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Serrano-Coll H, Arrieta A, Miranda J, López A, Mattar AS, Arrieta G, Mattar S. Case Report: A Case of Sepsis due to Shewanella algae Infection in the Colombian Caribbean. Am J Trop Med Hyg 2023:tpmd220786. [PMID: 37160277 DOI: 10.4269/ajtmh.22-0786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/18/2023] [Indexed: 05/11/2023] Open
Abstract
Shewanella algae is an opportunistic Gram-negative bacillus that inhabits marine ecosystems and can cause sepsis in humans. This case report describes an 80-year-old obese woman with liver cirrhosis who presented with neurological and respiratory impairment. Shewanella algae were isolated in the blood cultures. Due to age and comorbidities, sepsis could be the cause of the patient's fatal outcome. Shewanella algae infection is a risk for immunocompromised people in the tropics.
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Affiliation(s)
- Héctor Serrano-Coll
- Instituto Colombiano de Medicina Tropical, Universidad CES, Medellín, Colombia
| | - Andres Arrieta
- Facultad de Medicina, Universidad del Norte, Barranquilla, Colombia
| | - Jorge Miranda
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Montería, Colombia
| | | | | | - Germán Arrieta
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Montería, Colombia
- Clínica Salud Social, Sincelejo, Colombia
| | - Salim Mattar
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Montería, Colombia
- Clínica Salud Social, Sincelejo, Colombia
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Arrieta A, Blanco de Tord M, Boada A. RF - Neoadjuvant Therapy in Melanoma. Actas Dermosifiliogr 2023; 114:253-254. [PMID: 36075404 DOI: 10.1016/j.ad.2021.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 05/30/2021] [Indexed: 10/14/2022] Open
Affiliation(s)
- A Arrieta
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Barcelona, España; Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, España.
| | - M Blanco de Tord
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Barcelona, España; Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, España
| | - A Boada
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Barcelona, España; Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España
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3
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Arrieta A, Blanco de Tord M, Boada A. [Translated article] RF - Neoadjuvant Therapy in Melanoma. Actas Dermo-Sifiliográficas 2023; 114:T253-T254. [PMID: 36717074 DOI: 10.1016/j.ad.2021.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 05/30/2021] [Indexed: 01/29/2023] Open
Affiliation(s)
- A Arrieta
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain; Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, Spain.
| | - M Blanco de Tord
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain; Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - A Boada
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain; Institut d'Investigació Germans Trias i Pujol, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Spain
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Blanco de Tord M, Vilchez-Márquez F, del Alcázar E, Arrieta A, Jaka A. Sclerotherapy With Polidocanol for Digital Myxoid Cysts: A Series of 15 Cases. Actas Dermo-Sifiliográficas (English Edition) 2021. [DOI: 10.1016/j.adengl.2021.10.001] [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: 11/25/2022] Open
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5
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Blanco de Tord M, Vilchez-Márquez F, Del Alcázar E, Arrieta A, Jaka A. Sclerotherapy With Polidocanol for Digital Myxoid Cysts: A Series of 15 Cases. Actas Dermosifiliogr (Engl Ed) 2021; 112:S0001-7310(21)00194-0. [PMID: 34029517 DOI: 10.1016/j.ad.2020.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 10/21/2022] Open
Affiliation(s)
- M Blanco de Tord
- Departamento de Dermatología Hospital Universitari Germans Trias I Pujol, Badalona, Universitat Autònoma de Barcelona, Barcelona, España.
| | - F Vilchez-Márquez
- Departamento de Dermatología Hospital Universitario Virgen de las Nieves, Universidad de Granada, Granada, España
| | - E Del Alcázar
- Departamento de Dermatología Hospital Universitari Germans Trias I Pujol, Badalona, Universitat Autònoma de Barcelona, Barcelona, España
| | - A Arrieta
- Departamento de Dermatología Hospital Universitari Germans Trias I Pujol, Badalona, Universitat Autònoma de Barcelona, Barcelona, España
| | - A Jaka
- Departamento de Dermatología Hospital Universitari Germans Trias I Pujol, Badalona, Universitat Autònoma de Barcelona, Barcelona, España
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Arrieta A, Jaka A, del Alcázar E, Blanco M, Carrascosa J. Phototherapy for Prurigo Nodularis: Our Experience and a Review of the Literature. Actas Dermo-Sifiliográficas (English Edition) 2021. [DOI: 10.1016/j.adengl.2020.11.006] [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: 11/25/2022] Open
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Arrieta A, Jaka A, Del Alcázar E, Blanco M, Carrascosa JM. Phototherapy for Prurigo Nodularis: Our Experience and a Review of the Literature. Actas Dermosifiliogr (Engl Ed) 2020; 112:339-344. [PMID: 33221272 DOI: 10.1016/j.ad.2020.11.007] [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: 09/18/2020] [Revised: 11/01/2020] [Accepted: 11/09/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Prurigo nodularis is a chronic inflammatory skin disease characterized by highly pruritic nodular lesions that cause constant itching and scratching and significant quality-of-life impairment. It has been described in a range of conditions, including skin diseases (mainly atopic dermatitis) and metabolic, neurological, and psychiatric disorders. The pathophysiological mechanisms are largely unknown. Various modalities of phototherapy have been described as appropriate and safe treatments for achieving clinical control and alleviating symptoms. In this article, we describe our experience with phototherapy in patients with prurigo nodularis. MATERIAL AND METHODS Retrospective observational study of patients who received their first cycle of phototherapy to treat prurigo nodularis between March 2011 and October 2019. Information was collected on epidemiological and clinical characteristics, concomitant treatments, type and duration of phototherapy, maximum dose reached, and response to treatment. RESULTS We studied 44 patients (30 women and 14 men) with a median age of 65.5years. The most common form of phototherapy used was narrowband UV-B phototherapy (34 cycles, 77.27%) followed by a combination of UV-B and UV-A phototherapy (8 cycles). Response to treatment was considered satisfactory (clearance rate of ≥75%) in 24 patients (55.4%). CONCLUSIONS Phototherapy is a suitable treatment for prurigo nodularis in a considerable proportion of patients. It can be used as monotherapy or combined with other treatments.
