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Coca A, Whelton SP, Camafort M, López-López JP, Yang E. Single-pill combination for treatment of hypertension: Just a matter of practicality or is there a real clinical benefit? Eur J Intern Med 2024:S0953-6205(24)00172-9. [PMID: 38653633 DOI: 10.1016/j.ejim.2024.04.011] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 03/27/2024] [Accepted: 04/16/2024] [Indexed: 04/25/2024]
Abstract
Elevated blood pressure (BP) is the largest contributor to the incident cardiovascular disease worldwide. Despite explicit guideline recommendations for the diagnosis and management of hypertension, a large proportion of patients remain undiagnosed, untreated, or treated but uncontrolled. Inadequate BP control is associated with many complex factors including patient preference, physician's inertia, health systems disparities, and poor adherence to prescribed antihypertensive drug treatment. The primary driver for reduced cardiovascular morbidity and mortality is lowering of BP ''per se'' and not class effects of specific pharmacotherapies. The recent ESH guidelines recommend the use of four major classes of drugs including renin-angiotensin-aldosterone system (RAS) blockers (angiotensin receptor blockers (ARB) or angiotensin-converting enzyme inhibitors (ACEi)), calcium channel blockers (CCB), thiazide and thiazide-like diuretics, and betablockers. Initiation of treatment for hypertension with a two-drug regimen, preferably in a single pill combination (SPC), is recommended for most patients. Preferred combinations should comprise a RAS blocker (either an ACEi or an ARB) with a CCB or thiazide/thiazide-like diuretic. These strategies are supported by robust evidence that combination therapy produces greater BP reductions than monotherapy, reduces side effects of the individual components, improves therapeutic adherence and long-term persistence on treatment, and permits achievement of earlier BP control.
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Affiliation(s)
- A Coca
- Hypertension and Vascular Risk Unit. Department of Internal Medicine. Hospital Clínic, University of Barcelona, Barcelona, Spain.
| | - S P Whelton
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - M Camafort
- Hypertension and Vascular Risk Unit. Department of Internal Medicine. Hospital Clínic (IDIBAPS, CIBER-OBN). University of Barcelona, Barcelona, Spain
| | - J P López-López
- Masira Research Institute, University of Santander (UDES), Bucaramanga, Colombia
| | - E Yang
- Division of Cardiology, University of Washington School of Medicine, Seattle, Washington, USA
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2
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Sotomayor Julio AD, Montana-Jimenez LP, Bernal Torres W, López Ponce de León JD, Zambrano Franco JA, Coca A, Camafort M, Vesga Reyes C. [Ambulatory blood pressure monitoring, adult and pediatric population. A narrative review]. Hipertens Riesgo Vasc 2024; 41:104-117. [PMID: 38480108 DOI: 10.1016/j.hipert.2024.01.001] [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: 10/30/2023] [Revised: 01/05/2024] [Accepted: 01/09/2024] [Indexed: 04/14/2024]
Abstract
Hypertension has become a central risk factor for the development of cardiovascular disease, underscoring the importance of its accurate diagnosis. Numerous studies have established a close relationship between elevated systolic (SBP) and diastolic (DBP) blood pressure and an increased risk of cardiovascular event (CVE). Traditionally, blood pressure (BP) measurements performed in clinical settings have been the main method for diagnosing and assessing hypertension. However, in recent years, it has been recognized that BP measurements obtained outside the clinical setting, using self-monitoring blood pressure (SMBP) and ambulatory blood pressure monitoring (ABPM), offer a more realistic perspective of patients' daily lives and therefore provide more reliable results. Given the evolution of medical devices, diagnostic criteria, and the increasing relevance of certain components of ABPM in the prediction of adverse cardiovascular outcomes, a comprehensive update that is practical for daily clinical practice is required. The main objective of this article is to provide an updated review of ABPM, focusing on its importance in the evaluation of hypertension and its impact on public health in Colombia. In addition, it will discuss the implications of changes in diagnostic thresholds and provide concrete recommendations for the effective implementation of ABPM in clinical practice, allowing health professionals to make informed decisions and improve the care of their patients.
