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Tejera-Vaquerizo A, Boada A, Puig S, Nagore E, Fernández-de-Misa R, Ferrándiz L, Conde-Taboada A, Castro E, Richarz NA, Paradela S, Llambrich Á, Salgüero I, Diago A, Samaniego E, Flórez Á, Segura S, Maldonado-Seral C, Coronel-Pérez IM, Tomás-Velázquez A, Rodríguez P, Mayor A, García-Doval I, Grau-Pérez M. Melanoma Registry of the Spanish Academy of Dermatology and Venereology (REGESMEL): Description and Data in its First Year of Operation. Actas Dermosifiliogr 2024:S0001-7310(24)00184-4. [PMID: 38452890 DOI: 10.1016/j.ad.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/24/2024] [Accepted: 02/25/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION The incidence of melanoma is rising in Spain. The prognostic stages of patients with melanoma are determined by various biological factors, such as tumor thickness, ulceration, or the presence of regional or distant metastases. The Spanish Academy of Dermatology and Venereology (AEDV) has encouraged the creation of a Spanish Melanoma Registry (REGESMEL) to evaluate other individual and health system-related factors that may impact the prognosis of patients with melanoma. The aim of this article is to introduce REGESMEL and provide basic descriptive data for its first year of operation. METHODS REGESMEL is a prospective, multicentre cohort of consecutive patients with invasive cutaneous melanoma that collects demographic and staging data as well as individual and healthcare-related baseline data. It also records the medical and surgical treatment received by patients. RESULTS A total of 450 cases of invasive cutaneous melanoma from 19 participant centres were included, with a predominance of thin melanomas≤1mm thick (54.7%), mainly located on the posterior trunk (35.2%). Selective sentinel lymph node biopsy was performed in 40.7% of cases. Most cases of melanoma were suspected by the patient (30.4%), or his/her dermatologist (29.6%). Patients received care mainly in public health centers (85.2%), with tele-dermatology resources being used in 21.6% of the cases. CONCLUSIONS The distribution of the pathological and demographic variables of melanoma cases is consistent with data from former studies. REGESMEL has already recruited patients from 15 Spanish provinces and given its potential representativeness, it renders the Registry as an important tool to address a wide range of research questions.
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Affiliation(s)
| | - A Boada
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, España
| | - S Puig
- Servicio de Dermatología, Hospital Clínic de Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, España; Centro de investigación biomédica en red de enfermedades raras, CIBERER, Barcelona, España
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - R Fernández-de-Misa
- Servicio de Dermatología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - L Ferrándiz
- Unidad de Melanoma, Servicio de Dermatología médico-quirúrgico, Hospital Universitario Virgen Macarena, Sevilla, España
| | - A Conde-Taboada
- Servicio de Dermatología, Hospital Clínico San Carlos, Madrid, España
| | - E Castro
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España
| | - N A Richarz
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, España
| | - S Paradela
- Servicio de Dermatología, Complexo Hospitalario A Coruña, A Coruña, España
| | - Á Llambrich
- Servicio de Dermatología, Hospital Universitario Son Llàtzer, Palma de Mallorca, España
| | - I Salgüero
- Servicio de Dermatología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - A Diago
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - E Samaniego
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, España
| | - Á Flórez
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Grupo de Investigación DIPO, Instituto de Investigación Sanitaria Galicia Sur, SERGAS-UVIGO, Pontevedra, España
| | - S Segura
- Servicio de Dermatología, Hospital del Mar de Barcelona, Barcelona, España
| | - C Maldonado-Seral
- Servicio de Dermatología, Hospital Universitario Central de Asturias, Oviedo, España
| | - I M Coronel-Pérez
- Servicio de Dermatología, Hospital Universitario Virgen de Valme de Sevilla, Sevilla, España
| | - A Tomás-Velázquez
- Servicio de Dermatología, Clínica Universidad de Navarra, Madrid, España
| | - P Rodríguez
- Servicio de Dermatología, Hospital Universitario La Princesa, Madrid, España; Servicio de Dermatología, Hospital Ruber Internacional, Madrid, España
| | - A Mayor
- Servicio de Dermatología, Hospital Universitario La Paz, Madrid, España
| | - I García-Doval
- Unidad de Investigación, Academia Española de Dermatología y Venereología, Madrid, España; Servicio de Dermatología, Complexo Hospitalario Universitario de Vigo, Vigo, España
| | - M Grau-Pérez
- Unidad de Investigación, Academia Española de Dermatología y Venereología, Madrid, España; Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
