1.Effect of preoperative donation of autologous blood on venous thromboembolism disease after total hip replacement.
Ning LU ; Yang YANG ; Alejandro González Della VALLE ; Eduardo A SALVATI
China Journal of Orthopaedics and Traumatology 2013;26(1):38-40
OBJECTIVETo evaluate the effect of preoperative donation of autologous bood on venous thromboembolism (VTE) after total hip arthroplasty (THA).
METHODSBetween Jan. 2007 and March. 2010,912 consecutive patients who had THAs performed in Hosptal for Special Surgery were collected, excluded patients with thrombocytopenia or pre-exising bleeding diathesis and patients for whom epidural analgesia was not possible. Among them, there were 428 males and 484 females with an average age of (65.28 +/- 11.90) years (ranged from 24 to 93 years). Among them, 835 cases (91.3%) had osteoarthritis, 32 cases (3.6%) had osteonerrosis, 20 cases (2.3%) had dysplasia, 20 cases (2.2%) had rheumatoid arthritis, and 5 cases (0.6%) had other diagnoses. The surgeries were performed under hypotensive epidural anestheisa (mean arterial pressure between 45 to 55 mm Hg) and through a posterolateral approach, minimizing the duration of femoral vein obstruction and reducing the load of intramedullary content to the venous system by repeated pulsatile lavage and aspiration of the femoral canal. The lower extremity was in the neutral position while working on the acetabulum and flexed and internally rotated while working on the femur. Whenever possible,the lower extremity was extended to a neutral position to restore femoral venous flow. Patients received one bolus of unfractionated intravenous heparin (10 to 15 U/kg), 1 to 2 minutes before femoral canal preparation. All patients were followed up at least 3 months postoperatively. No patient was lost to followed-up.
RESULTSSeven hundreds and fifty-two patients donated autologous blood before THA, 160 did not donate autologoud blood. The incidence of clinical symoptomatic VTE was 1.3% (11/912). Among the 11 patients with clinical symoptomatic VTE, 5 donated blood pre-operation (0.66%, 5/752) and 6 did not donate pre-operation (3.8%, 6/160). The rate of VTE after THA between autologous blood donation and no blood donation was statistically significant (P = 0.021 < 0.05. The incidence of deep vein thrombosis was 0.8%(8/ 912). Three patients had a symptomatic of Pulmonary embolism.
CONCLUSIONA significant decrease in the incidence of VTE is noted in those who had donated blood preoperatively compared with those who had not.
Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; Blood Transfusion, Autologous ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Venous Thromboembolism ; epidemiology ; prevention & control
2.Controversies in the treatment of advanced ovarian cancer in the PARP inhibitors era: a Delphi consensus
Andrés REDONDO ; Pilar BARRETINA ; Alejandro PÉREZ-FIDALGO ; María Jesús RUBIO ; Antonio GONZÁLEZ-MARTÍN
Journal of Gynecologic Oncology 2023;34(5):e57-
Objective:
Our aim was to reach a consensus on the management of the most controversial issues of advanced ovarian cancer.
Methods:
Nominal group and Delphi techniques were used. A steering committee of 5 experts analyzed current management of advanced ovarian cancer, identified controversies, critically analyzed the evidence, and formulated guiding statements for clinicians. Subsequently, a panel of 15 experts was selected to test agreement with the statements through two Delphi rounds. Items were scored on a 4-point Likert scale from 1 (totally disagree) to 4 (totally agree). In the first and second rounds, consensus was considered if ≥70% of answers pertained to category 1 or category 4.
Results:
Overall, 112 statements were incorporated in the following areas: 1) biomarkers and hereditary ovarian cancer; 2) first-line treatment; 3) recurrent disease when platinum might be the best option; and 4) post-poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitors setting. In the first Delphi round, 37 statements reached consensus and did thus not pass to the second round. After the second round, another 18 statements reached consensus. Forty-six of the consensus were with the agreement and 9 with the disagreement.
Conclusion
Through the methodology used, a consensus was reached in approximately half of the statements. The results of this work may be useful in addressing the most controversial issues on the management of advanced ovarian cancer.
3.Mediterranean Diet and Physical Activity Protect from Silent Brain Infarcts in a Cohort of Patients with Atrial Fibrillation
Irene ESCUDERO-MARTÍNEZ ; Fernando MANCHA ; Angela VEGA-SALVATIERRA ; María Irene AYUSO ; Rafael F OCETE ; Pilar ALGABA ; Antonio LÓPEZ-RUEDA ; Pilar PIÑERO ; Elena FAJARDO ; José Román FERNÁNDEZ-ENGO ; Eva María MARTÍN-SÁNCHEZ ; Alejandro GALVAO-CARMONA ; Elena ZAPATA-ARRIAZA ; Lucía LEBRATO ; Blanca PARDO-GALIANA ; Juan Antonio CABEZAS ; Alejandro GONZÁLEZ ; Francisco MONICHE ; Joan MONTANER
Journal of Stroke 2019;21(3):353-355
No abstract available.