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Affiliation(s)
- A Arrieta
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España.
| | - A Jaka
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - E Del Alcázar
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - M Blanco
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
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Choudhary P, de Portu S, Arrieta A, Castañeda J, Campbell FM. Use of sensor-integrated pump therapy to reduce hypoglycaemia in people with Type 1 diabetes: a real-world study in the UK. Diabet Med 2019; 36:1100-1108. [PMID: 31134668 DOI: 10.1111/dme.14043] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/25/2019] [Indexed: 01/04/2023]
Abstract
AIMS To assess the efficacy of insulin pumps with automated insulin suspension systems in a real-world setting. METHODS We analysed anonymized data uploaded to CareLink™ by people (n=920) with Type 1 diabetes using the MiniMed Paradigm Veo system and the MiniMed 640G system (Medtronic International Trading Sàrl, Tolochanez, Switzerland) with SmartGuard technology, with or without automated insulin suspension enabled, between February 2016 and June 2018. Users with ≥15 days of sensor data and ≥70% sensor-wear time were classified as sensor-augmented pump alone, sensor-integrated pump with low glucose suspend enabled or sensor-integrated pump with predictive low glucose management enabled. RESULTS The median (25th -75th percentile) system use was 161 (58-348) days. The median time spent with sensor glucose values ≤3 mmol/l was 0.8 (0.3-1.7)% in the sensor-augmented pump group, 0.3 (0.1-0.7)% in the sensor-integrated pump with low glucose suspend group, and 0.3 (0.1-0.5)% in the sensor-integrated pump with predictive low glucose management group. In individuals switching from sensor-augmented pump to sensor-integrated pump with low glucose suspend (n=31), there were significant reductions in the monthly rate of hypoglycaemic events <3 mmol/l (rate ratio 0.63, 95% CI 0.45-0.89; P=0.009) and in the percentage of time with glucose values ≤3 mmol/l [sensor-augmented pump: 0.63% (95% CI 0.34-1.29), sensor-integrated pump with low glucose suspend: 0.33% (95% CI 0.16-0.64); P=0.001]. The monthly rate of hypoglycaemic events decreased further in individuals (n=139) switching from sensor-integrated pump with low glucose suspend to sensor-integrated pump with predictive low glucose management [rate ratio 0.82 (95% CI 0.69-0.98); P<0.0274]. Similar results were seen for events <3.9 mmol/l. There was no difference in median time spent in target glucose range. CONCLUSION Real-world UK data show that increasing automation of insulin suspension reduces hypoglycaemia exposure in people with Type 1 diabetes.
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Affiliation(s)
- P Choudhary
- King's College London, School of Life Course Sciences, London, UK
| | - S de Portu
- Medtronic International Trading Sàrl, Tolochenaz, Switzerland
| | - A Arrieta
- Medtronic, Bakken Research Centre, Maastricht, The Netherlands
| | - J Castañeda
- Medtronic, Bakken Research Centre, Maastricht, The Netherlands
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Arrieta A, Guillen J. The birthweight toll of mining pollution: evidence from the most contaminated mine site in the Andean region. BJOG 2018; 125:1272-1278. [PMID: 29700946 DOI: 10.1111/1471-0528.15257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 04/12/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the effect of mining pollution on birthweight. DESIGN A retrospective before-and-after study with an untreated comparison group. SETTING La Oroya, a mining town in the Peruvian Andes, considered the most contaminated town in the Andean region. POPULATION All pregnant women who delivered in the social security healthcare system in years 2005, 2006, 2008 and 2009. A total of 214 983 births records were used, 957 from La Oroya and 214 026 from the rest of the country. METHODS A difference-in-difference estimation is used to assess the effect of mining pollution on birthweight before and after two business policy changes: a partial environmental improvement and a subsequent closure of smelter operations in La Oroya. Birthweight was compared with a group not affected by the environmental changes in La Oroya. MAIN OUTCOME MEASURES Birthweight in grams. RESULTS A steep reduction in mining pollution due to the closure of smelter operations in La Oroya showed an increased birthweight of 71.6 g after controlling for socio-economic and medical characteristics. None of the environmental improvements prior to the closure had a statistically significant effect on birthweight. CONCLUSIONS Mining pollution in La Oroya had a negative impact on birthweight. Partial environmental improvements were not enough to improve birthweight. Only after the closure of all mining and smelter operations in La Oroya was a significant gain in birthweight shown. TWEETABLE ABSTRACT The closure of the most contaminated mine site in the Andean region increased birthweight by 72 g.
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Affiliation(s)
- A Arrieta
- Department of Health Policy and Management, Florida International University, Miami, FL, USA
| | - J Guillen
- Graduate School of Business, ESAN, Lima, Peru
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10
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Ayou C, Gauducheau E, Arrieta A, Roussey M, Marichal M, Vabres N, Balençon M. Évaluation des connaissances et des pratiques des pédiatres de Bretagne concernant la protection de l’enfance. Arch Pediatr 2018; 25:207-212. [DOI: 10.1016/j.arcped.2017.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 08/28/2017] [Accepted: 11/05/2017] [Indexed: 11/17/2022]
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11
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Pacho A, Arrieta A, Balas A, De Juan MD, Vicario JL. Two new HLA class I alleles described in a Spanish individual, HLA-A*11:01:01:04 and HLA-B*35:330. HLA 2017; 89:236-237. [PMID: 28233472 DOI: 10.1111/tan.12990] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 11/30/2022]
Abstract
Two new HLA class I alleles, HLA-A*11:01:01:04 and HLA-B*35:330, were characterized in a Spanish patient.
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Affiliation(s)
- A Pacho
- Inmunología. Hospital de Cruces, Baracaldo, Spain
| | - A Arrieta
- Inmunología. Hospital de Cruces, Baracaldo, Spain
| | - A Balas
- Histocompatibilidad. Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain
| | - M D De Juan
- Inmunología. Hospital Universitario Donostia, Guipuzcoa, Spain
| | - J L Vicario
- Histocompatibilidad. Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain
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Abstract
Cardiac myocytes are the cells responsible for the robust ability of the heart to pump blood throughout the circulatory system. Cardiac myocytes grow in response to a variety of physiological and pathological conditions; this growth challenges endoplasmic reticulum-protein quality control (ER-PQC), a major feature of which includes the unfolded protein response (UPR). ER-PQC and the UPR in cardiac myocytes growing under physiological conditions, including normal development, exercise, and pregnancy, are sufficient to support hypertrophic growth of each cardiac myocyte. However, the ER-PQC and UPR are insufficient to respond to the challenge of cardiac myocyte growth under pathological conditions, including myocardial infarction and heart failure. In part, this insufficiency is due to a continual decline in the expression levels of important adaptive UPR components as a function of age and during myocardial pathology. This chapter will discuss the physiological and pathological conditions unique to the heart that involves ER-PQC, and whether the UPR is adaptive or maladaptive under these circumstances.
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Affiliation(s)
- A Arrieta
- San Diego State University Heart Institute and the Department of Biology, San Diego State University, San Diego, CA, 92182, USA
| | - E A Blackwood
- San Diego State University Heart Institute and the Department of Biology, San Diego State University, San Diego, CA, 92182, USA
| | - C C Glembotski
- San Diego State University Heart Institute and the Department of Biology, San Diego State University, San Diego, CA, 92182, USA.