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Mitchell RJ, Wijekulasuriya S, Mayor A, Borges FK, Tonelli AC, Ahn J, Seymour H. Principles for management of hip fracture for older adults taking direct oral anticoagulants: an international consensus statement. Anaesthesia 2024. [PMID: 38319797 DOI: 10.1111/anae.16226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 02/08/2024]
Abstract
Hip fracture is a common serious injury among older adults, yet the management of hip fractures for patients taking direct oral anticoagulants remains inconsistent worldwide. Drawing from a synthesis of available evidence and expert opinion, best practice approaches for managing patients with a hip fracture and who are taking direct oral anticoagulants pre-operatively were considered by a working group of the Fragility Fracture Network Hip Fracture Audit Special Interest Group. The literature and related clinical guidelines were reviewed and a two-round modified Delphi study was conducted with a panel of experts from 16 countries and involved seven clinical specialities. Four consensus statements were achieved: peripheral nerve blocks can reasonably be performed on presentation for patients with hip fracture who are receiving direct oral anticoagulants; hip fracture surgery can reasonably be performed for patients taking direct oral anticoagulants < 36 h from last dose; general anaesthesia could reasonably be administered for patients with hip fracture and who are taking direct oral anticoagulants < 36 h from last dose (assuming eGFR > 60 ml.min-1 .1.73 m-2 ); and it is generally reasonable to consider recommencing direct oral anticoagulants (considering blood loss and haemoglobin) < 48 h after hip fracture surgery. No consensus was achieved regarding timing of spinal anaesthesia. The consensus statements were developed to aid clinicians in their decision-making and to reduce practice variations in the management of patients with hip fracture and who are taking direct oral anticoagulants. Each statement will need to be considered specific to each individual patient's treatment.
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Affiliation(s)
- R J Mitchell
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - S Wijekulasuriya
- Department of Anaesthesia, Huddersfield Royal Infirmary, Huddersfield, UK
| | - A Mayor
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - F K Borges
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - A C Tonelli
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Michigan, Ann Arbour, MI, USA
| | - J Ahn
- Department of Geriatric Medicine, Fiona Stanley Fremantle Hospitals Group, Perth, WA, Australia
| | - H Seymour
- Department of Geriatric Medicine, Fiona Stanley Fremantle Hospitals Group, Perth, WA, Australia
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Balerdi-Sarasola L, Parolo C, Fleitas P, Cruz A, Subirà C, Rodríguez-Valero N, Almuedo-Riera A, Letona L, Álvarez-Martínez MJ, Valls ME, Vera I, Mayor A, Muñoz J, Camprubí-Ferrer D. Host biomarkers for early identification of severe imported Plasmodium falciparum malaria. Travel Med Infect Dis 2023; 54:102608. [PMID: 37348666 DOI: 10.1016/j.tmaid.2023.102608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/30/2023] [Accepted: 06/13/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Severe imported P. falciparum malaria is a source of morbi-mortality in non-endemic regions. WHO criteria don't accurately classify patients at risk of complications. There is a need to evaluate new tools such as biomarkers to better identify patients with severe imported malaria. METHODS A case-control study was conducted in Barcelona, from January 2011-January 2021. Adult patients with microbiologically confirmed P. falciparum malaria were classified according to WHO criteria. Patients with imported non-malarial fevers were included as controls. In each group, angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), soluble triggering receptor expressed on myeloid cells (sTREM-1), C-reactive protein (CRP) and platelets were measured and their concentrations were compared between groups. New groups were made with a modified WHO severity classification and biomarkers' performance was evaluated using multiple imputation models. RESULTS 131 participants were included: 52 severe malaria, 30 uncomplicated malaria and 49 non-malarial fever cases. All biomarkers except sTREM-1 showed significant differences between groups. Using the modified WHO severity classification, Ang-2 and CRP presented the best AUROC; 0.79 (95%CI 0.64-0.94) and 0.80(95%CI 0.67-0.93). A model combining CRP and Ang-2 showed the best AUROC, of 0.84(95%CI 0.68-0.99), with the highest sensitivity and specificity: 84.6%(95%CI 58.9-98.1) and 77.4% (95%CI 65.9-87.7), respectively. CONCLUSIONS The combination of Ang-2 and CRP may be a reliable tool for the early identification of severe imported malaria. The use of a rapid prognostic test including the mentioned biomarkers could optimize imported malaria management, with the potential to decrease the rate of complications and hospitalizations in patients with imported malaria.
