Person: Ortuño Andériz, Francisco
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First Name
Francisco
Last Name
Ortuño Andériz
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Medicina
Department
Medicina
Area
Medicina
Identifiers
3 results
Search Results
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Item Low-dose Radiation Therapy in the Management of COVID-19 Pneumonia (LOWRAD-Cov19). Final results of a prospective phase I–II trial(Radiotherapy and Oncology, 2022) Sanmamed, Noelia; Alcántara Carrió, María Del Pino; Bustos García De Castro, Ana María; Corona Sánchez, Juan Antonio; Gaztañaga Boronat, Miren; Cabello Clotet, Noemí; Ortuño Andériz, Francisco; Castro Fernández, Javier De; Fuentes Ramos, Manuel; Vazquez, Manuel; Michael Baumann, MDBackground and purpose: To evaluate the results of low-dose radiation therapy (LD-RT) to lungs in the management of patients with COVID-19 pneumonia. Material and methods: We conducted a prospective phase I-II trial enrolling COVID-19 patients ≥50 years-old, with bilateral lung involvement at imaging study and oxygen requirement (oxygen saturation ≤93% on room air). Patients received 1 Gy to whole lungs in a single fraction. Primary outcome was a radiological response assessed as severity and extension scores at days +3 and +7. Secondary outcomes were toxicity (CTCAE v5.0), days of hospitalization, changes in inflammatory blood parameters (ferritin, lymphocytes, C-reactive protein, d-dimer and LDH) and SatO2/FiO2 index (SAFI), at day +3 and +7. Descriptive analyses were summarized as means with standard deviation (SD) and/or medians with interquartile ranges (IQR). A Wilcoxon sign rank test for paired data was used to assess the CT scores and Chi Square was used to assess for comparison of categorical variables. Results: Forty-one patients were included. Median age was 71 (IQR 60-84). Eighteen patients (44%) previously received an anti-COVID treatment (tocilizumab, lopinavir/ritonavir, remdesivir) and thirty-two patients (84%) received steroids during LD-RT. The extension score improved significantly (p = 0.02) on day +7. Mean baseline extension score was 13.7 (SD ± 4.9) with a score of 12.2 (±5.2) at day 3, and 12.4 ± 4.7 at day 7. No differences were found in the severity score. SAFI improved significantly on day +3 and +7 (p < 0.01). Median SAFI on day 0 was 147 (IQR 118-264), 230 (IQR 120-343) on day +3 and 293 (IQR 121-353) on day +7. Significant decrease was found in C-reactive protein on day +7 (p = 0.02) and in lymphocytes counts on day +3 and +7 (p = 0.02). The median number of days in hospital after RT was 11 (range 4-78). With a median follow-up of 60 days after LD-RT, 26 (63%) patients were discharged, 11 (27%) died because of COVID respiratory failure and 4 (10%) died of other causes. Conclusions: LD-RT is a feasible and well-tolerated treatment that could lead to rapid clinical improvement. Large randomized trials would be required to establish the efficacy of LD-RT to treat COVID-19 pneumonia.Item Disfunción renal aguda en la sepsis grave y el shock séptico: contribución de la cistatina C al diagnóstico precoz(2011) Ortuño Andériz, Francisco; Barrientos Guzmán, AlbertoLa sepsis va a ser mucho más frecuente en los próximos años de lo que es actualmente, y cada vez tendrá mayor morbi-mortalidad. Consumirá cuantiosos recursos. Además, cada vez más pacientes evolucionarán a Síndrome de Disfunción Multiorgánica (SDMO). El Fracaso Renal Agudo (FRA) está claramente relacionado con la morbimortalidad de estos pacientes, mucho más que el fracaso de cualquier otro órgano o sistema. El tratamiento actual del FRA, pasa por una detección precoz del mismo, para intentar limitar la pérdida de funcionalidad y por la instauración de medidas de soporte. Con la aplicación de guías terapéuticas guiadas por objetivos, muchos clínicos tenemos la