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Balas A, Pacho A, Arrieta A, García-Sánchez F, Vicario JL. Four new HLA class I alleles in Spaniards, HLA-A*32:01:23, HLA-B*18:01:24, HLA-B*18:72:02 and HLA-C*12:166. HLA 2016; 88:42-3. [PMID: 27378606 DOI: 10.1111/tan.12836] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 06/16/2016] [Accepted: 06/17/2016] [Indexed: 11/30/2022]
Abstract
Characterization of four new human leukocyte antigen (HLA) class I alleles, A*32:01:23, B*18:01:24, B*18:72:02 and C*12:166.
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Affiliation(s)
- A Balas
- Histocompatibilidad, Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain
| | - A Pacho
- Inmunología, Hospital de Cruces, Baracaldo, Spain
| | - A Arrieta
- Inmunología, Hospital de Cruces, Baracaldo, Spain
| | - F García-Sánchez
- Histocompatibilidad, Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain
| | - J L Vicario
- Histocompatibilidad, Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain
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14
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Del Orbe Barreto R, Arrizabalaga B, de la Hoz AB, Aragües P, Garcia-Ruiz JC, Arrieta A, Adán R, Manco L, Macedo-Ribeiro S, Bento C, Ribeiro ML. Severe neonatal jaundice due to a de novo glucose-6-phosphate dehydrogenase deficient mutation. Int J Lab Hematol 2015; 38:e27-9. [PMID: 26693676 DOI: 10.1111/ijlh.12455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - B Arrizabalaga
- BioCruces Health Research Institute, Barakaldo, Spain.,Servicio de Hematología, Hospital Universitario Cruces, Barakaldo, Spain
| | - A B de la Hoz
- BioCruces Health Research Institute, Barakaldo, Spain
| | - P Aragües
- Servicio de Hematología, Hospital Universitario Cruces, Barakaldo, Spain
| | - J C Garcia-Ruiz
- BioCruces Health Research Institute, Barakaldo, Spain.,Servicio de Hematología, Hospital Universitario Cruces, Barakaldo, Spain
| | - A Arrieta
- Servicio de Inmunología, Hospital Universitario Cruces, Barakaldo, Spain
| | - R Adán
- Servicio de Pediatría, Hospital Universitario Cruces, Barakaldo, Spain
| | - L Manco
- Serviço de Hematologia Clínica, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,CIAS/Departamento de Ciências da Vida, Universidade de Coimbra, Coimbra, Portugal
| | - S Macedo-Ribeiro
- Protein Crystallography Group, Institute for Molecular and Cell Biology (IBMC), Universidade do Porto, Porto, Portugal
| | - C Bento
- Serviço de Hematologia Clínica, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M L Ribeiro
- Serviço de Hematologia Clínica, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Battelino T, Liabat S, Veeze HJ, Castañeda J, Arrieta A, Cohen O. Routine use of continuous glucose monitoring in 10 501 people with diabetes mellitus. Diabet Med 2015; 32:1568-74. [PMID: 26042926 PMCID: PMC4744771 DOI: 10.1111/dme.12825] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/01/2015] [Indexed: 01/04/2023]
Abstract
AIMS To analyse blood glucose control according to continuous glucose monitoring use in data from the CareLink database, and to identify factors associated with continuation of sensor use during sensor-augmented pump therapy. METHODS The analysis used data from 10 501 people with Type 1 and 2 diabetes mellitus, of whom 7916 (61.7%) had used glucose sensors for ≥ 15 days during any 6-month period over a 2-year observation period. Data were analysed according to the extent of sensor use ( < 25%, 25-49%, 50-74% and ≥ 75% of the time). Time to discontinuation of sensor use was also analysed in new users of glucose sensors. RESULTS Compared with patients in the lowest sensor usage group and non-users, the highest glucose sensor usage group had significantly (P < 0.0001) lower mean blood glucose and blood glucose sd, were more likely to achieve a mean blood glucose concentration < 8.6 mmol/l, (odds ratio 1.5, 95% CI 1.3-1.7; P < 0.0001), and had 50% fewer hypoglycaemic (blood glucose concentration < 2.8 mmol/l) episodes. Among new users, sensor use during the first month of therapy was an important predictor of subsequent discontinuation. Lack of full reimbursement was also significantly associated with early discontinuation, whereas measures of glycaemic control were predictive of discontinuation during long-term treatment. CONCLUSIONS The use of continuous glucose monitoring was significantly associated with reductions in hypoglycaemia and improved metabolic control during insulin pump therapy. Sensor use during the first month was strongly associated with long-term adherence; patient education and training may be helpful in achieving this.
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MESH Headings
- Blood Glucose/analysis
- Canada
- Cohort Studies
- Diabetes Mellitus, Type 1/blood
- Diabetes Mellitus, Type 1/drug therapy
- Diabetes Mellitus, Type 1/economics
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/drug therapy
- Diabetes Mellitus, Type 2/economics
- Drug Resistance
- Europe
- Health Information Exchange
- Humans
- Hyperglycemia/prevention & control
- Hypoglycemia/chemically induced
- Hypoglycemia/prevention & control
- Hypoglycemic Agents/administration & dosage
- Hypoglycemic Agents/adverse effects
- Hypoglycemic Agents/therapeutic use
- Insulin/administration & dosage
- Insulin/adverse effects
- Insulin/therapeutic use
- Insulin Infusion Systems/adverse effects
- Insurance, Health, Reimbursement
- Israel
- Monitoring, Ambulatory/economics
- Patient Compliance
- Practice Patterns, Physicians'
- Time Factors
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Affiliation(s)
- T Battelino
- University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - S Liabat
- Medtronic International Trading Sàrl, Tolochenaz, Switzerland
| | - H J Veeze
- Diabeter, Centre for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
| | - J Castañeda
- Medtronic Bakken Research Center, Maastricht, The Netherlands
| | - A Arrieta
- Medtronic Bakken Research Center, Maastricht, The Netherlands
| | - O Cohen
- Chaim Sheba Medical Centre, Ramat Gan, Israel
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Balençon M, Arrieta A, You CA, Brun JF, Federico-Desgranges M, Roussey M. [Child protection system: Knowledge and role of the general practitioners in Ille-et-Vilaine]. Arch Pediatr 2015; 23:21-6. [PMID: 26552620 DOI: 10.1016/j.arcped.2015.09.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 09/30/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIMS On 5 March 2007 the law concerning the child protection system was reformed. Since this date, child protection services are responsible for child abuse and neglect. Child protection services are now attempting to determine the rightful place for parents. Asking for child protection is now easier for the general practitioner (GP), who can submit a "preoccupying information (PI)" form. The aim of this study was to review GPs' knowledge on this issue 6 years after the passage of this new law. METHODS Prospective postal investigation between 04/01/2013 and 06/01/2013. RESULTS A total of 298 (113 women) of the 899 GPs of the Ille-et-Vilaine area in Brittany answered a few questions about their activity and their knowledge on child abuse and neglect. The sample's mean age, sex, and practice was representative of the GPs in this area. Only 25.5% of the GPs had any knowledge of this new law. The term "preoccupying information" was unfamiliar to 70.1% of the GPs and what to do with the PI was unknown to 77.2%. The GPs did not know which type of letter to send nor where to send it between legal child protection and social protection services. Only 5% of the GPs had child protection training on PI. The main problem informing the child protection services was the lack of training. Consequently, 91.9% of the GPs would like training. CONCLUSIONS The GPs in the Ille-et-Vilaine area in Brittany are unfamiliar with the child protection updates and need special training.
