Almendral J.,Hospital Universitario Madrid Norte Sanchinarro |
Almendral J.,University of San Pablo - CEU |
Atienza F.,Hospital Universitario Madrid Norte Sanchinarro |
Everss E.,Rey Juan Carlos University |
And 11 more authors.
Journal of Cardiovascular Electrophysiology | Year: 2012
ICD Electrograms and Origin of Impulses. Introduction: The implantable cardioverter-defibrillator (ICD) electrogram (EG) is a documentation of ventricular tachycardia. We prospectively analyzed EGs from ICD electrodes located at the right ventricle apex to establish (1) ability to regionalize origin of left ventricle (LV) impulses, and (2) spatial resolution to distinguish between paced sites. Methods and Results: LV electro-anatomic maps were generated in 15 patients. ICD-EGs were recorded during pacing from 22 ± 10 LV sites. Voltage of far-field EG deflections (initial, peak, final) and time intervals between far-field and bipolar EGs were measured. Blinded visual analysis was used for spatial resolution. Initial deflections were more negative and initial/peak ratios were larger for lateral versus septal and superior versus inferior sites. Time intervals were shorter for apical versus basal and septal versus lateral sites. Best predictive cutoff values were voltage of initial deflection <-1.24 mV, and initial/peak ratio >0.45 for a lateral site, voltage of final deflection <-0.30 for an inferior site, and time interval <80 milliseconds for an apical site. In a subsequent group of 9 patients, these values predicted correctly paced site location in 54-75% and tachycardia exit site in 60-100%. Recognition of paced sites as different by EG inspection was 91% accurate. Sensitivity increased with distance (0.96 if ≥ 2 cm vs 0.84 if < 2 cm, P < 0.001) and with presence of low-voltage tissue between sites (0.94 vs 0.88, P < 0.001). Conclusions: Standard ICD-EG analysis can help regionalize LV sites of impulse formation. It can accurately distinguish between 2 sites of impulse formation if they are ≥2 cm apart. © 2011 Wiley Periodicals, Inc.
Peiretti M.,Italian National Cancer Institute |
Zanagnolo V.,Italian National Cancer Institute |
Aletti G.D.,Italian National Cancer Institute |
Bocciolone L.,Italian National Cancer Institute |
And 6 more authors.
Gynecologic Oncology | Year: 2010
Objective: To determinate the impact of maximal cytoreductive surgery on progression free survival (PFS), overall survival (OS) rates and morbidity, in patients with advanced epithelial ovarian or fallopian tube cancer. Methods: We reviewed all medical records of patients with stages IIIC-IV epithelial ovarian and fallopian tube cancer that were managed at our institution between January 2001 and December 2008. The following information was collected: demographics, tumor characteristics, operative information, surgical outcomes and peri-operative complication. Results: A total of 288 patients with advanced epithelial ovarian and fallopian tube cancer were referred to our institution between January 2001 and December 2008, 259 consecutive patients were enrolled in the study. After a median follow-up of 29.8 months, the PFS and OS were 19.9 and 57.6 months, respectively. At univariate analysis, factors significantly associated with decreased PFS included: age greater than median (> 60 years), stage IV, presence of ascites > 1000 cc, presence of diffuse peritoneal carcinomatosis and diameter of residual disease. This was confirmed also at multivariate analysis with age greater than 60 years (P = 0.025), stage IV vs IIIC (P = 0.037) and any residual disease (P = 0.032) having an independent association with worse PFS. Conclusions: Our study seems to demonstrate that a more extensive surgical approach is associated with prolonged disease-free interval and improved survival in patients with stages IIIC-IV epithelial ovarian and fallopian tube cancer. Moreover all patients with no residual tumor seem to have the best prognosis and in view of these results we believe that the goal of primary surgery should be considered as leaving no macroscopic disease. © 2010 Elsevier Inc. All rights reserved.
Carmona F.D.,Institute Parasitologia Y Biomedicina Lopez Neyra |
Gutala R.,University of Texas Health Science Center at Houston |
Simeon C.P.,Hospital Valle Of Hebron |
Carreira P.,Hospital 12 Of Octubre |
And 15 more authors.
