Publications by authors named "A Moreno"

2,737 Publications

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How the Number of Players and Floaters' Positioning Changes the Offensive Performance during Futsal Small-Sided and Conditioned Games.

Int J Environ Res Public Health 2021 Jul 15;18(14). Epub 2021 Jul 15.

Faculty of Sport Sciences, University of Extremadura, 06006 Cáceres, Spain.

This study aims to analyse the effects of floater positioning within futsal Gk + 3vs3 + Gk and Gk + 2vs2 + Gk small-sided and conditioned games (SSCG) on youth offensive performance on an action per minute per player basis. Three experimental conditions were carried out through the manipulation of floater positioning: floaters off (FO), final line floaters (FLF) and lateral floaters (LF). Thirty male futsal players (U19 age category) participated in the study and played once within each situation in a random order on different days. Offensive performance based on "action per minute per player" was analysed through indirect and external systematic observation. Results showed significant differences between both SSCGs (2vs2 and 3vs3). Specifically, according to the game principles analysed, 3vs3 is associated with higher values of passing and dribbling action to progress towards the goal without beating a defensive line (moderate to large effect size), while 2vs2 is associated with higher values of passing and dribbling actions that beating a defensive line (moderate to very large effect size). In addition, 2vs2 is associated with dribbling and shooting actions to shoot at goal with the lowest level of opposition (moderate effect size). Indeed, whilst the 2vs2 game format seems to promote more 1vs1 situations, the 3vs3 game format encourages more ball possession and collective tactical behaviours. Thus, training tasks intended to improve dribbling and shooting actions should use a smaller number of players whereas tasks intended to improve passing actions for ball possession should include a higher number of players with or without floaters. It seems that the number of players can influence the tactical behaviour of the team. These findings should be considered for the design of futsal training tasks, according to the main objective of the training session. For example, if the coach aims to promote the number of dribbles and shots within a SSCG, 2vs2 SSCG situations should be prioritised.
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http://dx.doi.org/10.3390/ijerph18147557DOI Listing
July 2021

Cellular and humoral immune response after mRNA-1273 SARS-CoV-2 vaccine in liver and heart transplant recipients.

Am J Transplant 2021 Jul 22. Epub 2021 Jul 22.

Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain.

Recent published studies have found an impaired immune response after SARS-CoV-2 vaccination in solid organ recipients. However, most of these studies have not assessed immune cellular responses in liver and heart transplant recipients. We prospectively studied heart and liver transplant recipients eligible for SARS-CoV-2 vaccination. Patients with past history of SARS-CoV-2 infection or SARS-CoV-2 detectable antibodies (IgM or IgG) were excluded. We assessed IgM/IgG antibodies and ELISpot against the S protein four weeks after receiving the second dose of the mRNA-1273 (Moderna) vaccine. Side effects, troponin I, liver tests and anti-HLA donor-specific antibodies (DSA) were also assessed. A total of 58 liver and 46 heart recipients received 2 doses of mRNA-1273 vaccine. Median time from transplantation to vaccination was 5.4 years (IQR 0.3-27). Sixty four percent of the patients developed SARS-CoV-2 IgM/IgG antibodies and 79% S-ELISpot positivity. Ninety percent of recipients developed either humoral or cellular response (87% in heart recipients and 93% in liver recipients). Factors associated with vaccine unresponsiveness were hypogammaglobulinemia and vaccination during the first year after transplantation. Local and systemic side-effects were mild or moderate and none presented DSA or graft dysfunction after vaccination. Ninety percent of our patients did develop humoral or cellular responses to mRNA-1273 vaccine. Factors associated with vaccine unresponsiveness were hypogammaglobulinemia and vaccination during the first year after transplantation, highlighting the need to further protect these patients.
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http://dx.doi.org/10.1111/ajt.16768DOI Listing
July 2021

Temporal Bone Osteoradionecrosis: An 18-year, Single-Institution Experience.

Laryngoscope 2021 Jul 20. Epub 2021 Jul 20.

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

Objectives/hypothesis: To report the largest single-institution review of temporal bone osteoradionecrosis (TBORN), and characterize the disease's natural history, prognostic factors, management, and outcomes.

Study Design: Retrospective chart review.

Methods: Retrospective review was conducted to identify patients with TBORN. Pertinent data were extracted. Descriptive statistics were used to summarize patient, tumor, and treatment characteristics. Multivariable analyses were conducted to explore associations between these characteristics and time to TBORN diagnosis and risk of developing diffuse disease.

Results: TBORN was identified in 145 temporal bones from 128 patients. Mean age at diagnosis was 62 years, and mean time to diagnosis after radiotherapy was 10 years. Age greater than 50 years was associated with earlier diagnosis. According to the Ramsden criteria, 76% of TBs had localized and 24% had diffuse disease at initial diagnosis; 37% had diffuse disease at last follow-up. On multivariable analysis, diabetes, three-dimensional conformal radiotherapy (3D-CRT), and periauricular skin malignancy were significant risk factors for developing diffuse disease. Localized disease was successfully managed with conservative measures, whereas surgery was often necessary for diffuse disease. When TBORN spread outside the mastoid or infratemporal fossa, conservative measures were always unsuccessful.

