Nuestros investigadores

Manuel Fortún Landecho Acha

Publicaciones científicas más recientes (desde 2010)

Autores: Beloqui, Óscar; Moreno, MU; San José, Gorka; et al.
ISSN 1071-5762  Vol. 51  Nº 4  2017  págs. 389 - 396
Vascular calcification is a common feature in atherosclerosis and associates with cardiovascular events. Oxidative stress may be involved in the pathogenesis of vascular calcification. Previous studies have shown that the phagocytic NADPH oxidase is associated with atherosclerosis. The objective of the present study was to investigate the association between phagocytic NADPH oxidase-mediated superoxide production and coronary artery calcium (CAC). NADPH oxidase-mediated superoxide production was determined by chemiluminescence and CAC by computed tomography in 159 asymptomatic men free of overt clinical atherosclerosis. Multivariate linear regression analyses were used to assess the relationship between CAC and NADPH oxidase-mediated superoxide production. Compared with individuals in the lowest score of CAC (= 0 Agatston units), those in the upper score (> 400 Agatston units) showed higher superoxide production (p < 0.05). In correlation analysis, superoxide production positively (p < 0.01) correlated with CAC, which in multivariate analysis remained significant after adjusting for age, HDL-cholesterol, triglycerides, body mass index, smoking, arterial hypertension and diabetes mellitus. In conclusion, in a population of men without clinically overt atherosclerotic disease, increased NADPH oxidase-mediated superoxide production associated with enhanced CAC. Albeit descriptive, these findings suggest a potential involvement of phagocytic NADPH oxidase-mediated oxidative stress in CAC.
Autores: Rosado, I. A.; Morales, María Isabel; et al.
ISSN 0269-4727  Vol. 42  Nº 5  2017  págs. 638 - 641
What is known and objectiveChylous ascites is a rare condition. The most frequent causes are lymphomas, solid malignancies, abdominal trauma and cirrhosis. Isolated case reports describe the relationship between calcium channel blockers (CCB) and chyloperitoneum. Lercanidipine is a third-generation dihydropyridine with low rate of adverse events. We describe a case of lercanidipine-induced chylous ascites. Case summaryAn 80-year-old white female with hypertension treated with lercanidipine, developed chylous ascites and abdominal pain after the dosage of the CCB was doubled. The initial suspicion was a hidden neoplasm, but after a thorough research, no apparent cause was detected and the symptoms resolved after the drug was suspended. What is new and conclusionCalcium channel blockers should be considered as possible causes in cases of chyloperitoneum of unknown aetiology.
Autores: Moctezuma, S. I.; Panizo, Carlos Manuel; Landecho, Manuel Fortún;
ISSN 0025-7753  Vol. 149  Nº 7  2017  págs. 312 - 313
Autores: González, A; Pueyo, Jesús Ciro; et al.
ISSN 1388-9842  Vol. 19  Nº Supl. 1  2017  págs. 123
Autores: Artaiz, Miguel; Landecho, Manuel Fortún;
ISSN 1137-6627  Vol. 39  Nº 1  2016  págs. 9-11
Adicionalmente, la disponibilidad de infraestructuras que hacen que se tarde más o menos tiempo en recorrer una distancia son exclusivas de cada región, y se trata de una información imprescindible para la gestión óptima de los recursos. En conclusión, consideramos que trabajos como el realizado por Daponte-Codina1 y col1 dota a los responsables de la gestión de recursos de 112 del SAS de argumentos para la toma de decisiones correctas.
Autores: Pérez, Alejandra; Landecho, Manuel Fortún; et al.
ISSN 1368-5031  Vol. 70  Nº 2  2016  págs. 147-155
The predictive rule was able to predict risk of death as a result of enterococcal bloodstream infection as well as to identify patients, who being below the threshold value, will have a low risk of death with a negative predictive value of 96%
Autores: Catalán, V; Gómez-Ambrosi, J; Rodríguez, Amaia; et al.
ISSN 0012-1797  Vol. 65  Nº 12  2016  págs. 3636 - 3648