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Affiliation(s)
| | - C Parolo
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - P Fleitas
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - A Cruz
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - C Subirà
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | | | - A Almuedo-Riera
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - L Letona
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - M J Álvarez-Martínez
- Microbiology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - M Eugenia Valls
- Microbiology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - I Vera
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - A Mayor
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - J Muñoz
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain
| | - D Camprubí-Ferrer
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
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Tortajada C, Navarro A, Andreu-Ballester JC, Mayor A, Añón S, Flores J. Prevalence and duration of symptoms among moderate and severe COVID-19 patients 12 months after discharge. Intern Emerg Med 2022; 17:929-934. [PMID: 35023003 PMCID: PMC8754532 DOI: 10.1007/s11739-021-02895-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 11/15/2021] [Indexed: 11/28/2022]
Affiliation(s)
- C Tortajada
- Infectious Disease Unit, Internal Medicine Department, Hospital Arnau de Vilanova, San Clemente 12, 46015, Valencia, Spain.
| | - A Navarro
- Internal Medicine Department, Hospital Arnau de Vilanova, San Clemente 12, 46015, Valencia, Spain
| | - J C Andreu-Ballester
- Research Department, Hospital Arnau de Vilanova, San Clemente 12, 46015, Valencia, Spain
| | - A Mayor
- Internal Medicine Department, Hospital Arnau de Vilanova, San Clemente 12, 46015, Valencia, Spain
| | - S Añón
- Internal Medicine Department, Hospital Arnau de Vilanova, San Clemente 12, 46015, Valencia, Spain
| | - J Flores
- Infectious Disease Unit, Internal Medicine Department, Hospital Arnau de Vilanova, San Clemente 12, 46015, Valencia, Spain
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Affiliation(s)
- A Mayor
- Department of Anaesthesia, Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, Yorkshire, UK
| | - S M White
- Department of Anaesthesia, Brighton and Sussex University Hospitals NHS Trust, Brighton, Sussex, UK
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Actis O, Meer D, Mayor A, Weber D. PO-0949: Effective and efficient rescanning method for PBS proton therapy. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31259-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Černý V, Kulichová I, Poloni ES, Nunes JM, Pereira L, Mayor A, Sanchez-Mazas A. Genetic history of the African Sahelian populations. HLA 2018; 91:153-166. [DOI: 10.1111/tan.13189] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 12/03/2017] [Indexed: 12/13/2022]
Affiliation(s)
- V. Černý
- Department of Anthropology, Faculty of Natural Sciences; Comenius University, Ilkovicova 6; 842 15 Bratislava Slovakia
| | - I. Kulichová
- Department of Anthropology and Human Genetics, Faculty of Science; Charles University in Prague; Prague Czech Republic
| | - E. S. Poloni
- Laboratory of Anthropology, Genetics and Peopling History (AGP), Department of Genetics and Evolution, Anthropology Unit; University of Geneva; Geneva Switzerland
- Institute of Genetics and Genomics in Geneva (IGE3); Geneva Switzerland
| | - J. M. Nunes
- Laboratory of Anthropology, Genetics and Peopling History (AGP), Department of Genetics and Evolution, Anthropology Unit; University of Geneva; Geneva Switzerland
- Institute of Genetics and Genomics in Geneva (IGE3); Geneva Switzerland
| | - L. Pereira
- Instituto de Investigação e Inovação em Saúde; Universidade do Porto (i3S); Porto Portugal
- Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP); Porto Portugal
| | - A. Mayor
- Laboratory of African Archaeology and Peopling History (APA), Department of Genetics and Evolution, Anthropology Unit; University of Geneva; Geneva Switzerland
| | - A. Sanchez-Mazas
- Laboratory of Anthropology, Genetics and Peopling History (AGP), Department of Genetics and Evolution, Anthropology Unit; University of Geneva; Geneva Switzerland
- Institute of Genetics and Genomics in Geneva (IGE3); Geneva Switzerland
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Abstract
There are several general recommendations for quality assurance (QA) measures, which have to be performed at proton therapy centres. However, almost each centre uses a different therapy system. In particular, there is no standard procedure for centres employing pencil beam scanning and each centre applies a specific QA program. Gantry 2 is an operating therapy system which was developed at PSI and relies on the most advanced technological innovations. We developed a comprehensive daily QA program in order to verify the main beam characteristics to assure the functionality of the therapy delivery system and the patient safety system. The daily QA program entails new hardware and software solutions for a highly efficient clinical operation. In this paper, we describe a dosimetric phantom used for verifying the most critical beam parameters and the software architecture developed for a fully automated QA procedure. The connection between our QA software and the database allows us to store the data collected on a daily basis and use it for trend analysis over longer periods of time. All the data presented here have been collected during a time span of over two years, since the beginning of the Gantry 2 clinical operation in 2013. Our procedure operates in a stable way and delivers the expected beam quality. The daily QA program takes only 20 min. At the same time, the comprehensive approach allows us to avoid most of the weekly and monthly QA checks and increases the clinical beam availability.
