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Singer D, Thompson-Leduc P, Poston S, Gupta D, Cheng WY, Ma S, Devine F, Enrique A, Duh MS, Curtis JR. Clinical and Economic Burden of Herpes Zoster in Patients with Rheumatoid Arthritis: A Retrospective Cohort Study Using Administrative Claims. Rheumatol Ther 2023; 10:933-950. [PMID: 37219822 PMCID: PMC10326220 DOI: 10.1007/s40744-023-00549-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/06/2023] [Indexed: 05/24/2023] Open
Abstract
OBJECTIVE To estimate the incremental healthcare resource utilization (HRU) and cost burden posed by herpes zoster (HZ) in adult patients with rheumatoid arthritis (RA) in the United States. METHODS A retrospective cohort study was conducted using an administrative claims database containing commercial and Medicare Advantage with Part D data, between October 2015 and February 2020. Patients with RA and HZ (RA+/HZ+) or RA without HZ (RA+/HZ-) were identified based on diagnosis codes and relevant medications. Outcomes measured included HRU and medical, pharmacy, and total costs at month 1, quarter 1, and year 1 after the index date (HZ diagnosis for RA+/HZ+ cohort, randomly assigned for RA+/HZ- cohort). Generalized linear models incorporating propensity scores and other covariates were used to estimate differences in outcomes between cohorts. RESULTS A total of 1866 patients from the RA+/HZ+ cohort and 38,846 patients from the RA+/HZ- cohort were included. Hospitalizations and emergency department visits occurred more frequently in the RA+/HZ+ than the RA+/HZ- cohort, especially in the month after HZ diagnosis (adjusted incidence rate ratio [95% confidence interval (CI)] for hospitalizations: 3.4 [2.8; 4.2]; emergency department visits: 3.7 [3.0; 4.4]). Total costs were also higher in the month after HZ diagnosis (mean adjusted cost difference [95% CI]: $3404 [$2089; $4779]), with cost differences driven by increased medical costs ($2677 [$1692; $3670]). CONCLUSIONS These findings highlight the high economic burden of HZ among individuals with RA in the United States. Strategies to reduce the risk of HZ in patients with RA (such as vaccination) may serve to reduce this burden. Video abstract.
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Enrique A, Mooney O, Salamanca-Sanabria A, Lee C, Farrell S, Richards D. Assessing the efficacy and acceptability of an internet-delivered intervention for resilience among college students: A pilot randomised control trial protocol. Internet Interv 2019; 17:100254. [PMID: 31304095 PMCID: PMC6603299 DOI: 10.1016/j.invent.2019.100254] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/11/2019] [Accepted: 06/11/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Exposure to new stressors places college students at increased risk for developing mental health problems. Preventive interventions aimed at enhancing resilience have the potential to improve mental health and well-being in college students and internet-delivery may improve access to these interventions. However, few studies have evaluated the efficacy of online interventions for resilience in college students. The present study seeks to assess the feasibility [initial efficacy and acceptability] of a newly developed internet-delivered intervention for resilience provided with human or automated support, in a sample of college students. METHOD A pilot randomised controlled trial including three groups: 1) an intervention group with human support; 2) an intervention group with automated support; and 3) a waiting list control group. The intervention, Space for Resilience, is based on positive psychology and consists of seven modules, delivered over a period of eight weeks. Primary outcomes measures will include the Connor-Davidson Resilience Scale (CD-RISC) and the Pemberton Happiness Index (PHI). Secondary outcomes measures will include the Brief Resilience Scale (BRS), the Patient Health Questionnaire - 4 items (PHQ-4), the Rosenberg Self-Esteem Scale (RSES), and the Perceived Stress Scale - 4 items (PSS-4). Acceptability will be examined using the Satisfaction with Treatment (SAT) questionnaire. Analysis will be conducted on an intention-to-treat basis. DISCUSSION The study seeks to establish the initial efficacy and acceptability of an internet-delivered intervention for resilience with human support and automated support. Apart from determining the impact of the intervention on acceptability and effectiveness, this study will be a first to explore more clearly the relative benefits of different support modes.