impresión subjetiva, de que consiguiendo una estabilidad hemodinámica en los estadios precoces de la sepsis y del shock séptico, disminuímos la incidencia del FRA. El FRA de etiología séptica es probablemente el más frecuente y posee unas características clínicas, evolutivas y fisiopatológicas distintas. Los escasos estudios histopatológicos orientan a una manifestación renal de un proceso inflamatorio sistémico como causante del mismo, al que probablemente se añaden componentes pre-renales y de NTA isquémica por el cuadro de deshidratación y de shock que acompañan a las infecciones graves. No existe un tratamiento específico para el FRA, ni tampoco un marcador fiel de la función renal, aunque en las últimas décadas se busca afanosamente, para así instaurar las medidas terapéuticas de manera precoz. La cistatina C sérica podría ser ese marcador, aunque todavía no existen estudios amplios y prospectivos, y menos aún en el subgrupo de pacientes sépticos. Este trabajo pretende arrojar algo de luz a la utilidad de la cistatina C para la detección de forma precoz (subclínica o antes de la elevación de los marcadores analíticos clásicos) del FRA de los pacientes sépticos en la UCI.Item Low-Dose Radiation Therapy in the Management of Coronavirus Disease 2019 (COVID-19) Pneumonia (LOWRAD-Cov19): Preliminary Report(International journal of radiation oncology, biology, physics, 2021) Noelia Sanmamed; Alcántara Carrió, María Del Pino; Elena Cerezo; Gaztañaga Boronat, Miren; Cabello Clotet, Noemí; Sara Gómez; Bustos García De Castro, Ana María; Mercedes Duffort; Anxela Doval; Corona Sánchez, Juan Antonio; Gabriel Rodriguez; Ortuño Andériz, Francisco; Castro Fernández, Javier De; Manuel Enrique Fuentes; Alvaro Sanz; Amanda López; Pérez Vázquez, José ManuelPurpose: Low-dose radiation therapy (LD-RT) has been shown to have an anti-inflammatory effect, and preliminary results suggest it is feasible to treat patients with coronavirus disease 2019 (COVID-19) pneumonia. Materials and methods: We conducted a prospective, single-arm, phase 1/2 clinical trial enrolling patients aged ≥50 years, who were coronavirus disease 2019 (COVID-19) positive, at phase 2 or 3 with lung involvement at imaging study and oxygen requirement. Patients received 100 cGy to total lungs in a single fraction. Primary outcome was radiologic response using severity and extension score on baseline computed tomography (CT), at days 3 and 7 after LD-RT. Secondary outcomes were toxicity using Common Terminology Criteria for Adverse Events v.5.0, duration of hospitalization, blood work evolution, and oxygen requirements using SatO2/FiO2 index (SAFI), at days 3 and 7 after LD-RT. Results: Nine patients were included. Median age was 66 (interquartile range, 57-77). Severity score was stable or decreased in the third CT but was not statistically significant (P = .28); however, there were statistically significant changes in the extension score (P = .03). SAFI index significantly improved 72 hours and 1 week after LD-RT (P = .01). Inflammatory blood parameters decreased 1 week after RT compared with baseline; only lactate dehydrogenase decreased significantly (P = .04). Two patients presented grade 2 lymphopenia after RT and another (with baseline grade 3) worsened to grade 4. Overall, the median number of days of hospitalization was 59 (range, 26-151). After RT the median number of days in the hospital was 13 (range, 4-77). With a median follow-up after RT of 112 days (range, 105-150), 7 patients were discharged and 2 patients died, 1 due to sepsis and the other with severe baseline chronic obstructive pulmonary disease from COVID-19 pneumonia. Conclusions: Our preliminary results show that LD-RT was a feasible and well-tolerated treatment, with potential clinical improvement. Randomized trials are needed to establish whether LD-RT improves severe pneumonia.