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Affiliation(s)
- O Actis
- Centre for Proton Therapy, Paul Scherrer Institute, 5232 Villigen PSI, Switzerland
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Meier G, Leiser D, Besson R, Mayor A, Safai S, Weber DC, Lomax AJ. Contour scanning for penumbra improvement in pencil beam scanned proton therapy. Phys Med Biol 2017; 62:2398-2416. [PMID: 28151727 DOI: 10.1088/1361-6560/aa5dde] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Proton therapy, especially in the form of pencil beam scanning (PBS), allows for the delivery of highly conformal dose distributions for complex tumor geometries. However, due to scattering of protons inside the patient, lateral dose gradients cannot be arbitrarily steep, which is of importance in cases with organs at risk (OARs) in close proximity to, or overlapping with, planning target volumes (PTVs). In the PBS approach, physical pencil beams are planned using a regular grid orthogonal to the beam direction. In this work, we propose an alternative to this commonly used approach where pencil beams are placed on an irregular grid along concentric paths based on the target contour. Contour driven pencil beam placement is expected to improve dose confirmation by allowing the optimizer to best enhance the penumbra of irregularly shaped targets using edge enhancement. Its effectiveness has been shown to improve dose confirmation to the target volume and reduce doses to OARs in head-and-neck planning studies. Furthermore, the deliverability of such plans, as well as the dosimetric improvements over conventional grid-based plans, have been confirmed in first phantom based verifications.
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Affiliation(s)
- G Meier
- Centre for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland. ETH Zürich, Zürich, Switzerland
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Kuchmizhak A, Vitrik O, Kulchin Y, Storozhenko D, Mayor A, Mirochnik A, Makarov S, Milichko V, Kudryashov S, Zhakhovsky V, Inogamov N. Laser printing of resonant plasmonic nanovoids. Nanoscale 2016; 8:12352-61. [PMID: 27273005 DOI: 10.1039/c6nr01317a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Hollow reduced-symmetry resonant plasmonic nanostructures possess pronounced tunable optical resonances in the UV-vis-IR range, being a promising platform for advanced nanophotonic devices. However, the present fabrication approaches require several consecutive technological steps to produce such nanostructures, making their large-scale fabrication rather time-consuming and expensive. Here, we report on direct single-step fabrication of large-scale arrays of hollow parabolic- and cone-shaped nanovoids in silver and gold thin films, using single-pulse femtosecond nanoablation at high repetition rates. The lateral and vertical size of such nanovoids was found to be laser energy-tunable. Resonant light scattering from individual nanovoids was observed in the visible spectral range, using dark-field confocal microspectroscopy, with the size-dependent resonant peak positions. These colored geometric resonances in far-field scattering were related to excitation and interference of transverse surface plasmon modes in nanovoid shells. Plasmon-mediated electromagnetic field enhancement near the nanovoids was evaluated via finite-difference time-domain calculations for their model shapes simulated by three-dimensional molecular dynamics, and experimentally verified by means of photoluminescence microscopy and Raman spectroscopy.
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Affiliation(s)
- A Kuchmizhak
- School of Natural Sciences, Far Eastern Federal University, 8 Sukhanova str., Vladivostok 690041, Russia. and Institute of Automation and Control Processes, Far Eastern Branch, Russian Academy of Science, Vladivostok 690041, Russia
| | - O Vitrik
- School of Natural Sciences, Far Eastern Federal University, 8 Sukhanova str., Vladivostok 690041, Russia. and Institute of Automation and Control Processes, Far Eastern Branch, Russian Academy of Science, Vladivostok 690041, Russia
| | - Yu Kulchin
- Institute of Automation and Control Processes, Far Eastern Branch, Russian Academy of Science, Vladivostok 690041, Russia
| | - D Storozhenko
- Institute of Automation and Control Processes, Far Eastern Branch, Russian Academy of Science, Vladivostok 690041, Russia
| | - A Mayor
- Institute of Automation and Control Processes, Far Eastern Branch, Russian Academy of Science, Vladivostok 690041, Russia
| | - A Mirochnik
- Institute of Chemistry, Far Eastern Branch, Russian Academy of Science, Vladivostok, 690022, Russia
| | - S Makarov
- ITMO University, St Petersburg 197101, Russia
| | - V Milichko
- ITMO University, St Petersburg 197101, Russia
| | - S Kudryashov
- ITMO University, St Petersburg 197101, Russia and Lebedev Physical Institute, Russian Academy of Science, Moscow 119991, Russia
| | - V Zhakhovsky
- Dukhov Research Institute of Automatics (SC Rosatom), 127055 Moscow, Russian Federation
| | - N Inogamov
- Dukhov Research Institute of Automatics (SC Rosatom), 127055 Moscow, Russian Federation and Landau Institute for Theoretical Physics, Russian Academy of Sciences, Chernogolovka, Russian Federation