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Affiliation(s)
- A. Enrique
- E-Mental Research group, School of Psychology, Trinity College Dublin, Ireland,Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
| | - O. Mooney
- E-Mental Research group, School of Psychology, Trinity College Dublin, Ireland
| | - A. Salamanca-Sanabria
- E-Mental Research group, School of Psychology, Trinity College Dublin, Ireland,Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
| | - C.T. Lee
- Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
| | - S. Farrell
- Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
| | - D. Richards
- E-Mental Research group, School of Psychology, Trinity College Dublin, Ireland,Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland,Corresponding author at: E-Mental Research group, School of Psychology, Trinity College Dublin, Ireland.
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Alvarez-Berdugo D, Rofes L, Casamitjana JF, Enrique A, Chamizo J, Viña C, Pollán CM, Clavé P. TRPM8, ASIC1, and ASIC3 localization and expression in the human oropharynx. Neurogastroenterol Motil 2018; 30:e13398. [PMID: 29971861 DOI: 10.1111/nmo.13398] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 05/24/2018] [Indexed: 12/06/2022]
Abstract
BACKGROUND Oropharyngeal dysphagia (OD) is a prevalent disease with poor prognosis among older people and has no pharmacological treatment. Polymodal sensory receptors like the TRP or ASIC family receptors are potential targets to treat OD. TRPM8 agonists and acidic solutions can improve the swallow response in patients with OD, but little is known about the expression of TRPM8, ASIC1, and ASIC3 in the human oropharynx. The aim of this study was to assess the expression and localization of TRPM8, ASIC1, and ASIC3 in human samples of the oropharynx to lay the basis for new pharmacological treatments for OD. METHODS Pathology-free samples from oropharyngeal regions innervated by cranial nerves V, IX, and X were obtained during major ENT surgery and processed to obtain mRNA (20 patients) or to be used in immunohistochemical assays (12 patients). TRPM8, ASIC1, and ASIC3 expression and localization were studied with RT-qPCR and fluorescent immunohistochemistry. KEY RESULTS ASIC3 was expressed in the 3 regions studied with similar levels and was localized on sensory fibers innervating the mucosa below the basal lamina of all studied regions. TRPM8 was also co-localized on the sensory fibers innervating the mucosa below the basal lamina of all studied regions. In contrast, ASIC1 was only found in the nerves innervating the tongue muscular fibers. CONCLUSIONS & INFERENCES TRPM8 and ASIC3 are found on submucosal sensory nerves in the human oropharynx. Our study lays the basis to use oropharyngeal TRPM8 and ASIC3 receptors as therapeutic targets to develop new active pharmacological treatments for OD patients.
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Affiliation(s)
- D Alvarez-Berdugo
- Gastrointestinal Motility Laboratory, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Barcelona, Spain
| | - L Rofes
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Barcelona, Spain
| | - J F Casamitjana
- ENT Department, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - A Enrique
- ENT Department, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - J Chamizo
- ENT Department, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - C Viña
- ENT Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - C M Pollán
- ENT Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - P Clavé
- Gastrointestinal Motility Laboratory, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Barcelona, Spain.,Fundació Institut de Investigació Germans Trias i Pujol, Badalona, Spain
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Alvarez-Berdugo D, Rofes L, Farré R, Casamitjana JF, Enrique A, Chamizo J, Padrón A, Navarro X, Clavé P. Localization and expression of TRPV1 and TRPA1 in the human oropharynx and larynx. Neurogastroenterol Motil 2016; 28:91-100. [PMID: 26530852 DOI: 10.1111/nmo.12701] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 09/08/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Previous studies have found that TRPV1 and TRPA1 receptor agonists improve swallow response in patients with oropharyngeal dysphagia (OD), but little is known about the expression of these receptors in the human oropharynx. The aim of this study was to assess the expression and localization of TRPV1 and TRPA1 in human samples from the oropharynx of healthy patients, to provide the basis for new pharmacological treatments for OD. METHODS Samples from oropharyngeal regions innervated by cranial nerves V, IX, and X (tongue, pharynx, and epiglottis) were obtained during ENT surgery and processed either for mRNA (21 patients) or for