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Affiliation(s)
- M Balençon
- CASED, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France; UMJ Hôtel-Dieu, 1, parvis Notre-Dame, 75181 Paris cedex 04, France; Faculté de médecine, université de Rennes 1, 2, avenue du Professeur-L.-Bernard, 35043 Rennes cedex, France.
| | - A Arrieta
- Faculté de médecine, université de Rennes 1, 2, avenue du Professeur-L.-Bernard, 35043 Rennes cedex, France
| | - C A You
- CASED, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France; Faculté de médecine, université de Rennes 1, 2, avenue du Professeur-L.-Bernard, 35043 Rennes cedex, France
| | - J-F Brun
- SOS Médecin, 19, rue Le-Guen-de-Kerangal, 35200 Rennes, France; Conseil départemental de l'Ordre des médecins d'Ille-et-Vilaine, 4, cours R.-Binet, 35000 Rennes, France
| | - M Federico-Desgranges
- CASED, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | - M Roussey
- CASED, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France; Faculté de médecine, université de Rennes 1, 2, avenue du Professeur-L.-Bernard, 35043 Rennes cedex, France
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Sánchez-Gordo F, Pacho A, Balas A, Arrieta A, Vicario JL. Two new HLA-B35 subtypes characterized in Spaniards: HLA-B*35:270 and HLA-B*35:273. Tissue Antigens 2015; 86:385-6. [PMID: 26399227 DOI: 10.1111/tan.12674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 08/10/2015] [Accepted: 09/03/2015] [Indexed: 11/28/2022]
Abstract
Two new HLA-B*35 alleles, B*35:270 and B*35:273, were characterized in the Spanish population.
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Affiliation(s)
- F Sánchez-Gordo
- Departamento de Histocompatibilidad, Centro de Transfusión de Málaga, Málaga, Spain
| | - A Pacho
- Departamento de Inmunología, Hospital de Cruces, Baracaldo, Spain
| | - A Balas
- Departamento de Histocompatibilidad, Centro de Transfusión de Madrid, Madrid, Spain
| | - A Arrieta
- Departamento de Inmunología, Hospital de Cruces, Baracaldo, Spain
| | - J L Vicario
- Departamento de Histocompatibilidad, Centro de Transfusión de Madrid, Madrid, Spain
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Saralegui I, Delgado A, Salazar M, Arrieta A, Gómez MT, Amiano MT, Ibáñez MI, Pereda L. P-77 Less papers, more conversation. Bottom-up project about advance care planning in primary care setting. BMJ Support Palliat Care 2015. [DOI: 10.1136/bmjspcare-2015-000978.207] [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: 11/03/2022]
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Rocha ML, Del Ángel G, Torres-Torres G, Cervantes A, Vázquez A, Arrieta A, Beltramini J. Effect of the Pt oxidation state and Ce3+/Ce4+ ratio on the Pt/TiO2-CeO2 catalysts in the phenol degradation by catalytic wet air oxidation (CWAO). Catal Today 2015. [DOI: 10.1016/j.cattod.2014.09.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Clemens P, Spurney C, McCaffrey F, Hache L, Gordish-Dressman H, Arrieta A, Lasota M, Connolly A, McDonald C, Lotze T, Cnaan A. P.2.16 Cooperative International Neuromuscular Research Group (CINRG) study of echocardiographic outcome measures for use in clinical trials in muscular dystrophy. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.421] [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: 10/26/2022]
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Ramos JL, Aldazabal P, Zuza E, Sarasúa JR, Arrieta A, Villanueva A, Eizaguirre I. [Biodegradable catheters for fistula prevention in hypospadias. Experimental preliminary study]. Cir Pediatr 2013; 26:91-94. [PMID: 24228360] [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: 06/02/2023]
Abstract
INTRODUCTION Continuous technical innovations are not enough to resolve the high incidence of fistula after hypospadias repair. A urethral catheter-tutor made of reabsorbable polymeric biomaterial (RPB) which could be left in situ long enough could reduce the complications. TARGET To investigate in an animal model differents RPB to be used in urology. METHODOLOGY CRL Wistar rats, males, divided into 5 equal groups according to the used polymers: polylactide; lactic-coprolactone copolymer; lactic-glycolic copolymer; simulated; control silicones. Three individuals were sacrificed per group at 4th, 10th and 16th week. In all animals (exceptuating the simulated group), biomaterial was fixed to the bladder wall bylaparotomy. Animals remained in individual housing and kept under daily control of hematuria during the first 15 days and weekly weight and urine control for pH and lactate. After being slaughtered, remaining polymer was collected for chemical analysis and bladder tissue for hystologic study. RESULTS There was no mortality, hematuria nor other clinical signs. The bladder wall showed a mild foreign body reaction. The values of lactate and pH in urine did not reach toxic levels. Lactic-glycolic was totally reabsorbed by the 10th week and had the lowest degree of calcification. Polylactide and lactic-coprolactone remained intact. CONCLUSION The model of urinary bladder has proven useful for studying the degradation of bioresorbable polymers. The analyzed polymers have spent long time to be reabsorbed, so we will have to study new others.
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Affiliation(s)
- J L Ramos
- Servicio de Cirugía Pediátrica, Hospital Donostia, San Sebastián.
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Escolar DM, Zimmerman A, Bertorini T, Clemens PR, Connolly AM, Mesa L, Gorni K, Kornberg A, Kolski H, Kuntz N, Nevo Y, Tesi-Rocha C, Nagaraju K, Rayavarapu S, Hache LP, Mayhew JE, Florence J, Hu F, Arrieta A, Henricson E, Leshner RT, Mah JK. Pentoxifylline as a rescue treatment for DMD: a randomized double-blind clinical trial. Neurology 2012; 78:904-13. [PMID: 22402864 DOI: 10.1212/wnl.0b013e31824c46be] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether pentoxifylline (PTX) slows the decline of muscle strength and function in ambulatory boys with Duchenne muscular dystrophy (DMD). METHODS This was a multicenter, randomized, double-blinded, controlled trial comparing 12 months of daily treatment with PTX or placebo in corticosteroid-treated boys with DMD using a slow-release PTX formulation (~20 mg/kg/day). The primary outcome was the change in mean total quantitative muscle testing (QMT) score. Secondary outcomes included changes in QMT subscales, manual muscle strength, pulmonary function, and timed function tests. Outcomes were compared using Student t tests and a linear mixed-effects model. Adverse events (AEs) were compared using the Fisher exact test. RESULTS A total of 64 boys with DMD with a mean age of 9.9 ± 2.9 years were randomly assigned to PTX or placebo in 11 participating Cooperative International Neuromuscular Research Group centers. There was no significant difference between PTX and the placebo group in total QMT scores (p = 0.14) or in most of the secondary outcomes after a 12-month treatment. The use of PTX was associated with mild to moderate gastrointestinal or hematologic AEs. CONCLUSION The addition of PTX to corticosteroid-treated boys with DMD at a moderate to late ambulatory stage of disease did not improve or halt the deterioration of muscle strength and function over a 12-month study period. CLASSIFICATION OF EVIDENCE This study provides Class I evidence that treatment with PTX does not prevent deterioration in muscle function or strength in corticosteroid-treated boys with DMD.