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Mayor A. Artefakte in der CT. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Heilmaier C, Mayor A, Zuber N, Fodor P, Weishaupt D. Improving Radiation Awareness and Feeling of Personal Security of Non-Radiological Medical Staff by Implementing a Traffic Light System in Computed Tomography. ROFO-FORTSCHR RONTG 2016; 188:280-7. [PMID: 26815282 DOI: 10.1055/s-0041-110450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Non-radiological medical professionals often need to remain in the scanning room during computed tomography (CT) examinations to supervise patients in critical condition. Independent of protective devices, their position significantly influences the radiation dose they receive. The purpose of this study was to assess if a traffic light system indicating areas of different radiation exposure improves non-radiological medical staff's radiation awareness and feeling of personal security. MATERIAL AND METHODS Phantom measurements were performed to define areas of different dose rates and colored stickers were applied on the floor according to a traffic light system: green = lowest, orange = intermediate, and red = highest possible radiation exposure. Non-radiological medical professionals with different years of working experience evaluated the system using a structured questionnaire. Kruskal-Wallis and Spearman's correlation test were applied for statistical analysis. RESULTS Fifty-six subjects (30 physicians, 26 nursing staff) took part in this prospective study. Overall rating of the system was very good, and almost all professionals tried to stand in the green stickers during the scan. The system significantly increased radiation awareness and feeling of personal protection particularly in staff with ≤ 5 years of working experience (p < 0.05). The majority of non-radiological medical professionals stated that staying in the green stickers and patient care would be compatible. Knowledge of radiation protection was poor in all groups, especially among entry-level employees (p < 0.05). CONCLUSION A traffic light system in the CT scanning room indicating areas with lowest, intermediate, and highest possible radiation exposure is much appreciated. It increases radiation awareness, improves the sense of personal radiation protection, and may support endeavors to lower occupational radiation exposure, although the best radiation protection always is to re-main outside the CT room during the scan. KEY POINTS • A traffic light system indicating areas with different radiation exposure within the computed tomography scanner room is much appreciated by non-radiological medical staff. • The traffic light system increases non-radiological medical staff's radiation awareness and feeling of personal protection. • Knowledge on radiation protection was poor in non-radiological medical staff, especially in those with few working experience.
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Affiliation(s)
- C Heilmaier
- Department of Radiology and Nuclear Medicine, Stadtspital Triemli, Zurich, Switzerland
| | - A Mayor
- Department of Radiology and Nuclear Medicine, Stadtspital Triemli, Zurich, Switzerland
| | - N Zuber
- Department of Radiology and Nuclear Medicine, Stadtspital Triemli, Zurich, Switzerland
| | - P Fodor
- Department of Anesthesiology and Intensive Care Medicine, Stadtspital Triemli, Zurich, Switzerland
| | - D Weishaupt
- Department of Radiology and Nuclear Medicine, Stadtspital Triemli, Zurich, Switzerland
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Perrin R, Peroni M, Bernatowicz K, Schaetti A, Knopf A, Zakova M, Oxley D, Mayor A, Safai S, Parkel T, Weber D, Lomax T. OC-0484: Rescanning measurements in a 4D anthropomorphic phantom for evaluation of motion-mitigated, PBS proton therapy. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40480-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Castillo P, Menéndez C, Mayor A, Carrilho C, Ismail M, Lorenzoni C, Machungo F, Osman N, Quintó L, Romagosa C, Dobaño C, Alonso P, Ordi J. Massive Plasmodium falciparum visceral sequestration: a cause of maternal death in Africa. Clin Microbiol Infect 2013; 19:1035-41. [DOI: 10.1111/1469-0691.12068] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 10/04/2012] [Accepted: 10/04/2012] [Indexed: 11/30/2022]
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Menendez C, Serra-Casas E, Scahill MD, Sanz S, Nhabomba A, Bardaji A, Sigauque B, Cistero P, Mandomando I, Dobano C, Alonso PL, Mayor A. HIV and Placental Infection Modulate the Appearance of Drug-Resistant Plasmodium falciparum in Pregnant Women who Receive Intermittent Preventive Treatment. Clin Infect Dis 2011; 52:41-8. [DOI: 10.1093/cid/ciq049] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Pétrilli V, Papin S, Dostert C, Mayor A, Martinon F, Tschopp J. Activation of the NALP3 inflammasome is triggered by low intracellular potassium concentration. Cell Death Differ 2007; 14:1583-9. [PMID: 17599094 DOI: 10.1038/sj.cdd.4402195] [Citation(s) in RCA: 1082] [Impact Index Per Article: 63.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Inflammasomes are Nod-like receptor(NLR)- and caspase-1-containing cytoplasmic multiprotein complexes, which upon their assembly, process and activate the proinflammatory cytokines interleukin (IL)-1beta and IL-18. The inflammasomes harboring the NLR members NALP1, NALP3 and IPAF have been best characterized. While the IPAF inflammasome is activated by bacterial flagellin, activation of the NALP3 inflammasome is triggered not only by several microbial components, but also by a plethora of danger-associated host molecules such as uric acid. How NALP3 senses these chemically unrelated activators is not known. Here, we provide evidence that activation of NALP3, but not of the IPAF inflammasome, is blocked by inhibiting K(+) efflux from cells. Low intracellular K(+) is also a requirement for NALP1 inflammasome activation by lethal toxin of Bacillus anthracis. In vitro, NALP inflammasome assembly and caspase-1 recruitment occurs spontaneously at K(+) concentrations below 90 mM, but is prevented at higher concentrations. Thus, low intracellular K(+) may be the least common trigger of NALP-inflammasome activation.