Interleukin (IL)-32 is a recently described cytokine involved in the regulation of inflammation. We aimed to explore whether IL-32 could function as an inflammatory and angiogenic factor in human obesity and obesity-associated type 2 diabetes. Samples obtained from 90 subjects were used in the study. Obese patients exhibited higher expression levels of IL-32 in visceral adipose tissue (AT) as well as in subcutaneous AT and peripheral blood mononuclear cells. IL32 was mainly expressed by stromovascular fraction cells, and its expression was significantly enhanced by inflammatory stimuli and hypoxia, whereas no changes were found after the incubation with anti-inflammatory cytokines. The addition of exogenous IL-32 induced the expression of inflammation and extracellular matrix¿related genes in human adipocyte cultures, and IL32-silenced adipocytes showed a downregulation of inflammatory genes. Furthermore, adipocyte-conditioned media obtained from obese patients increased IL32 gene expression in human monocyte cultures, whereas the adipocyte-conditioned media from lean volunteers had no effect on IL32 mRNA levels. These findings provide evidence, for the first time, about the inflammatory and remodeling properties of IL-32 in AT, implicating this cytokine in obesity-associated comorbidities.
Autores: Alegre, Félix; Huerta, Ana; Landecho, Manuel Fortún; et al.
ISSN 1590-8658  Vol. 48  Nº 2  2016  págs. 209 - 210
Autores: Pérez, Alejandra; Gea, Alfredo; et al.
ISSN 1137-6627  Vol. 38  Nº 1  2015  págs. 71-77
Analizar los predictores de mortalidad y mal pronóstico en el paciente oncológico diagnosticado de bacteriemia por E. faecium. Métodos. Se analizaron datos demográficos, clínicos y microbiológicos (Enero 1998-Junio 2011). Resultados. El análisis multivariable demostró que la presencia de una sonda urinaria se asoció a mal pronóstico a los 7 días y alta mortalidad del paciente al final del estudio. Un índice de Charlson elevado se asoció a un aumento en la mortalidad a los 7 días. Conclusión. En nuestro estudio, la presencia de sonda urinaria se asoció con mal pronóstico del paciente a los 7 días y aumento de la mortalida
Autores: Landecho, Manuel Fortún; Urquiza, L.; et al.
ISSN 0022-1767  Vol. 194  Nº 5  2015  págs. 2190 - 2198
Germline GATA2 mutations have been identified as the cause of familial syndromes with immunodeficiency and predisposition to myeloid malignancies. GATA2 mutations appear to cause loss of function of the mutated allele leading to haploinsufficiency; however, this postulate has not been experimentally validated as the basis of these syndromes. We hypothesized that mutations that are translated into abnormal proteins could affect the transcription of GATA2, triggering GATA2 deficiency. Chromatin immunoprecipitation and luciferase assays showed that the human GATA2 protein activates its own transcription through a specific region located at -2.4 kb, whereas the p.Thr354Met, p.Thr355del, and p.Arg396Gln germline mutations impair GATA2 promoter activation. Accordingly, GATA2 expression was decreased to ~58% in a patient with p.Arg396Gln, compared with controls. p.Arg396Gln is the second most common mutation in these syndromes, and no previous functional analyses have been performed. We therefore analyzed p.Arg396Gln. Our data show that p.Arg396Gln is a loss-of-function mutation affecting DNA-binding ability and, as a consequence, it fails to maintain the immature characteristics of hematopoietic stem and progenitor cells, which could result in defects in this cell compartment. In conclusion, we show that human GATA2 binds to its own promoter, activating its transcription, and that the aforementioned mutations impair the transcription of GATA2. Our results indicate that they can affect other GATA2 target genes, which could partially explain the variability of symptoms in these diseases. Moreover, we show that p.Arg396Gln is a loss-of-function mutation, which is unable to retain the progenitor phenotype in cells where it is expressed.
Autores: Alegre, Félix; Landecho, Manuel Fortún; Huerta, Ana; et al.
Revista: PLOS ONE
ISSN 1932-6203  Vol. 10  Nº 6  2015  págs. e0130989
Background Application of illness-severity scores in Intermediate Care Units (ImCU) shows conflicting results. The aim of the study is to design a severity-of-illness score for patients admitted to an ImCU. Methods We performed a retrospective observational study in a single academic medical centre in Pamplona, Spain. Demographics, past medical history, reasons for admission, physiological parameters at admission and during the first 24 hours of ImCU stay, laboratory variables and survival to hospital discharge were recorded. Logistic regression analysis was performed to identify variables for mortality prediction. Results A total of 743 patients were included. The final multivariable model (derivation cohort = 554 patients) contained only 9 variables obtained at admission to the ImCU: previous length of stay 7 days (6 points), health-care related infection (11), metastatic cancer (9), immunosuppressive therapy (6), Glasgow comma scale 12 (10), need of non-invasive ventilation (14), platelets 50000/mcL (9), urea 0.6 g/L (10) and bilirubin 4 mg/dL (9). The