Sainz T.,Hosp General Universitario Gregorio Maranon |
Sainz T.,Hospital General Universitario Gregorio Maranon |
Alvarez-Fuente M.,Hospital General Universitario Gregorio Maranon |
Navarro M.L.,Hospital General Universitario Gregorio Maranon |
And 10 more authors.
Journal of Acquired Immune Deficiency Syndromes | Year: 2014
Background: HIV-infected adults display increased cardiovascular disease, probably driven by inflammation and immune activation. These relationships have not been addressed in vertically HIVinfected children and adolescents, a population at very high risk for long-term non-AIDS complications. Methods: Carotid intima media thickness (IMT) was measured in a cohort of HIV-infected children and adolescents and healthy controls. C-reactive protein and markers of immune activation (CD38+HLA-DR+) and immune senescence (CD282CD57+) were determined. Results: One hundred fifty HIV-infected patients and 150 controls were included, 64.8% female. IMT was thicker in HIV-infected patients (0.434 mm 6 0.025 vs. 0.424 mm 6 0.018, P , 0.001). After adjustment by age, sex, body mass index, and smoking status, HIV infection was independently associated with thicker IMT (odds ratio, 2.28; 95% confidence interval: 1.25 to 4.13; P = 0.007). Among HIV-related variables, a low CD4 nadir was related to an increased IMT. Although HIV-infected subjects presented higher frequencies of activated CD4+ and CD8+ T cells (P = 0.002 and P = 0.087, respectively), no relation was found between IMT and inflammation, immune activation, or senescence. Conclusions: Structural changes of the vasculature present early in vertically HIV-infected subjects as well as immune activation and senescence. These patients should be carefully monitored for the prompt detection and early treatment of cardiovascular disease. Copyright © 2013 by Lippincott Williams & Wilkins.
Garulo D.C.,Hospital Universitario Nino Jesus
Pediatria Integral | Year: 2013
Connective tissue diseases are a heterogeneous group of disorders caused by the development of autoantibodies or autoreactive T cells against differen body structures. They are characterized by multi-system involvement without apparent cause, with variables signs and symptoms that may appear simultaneously or in the course of several weeks and months. The presence of constitutional symptoms associated to certain clinical features (malar rash, Raynaud́s phenomenon, Gottrońs rash, sclerodactyly) should alert of a connective tissue disease. It is common to find anti-nuclear and other autoantibodies and helps to confirm the diagnosis. Though rare in childhood, early recognition is important to initiate appropriate treatment to achieve the control of the disease an improve the long term outcome of these patients.
Ramirez M.,Hospital Universitario Nino Jesus
Discovery medicine | Year: 2010
Metastatic neuroblastoma (NB) remains a clinical challenge for pediatric oncologists. Overall survival rates stay less than 40% despite intensive multimodal therapy, with the toll of toxicity being related to high-dose chemotherapy. These rates have shown minor improvements over the last years, and the development of newer therapeutic strategies is necessary. Oncolytic viruses bear the promise of killing cancer cells with low toxicities to healthy tissues. Acting through mechanisms different from chemo- and radiotherapies, a growing arsenal of genetically engineered viruses is being tested in preclinical models of human cancers. Viral infection and selective replication inside tumor cells are achieved by modification of the virus genome in order to target specific molecules or signal transduction pathways of cancer. Cell death may also activate antitumor immune responses to further amplify the beneficial effects. Clinical trials in humans have been conducted and initial results have been reported, giving the first glance of information on safety and efficacy in patients. In this review we will summarize information about how oncolytic virotherapy is being evaluated against NB in preclinical models and recent reports on the use of this new therapy in sporadic cases of children with refractory NB.
Arango C.,Hospital General Universitario Gregorio Maranon |
Giraldez M.,Hospital General Universitario Gregorio Maranon |
Merchan-Naranjo J.,Hospital General Universitario Gregorio Maranon |
Baeza I.,University of Barcelona |
And 10 more authors.