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Affiliation(s)
- V Pétrilli
- Department of Biochemistry, University of Lausanne, Chemin des Boveresses 155, Center of Immunology Lausanne, Epalinges 1066, Switzerland
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17
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Jelinek T, Aida AO, Peyerl-Hoffmann G, Jordan S, Mayor A, Heuschkel C, el Valy AO, von Sonnenburg F, Christophel EM. Diagnostic value of molecular markers in chloroquine-resistant falciparum malaria in Southern Mauritania. Am J Trop Med Hyg 2002; 67:449-53. [PMID: 12479542 DOI: 10.4269/ajtmh.2002.67.449] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Despite its diminishing efficacy because of increased resistance, chloroquine remains the primary antimalarial agent in many endemic areas. Evidence is mounting that point mutations on the Pfcrt and possibly the Pfmdr1 genes are conferring plasmodial resistance to chloroquine. In 1998, atypically strong rainfalls led to an increased activity of falciparum malaria in Mauritania that affected non-endemic regions bordering the Saharan desert. An in vivo study on chloroqine resistance was combined with studies for molecular markers of drug resistance. Detection of Pfmdr1-76-tyrosine showed an increased odds ratio (2.91) for resistance (P = 0.0195). However, by use of this codon alone, sensitivity for detection of resistance was 60.6%, and specificity was 65.3%. In comparison, detection of the K76T mutation at Pfcrt showed a very high sensitivity (100%) while specificity remained relatively low (65.4%). For the combination of mutations on both genes, the odds ratio for detection of resistance increased to 5.31 (P = 0.0005). Here, sensitivity was again decreased to 60.6% while specificity increased to 76.9%. The results of this study suggest that detection of Pfcrt T76 can be applied for predicting chloroquine resistance in epidemiologic settings with sufficiently high sensitivity to make it an attractive alternative to time- and labor-consuming in vivo trials. Additional testing for Pfmdr Y76 provides increased specificity to this approach.
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Affiliation(s)
- T Jelinek
- Department of Infectious Diseases and Tropical Medicine, University of Munich, Munich, Germany.
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18
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Mayor A. SRP Meeting: Visit to Hack Green Secret Nuclear Bunker. 20 June 2001. J Radiol Prot 2001; 21:413. [PMID: 11787900 DOI: 10.1088/0952-4746/21/4/612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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19
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Abstract
BACKGROUND Adenotonsillectomy is commonly needed by children with obstructive sleep apnoea syndrome. This population is at high risk of life threatening airway obstruction in the postoperative period. METHODS Fifty children were studied to test the efficacy of an alternative analgesic to the use of opioids in providing analgesia in the immediate postoperative period. Patients were randomized to receive either 0.1 mg.kg-1 morphine or 0.5 mg.kg-1 ketamine at induction. RESULTS Ketamine was as effective as morphine with no additional side-effects. CONCLUSIONS Ketamine is a safe and effective alternative to morphine to provide analgesia in the immediate postoperative period after tonsillectomy.
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Affiliation(s)
- R L Aspinall
- Anaesthetic Department, Royal United Hospital, Bath, UK
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20
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Lambert AW, Mayor A. Analgesic requirements for appendicectomy: the differences between adults and children. Ann R Coll Surg Engl 2000; 82:111-2. [PMID: 10743430 PMCID: PMC2503543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
AIM The analgesia provided for children is often less than for adults with the same underlying pathology. This paper attempts to quantify the postoperative analgesic requirements of patients undergoing appendicectomy. METHODS Patients between 6 and 30 years of age who underwent an unscheduled appendicectomy were prospectively recruited. Regular non-opiate analgesia, calculated according to weight, was administered. Hourly visual analogue pain scores and morphine patient controlled analgesia (mPCA) usage were recorded for 24 h following surgery. RESULTS 19 children (6-16 years) and 23 adults (17-30 years) were recruited. There was no significant difference in the pain scores following appendicectomy between the two groups. Significantly more mPCA was demanded (t = 2.02, P < 0.02) and morphine received (t = 2.02, P < 0.005) by adults than children following appendicectomy. CONCLUSION Children appear to require and do demand less analgesia than adults following appendicectomy to maintain similar postoperative pain scores. Acceptable pain scores may be achieved by the administration of regular analgesia to these patients.