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Affiliation(s)
- D M Escolar
- Children’s National Medical Center, Washington, DC, USA.
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Escolar DM, Hache LP, Clemens PR, Cnaan A, McDonald CM, Viswanathan V, Kornberg AJ, Bertorini TE, Nevo Y, Lotze T, Pestronk A, Ryan MM, Monasterio E, Day JW, Zimmerman A, Arrieta A, Henricson E, Mayhew J, Florence J, Hu F, Connolly AM. Randomized, blinded trial of weekend vs daily prednisone in Duchenne muscular dystrophy. Neurology 2011; 77:444-52. [PMID: 21753160 DOI: 10.1212/wnl.0b013e318227b164] [Citation(s) in RCA: 109] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To perform a double-blind, randomized study comparing efficacy and safety of daily and weekend prednisone in boys with Duchenne muscular dystrophy (DMD). METHODS A total of 64 boys with DMD who were between 4 and 10 years of age were randomized at 1 of 12 centers of the Cooperative International Neuromuscular Research Group. Efficacy and safety of 2 prednisone schedules (daily 0.75 mg/kg/day and weekend 10 mg/kg/wk) were evaluated over 12 months. RESULTS Equivalence was met for weekend and daily dosing of prednisone for the primary outcomes of quantitative muscle testing (QMT) arm score and QMT leg score. Secondary strength scores for QMT elbow flexors also showed equivalence between the 2 treatment groups. Overall side effect profiles of height and weight, bone density, cataract formation, blood pressure, and behavior, analyzed at 12 months, did not differ between weekend and daily dosing of prednisone. CONCLUSIONS Weekend dosing of prednisone is equally beneficial to the standard daily dosing of prednisone. Analysis of side effect profiles demonstrated overall tolerability of both dosing regimens. CLASSIFICATION OF EVIDENCE This study provides Class I evidence that weekend prednisone dosing is as safe and effective as daily prednisone in preserving muscle strength and preventing body mass index increases in boys with DMD over a 12-month period.
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Affiliation(s)
- D M Escolar
- Children's National Medical Center, Washington, DC, USA.
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Avery RK, Marty FM, Strasfeld L, Lee I, Arrieta A, Chou S, Tatarowicz W, Villano S. Oral maribavir for treatment of refractory or resistant cytomegalovirus infections in transplant recipients. Transpl Infect Dis 2011; 12:489-96. [PMID: 20682012 DOI: 10.1111/j.1399-3062.2010.00550.x] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Despite advances in cytomegalovirus (CMV) prophylaxis and therapy, some transplant recipients still develop refractory CMV infections. Maribavir (MBV), an investigational benzimidazole antiviral agent, acts by a mechanism different from that of existing anti-CMV drugs. Previous Phase I and II studies have demonstrated a favorable safety profile for MBV, but its utility in treatment of complex CMV syndromes is unknown. METHODS Between June and December 2008, MBV was released for use under individual emergency investigational new drug applications requested by treating physicians and approved by the US Food and Drug Administration and local institutional review boards. Six patients (5 solid organ transplant recipients and 1 hematopoietic stem cell transplant recipient) who had failed to respond to other therapies and/or had known ganciclovir-resistant CMV were treated with MBV at a starting oral dose of 400 mg twice daily. RESULTS Patients were treated for a median of 207 days (range, 15-376). Four of 6 patients had no detectable CMV DNAemia within 6 weeks of starting MBV therapy. One patient, who had an initial viral load of 1.8 million copies/mL, developed MBV resistance mutations. One patient, who had low serum levels of MBV, had persistent CMV DNAemia and viruria without developing genotypic or phenotypic resistance to MBV. One patient cleared CMV DNAemia, but died of pneumonia and multiorgan failure. No significant adverse effects attributable to MBV were observed. CONCLUSIONS MBV deserves further systematic evaluation as treatment for CMV infection that is resistant and/or refractory to standard therapies, but its optimal dose, duration of therapy, and use in combinations versus as a single agent have yet to be determined.
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Affiliation(s)
- R K Avery
- Infectious Diseases, The Cleveland Clinic, Cleveland, Ohio, USA
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Groll A, Maddison P, Arrieta A. Micafungin – Overview of Safety in Pediatric Patients. Klin Padiatr 2010. [DOI: 10.1055/s-0030-1261435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Groll A, Seibel NL, Walsh TJ, Arnold L, Arrieta A. Micafungin – Overview of Efficacy in Pediatric Patients. Klin Padiatr 2010. [DOI: 10.1055/s-0030-1261436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Benjamin DK, Smith PB, Arrieta A, Castro L, Sánchez PJ, Kaufman D, Arnold LJ, Kovanda LL, Sawamoto T, Buell DN, Hope WW, Walsh TJ. Safety and pharmacokinetics of repeat-dose micafungin in young infants. Clin Pharmacol Ther 2009; 87:93-9. [PMID: 19890251 DOI: 10.1038/clpt.2009.200] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Given the risk of central nervous system infection, relatively high weight-based echinocandin dosages may be required for the successful treatment of invasive candidiasis and candidemia in young infants. This open-label study assessed the safety and pharmacokinetics (PK) of micafungin in 13 young infants (>48 h and <120 days of life) with suspected candidemia or invasive candidiasis. Infants of body weight > or =1,000 and <1,000 g received 7 and 10 mg/kg/day, respectively, for a minimum of 4-5 days. In the 7-mg/kg/day group, the mean baseline weight and gestational age were 2,101 g and 30 weeks, respectively; in the 10-mg/kg/day group, they were 688 g and 25 weeks, respectively. The median pharmacokinetic values for the 7- and 10-mg/kg/day groups, respectively, were as follows: area under the concentration-time curve from 0 to 24 h (AUC(0-24)), 258.1 and 291.2 microg x h/ml; clearance at steady state adjusted for body weight, 0.45 and 0.57 ml/min/kg; maximum plasma concentration, 23.3 and 24.9 micro g/ml; and volume of distribution at steady state adjusted for body weight, 341.4 and 542.8 ml/kg. No deaths or discontinuations from treatment occurred. These data suggest that micafungin dosages of 7 and 10 mg/kg/day are well tolerated and provide exposure levels that have been shown (in animal models) to be adequate for central nervous system coverage.