ImCU severity score (ImCUSS) is generated by summing the individual point values, and the formula for determining the expected in-hospital mortality risk is: eImCUSS points*0.099 ¿ 4,111 / (1 + eImCUSS points*0.099 ¿ 4,111). The model showed adequate calibration and discrimination. Performance of ImCUSS (validation cohort = 189 patients) was comparable to that of SAPS II and 3. Hosmer-Lemeshow goodness-of-fit C test was ¿2 8.078 (p=0.326) and the area under receiver operating curve 0.802. Conclusions ImCUSS, specially designed for intermediate care, is based on easy to obtain variables at admission to ImCU. Additionally, it shows a notable performance in terms of calibration and mortality discrimination.
Autores: Pérez, Alejandra; Gea, Alfredo; et al.
ISSN 1137-6627  Vol. 38  Nº 1  2015  págs. 71-7
After multivariate analysis, presence of a urinary catheter was associated with a worse 7-day prognosis, and higher mortality at discharge. A high Charlson index was also associated with higher 7-day mortality. CONCLUSION: Presence of a urinary catheter was associated with poor 7-day prognosis and higher mortality at discharge in the present series.
Autores: Martínez, Diego; Alegre, Félix; Carmona, Francisco de Asís; et al.
Revista: PLOS ONE
ISSN 1932-6203  Vol. 10  Nº 10  2015  págs. e0139702.
These results suggest that SAPS II and 3 should be customized with additional patient-risk factors to improve mortality prediction in patients undergoing NIV in intermediate car
Autores: Moreno, MU; San José, Gorka; Pejenaute, Á.; et al.
ISSN 0194-911X  Vol. 63  Nº 3  2014  págs. 468 - 474
Left ventricular hypertrophy (LVH) is an independent marker of mortality in hypertension. Although the mechanisms contributing to LVH are complex, inflammation and oxidative stress may favor its development. We analyzed the association of the phagocytic NADPH oxidase-mediated superoxide anion release and LVH in patients with essential hypertension and the role of cardiotrophin-1 (CT-1) and interleukin-6 (IL-6), cytokines implicated in cardiac growth. Blood pressure, echocardiography data, and serum CT-1 and IL-6 levels were obtained in 140 subjects: 18 normotensives without LVH, 42 hypertensives without LVH, and 80 hypertensives with LVH. The NADPH oxidase-dependent superoxide production was assessed by chemiluminescence in peripheral blood mononuclear cells. Peripheral blood mononuclear cells were stimulated with CT-1 in vitro. Superoxide anion production by peripheral blood mononuclear cells associated with LVH and correlated with the left ventricular mass index. Serum CT-1 and IL-6 levels, which associated with the left ventricular mass index, correlated with superoxide production. Serum CT-1 and IL-6 levels were correlated. CT-1 stimulated NADPH oxidase superoxide production in peripheral blood mononuclear cells, which resulted in an increased release of IL-6. Our results show that superoxide anion production by the phagocytic NADPH oxidase associates with hypertensive heart disease, being significantly enhanced in hypertensive patients with LVH. This may be attributable to the activation of the NADPH oxidase by CT-1 and the subsequent release of IL-6. The phagocytic NADPH oxidase may be a therapeutic target in hypertensive heart disease.
Autores: Landecho, Manuel Fortún; Alegre, Félix; Lucena, Juan Felipe; et al.
ISSN 0887-8994  Vol. 51  Nº 3  2014  págs. e9-e10
Currently there is no strong evidence to recommend any determined trough plasma levels, and thus we wait for additional observations and clinical trials to clarify the optimal dosage required to avoid unnecessary side effects. Meanwhile, we have found a safe and acceptable response with plasma levels within the lower range of efficacy described.
Autores: Landecho, Manuel Fortún; Alegre, Félix; Lucena, Juan Felipe; et al.
ISSN 0887-8994  Vol. 51   Nº 3  2014  págs. e9 - e10
Autores: Pascual, Juan Ignacio; et al.
ISSN 0890-5096  Vol. 27  Nº 7  2013  págs. 974.e1 - 974.e6
In the last 20 years, endovascular procedures have radically altered the treatment of diseases of the aorta. The objective of endovascular treatment of dissections is to close the entry point to redirect blood flow toward the true lumen, thereby achieving thrombosis of the false lumen. In extensive chronic dissections that have evolved with the formation of a large aneurysm, the dissection is maintained from the end of the endoprosthesis due to multiple orifices, or reentries, that communicate with the lumens. In addition, one of the primary limitations of this technique is when the visceral arteries have disease involvement. In this report we present a case where, despite having treated the entire length of the descending thoracic aorta, the dissection was maintained distally, leading to progression of the diameter of the aneurysm. After reviewing the literature, and to the best of our knowledge, we describe the first case in which renal autotransplant was performed to allow for subsequent exclusion of the aorta at the thoracoabdominal level using a fenestrated endoprosthesis for the celiac trunk and the superior mesenteric artery.