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Affiliation(s)
- A W Lambert
- Department of Surgery, Royal United Hospital, Bath, UK
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21
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Mayor A. [Kenya: scientific savanna]. Microbiologia 1996; 12:651-8. [PMID: 9101662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- A Mayor
- ICIPE Science Press, Nairobi, Kenia
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22
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Abstract
Current evidence suggests that elevations in blood pressure during obstructive apnoeic episodes increase pharyngeal collapsibility and the severity of obstructive sleep apnoea.
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Affiliation(s)
- AR Schwartz
- Johns Hopkins Sleep Disorders Center, Pulmonary & Critical Care Division, Department of Medicine, and Department of Anesthesiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
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23
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Taberner JL, Bruguera M, Rodriguez MC, Mayor A, Batalla J. Seroepidemiological survey of hepatitis B infection in a cohort of military recruits in Barcelona, Spain. Eur J Epidemiol 1992; 8:117-9. [PMID: 1572419 DOI: 10.1007/bf03334984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The prevalence of HBsAg and anti-HBs in a representative sample of 839 recruits from a cohort of 17-18 year-old males living in Barcelona has been determined by radioimmunoassay of eluates of finger-prick dried blood. It was 0.48% for HBsAg, and 3.22% for anti-HBs. All carriers of HBsAg were anti-HBe positive and had normal liver function tests. Half of them had antecedents suggestive of a materno-fetal acquisition of the infection. A relationship between educational level and the risk of infection was also demonstrated.
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Affiliation(s)
- J L Taberner
- Instituto Municipal de Higiene, Barcelona, Spain
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24
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Torres JM, Bruguera M, Fos E, Mayor A, Hierro FR. [Immunogenicity and long-term effectiveness of the hepatitis B vaccine in newborns from HBsAg-positive mothers]. Med Clin (Barc) 1990; 95:247-9. [PMID: 2149403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We have followed up until age 2 years 25 infants who had received the hepatitis B vaccine to prevent being infected from their mothers who were HBsAg carriers. All had developed antibodies. At 2 years of age, 24% of infants had antiHBsAg titers lower than 10 mU/ml. The geometric mean of antiHBsAg titer in those infants who had received plasma derived vaccine was 660 mU/ml and in those having received recombinant vaccine was 903 mU/ml. HBsAg was negative in all the studied samples. In two infants positive antiHBc were detected.
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Affiliation(s)
- J M Torres
- Servicio de Pediatría, Hospital Clínic i Provincial, Barcelona
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25
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García O, Bruguera M, Mayor A, Sánchez-Tapias JM, Vall O, Rodés J. [Hepatitis B at an open institution for the mentally retarded. Immunogenic effect of a recombinant anti-hepatitis-B vaccine]. Enferm Infecc Microbiol Clin 1990; 8:148-52. [PMID: 2151250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The diffusion of hepatitis B virus was investigated in an open institution for mentally retarded patients, where 24 patients with Down's syndrome (DS) and 94 with other types of mental retardation (OMR) were being cared for. The immunogenic response to a recombinant vaccine intramuscularly injected to the deltoid muscle at a dosage of 20 mcg in the months 0, 1 and 6 was also evaluated. Seropositivity for some hepatitis B serum marker was found in 19.4% of patients (12.5% of those with DS and 21.2% of those with OMR). HBsAg was found in 8.3% of patients with DS and in 4.2% of those with OMR. The seroconversion to antiHBs induced by the vaccine 8 months after the first dose was found in 72.3% of DS and in 100% of OMR. The poor immunogenic response in DS was attributed to age, as in patients younger than 20 years it was 91.6% while in those over that age it was only 33.3%. It was concluded that in open institutions for mentally retarded patients there is a risk of hepatitis B infection, also shown in closed institutions, and that recombinant hepatitis B vaccine is highly immunogenic in this population, although it has been found that in patients with DS the age has a very marked negative influence on the response to the vaccine.