Journal of the American Academy of Child and Adolescent Psychiatry | Year: 2014
Objective: To assess weight and metabolic effects of 6 months of treatment with secondgeneration antipsychotics in naïve/quasi-naïve youths. Method: This study looked at a nonrandomized, naturalistic, multicenter, inception cohort study of 279 patients aged 4 to 17 years (mean = 14.6 ± 2.9 years). Of those, 248 (88.8%) received a single antipsychotic (risperidone, olanzapine, or quetiapine) and completed 2 visits, and 178 (63.8%) completed the 6-month follow-up. Patients had schizophrenia-spectrum disorders (44.5%), mood-spectrum disorders (23.2%), disruptive behavioral disorders (17.3%), or other disorders (15.1%). Fifteen age- and gender-matched, healthy, nonmedicated individuals served as a comparison group. Results: From baseline to 1 month, 3 months, and 6 months, all anthropometric measures increased significantly with each antipsychotic, that is, 6-month changes with risperidone (n = 157; 7.1 kg and 0.66 body mass index [BMI] z score), olanzapine (n = 44; 11.5 kg and 1.08 BMI z score), and quetiapine (n = 47; 6.3 kg and 0.54 BMI z score), but not in healthy control participants (-0.11 kg and 0.006 BMI z score). Fasting metabolic parameters increased significantly with risperidone (glucose [3.8] mg/dL, insulin [4.9] mU/L, homeostasis model assessment of insulin resistance [HOMA-IR: 1.2], triglycerides [15.6] mg/dL), and olanzapine (glucose [5.0] mg/dL, total cholesterol [21.2] mg/dL, and low-density lipoprotein cholesterol [44.6] mg/dL), but not with quetiapine or in healthy control participants. The percentage of research participants considered to be "at risk of adverse health outcome" increased during the 6 months from 8.9% to 29.2% for risperidone (p <.0001), 6.8% to 38.1% for olanzapine (p <.0001), and 6.3% to 4.0% for quetiapine (p =.91). Conclusion: Olanzapine, quetiapine, and risperidone increase body weight but have different cardiometabolic side effect profiles and different temporal side effect patterns. © 2014 American Academy of Child and Adolescent Psychiatry.
Lassaletta Atienza A.,Hospital Universitario Nino Jesus
Pediatria Integral | Year: 2016
Acute leukemia is the most common type of cancer in children. Acute lymphoblastic leukemia (ALL) accounts for 80% of the total number of cases of acute leukemia among children. The etiology of acute leukemia is unknown, but many predisposing genetic, environmental, and viral factors have been implicated. The clinical manifestations of leukemia are a direct result of the marrow invasion and resultant cytopenias (anemia, thrombocytopenia, and leukopenia). The diagnosis of acute leukemia requires the presence of 25% or more blasts in the bone marrow. Treatment lasts for a minimum of two years. The outcome for children with ALL has improved dramatically with current therapy resulting in an event free survival exceeding 80-90% for most patients in high-income countries. © 2011 Sociedad Española de PEDIATRÍA Extrahospitalaria y Atención Primaria (SEPEAP).
Ramirez A.,Hospital Universitario Nino Jesus |
Abril J.C.,Hospital Universitario Nino Jesus |
Chaparro M.,Hospital Universitario Nino Jesus
Journal of Pediatric Orthopaedics | Year: 2010
Background: Management of osteochondritis dissecans of the femoral condyle in children remains uncertain. The aim of this study was to determine the presence of a perilesional sclerotic ring in radiologic examination and to establish its value for prognosis. Methods: We retrospectively reviewed 85 patients diagnosed with osteochondritis dissecans. The population was distributed according to the grade of perilesional radiologic sclerosis: stage 0, patients who did not show a sclerotic rim in the anteroposterior and the lateral views; stage I, patients with marginal sclerosis only in 1 radiologic view; stage II, patients with sclerosis in both views. Patients were also distributed in different age groups: group 1, children under 12 years of age; group 2, children between 12 and 15 years of age; and group 3, children more than 15 years of age. These groups were correlated with the stage of perilesional sclerosis. Radiologic results were analyzed according to the Hughston scale after conservative or surgical treatment of the lesion. Results: Lesions without perilesional sclerosis (stage 0) were cured in all the cases, with good results by means of conservative treatment (P<0.05). In patients with stage I or II perilesional sclerosis, the percentage of healing was smaller; in these cases, surgical treatment improved the results compared with those in which conservative treatment was used (P<0.05). Children under 12 years of age showed less perilesional sclerosis and more tendencies to spontaneous healing than those more than 15 years of age. In these patients, radiologic sclerosis is greater (P<0.05). Conclusions: The presence of a sclerotic rim in the osteochondritis dissecans lesions of the knees in children is considered a prognostic indicator of the process. Lesions without sclerosis show a tendency toward spontaneous recovery with conservative treatment. Lesions with perilesional sclerosis show worse evolution, and treatment with perforations is still essential for enhancement of healing. Level of Evidence: Prognostic study, Level II (retrospective study). Copyright © 2010 by Lippincott Williams & Wilkins.