Atrial Fibrillation
;
Brain
;
Cohort Studies
;
Diet, Mediterranean
;
Humans
;
Motor Activity
4.The Value of Transcranial Doppler Sonography in Hyperperfusion Syndrome after Carotid Artery Stenting: A Nationwide Prospective Study
Francisco MONICHE ; Irene ESCUDERO-MARTÍNEZ ; Fernando MANCHA ; Alejandro TOMASELLO ; Marc RIBÓ ; Fernando DELGADO-ACOSTA ; Juán José OCHOA ; Joaquín GIL ; Rosario GIL ; Montserrat GONZÁLEZ-DELGADO ; Eduardo MURIAS ; Alain LUNA ; Alberto GIL ; Sonia MOSTEIRO ; María Dolores FERNÁNDEZ-COUTO ; Luis Fernández de ALARCÓN ; José M. RAMÍREZ-MORENO ; Joaquín ZAMARRO ; Guillermo PARRILLA ; José L. CANIEGO ; Gustavo ZAPATA-WAINBERG ; Andrés GONZÁLEZ-MANDLY ; José A. de las HERAS ; Luis LÓPEZ-MESONERO ; Joaquín ORTEGA ; Juan F. ARENILLAS ; Ernesto GARCÍA ; Pedro P. ALCÁZAR ; Elena ZAPATA-ARRIAZA ; Asier de ALBÓNIGA-CHINDURZA ; Juan Antonio CABEZAS ; Pilar ALGABA ; Aurelio CAYUELA ; Joan MONTANER ; Alejandro González GARCÍA
Journal of Stroke 2020;22(2):254-257
5.Clinical Outcomes of Mechanical Thrombectomy in Stroke Tandem Lesions According to Intracranial Occlusion Location
Elena ZAPATA-ARRIAZA ; Asier de ALBÓNIGA-CHINDURZA ; Joaquin ORTEGA-QUINTANILLA ; Irene ESCUDERO-MARTÍNEZ ; Francisco MONICHE ; Manuel MEDINA-RODRÍGUEZ ; Blanca PARDO-GALIANA ; Juan Antonio Cabezas RODRÍGUEZ ; Lucía Lebrato HERNÁNDEZ ; Leire AINZ ; Soledad PÉREZ-SÁNCHEZ ; Ana DOMÍNGUEZ-MAYORAL ; Ana BARRAGÁN ; Aurelio CAYUELA ; Joan MONTANER ; Alejandro González GARCÍA
Journal of Stroke 2021;23(1):124-127
6.Clinical Variables and Genetic Risk Factors Associated with the Acute Outcome of Ischemic Stroke: A Systematic Review
Nuria P TORRES-AGUILA ; Caty CARRERA ; Elena MUIÑO ; Natalia CULLELL ; Jara CÁRCEL-MÁRQUEZ ; Cristina GALLEGO-FABREGA ; Jonathan GONZÁLEZ-SÁNCHEZ ; Alejandro BUSTAMANTE ; Pilar DELGADO ; Laura IBAÑEZ ; Laura HEITSCH ; Jerzy KRUPINSKI ; Joan MONTANER ; Joan MARTÍ-FÀBREGAS ; Carlos CRUCHAGA ; Jin Moo LEE ; Israel FERNANDEZ-CADENAS ;
Journal of Stroke 2019;21(3):276-289
Stroke is a complex disease and one of the main causes of morbidity and mortality among the adult population. A huge variety of factors is known to influence patient outcome, including demographic variables, comorbidities or genetics. In this review, we expound what is known about the influence of clinical variables and related genetic risk factors on ischemic stroke outcome, focusing on acute and subacute outcome (within 24 to 48 hours after stroke and until day 10, respectively), as they are the first indicators of stroke damage. We searched the PubMed data base for articles that investigated the interaction between clinical variables or genetic factors and acute or subacute stroke outcome. A total of 61 studies were finally included in this review. Regarding the data collected, the variables consistently associated with acute stroke outcome are: glucose levels, blood pressure, presence of atrial fibrillation, prior statin treatment, stroke severity, type of acute treatment performed, severe neurological complications, leukocyte levels, and genetic risk factors. Further research and international efforts are required in this field, which should include genome-wide association studies.