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Affiliation(s)
- O García
- Servicio de Pediatría, Hospital Sant Jaume i Santa Magdalena, Mataró, Barcelona
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26
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Bayas JM, Bruguera M, Martín V, Mayor A, de la Fuente ML, Laliga A, Salleras L. [Hepatitis B and hepatitis delta in young inmates]. Med Clin (Barc) 1990; 94:164-8. [PMID: 2325476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The prevalence of infection by hepatitis B (HBV) and delta (HDV) viruses and presumably related variables were evaluated in a prison for young male convicts, aged 16-21 years (n = 686), 55.1% of convicts were positive for one or more VHB markers, and 7.1% were positive for HBsAg; 89.7% of these were negative for IgM anti-HBc (chronic carriers), while 36.6% were positive for HBeAg. Anti-delta antibodies were detected in 37.5% of chronic carriers. The seropositivity of HVB markers was much higher in parenteral drug abusers (PDA) as compared with non PDA (76.3% vs 26.7%, p less than 0.0000001, OR = 8.82). Among PDA, it was higher in regular users than in occasional ones (83.3% vs 62.9%, p = 0.0001, OR = 2.95) and in those who had acquired the habit at an early age (p = 0.035). The stratified analysis also showed an association of VHB infection with other variables, basically ethical and prison-related. The possibility to develop active immunization programs is evaluated.
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Affiliation(s)
- J M Bayas
- Servicios de Medicina Preventiva y de Hepatología, Hospital Clínic i Provincial, Barcelona
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27
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Cremades M, Bas J, Mayor A, Laguna P, Sanjosé L, Bruguera M. [Recombinant hepatitis B vaccine in health personnel. Immunogenicity of a rapid vaccination schedule]. Med Clin (Barc) 1989; 93:684-6. [PMID: 2532693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The immunogenic effect of a recombinant hepatitis B vaccine, administered in a dosage of 20 micrograms intramuscularly in the deltoid muscle on the months 0, 1 and 2, was evaluated in 185 employers of a general hospital. The influence of sex, age, overweight and smoking habit on the antibody response induced by the vaccine was also assessed. The seroconversion rate 40-60 days after the third dose in the 160 health professionals who completed the vaccination schedule was 88% (83% in males and 90% in females). It was 97% in individuals less than 30 years of age, 89% in those between 30 and 50 years, and 69% in those over 50 years. It was 97% in non obese and 66% in obese individuals (p less than 0.0001). No differences in seroconversion rate were found between nonsmokers, moderate smokers and heavy smokers. Untoward reactions were minimal. The rate of vaccinated individuals developing anti-HBs titers higher than 10 mIU/ml was 68%. This rate was lower than that found in most studies after vaccination in the months 0, 1 and 6, the difference being probably due to the use of a rapid schedule with a short interval between the second and third doses. Nevertheless, this schedule facilitates the vaccination programs in health staff and reduces the failure rate due to poor compliance.
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28
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Gascon J, Bruguera M, Corachan M, Mayor A, Sanchez Tapias JM, Rodes J. Serological survey of hepatitis B in northern Rwanda. Trop Geogr Med 1988; 40:293-7. [PMID: 3265811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
To assess the importance of perinatal transmission of hepatitis B virus and the risk of infection in different age groups in Northern Rwanda, filter paper dried blood samples from 350 subjects were examined for HBsAg and anti HBs. The study shows that vertical transmission is not very frequent in this area, and that the risk of infection increases with age. These results indicate that vaccination against hepatitis B in children could be delayed and included in the standard immunization programme.
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29
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Mayor A. [Life cycle and existential crises]. Rev Med Suisse Romande 1988; 108:327-39. [PMID: 3387769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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30
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Peiró A, Junqué C, Vendrell P, Mayor A, Grau-Veciana JM. Reaction time and catecholamine in Parkinson's disease. Arch Neurol 1988; 45:15. [PMID: 3337668 DOI: 10.1001/archneur.1988.00520250017007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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31
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Abstract
Recombinant alpha 2c-interferon was administered to 12 consecutive patients with fulminant viral hepatitis. The disease was caused by coinfection by HBV and HDV in seven patients, by HDV superinfection of a chronic HBV carrier in two, by HBV alone in two and by HAV in one. Eight patients were drug addicts. Interferon administration was initiated shortly after the onset of hepatic encephalopathy and no patient was in grade IV coma at the beginning of therapy. Ten patients died and only two survived. One of the survivors was an asymptomatic HBV carrier superinfected by HDV in whom treatment with interferon for 3 months did not prevent the development of chronic delta infection and liver cirrhosis. These results show that alpha 2c-interferon does not have significant therapeutic value in fulminant viral hepatitis, particularly if it is caused by HDV.
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Affiliation(s)
- J M Sánchez-Tapias
- Liver Unit, Hospital Clínic i Provincial, University of Barcelona, Spain
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32
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Mayor A. [Involutional melancholia (author's transl)]. Ther Umsch 1978; 35:22-8. [PMID: 625724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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