Chocarro Gonzalez L.,Hospital Universitario Nino Jesus
Index de Enfermeria | Year: 2013
The aim of this article is to reflect on the attributes of the Itersubjectivity concept and its importance in nursing. From the contributions of the symbolic interactionism and the science of nursing, it proposes a theoretical reflection on the intersubjective relations established in the application of nursing care. Interpersonal relationships are a part of the everyday reality in the field of nursing, and they emerge as an intersubjective process between the social actors involved in the caring action. Delve into the nature of the intersubjectivity concept will increase the efficacy of the therapeutic relationship between the nursing professional and the patient. ©2014 Fundación Index.
Garcia-Castro J.,Hospital Universitario Nino Jesus |
Alemany R.,Institute Catala dOncologia |
Cascallo M.,Institute Catala dOncologia |
Martinez-Quintanilla J.,Institute Catala dOncologia |
And 4 more authors.
Cancer Gene Therapy | Year: 2010
Treatment of metastatic tumors with engineered adenoviruses that replicate selectively in tumor cells is a new therapeutic approach in cancer. Systemic administration of these oncolytic adenoviruses lack metastatic targeting ability. The tumor stroma engrafting property of intravenously injected mesenchymal stem cells (MSCs) may allow the use of MSCs as cellular vehicles for targeted delivery. In this work, we study the safety and the efficacy of infusing autologous MSCs infected with ICOVIR-5, a new oncolytic adenovirus, for treating metastatic neuroblastoma. Four children with metastatic neuroblastoma refractory to front-line therapies received several doses of autologous MSCs carrying ICOVIR-5, under an approved preliminary study. The tolerance to the treatment was excellent. A complete clinical response was documented in one case, and the child is in complete remission 3 years after this therapy. We postulate that MSCs can deliver oncolytic adenoviruses to metastatic tumors with very low systemic toxicity and with beneficial antitumor effects. © 2010 Nature Publishing Group All rights reserved.
Lopez E.,Hospital Universitario Nino Jesus |
Cho W.C.S.,Queen Elizabeth Hospital
International Journal of Molecular Sciences | Year: 2012
Massive evidence suggests that genetic abnormalities contribute to the development of lung cancer. These molecular abnormalities may serve as diagnostic, prognostic and predictive biomarkers for this deadly disease. It is imperative to search these biomarkers in different tumorigenesis pathways so as to provide the most appropriate therapy for each individual patient with lung malignancy. Phosphoproteomics is a promising technology for the identification of biomarkers and novel therapeutic targets for cancer. Thousands of proteins interact via physical and chemical association. Moreover, some proteins can covalently modify other proteins post-translationally. These post-translational modifications ultimately give rise to the emergent functions of cells in sequence, space and time. Phosphoproteomics clinical researches imply the comprehensive analysis of the proteins that are expressed in cells or tissues and can be employed at different stages. In addition, understanding the functions of phosphorylated proteins requires the study of proteomes as linked systems rather than collections of individual protein molecules. In fact, proteomics approaches coupled with affinity chromatography strategies followed by mass spectrometry have been used to elucidate relevant biological questions. This article will discuss the relevant clues of post-translational modifications, phosphorylated proteins, and useful proteomics approaches to identify molecular cancer signatures. The recent progress in phosphoproteomics research in lung cancer will be also discussed. © 2012 by the authors; licensee MDPI, Basel, Switzerland.
Martinez Gomez M.J.,Hospital Universitario Nino Jesus
Pediatria Integral | Year: 2015
Inflammatory bowel disease (IBD) is chronic inflammation of the digestive tract comprising two distinct diseases: Crohn’s Disease and Ulcerative Colitis and a third that shares characteristics of both, the Unclassified Inflammatory Bowel Disease or indeterminate colitis. The child has specific characteristics in relation to the increased aggressiveness of the disease in this age, along with the impact on growth, bone maturation and the impact on nutricional state. Treatment, especially in the case Crohn Disease, should aim to minimize the impact of the disease in these areas and get a better quality of life, along with proper growth and development.