Biography:

In the past Teresa Lozano has collaborated on articles with Javier Ena and Francesc Rudilla. One of their most recent publications is Long-term improvements in insulin prescribing habits and glycaemic control in medical inpatients associated with the introduction of a standardized educational approach. Which was published in journal Diabetes Research and Clinical Practice.

More information about Teresa Lozano research including statistics on their citations can be found on their Copernicus Academic profile page.

Teresa Lozano's Articles: (4)

Long-term improvements in insulin prescribing habits and glycaemic control in medical inpatients associated with the introduction of a standardized educational approach

AbstractBackgroundWe carried out an educational strategy to increase physician adherence to 8 recommendations for inpatient evaluation and management of diabetes endorsed by the American Diabetes Association.MethodsWe evaluated physician attitude, barriers and facilitators to incorporate the proposed recommendations into clinical practice. We analyzed the impact of the educational strategy on process-of-care and outcome variables in 138 patients with type 2 diabetes discharged from the internal medicine department before the intervention, at 3-month and at 9-month after the intervention.ResultsAfter the educational intervention there was a high motivation of physicians to adhere to the proposed recommendations. The intervention caused a significant reduction of insulin administered by sliding scale (50% vs. 7% vs. 3%, P = 0.000), and in the median pre-discharge glycaemic values (185 mg/dL vs. 153 mg/dL vs. 161 mg/dL, P = 0.005), in the three periods, respectively. The use basal-bolus-correction insulin dosage increased in postintervention periods (17% vs. 85% vs. 99%, P = 0.004). Hypoglycaemia (glycaemia <60 mg/dL) episodes were similar among the three periods (0.30% vs. 0.70% vs. 1.07%, P = 0.10). The intervention required improvements to promote haemoglobinA1c ordering on admission and diabetes intensification therapy at discharge when needed.ConclusionOur educational strategy improved physician adoption of practice guidelines.

Combination of a TLR4 ligand and anaphylatoxin C5a for the induction of antigen-specific cytotoxic T cell responses☆

AbstractThe complement system and Toll-like receptors (TLR) are key innate defense systems which might interact synergistically on dendritic cells (DC) to reinforce adaptive immunity. In a previous work, we found that the extra domain A from fibronectin EDA (an endogenous ligand for TLR4) can favour antigen delivery to DC and induce their maturation. Given the potential of anaphylatoxins to cause inflammation and activation of myeloid cells, we hypothesized that a fusion protein between EDA, and anaphylatoxins C3a, C4a or C5a together with an antigen might improve the immunogenicity of the antigen. Naked DNA immunization with a construct expressing the fusion protein between C5a, EDA and the cytotoxic T cell epitope SIINFEKL from ovalbumin, induced strong antigen specific T cell responses. The purified recombinant fusion protein EDA–SIINFEKL–C5a induced activation of dendritic cells, the production of proinflammatory cytokines/chemokines and stimulated antigen presenting cell migration and NK cell activation. As compared to EDA–SIINFEKL, the fusion protein EDA–SIINFEKL–C5a did not induce the production of the immunosuppressive molecules IL-10, CCL17, CCL1, CXCL12 or XCL1 by DC. Moreover, EDA–SIINFEKL–C5a induced strong specific T cell responses in vivo and protected mice against E.G7-OVA tumor growth more efficiently than EDA–SIINFEKL or SIINFEKL–C5a recombinant proteins. Our results suggest that fusion proteins containing EDA, the anaphylatoxin C5a and the antigen may serve as a suitable strategy for the development of anti-tumor or anti-viral vaccines.

Artículo originalEvaluación de los pacientes con dolor torácico agudo de origen incierto mediante la determinación seriada de los valores de proteína C reactiva de alta sensibilidadEvaluation of Patients With Acute Chest Pain of Uncertain Origin by Means of Serial Measurement of High-Sensitivity C-Reactive Protein

Introducción y objetivosInvestigamos la utilidad de 2 medidas seriadas de proteína C reactiva de alta sensibilidad (PCR-as) para evaluar el dolor torácico en pacientes con electrocardiograma no diagnóstico y marcadores de daño miocárdico normales. Partimos de la hipótesis de que la concentración de PCR-as se incrementaría si los síntomas fueran causados por daño endotelial coronario o rotura de placa arteriosclerótica.MétodosEstudiamos a 468 pacientes consecutivos atendidos en urgencias con dolor torácico, 191 con diagnóstico no concluyente. En esta población determinamos la PCR-as en el momento del ingreso en urgencias y a las 24 h. Seguimos el protocolo de tratamiento del dolor torácico con sospecha de origen coronario. Cualquier incremento de la PCR-as a las 24 h en relación con la basal se consideró un resultado positivo.ResultadosEn total, 38 (20%) pacientes fueron diagnosticados de dolor torácico coronario. La diferencia de PCR-as (PCR-as a las 24 h menos PCR-as basal en urgencias) mostró una sensibilidad del 95% (intervalo de confianza [IC] del 95%, 81-98%), una especificidad del 40% (IC del 95%, 32-47%), una razón de probabilidad positiva de 1,57 (IC del 95%, 1,33-1,83), una razón de probabilidad negativa de 0,13 (IC del 95%, 0,04-0,44) y área bajo la curva receptor-operador de 0,77 (IC del 95%, 0,69-0,85). A los 30 días no hubo eventos cardiacos en los pacientes con diferencia negativa del valor de PCR-as.ConclusionesLa diferencia de PCR-as resulta útil como herramienta diagnóstica en los pacientes con dolor torácico agudo de probable origen isquémico. Los resultados negativos se asocian con un bajo riesgo de isquemia coronaria significativa y permitirían dar de alta de forma segura a los pacientes desde el servicio de urgencias.

Original ArticleICOS Costimulation at the Tumor Site in Combination with CTLA-4 Blockade Therapy Elicits Strong Tumor Immunity

Cytotoxic T lymphocyte-associated protein 4 (CTLA-4) blockade therapy is able to induce long-lasting antitumor responses in a fraction of cancer patients. Nonetheless, there is still room for improvement in the quest for new therapeutic combinations. ICOS costimulation has been underscored as a possible target to include with CTLA-4 blocking treatment. Herein, we describe an ICOS agonistic aptamer that potentiates T cell activation and induces stronger antitumor responses when locally injected at the tumor site in combination with anti-CTLA-4 antibody in different tumor models. Furthermore, ICOS agonistic aptamer was engineered as a bi-specific tumor-targeting aptamer to reach any disseminated tumor lesions after systemic injection. Treatment with the bi-specific aptamer in combination with CTLA-4 blockade showed strong antitumor immunity, even in a melanoma tumor model where CTLA-4 treatment alone did not display any significant therapeutic benefit. Thus, this work provides strong support for the development of combinatorial therapies involving anti-CTLA-4 blockade and ICOS agonist tumor-targeting agents.

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