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Affiliation(s)
- D K Benjamin
- Department of Pediatrics and Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA.
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Arrieta A, Seibel NL, Walsh TJ, Arnold L, Groll AH. Micafungin for the treatment of pediatric invasive fungal infections. Crit Care 2009. [PMCID: PMC4084199 DOI: 10.1186/cc7477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Arrieta A, García T, Lago JM, Palomo C. Reagents and Synthetic Methods 28. Modified Procedures for Anhydrization, Esterification and Thiolesterification of Carboxylic Acids by Means of Available Phosphorus Reagents. SYNTHETIC COMMUN 2007. [DOI: 10.1080/00397918308081826] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [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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Arrieta A, Aizpurua JM, Palomo C. Reagents and Synthetic Methods 17. Phenyl-Dichlorophosphate-Dimethylformamide Complex. Direct High Yield Annelation of Imines to Alpha-Phtalimido Beta-Lactams. SYNTHETIC COMMUN 2006. [DOI: 10.1080/00397918208061934] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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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Arrieta A, Ganboa I, Palomo C. Reagents and Synthetic Methods 38. 4-(Dimethylamino)pyridinium Bromide Perbromide as a New Brominating Agent for Organic Compounds. SYNTHETIC COMMUN 2006. [DOI: 10.1080/00397918408063764] [Citation(s) in RCA: 18] [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] [Indexed: 10/23/2022]
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Garcia T, Arrieta A, Palomo C. Reagents and Synthetic Methods 15. Phenyl Dichlorophos-Phate-Dimethylfurmamide Complex. A Modified One-Pot Procedure for Esterification of Carboxylic Acids. SYNTHETIC COMMUN 2006. [DOI: 10.1080/00397918208061902] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [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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Lago JM, Arrieta A, Palomo C. Reagents and Synthetic Methods 25. A New Method for the Synthesis of Acyl Azides from Carboxylic Acids and Sodium Azide Induced by Phenyl Dichlorophosphate. SYNTHETIC COMMUN 2006. [DOI: 10.1080/00397918308066978] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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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Arrieta A, García T, Palomo C. Reagents and Synthetic Methods 21. Thionyl Chloride /4-(N,N-Dimethylamino) Pyridine Complex. A Simple One-Pot Method for Esterification of Carboxylic Acids. SYNTHETIC COMMUN 2006. [DOI: 10.1080/00397918208065981] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [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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Singh J, Burr B, Stringham D, Arrieta A. Commonly used antibacterial and antifungal agents for hospitalised paediatric patients: implications for therapy with an emphasis on clinical pharmacokinetics. Paediatr Drugs 2002; 3:733-61. [PMID: 11706924 DOI: 10.2165/00128072-200103100-00003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Due to normal growth and development, hospitalised paediatric patients with infection require unique consideration of immune function and drug disposition. Specifically, antibacterial and antifungal pharmacokinetics are influenced by volume of distribution, drug binding and elimination, which are a reflection of changing extracellular fluid volume, quantity and quality of plasma proteins, and renal and hepatic function. However, there is a paucity of data in paediatric patients addressing these issues and many empiric treatment practices are based on adult data. The penicillins and cephalosporins continue to be a mainstay of therapy because of their broad spectrum of activity, clinical efficacy and favourable tolerability profile. These antibacterials rapidly reach peak serum concentrations and readily diffuse into body tissues. Good penetration into the cerebrospinal fluid (CSF) has made the third-generation cephalosporins the agents of choice for the treatment of bacterial meningitis. These drugs are excreted primarily by the kidney. The carbapenems are broad-spectrum beta-lactam antibacterials which can potentially replace combination regimens. Vancomycin is a glycopeptide antibacterial with gram-positive activity useful for the treatment of resistant infections, or for those patients allergic to penicillins and cephalosporins. Volume of distribution is affected by age, gender, and bodyweight. It diffuses well across serous membranes and inflamed meninges. Vancomycin is excreted by the kidneys and is not removed by dialysis. The aminoglycosides continue to serve a useful role in the treatment of gram-negative, enterococcal and mycobacterial infections. Their volume of distribution approximates extracellular space. These drugs are also excreted renally and are removed by haemodialysis. Passage across the blood-brain barrier is poor, even in the face of meningeal inflammation. Low pH found in abscess conditions impairs function. Toxicity needs to be considered. Macrolide antibacterials are frequently used in the treatment of respiratory infections. Parenteral erythromycin can cause phlebitis, which limits its use. Parenteral azithromycin is better tolerated but paediatric pharmacokinetic data are lacking. Clindamycin is frequently used when anaerobic infections are suspected. Good oral absorption makes it a good choice for step-down therapy in intra-abdominal and skeletal infections. The use of quinolones in paediatrics has been restricted and most information available is in cystic fibrosis patients. High oral bioavailability is also important for step-down therapy. Amphotericin B has been the cornerstone of antifungal treatment in hospitalised patients. Its metabolism is poorly understood. The half-life increases with time and can be as long as 15 days after prolonged therapy. Oral absorption is poor. The azole antifungals are being used increasingly. Fluconazole is well tolerated, with high bioavailability and good penetration into the CSF. Itraconazole has greater activity against aspergillus, blastomycosis, histoplasmosis and sporotrichosis, although it's pharmacological and toxicity profiles are not as favourable.
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Affiliation(s)
- J Singh
- Division of Infectious Disease, Children's Hospital of Orange County, Orange, California 92868, USA
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Riñón M, Maruri N, Arrieta A, Fernández JR, Ortiz de Urbina J, García Masdevall MD. Selective immunosuppression with daclizumab in liver transplantation with graft-versus-host disease. Transplant Proc 2002; 34:109-10. [PMID: 11959211 DOI: 10.1016/s0041-1345(01)02828-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- M Riñón
- Section of Immunology, Hospital de Cruces, Baracaldo, Vizcaya, Spain
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Arrieta A, Maruri N, Riñón M, Fernández JR, Ortiz de Urbina J, García Masdevall MD. Confirmation of graft-versus-host disease by HLA typing after liver transplantation. Transplant Proc 2002; 34:278-9. [PMID: 11959285 DOI: 10.1016/s0041-1345(01)02833-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- A Arrieta
- Section of Immunology, Hospital de Cruces, Baracaldo, Vizcaya, Spain
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Alajarín M, Sánchez-Andrada P, Cossío FP, Arrieta A, Lecea B. On the mechanism of conversion of N-acyl-4-acyloxy-beta-lactams into 2-substituted 1,3-oxazin-6-ones. Can a low-barrier transition state be antiaromatic? J Org Chem 2001; 66:8470-7. [PMID: 11735527 DOI: 10.1021/jo015922e] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The mechanism of the conversion of N-acyl-4-acyloxy-beta-lactams into 1,3-oxazin-6-ones has been investigated using ab initio and density functional theories. It has been found that two pseudopericyclic reactions are involved in the whole process. The first key reaction is a retro-[4-exo-dig] cyclization instead of a thermal conrotatory electrocyclic ring opening. Magnetic characterization of the corresponding transition structure shows antiaromatic character, despite the low activation energy associated with this process. The second step is very exothermic and has no activation barrier. It corresponds to another pseudopericyclic reaction instead of a six-electron disrotatory electrocyclization. These results confirm that there is no correlation between aromaticity and pseudopericyclic reactions. In contrast, thermal-symmetry-allowed pericyclic reactions are always aromatic. Therefore, magnetic analysis of the corresponding transition structures constitutes a useful tool to distinguish between both kinds of processes.
