Examinando por Autor "Lopez Estebaranz, JL"

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Early outcome of a 31-gene expression profile test in 86 AJCC stage IB-II melanoma patients. A prospective multicentre cohort study
(Wiley, 2019) Podlipnik, S; Carrera, C; Boada, A; Richarz, N; Lopez Estebaranz, JL; Pinedo Moraleda, F; Elosua Gonzalez, M; Martin Gonzalez, MM; Carrillo Gijon, R; Redondo, P; Moreno, E; Malvehy, J; Puig, S
Background The clinical and pathological features of primary melanoma are not sufficiently sensitive to accurately pre dict which patients are at a greater risk of relapse. Recently, a 31-gene expression profile (DecisionDx-Melanoma) test has shown promising results. Objectives To evaluate the early prognostic performance of a genetic signature in a multicentre prospectively evalu ated cohort. Methods Inclusion of patients with AJCC stages IB and II conducted between April 2015 and December 2016. All patients were followed up prospectively to assess their risk of relapse. Prognostic performance of this test was evaluated individually and later combined with the AJCC staging system. Prognostic accuracy of disease-free survival was deter mined using Kaplan–Meier curves and Cox regression analysis. Results of the gene expression profile test were desig nated as Class 1 (low risk) and Class 2 (high risk). Results Median follow-up time was 26 months (IQR 22–30). The gene expression profile test was performed with 86 patients; seven had developed metastasis (8.1%) and all of them were in the Class 2 group, representing 21.2% of this group. Gene expression profile was an independent prognostic factor for relapse as indicated by multivariate Cox regression analysis, adjusted for AJCC stages and age. Conclusions This prospective multicentre cohort study, performed in a Spanish Caucasian cohort, shows that this 31- gene expression profile test could correctly identify patients at early AJCC stages who are at greater risk of relapse. We believe that gene expression profile in combination with the AJCC staging system could well improve the detection of patients who need intensive surveillance and optimize follow-up strategies
Expert consensus on the persistence of biological treatments in moderate-to-severe psoriasis
(Wiley, 2019) de la Cueva Dobao, P; Notario, J; Ferrandiz, C; Lopez Estebaranz, JL; Alarcon, I; Sulleiro, S; Borras, J; Dauden, E; Carrascosa, JM; Sanchez Carazo, JL; MOnte Boquet, E; Puig, L
Background Treatment persistence is becoming a useful measure to evaluate long-term effectiveness and safety of biological therapies in real-world settings. Objective The main objective of this study was to explore the scientific opinion of a panel of dermatologists and hospi tal pharmacists to reach a consensus about the impact, causes, and best strategies and interventions that might be associated with improved drug persistence in patients with psoriasis in Spain. Methods This research was conducted using a modified Delphi method organized in two rounds and involving a panel of 90 dermatologists and 34 hospital pharmacists. A questionnaire of 70 items was developed. The items proposed to reach a consensus included topics such as definitions and measures in the treatment of psoriasis, analysis of treatment persistence, factors that may influence treatment persistence, impact of treatment persistence and economic cost of treatment. Results Dermatologists reached a consensus on 77.1% of the items proposed, and hospital pharmacists reached a consensus on 71.4%. Both groups agreed that it is important to use standardized measures in the evaluation of treat ment maintenance over time. Dermatologists agreed that treatment survival, persistence and retention are synonymous, but hospital pharmacists considered only treatment persistence as a valid term. In addition, panelists agreed that drug persistence is an indicator of success in the treatment of psoriasis that may be influenced by a drug’s effectiveness and safety profile, as well as by patient satisfaction. They agreed that the different causes of treatment discontinuation should be considered in Kaplan–Meier analysis of treatment persistence. Moreover, treatment persistence was agreed to decrease the cost of therapy. Conclusion This Delphi consensus highlights the different perspectives of dermatologists and hospital pharmacists regarding the interpretation of treatment persistence, and the challenge of harmonizing the results obtaine
Molecular epidemiology of molluscum contagiosum virus and analysis of the host-serum, antibody response in Spanish HIV-negative patients
(Wiley, 2002) Agromayor, M; Ortiz, P; Lopez Estebaranz, JL; Gonzalez Nicolas, J; Esteban, M; Martín-Gallardo, A
Molluscum contagiosum virus (MCV) lesions from Spanish human immunode®ciency virus (HIV)-negative patients were clinically examined and analyzed for virus detection and typing. In a study of 147 patients, 97 (66%) were children under 10 years, of whom 49% had atopic dermatitis. MCV lesions were morphologically indistinguishable among the different age groups, but atopic patients presented larger lesions compared with patients without the disorder. In adults, lesions were observed mainly on the genitals. MCVI was the predominant subtype. The deduced MCVI/MCVII ratio (146:1) was much higher than that found in other geographical areas. Protein preparations of the virus-induced lesions were immunoblotted with sera from 25 MCVI patients. The host-serum antibody response was weak and variable, although no signi®cant differences were found between atopic and nonatopic patients. Three immunoreactive proteins of 74/80, 60, and 35 kDa were detected in almost all the analyzed sera. The 35 and 74/80-kDa proteins were virus speci®c, whereas the 60-kDa protein band was composed of a mix of human keratins. Immunoblotting of MCV lesions and vaccinia virus-infected cell extracts with either MCV patient serum or a rabbit antiserum against vaccinia virus showed no cross-reactivity of these two human poxviruses at the antigenic level,
Squamous cell carcinoma of the lip. A retrospective study of 146 patients
(Wiley, 2012) Gutierrez Pacual, M; Vicente Martín, FJ; Fernández Alvarez, JG; Martín López, R; Pinedo Moraleda, F; Lopez Estebaranz, JL
Background Squamous cell carcinoma of the lip (SCCL) accounts for 90% of all tumours of the oral cavity. We present a series of 146 patients with SCCL studied in our hospital. Objective To evaluate and identify the primary tumour parameters related to local and lymph node recurrence. Methods We retrospectively analysed the clinical characteristics, surgical procedures and tumour recurrences of the 146 patients diagnosed with SCCL in Hospital Universitario Fundacio´ n Alcorco´ n (Spain). Results A total of 122 of the 146 patients (91.7%) showed tumour stage £T1N0M0 at diagnosis, and 11 (8.3%) showed stage >T1N0M0. Local recurrences were observed in 11 of the 146 patients (7.5%), and five patients (3.4%) developed lymph node metastases during follow-up. Kaplan–Meier survival analysis showed an increased tumour size to imply a greater risk of local recurrence (P = 0.025). The probability of local recurrence over the 24 months of follow-up was 1% for tumour stages £T1N0M0 and 20% for stages ‡T1N0M0. There appears to be a greater tendency towards local relapse in male patients, in smokers, patients living in rural areas, in lower lip tumours and in those patients showing infiltration at physical exploration. Eleven patients (8%) died during follow-up, although in only two of them (18%), SCCL was the cause of death. Conclusion The low tumour stage of our patients may explain the few local and lymph node disease recurrences seen in our study. We have shown tumour size to be directly related to the probability of local recurrence