Annals of the Rheumatic Diseases | Year: 2012
Objective: Systemic sclerosis (SSc) and systemic lupus erythematosus (SLE) are related chronic autoimmune diseases of complex aetiology in which the interferon (IFN) pathway plays a key role. Recent studies have reported an association between IRF7 and SLE which confers a risk to autoantibody production. A study was undertaken to investigate whether the IRF7 genomic region is also involved in susceptibility to SSc and the main clinical features. Methods: Two case-control sets of Caucasian origin from the USA and Spain, comprising a total of 2316 cases of SSc and 2347 healthy controls, were included in the study. Five single nucleotide polymorphisms (SNPs) in the PHRF1-IRF7-CDHR5 locus were genotyped using TaqMan allelic discrimination technology. A meta-analysis was performed to test the overall effect of these genetic variants on SSc. Results: Four out of five analysed SNPs were significantly associated with the presence of anticentromere autoantibodies (ACA) in the patients with SSc in the combined analysis (rs1131665: p FDR=6.14 × 10 -4, OR=0.78; rs4963128: p FDR=6.14 × 10 -4, OR=0.79; rs702966: p FDR=3.83 × 10 -3, OR=0.82; and rs2246614: p FDR=3.83 × 10 -3, OR=0.83). Significant p values were also obtained when the disease was tested globally; however, the statistical significance was lost when the ACA-positive patients were excluded from the study, suggesting that these associations rely on ACA positivity. Conditional logistic regression and allelic combination analyses suggested that the functional IRF7 SNP rs1131665 is the most likely causal variant. Conclusions: The results show that variation in the IRF7 genomic region is associated with the presence of ACA in patients with SSc, supporting other evidence that this locus represents a common risk factor for autoantibody production in autoimmune diseases.
Minig L.,Italian National Cancer Institute |
Minig L.,Hospital Universitario Madrid Norte Sanchinarro |
Franchi D.,Italian National Cancer Institute |
Boveri S.,Italian National Cancer Institute |
And 3 more authors.
Annals of Oncology | Year: 2011
Background: To test the efficacy of levonorgestrel-release intrauterine device (LNG-IUD) plus gonadotropin-releasing hormone (GnRH) for treating women aged <40 years with atypical endometrial hyperplasia (AEH) or presumed International Federation of Gynecology and Obstetrics stage IA limited to the endometrium, well differentiated (G1), endometrioid endometrial cancer (EC), who wish to preserve their fertility. Patients and methods: A prospective observational study was conducted. Treatment consisted on the insertion of an LNG-IUD for 1 year plus GnRH analogue for 6 months. Results: From January 1996 to June 2009, 20 and 14 patients with AEH and EC, respectively, were studied. Complete response rate was 95% in patients with AEH and 57.1% in women with EC-G1. A progression of the disease was observed in one (5%) and in four patients (28%) with AEH and EC, respectively. Four of 20 patients with AEH and 2 of 14 with EC-G1 experienced recurrences. The average relapse time was 36 months (range: 16-62 months). All of them were alive without evidence of disease at the last follow-up, mean: 29 months (range: 4-102 months). Nine women achieved 11 spontaneous pregnancies. Conclusions: The combined treatment showed effectiveness in a substantial proportion of patients with AEH and EC. Close follow-up during and after treatment is crucial. © The Author 2010. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
Gonzalez De Castro D.,Institute of Cancer Research |
Angulo B.,Hospital Universitario Madrid Norte Sanchinarro |
Gomez B.,Institute of Cancer Research |
Mair D.,Institute of Cancer Research |
And 7 more authors.
British Journal of Cancer | Year: 2012
Background: KRAS mutation testing is required to select patients with metastatic colorectal cancer (CRC) to receive anti-epidermal growth factor receptor antibodies, but the optimal KRAS mutation test method is uncertain. Methods: We conducted a two-site comparison of two commercial KRAS mutation kits-the cobas KRAS Mutation Test and the Qiagen therascreen KRAS Kit-and Sanger sequencing. A panel of 120 CRC specimens was tested with all three methods. The agreement between the cobas test and each of the other methods was assessed. Specimens with discordant results were subjected to quantitative massively parallel pyrosequencing (MPP). DNA blends were tested to determine detection rates at 5% mutant alleles. Results: Reproducibility of the cobas test between sites was 98%. Six mutations were detected by cobas that were not detected by Sanger, and five were confirmed by MPP. The cobas test detected eight mutations which were not detected by the therascreen test, and seven were confirmed by MPP. Detection rates with 5% mutant DNA blends were 100% for the cobas and therascreen tests and 19% for Sanger. Conclusion: The cobas test was reproducible between sites, and detected several mutations that were not detected by the therascreen test or Sanger. Sanger sequencing had poor sensitivity for low levels of mutation. © 2012 Cancer Research UK All rights reserved.
