Hospital General Universitario Gregorio Marañón

About: Hospital General Universitario Gregorio Marañón is a healthcare organization based out in Madrid, Spain. It is known for research contribution in the topics: Population & Transplantation. The organization has 11975 authors who have published 12386 publications receiving 244847 citations.

ESC Working Group on Cellular Biology of the Heart: position paper for Cardiovascular Research: tissue engineering strategies combined with cell therapies for cardiac repair in ischaemic heart disease and heart failure

Abstract: Morbidity and mortality from ischaemic heart disease (IHD) and heart failure (HF) remain significant in Europe and are increasing worldwide. Patients with IHD or HF might benefit from novel therapeutic strategies, such as cell-based therapies. We recently discussed the therapeutic potential of cell-based therapies and provided recommendations on how to improve the therapeutic translation of these novel strategies for effective cardiac regeneration and repair. Despite major advances in optimizing these strategies with respect to cell source and delivery method, the clinical outcome of cell-based therapy remains unsatisfactory. Major obstacles are the low engraftment and survival rate of transplanted cells in the harmful microenvironment of the host tissue, and the paucity or even lack of endogenous cells with repair capacity. Therefore, new ways of delivering cells and their derivatives are required in order to empower cell-based cardiac repair and regeneration in patients with IHD or HF. Strategies using tissue engineering (TE) combine cells with matrix materials to enhance cell retention or cell delivery in the transplanted area, and have recently received much attention for this purpose. Here, we summarize knowledge on novel approaches emerging from the TE scenario. In particular, we will discuss how combinations of cell/bio-materials (e.g. hydrogels, cell sheets, prefabricated matrices, microspheres, and injectable matrices) combinations might enhance cell retention or cell delivery in the transplantation areas, thereby increase the success rate of cell therapies for IHD and HF. We will not focus on the use of classical engineering approaches, employing fully synthetic materials, because of their unsatisfactory material properties which render them not clinically applicable. The overall aim of this Position Paper from the ESC Working Group Cellular Biology of the Heart is to provide recommendations on how to proceed in research with these novel TE strategies combined with cell-based therapies to boost cardiac repair in the clinical settings of IHD and HF.

Large Cell and Small Cell Neuroendocrine Bladder Carcinoma Immunohistochemical and Outcome Study in a Single Institution

Abstract: We studied 44 cases of small cell bladder carcinoma (SCBC) and 2 cases of large cell neuroendocrine bladder carcinoma (LCNBC) to determine the immunohistochemical profile and biologic behavior. Thyroid transcription factor (TTF)-1, cytokeratin (CK)20, chromogranin A (CgA), synaptophysin, neuron-specific enolase (NSE), and Leu-7 studies were performed. TTF-1+ cases were stained for surfactant protein A (SP-A). The immunohistochemical profile for 44 SCBC cases was as follows: TTF-1+, 11 (25%); CK20+, 3 (7%); CgA+, 13 (30%); synaptophysin+, 22 (50%); NSE+, 35 (80%); and Leu-7+, 30 (68%), and for 2 LCNBC cases was as follows: TTF-1+, 2 (100%); CgA+, (50%); synaptophysin+, 1 (50%); NSE+, 2 (100%); and Leu-7+, 2 (100%). All cases with TTF-1 expression were negative for SP-A, except 1 case. This case was a mixed SCBC with TTF-1 expression in the urothelial component, which also expressed SP-A. Immunohistochemical markers were not associated with survival. The prognosis of SCBC is relatively better than its pulmonary counterpart. LCNBC seems to be a rarely recognized entity. TTF-1 expression is not limited to small cell lung carcinoma.