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Affiliation(s)
- M Alajarín
- Departamento de Química Orgánica, Facultad de Química, Universidad de Murcia, Spain.
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Kassir K, Vargas-Shiraishi O, Zaldivar F, Berman M, Singh J, Arrieta A. Cytokine profiles of pediatric patients treated with antibiotics for pyelonephritis: potential therapeutic impact. Clin Diagn Lab Immunol 2001; 8:1060-3. [PMID: 11687440 PMCID: PMC96226 DOI: 10.1128/cdli.8.6.1060-1063.2001] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Urinary tract infections are common in infants and children. Pyelonephritis may result in serious complications, such as renal scarring, hypertension, and renal failure. Identification of the timing of release of inflammatory cytokines in relation to pyelonephritis and its treatment is essential for designing interventions that would minimize tissue damage. To this end, we measured urinary cytokine concentrations of interleukin-1 beta (IL-1 beta), IL-6, and IL-8 in infants and children with pyelonephritis and in healthy children. Children that presented to our institution with presumed urinary tract infection were given the diagnosis of pyelonephritis if they had a positive urine culture, pyuria, and one or more of the following indicators of systemic involvement: fever, elevated peripheral white blood cell count, or elevated C-reactive protein. Urine samples were obtained at the time of presentation prior to the administration of antibiotics, immediately after completion of the first dose of antibiotics, and at follow up 12 to 24 h after presentation. IL-1 beta, IL-6, and IL-8 concentrations were measured by enzyme-linked immunosorbent assay. Creatinine concentrations were also determined, and cytokine/creatinine ratios were calculated to standardize samples. Differences between pre-antibiotic and follow-up cytokine/creatinine ratios were significant for IL-1 beta, IL-6, and IL-8 (P < 0.01). Differences between pre-antibiotic and control cytokine/creatinine ratios were also significant for IL-1 beta, IL-6, and IL-8 (P < 0.01). Our study revealed that the urinary tract cytokine response to infection is intense but dissipates shortly after the initiation of antibiotic treatment. This suggests that renal damage due to inflammation begins early in infection, underscoring the need for rapid diagnosis and intervention.
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Affiliation(s)
- K Kassir
- Division of Pediatric Critical Care and Harbor-UCLA Department of Pediatric Critical Care, Children's Hospital of Orange County, Orange, California 92868, USA.
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Arrieta A, Cossío FP, Lecea B. Direct evaluation of secondary orbital interactions in the Diels-Alder reaction between cyclopentadiene and maleic anhydride. J Org Chem 2001; 66:6178-80. [PMID: 11529749 DOI: 10.1021/jo0158478] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A Arrieta
- Kimika Fakultatea, Euskal Herriko Unibertsitatea, San Sebastián-Donostia, Spain
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Affiliation(s)
- J C Vitoria
- Department of Pediatrics, Hospital de Cruces and Basque University School of Medicine, Bilbao, Spain.
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Abstract
BACKGROUND These studies were designed to assess the efficacy and safety of cefepime, a fourth generation cephalosporin, for the treatment of serious infections, including lower respiratory tract infections (LRTI) in children. METHODS Four clinical trials of cefepime for the treatment of serious bacterial infections enrolled 259 children with LRTI. In 3 trials cefepime was compared with ceftazidime (n = 166), cefotaxime (n = 16) or cefuroxime (n = 12). One trial was noncomparative (n = 65). RESULTS Treatment with cefepime 50 mg/kg/ dose administered every 8 to 12 h produced a satisfactory clinical response (clinical signs of infection resolved or improved with no evidence of recurrent infection at posttreatment follow-up) in 88 to 100% of patients, comparable with comparator therapy. In children from whom a causative pathogen was identified, bacteriologic eradication was comparable between cefepime and comparator therapy. Cefepime was as safe and well-tolerated as comparator therapy. Few treatment-related clinical or laboratory adverse events were noted and were equivalent to comparator in all studies. CONCLUSION Cefepime is as effective, safe and well-tolerated for the empiric treatment of children with LRTI as comparator agents but offers the advantage of an enhanced spectrum of activity for Gram-positive and Gram-negative pathogens compared with second or third generation cephalosporins.
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Affiliation(s)
- J S Bradley
- Division of Infectious Diseases, Children's Hospital of San Diego, CA 92123, USA.
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Arrieta A, Cossío FP, Lecea B. New insights on the origins of the stereocontrol of the staudinger reaction: [2 + 2] cycloaddition between ketenes and N-silylimines. J Org Chem 2000; 65:8458-64. [PMID: 11112564 DOI: 10.1021/jo0007736] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Density-functional theory studies on the [2 + 2] reaction between N-silylimines and ketenes to form the corresponding 2-azetidinones (beta-lactams) help to clarify several aspects on the mechanism of the Staudinger reaction. This reaction has been studied experimentally by Panunzio et al. It is shown that the formation of the 2-azetidinone ring takes place via two consecutive reactions. The first reaction consists of the nucleophilic addition of the iminic nitrogen to the sp-hybridized carbon atom of the ketene, with simultaneous migration of the silyl group from the imine to the oxygen atom of the ketene. This leads to silyl enol intermediates, in good agreement with the experimental results. Formation of the N-silylated beta-lactam takes place via a domino reaction consisting of a conrotatory thermal electrocyclization followed by a new silatropic rearrangement. It is also found that isomerization of the starting N-silylimine has a lower activation barrier than that associated with the formation of the C-N bond, which explains the stereochemical outcome experimentally observed. Further considerations on the asymmetric torquoelectronic effects involved in this reaction are also reported.