Mortality due to prostate cancer in the Spanish arm of the European Randomized Study of Screening for Prostate Cancer (ERSPC). Results after a 15-year follow-up [Mortalidad por cáncer de próstata en la rama española del European Randomized Study of Screening for Prostate Cancer (ERSPC). Resultados tras 15 años de seguimiento]
Lujan M.,Hospital Universitario Infanta Cristina |
Paez A.,Rama Espanola Del European Randomized Study of Screening for Prostate Cancer |
Paez A.,Hospital Universitario Of Fuenlabrada |
Berenguer A.,Rama Espanola Del European Randomized Study of Screening for Prostate Cancer |
And 2 more authors.
Actas Urologicas Espanolas | Year: 2012
Objective: To address if prostate cancer (PCa) screening decreases PCa mortality in the asymptomatic population, within the setting of the Spanish arm of the European Randomized Study of Screening for Prostate Cancer (ERSPC). Material and methods: From 1996 to 1999, 4,278 men aged 45-70 years were recruited and randomized to the screening arm (PSA every 4 years, prostate biopsy when PSA ≥ 3 ng/ml) and control arm (no tests). Dates and causes of death were collected on an annual basis. A Kaplan-Meier analysis was used to calculate overall and cancer-specific survival. Results: A total of 2,416 men were recruited in the screening arm and 1,862 in the control arm. Mean age was 57.8 years, median follow-up was 13.3 years. At the end of the follow-up period, 427 deaths (9 from PCa) were observed. Survival analysis did not show any difference between the study arms with respect to overall and cancer-specific survival (p = 0.939 and p = 0.544 respectively). Most relevant causes of death were malignant tumors (52.9%), cardiovascular disease (17.3%) and respiratory (8.9%). Only 2.1% of deaths (0.2% of all recruited men) were due to PCa (2.5% screening, 1.6% control). Conclusions: The Spanish arm of ERSPC failed to reproduce the long-term results shown in the whole study. No differences in mortality (overall or cancer-specific) were observed after 15 years of follow-up. PCa mortality was infrequent (less than 1%). These results suggest limited yield of PCa screening in our setting. © 2011 AEU. Publicado por Elsevier España, S.L. Todos los derechos reservados.
Diaz-Padilla I.,Hospital Universitario Madrid Norte Sanchinarro |
Diaz-Padilla I.,University of Toronto |
Abdul Razak A.R.,University of Toronto |
Minig L.,Hospital Universitario Madrid Norte Sanchinarro |
And 2 more authors.
Clinical and Translational Oncology | Year: 2012
The serum cancer antigen 125 (CA-125) remains a reliable biomarker in the therapeutic management of epithelial ovarian cancer (EOC). Monitoring the effi cacy of cytotoxic chemotherapy (CT) and the early detection of relapse during the follow up of patients in remission represent the two most common clinical situations where the CA-125 has been successfully applied. There are however other scenarios along the course of the disease where the CA-125 can potentially aid in the decision-making process. Preoperative levels of CA-125 can help in selecting a subset of patients where an optimal cytoreduction may not be easily achieved. Perioperative variations in the CA-125 levels after primary surgery and, more importantly, the nadir value of the CA-125 after primary chemotherapy, are associated with patient outcome. This review focuses on the clinical relevance of dynamic changes in CA-125 levels during the primary treatment of EOC and its potential infl uence both in the patient management and in the design of clinical trials in the adjuvant setting.