Is Azole Resistance in Aspergillus fumigatus a Problem in Spain

Abstract: Aspergillus fumigatus complex comprises A fumigatus and other morphologically indistinguishable cryptic species We retrospectively studied 362 A fumigatus complex isolates (353 samples) from 150 patients with proven or probable invasive aspergillosis or aspergilloma (2, 121, and 6 samples, respectively) admitted to the hospital from 1999 to 2011 Isolates were identified using the β-tubulin gene, and only 1 isolate per species found in each sample was selected Antifungal susceptibility to azoles was determined using the CLSI M38-A2 procedure Isolates were considered resistant if they showed an MIC above the breakpoints for itraconazole, voriconazole, or posaconazole (>2, >2, or >05 μg/ml) Most of the samples yielded only 1 species (A fumigatus [n = 335], A novofumigatus [n = 4], A lentulus [n = 3], A viridinutans [n = 1], and Neosartorya udagawae [n = 1]) The remaining samples yielded a combination of 2 species Most of the patients were infected by a single species (A fumigatus [n = 143] or A lentulus [n = 2]) The remaining 5 patients were coinfected with multiple A fumigatus complex species, although A fumigatus was always involved; 4 of the 5 patients were diagnosed in 2009 or later Cryptic species were less susceptible than A fumigatus The frequency of resistance among A fumigatus complex and A fumigatus to itraconazole, voriconazole, and posaconazole was 25 and 03%, 31 and 03%, and 42 and 18%, respectively, in the per-isolate analysis and 13 and 07%, 26 and 07%, and 6 and 4% in the per-patient analysis Only 1 of the 6 A fumigatus isolates in which the cyp51A gene was sequenced had a mutation at position G448 The proportion of patients infected by azole-resistant A fumigatus isolates was low

Depression in bipolar disorder versus major depressive disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions

Abstract: Among subjects with bipolar disorder (BD), depression is much more prevalent (1, 2) and has stronger effects on mortality and psychosocial impairment than mania or hypomania (3, 4). Recently, the clinical, biological, and treatment characteristics of major depressive episodes (MDE) in BD as compared to major depressive disorder (MDD) have been a focus of attention for researchers and clinicians (5–21). However, specific clinical or biological markers for bipolar depression are still lacking. In current diagnostic systems, the same diagnostic criteria apply to MDE occurring during MDD or during the course of BD (22). In comparisons of MDD and depressed BD patients, atypical features, such as hypersomnia or leaden paralysis (5, 6, 9, 20), psychotic symptoms (13, 16, 17, 19), psychomotor retardation (5, 13, 16), shorter depressive episodes (13, 14), higher number of depressive recurrences (9, 18–20), family history of mood disorders (9, 14), comorbidity with substance abuse (8, 17), and earlier age at onset (7, 9, 18) are reported more frequently in BD; whereas, somatic disturbances (5, 6, 18), anxiety (7, 13), sleep loss (5, 6, 9, 11, 13, 14, 18), and appetite loss (5, 6, 14, 17) are reported more frequently in MDD. However, findings in one sample have seldom been replicated in another, resulting in conflicting results across studies. Most studies report on samples of bipolar I disorder (BD-I) patients or on heterogeneous samples comprising of mostly BD-I patients (5, 6, 13, 14, 16–18); only a few have addressed differences between bipolar II disorder (BD-II) and MDD (9–11, 23); and even fewer have compared BD-I and BD-II with MDD (19, 20). Those studies used clinical samples, which preclude extrapolation of their results to the general population, and did not account for the impact of severity of depression on the clinical presentation and treatment patterns. Current categorical classifications do not rely on specific clinical correlates to discriminate between different mood disorders. In fact, DSM-IV differences between MDD, BD-II, and BD-I are based on lifetime presence of increasing number and duration of manic symptoms (22). This, together with the absence of genetic or other biomarkers supporting boundaries between conditions (21, 24, 25), suggests that dimensional approaches may contribute to describe mood disorders more accurately. We used data from a large national representative survey, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (26), to address some of the gaps in previous research. Specifically, among individuals with a lifetime history of MDE, we compared those with lifetime BD-I, BD-II, and MDD on sociodemographic and clinical characteristics, symptoms of MDE, and lifetime treatment patterns, and explored whether the different mood diagnoses arrayed along a dimension. Our aim was to expand the knowledge regarding the differential features of MDE occurring in BD-I, BD-II, and MDD, which could aid in the clinical decision-making and the characterization of mood disorders in DSM-V.