT in whites and greater SAT in blacks. Besides therapeutic interventions to correct the high rates of vitamin D deficiency in youth, benefits of vitamin D optimization on adiposity measures and lipid profile need to be explored. Copyright © 2011 by The Endocrine Society.

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