immunohistochemical assays (seven patients). The expression analysis was performed with RT-qPCR using ACTBh as reference gene. Hemotoxylin and eosin staining was used to study the histology; the immunohistochemical assay used (i) neuron-specific enolase to detect nerve fibers or (ii) fluorescent probes to locate TRPV1 and TRPA1. RESULTS TRPV1 was expressed in the three studied regions, with higher levels in CN V region (tongue) than in CN X region (epiglottis; p < 0.05), and was localized at epithelial cells and nociceptive fibers in all studied regions. TRPA1 was also expressed in all studied regions, but was always localized below the basal lamina. No immunoreactivity for TRPA1 was found on epithelial cells. CONCLUSIONS & INFERENCES TRPV1 and TRPA1 are widely expressed in the human oropharynx with two distinct patterns. Our study further confirms that TRPV1/A1 receptors are promising therapeutic targets to develop active treatments for OD patients.
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Affiliation(s)
- D Alvarez-Berdugo
- Gastrointestinal Motility Laboratory, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - L Rofes
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Barcelona, Spain
| | - R Farré
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Barcelona, Spain.,Translational Research Center for Gastrointestinal Disorders, KU Leuven - University of Leuven, Leuven, Belgium
| | - J F Casamitjana
- ENT Department, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - A Enrique
- ENT Department, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - J Chamizo
- ENT Department, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - A Padrón
- Department of Pathology, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - X Navarro
- Department of Cell Biology, Physiology and Immunology, Institute of Neurosciences, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Bellaterra, Spain
| | - P Clavé
- Gastrointestinal Motility Laboratory, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Barcelona, Spain.,Fundació Institut de Investigació Germans Trias i Pujol, Badalona, Spain
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Lindner A, Signorini R, Brero L, Arn E, Mancini R, Enrique A. Effect of Conditioning Horses One, Two or Three Times a Week with 2 Runs of 100 Meters at Near Maximal Speed on v4. J Equine Vet Sci 2011. [DOI: 10.1016/j.jevs.2011.03.035] [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: 11/15/2022]
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Abstract
REASONS FOR PERFORMING STUDY There is limited published work on the effect of training using intensive and short intervals of exercise to condition horses for racing. OBJECTIVES To examine the effect of conditioning horses 1, 2 or 3 x a week using 2 short fast exercise intervals on blood lactate (LA), plasma ammonia (NH3) and urea (urea) as well as creatine kinase (CK) activity. METHODS Thoroughbreds (age 4-5 years) were conditioned at near maximal speed (12-14 m/sec) over 100 m, on 2 occasions separated by a 10 min period at walk, on dirt track (conditioning exercise; CE) during a 6 week conditioning period (CP). The CE was undertaken either once (5 horses), twice (5 horses) or 3 times a week (4 horses) during a CP. Before, every 2 weeks during and after the CP, blood was drawn during the CE at 0, 2 and 4 min after each run and additionally 6 min after the 2nd run to measure blood LA and determine the maximal LA post exercise (LAmax). Plasma NH3 was measured in the same samples and the maximal NH3 post exercise (NH3max) determined. Additional blood samples were taken from the horses when stabled before the CE, and 12 and 24 h after to measure urea and CK activity in plasma. RESULTS There was no differential effect of the number of weekly CE on LAmax, NH3max, LA and NH3 immediately after exercise (LAO and NH3O). Conditioning did not have an effect on LAmax and LA0 after the 1st interval (P>0.05), but LA0 after the 2nd interval was lower after conditioning. NH3max after the 1st and 2nd exercise interval decreased in response to the conditioning, but not NH3 immediately after exercise (P>0.05). Median plasma CK activity 12 h after exercise was higher than before exercise and returned to preexercise levels 24 h post exercise when horses were exercised once and twice/week. In contrast, the median plasma CK activity of horses exercising 3 times/week remained at the pre-exercise level 12 and 24 h post exercise (P>0.05). CONCLUSION Conditioning horses with 2 intervals of 100 m at near maximal speed had a positive effect on blood LA and plasma NH3. POTENTIAL RELEVANCE With the type of exercise examined, the fitness of racing horses can be maintained and eventually improved. In further studies the effect of increasing the number of runs in one exercise session should be investigated.