Diaz-Padilla I.,Hospital Universitario Madrid Norte Sanchinarro |
Poveda A.,Instituto Valenciano Of Oncologia
Clinical Ovarian Cancer | Year: 2010
Platinum-based chemotherapy constitutes the mainstay systemic treatment for patients with epithelial ovarian cancer (EOC). Significant and durable clinical responses are achieved when platinum is administered along with taxanes after debulking surgery, but relapses are common in advanced disease within 2 years upon completion of primary therapy. Furthermore, between 20% and 30% of patients will never respond or will progress shortly after finishing the platinum-containing regimen. To avoid unnecessary toxicities, ideally physicians should be capable of selecting which patients might benefit the most from a particular treatment based on established, predictive factors. Although the cytotoxicity of cisplatin is well described, the mechanisms of platinum resistance developed by tumoral cells are not so well understood. Changes in the DNA repair pathways in tumors possibly have an important role in the development of its platinum-resistant phenotype. Recent advances in this area have identified potential biomarkers (eg, ERCC1 mRNA and protein expression and BRCA mutational status) that may correlate with the clinical efficacy of a platinum-based chemotherapy. Clinical studies that evaluate its potential application in the management of patients with ovarian cancer are now emerging. Future validation of these predictive biomarkers of response to platinum, as well as to other chemotherapeutic agents (eg, taxanes), might set the stage for a more biology-based and rational therapeutic approach to advanced EOC. We review the most recent advances in translational research regarding the DNA repair pathways as a potential source for describing and validating biomarkers of response to platinum agents in ovarian cancer.
Casla S.,Technical University of Madrid |
Lopez-Tarruella S.,Institute Investigacion Sanitaria Gregorio Maranon |
Jerez Y.,Institute Investigacion Sanitaria Gregorio Maranon |
Marquez-Rodas I.,Institute Investigacion Sanitaria Gregorio Maranon |
And 9 more authors.
Breast Cancer Research and Treatment | Year: 2015
Breast cancer patients suffer impairment in cardiorespiratory fitness after treatment for primary disease, affecting patients’ health and survival. The aim of this study was to evaluate the ability of a pragmatic exercise intervention to improve cardiorespiratory fitness of breast cancer patients after primary treatment. Between February 2013 and December 2014, 94 women with early stage (I–III) breast cancer, 1–36 months post-chemotherapy, and radiotherapy were randomly assigned to an intervention program (EX) combining supervised aerobic and resistance exercise (n = 44) or usual care (CON) (n = 45) for 12 weeks. Primary study endpoint was VO2max. Secondary endpoints were muscle strength, shoulder range of motion, body composition, and quality of life (QoL). Assessments were undertaken at baseline, 12-week, and 6-month follow-ups. Eighty-nine patients aged 29–69 years were assessed at baseline and 12 weeks. The EX group showed significant improvements in VO2max, muscle strength, percent fat, and lean mass (p ≤ 0.001 in all cases) and QoL compared with usual care (CON). Apart from body composition, improvements were maintained for the EX at 6-month follow-up. There were no adverse events during the testing or exercise intervention program. A combined exercise intervention produced considerable improvement in cardiorespiratory fitness, physical function, and quality of life in breast cancer patients previously treated with chemotherapy and radiation therapy. Importantly, most of these benefits were maintained 6 months after ceasing the supervised exercise intervention. © 2015, Springer Science+Business Media New York.
Torres I.,Hospital Universitario La Paz |
Allona M.,Hospital Universitario Madrid Norte Sanchinarro |
Martinez M.,Hospital Universitario La Paz |
Lores V.,Hospital Universitario La Paz |
And 2 more authors.
Archivos de Bronconeumologia | Year: 2010
Background and objetives: We compare the inspiratory and expiratory regional lung densities between different levels of COPD severity (as assessed by the GOLD scale and by the BODE index), and to assess the relationship between regional lung densities and functional lung parameters. Patients and methods: Fifty-five stable moderate-severe COPD men were selected. Functional evaluation included dyspnoea scale, blood gases, spirometry, plethysmography, diffusing capacity and six-minute walk test. Severity was classified according the GOLD scale and the BODE index. High resolution computed tomography (HRCT) scans of the entire lung at full inspiration and two sections at full expiration were obtained. Densitometry software was used to calculate the densities of the lung areas. Results: Inspiratory and expiratory mean lung densities (MLD) of the lower lobes were significantly lower in very severe and severe COPD patients than in moderate patients. In contrast, we only found differences between the upper lobe MLD values of moderate and severe COPD patients. Inspiratory and expiratory HRCT densities were similar among all BODE quartiles, for both the upper and lower lobes. In a multiple regression analysis, airway obstruction parameters were mainly related to the expiratory MLD of the lower lobes, whereas lung hyperinflation parameters were predicted by the inspiratory MLD of the lower lobes. Lastly, diffusion capacity was independently related to the expiratory/inspiratory MLD of the lower lobes and to the inspiratory MLD of the upper lobes. Conclusions: There are differences in lung attenuation measurements by HRCT between the varying levels of COPD severity as assessed by the GOLD scale. © 2009 SEPAR.