Adult
;
Atrial Fibrillation
;
Blood Pressure
;
Comorbidity
;
Genetics
;
Genome-Wide Association Study
;
Glucose
;
Humans
;
Hydroxymethylglutaryl-CoA Reductase Inhibitors
;
Leukocytes
;
Mortality
;
Risk Factors
;
Stroke
7.Sex Differences by Hospital-Level in Performance and Outcomes of Endovascular Treatment for Acute Ischemic Stroke
Soledad PÉREZ-SÁNCHEZ ; Ana BARRAGÁN-PRIETO ; Joaquín ORTEGA-QUINTANILLA ; Ana DOMÍNGUEZ-MAYORAL ; Miguel Ángel GAMERO-GARCÍA ; Elena ZAPATA-ARRIAZA ; Reyes de TORRES-CHACÓN ; Asier de ALBÓNIGA-CHINDURZA ; Montserrat ZAPATA-HIDALGO ; Francisco MONICHE ; Irene ESCUDERO-MARTÍNEZ ; Pablo BAENA ; Juan Antonio CABEZAS ; Juan Miguel OROPESA-RUIZ ; Gema SANZ-FERNÁNDEZ ; Alejandro GONZÁLEZ ; Joan MONTANER
Journal of Stroke 2020;22(2):258-261
8. Activation and IL-1β secretion of human peripheral phagocytes infected with Actinomadura madurae, Nocardia asteroides and Candida albicans
Alejandro PALMA-RAMOS ; Gilberto CASILLAS-PÉTRIZ ; Laura Estela CASTRILLÓN-RIVERA ; Jorge Ismael CASTAÑEDA-SÁNCHEZ ; Maria Elisa DRAGO-SERRANO ; Teresita SAINZ-ESPUÑES ; Roberto ARENAS-GUZMÁN
Asian Pacific Journal of Tropical Medicine 2016;9(10):962-967
Objective To evaluate the ability of Actinomadura madurae (A. madurae) and Nocardia asteroides (N. asteroides), using Candida albicans (C. albicans) as prototypic control, to elicit the activation and IL-1β secretion of blood phagocytic cells from healthy donors. Methods Microscopic evaluation of phagocytosis/activation, cell viability and spectrophotometric quantitation of endocytosis/activation, were assessed by using formazan blue test in human blood phagocytes infected with C. albicans, A. madurae or N. asteroides treated with either normal human serum (NHS) or with decomplemented NHS. Interlukin-1β from culture supernatants of infected polymorphonuclear was tested by ELISA kit assay. Results Microscopic assay showed that phagocytosis and activation of adherent mononuclear phagocytes were greater with C. albicans followed by A. madurae and then by N. asteroides. Spectrophotometric assay in polymorphonuclear phagocytes infected with NHS-treated pathogens indicated that activation was similarly higher by C. albicans and A. madurae and lower by N. asteroides. Kinetic assays in infected polymorphonuclear cells showed that viability was decreased by C. albicans and N. asteroides or unaffected with A. madurae. Levels of IL-1β at 8 h of incubation were higher with C. albicans followed by A. madurae whereas lower levels were found with N. asteroides. Conclusions The extent of cell-viability and activation as well IL-1β secretion may be related with the virulence of C. albicans and N. asteroides and other parameters remain to be explored for assessing the virulence of A. madurae.
9.A pilot study of the modulation of sirtuins on arylamine -acetyltransferase 1 and 2 enzymatic activity.
Eneida TURIJÁN-ESPINOZA ; Rául Alejandro SALAZAR-GONZÁLEZ ; Edith Elena URESTI-RIVERA ; Gloria Estela HERNÁNDEZ-HERNÁNDEZ ; Montserrat ORTEGA-JUÁREZ ; Rosa MILÁN ; Diana PORTALES-PÉREZ
Acta Pharmaceutica Sinica B 2018;8(2):188-199
Arylamine -acetyltransferase (NAT; E.C. 2.3.1.5) enzymes are responsible for the biotransformation of several arylamine and hydrazine drugs by acetylation. In this process, the acetyl group transferred to the acceptor substrate produces NAT deacetylation and, in consequence, it is susceptible of degradation. Sirtuins are protein deacetylases, dependent on nicotine adenine dinucleotide, which perform post-translational modifications on cytosolic proteins. To explore possible sirtuin participation in the enzymatic activity of arylamine NATs, the expression levels of NAT1, NAT2, SIRT1 and SIRT6 in peripheral blood mononuclear cells (PBMC) from healthy subjects were examined by flow cytometry and Western blot. The activity of the sirtuins on NAT enzymatic activity was analyzed by HPLC, in the presence or absence of an agonist (resveratrol) and inhibitor (nicotinamide) of sirtuins. We detected a higher percentage of positive cells for NAT2 in comparison with NAT1, and higher numbers of SIRT1+ cells compared to SIRT6 in lymphocytes. NAT2 activity in the presence of NAM inhibitors was higher than in the presence of its substrate, but not in the presence of resveratrol. In contrast, the activity of NAT1 was not affected by sirtuins. These results showed that NAT2 activity might be modified by sirtuins.
10. Anti-inflammatory evaluation and acute toxicity of three food supplements that contain Moussonia deppeana
Gabriel Alfonso GUTIÉRREZ-REBOLLEDO ; Mariana Zuleima PÉREZ-GONZÁLEZ ; María Adelina JIMÉNEZ-ARELLANES ; Alejandro ZAMILPA
Asian Pacific Journal of Tropical Medicine 2017;10(2):141-147
Objective To identify the anti-inflammatory activity through two murine models and in the median Lethal Dose (LD