Conclusions: TBORN occurs earlier in older patients. While diffuse disease is less common than localized disease, it occurs more frequently in patients with diabetes, history of 3D-CRT, and periauricular skin malignancies. Conservative management is appropriate for localized disease, while surgery is often necessary for diffuse disease. The prognostic factors identified helped propose a TBORN staging system and treatment guidelines which may improve patient risk stratification and disease management.

Level Of Evidence: IV Laryngoscope, 2021.
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http://dx.doi.org/10.1002/lary.29758DOI Listing
July 2021

Proton Therapy for Major Salivary Gland Cancer: Clinical Outcomes.

Int J Part Ther 2021 25;8(1):261-272. Epub 2021 Jun 25.

Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Purpose: To report clinical outcomes in terms of disease control and toxicity in patients with major salivary gland cancers (SGCs) treated with proton beam therapy.

Materials And Methods: Clinical and dosimetric characteristics of patients with SGCs treated from August 2011 to February 2020 on an observational, prospective, single-institution protocol were abstracted. Local control and overall survival were calculated by the Kaplan-Meier method. During radiation, weekly assessments of toxicity were obtained, and for patients with ≥ 90 days of follow-up, late toxicity was assessed.

Results: Seventy-two patients were identified. Median age was 54 years (range, 23-87 years). Sixty-three patients (88%) received postoperative therapy, and nine patients (12%) were treated definitively. Twenty-six patients (36%) received concurrent chemotherapy. Nine patients (12%) had received prior radiation. All (99%) but one patient received unilateral treatment with a median dose of 64 GyRBE (relative biological effectiveness) (interquartile range [IQR], 60-66), and 53 patients (74%) received intensity-modulated proton therapy with either single-field or multifield optimization. The median follow-up time was 30 months. Two-year local control and overall survival rates were 96% (95% confidence interval [CI] 85%-99%) and 89% (95% CI 76%-95%], respectively. Radiation dermatitis was the predominant grade-3 toxicity (seen in 21% [n = 15] of the patients), and grade ≥ 2 mucositis was rare (14%; n = 10 patients). No late-grade ≥ 3 toxicities were reported.

Conclusion: Proton beam therapy for treatment of major SGCs manifests in low rates of acute mucosal toxicity. In addition, the current data suggest a high rate of local control and minimal late toxicity.
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http://dx.doi.org/10.14338/IJPT-20-00044.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270094PMC
June 2021

Proton Therapy for Head and Neck Cancer: A 12-Year, Single-Institution Experience.

Int J Part Ther 2021 25;8(1):108-118. Epub 2021 Jun 25.

Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Purpose: To characterize our experience and the disease control and toxicity of proton therapy (PT) for patients with head and neck cancer (HNC).

Patients And Methods: Clinical outcomes for patients with HNC treated with PT at our institution were prospectively collected in 2 institutional review board-approved prospective studies. Descriptive statistics were used to summarize patient characteristics and outcomes. Overall survival, local-regional control, and disease-free survival were estimated by the Kaplan-Meier method. Treatment-related toxicities were recorded according to the Common Terminology Criteria for Adverse Events (version 4.03) scale.

Results: The cohort consisted of 573 patients treated from February 2006 to June 2018. Median patient age was 61 years. Oropharynx (33.3%; n = 191), paranasal sinus (11%; n = 63), and periorbital tissues (11%; n = 62) were the most common primary sites. Patients with T3/T4 or recurrent disease comprised 46% (n = 262) of the cohort. The intent of PT was definitive in 53% (n = 303), postoperative in 37% (n = 211), and reirradiation in 10% (n = 59). Median dose was 66 Gy (radiobiological equivalent). Regarding systemic therapy, 43% had received concurrent (n = 244), 3% induction (n = 19), and 15% (n = 86) had both. At a median follow-up of 2.4 years, 88 patients (15%) had died and 127 (22%) developed disease recurrence. The overall survival, local-regional control, and disease-free survival at 2 and 5 years were, respectively, 87% and 75%, 87% and 78%, and 74% and 63%. Maximum toxicity (acute or late) was grade 3 in 293 patients (51%), grade 2 in 234 patients (41%), and grade 1 in 31 patients (5%). There were 381 acute grade 3 and 190 late grade 3 unique toxicities across 212 (37%) and 150 (26%) patients, respectively. There were 3 late-grade 4 events across 2 patients (0.3%), 2 (0.3%) acute-grade 5, and no (0%) late-grade 5 events.

Conclusions: The overall results from this prospective study of our initial decade of experience with PT for HNC show favorable disease control and toxicity outcomes in a multidisease-site cohort and provide a reference benchmark for future comparison and study.
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http://dx.doi.org/10.14338/IJPT-20-00065.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270083PMC
June 2021
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