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Affiliation(s)
- A Lindner
- Arbeitsgruppe Pferd, Jülich, Germany
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Abstract
Surgical wound infection is one of the most frequent complications in pharyngo-laryngeal external surgery. They are usually polimicro with gram-positive, negative both aerobial and anaerobial microrganisms. The trachea is usually sterile and contamination is due to the intoduction during intubation of germs from the oropharyngeal area. A retrospective study was performed including 40 patients with pharyngo-laryngeal carcinoma. When the tracheostomy was done a culture from the internal trachea wall was obtained for micro study. Only one patient had an sterile culture from the trachea. There were 3 patients with just one microorganism and all the rest had at least two, being mixed aerobial and anaerobial flora the most frequent.
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Affiliation(s)
- A Enrique
- Servicio ORL y Microbiología, Hospital Universitario Vall d'Hebron, Barcelona
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Abstract
Lymphomas of the head and neck arise in lymph nodes and extranodal areas as Waldeyer ring, nasal cavity, thyroid gland and salivary glands. Though anatomically in close proximity, lymphomas presenting at the ENT area have different clinical characteristics if they are Hodgkin or Non-Hodgkin. We included 31 patients with the diagnosis of lymphoma and diagnosed in our Department between 1999 and 2002. We studied all the different variables that differentiate Hodgkin and Non-Hodgkin's lymphoma. Both types of lymphoma usually present as a cervical mass. Non-Hodgkin lymphoma have extranodal involvement more frequently and also a more advance disease at diagnosis. It is important to include the lymphoma in the differential diagnosis of any cervical mass or ENT lesion.
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Affiliation(s)
- A Enrique
- Servicio de ORL, Hospital Vall D'Hebron, Barcelona.
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Esteller E, Modolell I, Segarra F, Matiño E, Enrique A, Ademà JM, Estivill E. Reflujo gastroesofágico proximal y síndrome de la apnea obstructiva del sueño. Acta Otorrinolaringológica Española 2005; 56:411-5. [PMID: 16353787 DOI: 10.1016/s0001-6519(05)78639-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 10/27/2022]
Abstract
INTRODUCTION Patients with mild or moderate Sleep Apnea Syndrome (SAS) need wider therapeutic scope options according to their disease severity. AIM To consider including proton pump inhibitors (PPI) to the therapeutical alternatives of these patients. MATERIAL AND METHODS A prospective study was designed, among patients with SAS. Nocturnal polysomnography and double channel pHmetry were performed simultaneously. RESULTS From the 18 patients included in this preliminary phase, in three (16.7%) nocturnal proximal ph monitoring was positive. These 3 patients were treated with PPI during at least 3 months with a very satisfactory outcome in two of them. CONCLUSIONS Treatment with PPI may be a useful therapeutical alternative in patients with mild to moderate SAS.
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Affiliation(s)
- E Esteller
- Servicio de Otorrinolaringología, Hospital General de Catalunya, San Cugat del Vallès, Barcelona.
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Valencia Ortega ME, Guinea J, Enrique A, Ortega G, Moreno V, González Lahoz J. Study of 42 cases of infective endocarditis in the HAART era in Spain. Clin Microbiol Infect 2004; 9:1073-5. [PMID: 14616757 DOI: 10.1046/j.1469-0691.2003.00720.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Affiliation(s)
- J L Quesada
- Servicio ORL, Hospital General University Vall d'Hebrón, Barcelona, Spain
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