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Affiliation(s)
- A Arrieta
- Farmazi Fakultatea, Euskal Herriko Unibertsitatea, P.K. 450, 01080 Vitoria-Gasteiz, Spain
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Wingard JR, White MH, Anaissie E, Raffalli J, Goodman J, Arrieta A. A randomized, double-blind comparative trial evaluating the safety of liposomal amphotericin B versus amphotericin B lipid complex in the empirical treatment of febrile neutropenia. L Amph/ABLC Collaborative Study Group. Clin Infect Dis 2000; 31:1155-63. [PMID: 11073745 DOI: 10.1086/317451] [Citation(s) in RCA: 340] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/1999] [Revised: 04/05/2000] [Indexed: 11/03/2022] Open
Abstract
In this double-blind study to compare safety of 2 lipid formulations of amphotericin B, neutropenic patients with unresolved fever after 3 days of antibacterial therapy were randomized (1:1:1) to receive amphotericin B lipid complex (ABLC) at a dose of 5 mg/kg/d (n=78), liposomal amphotericin B (L Amph) at a dose of 3 mg/kg/d (n=85), or L Amph at a dose of 5 mg/kg/d (n=81). L Amph (3 mg/kg/d and 5 mg/kg/d) had lower rates of fever (23.5% and 19.8% vs. 57.7% on day 1; P<.001), chills/rigors (18.8% and 23.5% vs. 79.5% on day 1; P<.001), nephrotoxicity (14.1% and 14.8% vs. 42.3%; P<.01), and toxicity-related discontinuations of therapy (12.9% and 12.3% vs. 32.1%; P=.004). After day 1, infusional reactions were less frequent with ABLC, but chills/rigors were still higher (21.0% and 24.3% vs. 50.7%; P<.001). Therapeutic success was similar in all 3 groups.
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Affiliation(s)
- J R Wingard
- Division of Hematology, University of Florida College of Medicine, Gainesville, FL 32610-0277, USA.
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Vitoria JC, Arrieta A, Arranz C, Ayesta A, Sojo A, Maruri N, García-Masdevall MD. Antibodies to gliadin, endomysium, and tissue transglutaminase for the diagnosis of celiac disease. J Pediatr Gastroenterol Nutr 1999; 29:571-4. [PMID: 10554125 DOI: 10.1097/00005176-199911000-00018] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Tissue transglutaminase has recently been identified as the main autoantigen recognized by antiendomysial antibodies in celiac disease. Serum immunoglobulin (Ig)A antibodies to tissue transglutaminase (tTG-ab) determined by an enzyme-linked immunosorbent assay (ELISA) technique have been reported to correlate closely with IgA antiendomysial antibodies (EMA). The purpose of this study was to assess the sensitivity, specificity, and predictive value of tTG-ab measured by a commercially available ELISA technique, compared with those of EMA and IgA antigliadin antibodies (AGA) for the diagnosis of celiac disease. METHODS Twenty-seven serum samples were obtained from patients with untreated celiac disease, 37 from patients who had had gluten withdrawn from their diets for varying time spans, and 34 from control subjects without celiac disease. All were younger than 14 years. Presence of tTG-ab and AGA was determined by ELISA and of EMA by indirect immunofluorescence. RESULTS Twenty-six of 27 serum samples obtained from patients at the time of diagnosis of celiac disease were AGA positive. All 27 (concordance rate 100%) were positive for EMA and tTG-ab. Of the 34 control subjects, 1 was for AGA and 2 for tTG-ab. All 34 were negative for EMA. Sensitivity, specificity, positive predictive value, and negative predictive value within this group were, for tTG-ab: 100%, 94%, 93%, and 100%, respectively; for EMA: all four indexes were 100%; and for AGA: 96%, 97%, 96%, and 97%, respectively. Of the 37 with treated celiac disease, 2 were AGA positive, 9 were EMA positive, and 6 were tTG-ab positive. The concordance rate between EMA and tTG-ab was 100% in the group with untreated celiac disease, 94% in the control subjects, and 76% in the group with treated celiac disease. CONCLUSIONS Immunoglobulin A antibodies to tissue transglutaminase are new, highly sensitive, and specific markers of celiac disease. They can be determined easily by an accurate, comparatively cheap technique and thereby may advantageously replace the EMA marker traditionally used.
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Affiliation(s)
- J C Vitoria
- Department of Pediatrics, Hospital de Cruces and Basque University School of Medicine, Bilbao, Spain
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Cebolla VL, Membrado L, Domingo MP, Henrion P, Garriga R, Gonzalez P, Cossio FP, Arrieta A, Vela J. Quantitative Applications of Fluorescence and Ultraviolet Scanning Densitometry for Compositional Analysis of Petroleum Products in Thin-Layer Chromatography. J Chromatogr Sci 1999. [DOI: 10.1093/chromsci/37.6.219] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Vitoria JC, Castaño L, Rica I, Bilbao JR, Arrieta A, García-Masdevall MD. Association of insulin-dependent diabetes mellitus and celiac disease: a study based on serologic markers. J Pediatr Gastroenterol Nutr 1998; 27:47-52. [PMID: 9669725 DOI: 10.1097/00005176-199807000-00008] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The association of celiac disease and insulin-dependent diabetes mellitus has been known for some time. In an attempt to clarify this association, the prevalence of celiac disease among diabetic children was determined, and the risk of insulin-dependent diabetes mellitus was defined in pediatric patients with celiac disease. METHODS Ninety-three children with diabetes were analyzed for the presence of celiac disease-related markers (antigliadin and antiendomysial antibodies) and characteristic alterations in the intestinal mucosa. In another group, 93 children with celiac disease were screened for pancreatic autoantibodies and pancreatic beta-cell function. RESULTS Among children with insulin-dependent diabetes mellitus, a 6.45% prevalence of celiac disease was observed, a value significantly higher than that found among healthy controls. In contrast, only three celiac disease patients showed potential autoimmunity toward the pancreatic beta cell, a proportion not significantly different from that in the general population. Additionally, no alteration of glucose metabolism was observed in the antibody-positive patients. CONCLUSION The increased risk of celiac disease among patients with diabetes requires a long follow-up to determine the presence of celiac disease markers among patients with diabetes, to avoid potential malignant disease derived from untreated celiac disease. In contrast, there is no evidence to support an increased risk of insulin-dependent diabetes mellitus among children with celiac disease. In accordance with the accepted influence of diet in the development of autoimmune diabetes, a hypothetical mechanism of protection against insulin-dependent diabetes mellitus that is mediated by environmental factors related to restricted diet is suggested in this population.
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Affiliation(s)
- J C Vitoria
- Department of Pediatrics, Hospital de Cruces and Universidad del Pais Vasco, Bilbao, Basque Country, Spain
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García Fernández E, Arrieta A, Riñón M, Maruri N, Arranz MC, Peña JA, García Masdevall MD. Genetic polymorphisms of HLA class I and class II system in the Basque population. Transplant Proc 1997; 29:3707-9. [PMID: 9414894 DOI: 10.1016/s0041-1345(97)01078-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Arrieta A, Maruri N, Riñón M, Arranz MC, Garcia Fernándex E, Gómez Ullate P, Masdevall G. Relative risk of policystic kidney disease in HLA-DR1 basque individuals. Transplant Proc 1997; 29:3719-20. [PMID: 9414900 DOI: 10.1016/s0041-1345(97)01084-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- A Arrieta
- Department of Immunology, Hospital de Cruces, Vizcaya, Spain
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