Autores: Lucena, Juan Felipe; Alegre, Félix; Martínez, Diego; et al.
Revista: PLOS ONE
ISSN 1932-6203  Vol. 8  Nº 10  2013  págs. e77229
Objective: The efficacy and reliability of prognostic scores has been described extensively for intensive care, but their role for predicting mortality in intermediate care patients is uncertain. To provide more information in this field, we have analyzed the performance of the Simplified Acute Physiology Score (SAPS) II and SAPS 3 in a single center intermediate care unit (ImCU). Materials and Methods: Cohort study with prospectively collected data from all patients admitted to a single center ImCU in Pamplona, Spain, from April 2006 to April 2012. The SAPS II and SAPS 3 scores with respective predicted mortality rates were calculated according to standard coefficients. Discrimination was evaluated by calculating the area under receiver operating characteristic curve (AUROC) and calibration with the Hosmer-Lemeshow goodness of fit test. Standardized mortality ratios (SMR) with 95% confidence interval (95% CI) were calculated for each model. Results: The study included 607 patients. The observed in-hospital mortality was 20.1% resulting in a SMR of 0.87 (95% CI 0.73-1.04) for SAPS II and 0.56 (95% CI 0.47-0.67) for SAPS 3. Both scores showed acceptable discrimination, with an AUROC of 0.76 (95% CI 0.71-0.80) for SAPS II and 0.75 (95% CI 0.71- 0.80) for SAPS 3. Calibration curves showed similar performance based on Hosmer-Lemeshow goodness of fit C-test: (X2=12.9, p=0.113) for SAPS II and (X2=4.07, p=0.851) for SAPS 3. Conclusions: Although both scores overpredicted mortality, SAPS II showed better discrimination for patients admitted to ImCU in terms of SMR.
Autores: Carmona, Francisco de Asís; Martínez, Diego; Landecho, Manuel Fortún; et al.
ISSN 1473-3099  Vol. 13  Nº 4  2013  págs. 294-295
Autores: Lucena, Juan Felipe; Alegre, Félix; Rodil, Raquel; et al.
ISSN 1553-5592  Vol. 7  Nº 5  2012  págs. 411-415
An ImCU led by hospitalists showed encouraging results regarding patient survival and SAPS II is an useful tool for prognostic evaluation in this population. Intermediate care serves as an expansion of role for hospitalists; and clinicians, trainees and patients may benefit from co-management and teaching opportunities at this unique level of care.
Autores: Lucena, Juan Felipe; Alegre, Félix; Rodil, Raquel; et al.
ISSN 1553-5592  Vol. 7  Nº 5  2012  págs. 411-415
An ImCU led by hospitalists showed encouraging results regarding patient survival and SAPS II is an useful tool for prognostic evaluation in this population. Intermediate care serves as an expansion of role for hospitalists; and clinicians, trainees and patients may benefit from co-management and teaching opportunities at this unique level of care.
Autores: Landecho, Manuel Fortún; Colina, María Inmaculada; Huerta, Ana; et al.
ISSN 0300-8932  Vol. 64  Nº 5  2011  págs. 373-378
Insulin resistance and all metabolic syndrome traits except low level of high-density lipoproteins were significantly associated with an increased OR for EKD. Both metabolic syndrome and EKD were independently and additively related to the presence of surrogate markers of arteriosclerosis
Autores: Landecho, Manuel Fortún; Fortuño, Ana; Zalba, Guillermo; et al.
ISSN 0300-8932  Vol. 64  Nº 10  2011  págs. 947 - 948
Autores: Landecho, Manuel Fortún; Alegre, Félix; et al.
ISSN 0190-9622  Vol. 64  Nº 6  2011  págs. e121-1
Autores: García, Emilio; Urdaneta Abate, M.M.; Sadaba, María Belén; et al.
Revista: Revista de Osteoporosis y Metabolismo Mineral
ISSN 1889-836X  Vol. 2  Nº 2  2010  págs. 35 - 46
Autores: Fortuño, Ana; Moreno, MU; et al.
ISSN 0263-6352  Vol. 28  Nº 9  2010  págs. 1944 - 1950



Trabajo Fin de Grado (F.Medicina). 
Universidad de Navarra - Facultad de Medicina.

Fisiopatología (F.Medicina). 
Universidad de Navarra - Facultad de Medicina.

Nutrición Clínica (Gr. Nutrición). 
Universidad de Navarra - Facultad de Farmacia y Nutrición.

Nutrición clínica (F. Farmacia). 
Universidad de Navarra - Facultad de Farmacia y Nutrición.