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Affiliation(s)
- A D Sotomayor Julio
- Departamento de Cardiología, Fundación Valle del Lili, Valle del Cauca, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia.
| | - L P Montana-Jimenez
- Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - W Bernal Torres
- Centro de Investigaciones Clínicas, Hospital Universitario Fundación Valle del Lili, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
| | - J D López Ponce de León
- Centro de Investigaciones Clínicas, Hospital Universitario Fundación Valle del Lili, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
| | - J A Zambrano Franco
- Departamento de Cardiología, Fundación Valle del Lili, Valle del Cauca, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
| | - A Coca
- Universidad de Barcelona, Barcelona, España
| | - M Camafort
- Universidad de Barcelona, Barcelona, España
| | - C Vesga Reyes
- Departamento de Cardiología, Fundación Valle del Lili, Valle del Cauca, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
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3
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Mellado-Sola I, Cobo-Vázquez E, Calvo-Fernandez A, Cervantes E, Coca A, Calderón-Llopis B, Saavedra-Lozano J, Calvo C. Mediastinitis secondary to invasive infection by group A Streptococcus in Spain. Eur J Pediatr 2024; 183:503-507. [PMID: 37889290 DOI: 10.1007/s00431-023-05288-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023]
Abstract
This study describes 5 mediastinitis cases secondary to invasive group A Streptococcus (iGAS) disease in a recent outbreak in Spain. Among 398 iGAS cases between January 2019-March 2023, 5 (1.3%) were mediastinitis, 4 occurring in December 2022, all secondary to pneumonia or deep neck infection. We outline the clinical outcome with a review of the scarce pediatric literature. Conclusion: mediastinistis is a rare but severe complication of iGAS and a high level of suspicion is required to diagnose it. What is Known: • Group A Streptococcus can cause invasive and severe infections in children. • Mediastinitis is a severe complication from some bacterial infections, mainly secondary due to deep-neck abscesses. What is New: • Mediastinitis is an unrecognized complication due to an invasive group A Streptococcus (iGAS) infection. • In cases of a deep-neck abscess or complicated pneumonia a high clinical suspicion of iGAS mediastinitis is required, especially when the clinical course is not favorable.
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Affiliation(s)
- I Mellado-Sola
- Pediatric and Infectious Diseases Department, La Paz University Hospital, Institute for Health Research (IdiPAZ), Pº Castellana, 261, Madrid, 28046, Spain.
| | - E Cobo-Vázquez
- Department of Pediatrics. Hospital, Universitario Fundación de Alcorcón, Alcorcón, Madrid, Spain
- Program in Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - A Calvo-Fernandez
- Pediatric Intensive Care Unit, La Paz University Hospital, Madrid, Spain
| | - E Cervantes
- Pediatrics and Infectious Diseases Department, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - A Coca
- Pediatric Intensive Care Unit, Ramón y Cajal University Hospital, Madrid, Spain
| | - B Calderón-Llopis
- Pediatric Intensive Care Unit, La Paz University Hospital, Madrid, Spain
| | - J Saavedra-Lozano
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Biomedical Research Network Centre for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
- Hospital Institute of Health Research (IiSGM), Madrid, Spain
- Universidad Complutense de Madrid, Madrid, Spain
| | - C Calvo
- Pediatric and Infectious Diseases Department, La Paz University Hospital, Institute for Health Research (IdiPAZ), Pº Castellana, 261, Madrid, 28046, Spain
- Biomedical Research Network Centre for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
- Universidad Autónoma de Madrid, Madrid, Spain
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4
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Mancia G, Cappuccio FP, Burnier M, Coca A, Persu A, Borghi C, Kreutz R, Sanner B. Perspectives on improving blood pressure control to reduce the clinical and economic burden of hypertension. J Intern Med 2023; 294:251-268. [PMID: 37401044 DOI: 10.1111/joim.13678] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
The clinical and economic burden of hypertension is high and continues to increase globally. Uncontrolled hypertension has severe but avoidable long-term consequences, including cardiovascular diseases, which are among the most burdensome and most preventable conditions in Europe. Yet, despite clear guidelines on screening, diagnosis and management of hypertension, a large proportion of patients remain undiagnosed or undertreated. Low adherence and persistence are common, exacerbating the issue of poor blood pressure (BP) control. Although current guidelines provide clear direction, implementation is hampered by barriers at the patient-, physician- and healthcare system levels. Underestimation of the impact of uncontrolled hypertension and limited health literacy lead to low adherence and persistence among patients, treatment inertia among physicians and a lack of decisive healthcare system action. Many options to improve BP control are available or under investigation. Patients would benefit from targeted health education, improved BP measurement, individualized treatment or simplified treatment regimens through single-pill combinations. For physicians, increasing awareness of the burden of hypertension, as well as offering training on monitoring and optimal management and provision of the necessary time to collaboratively engage with patients would be useful. Healthcare systems should establish nationwide strategies for hypertension screening and management. Furthermore, there is an unmet need to implement more comprehensive BP measurements to optimize management. In conclusion, an integrative, patient-focused, multimodal multidisciplinary approach to the management of hypertension by clinicians, payers and policymakers, involving patients, is required to achieve long-term improvements in population health and cost-efficiency for healthcare systems.
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Affiliation(s)
- G Mancia
- University of Milano-Bicocca, Milan, Italy
| | - F P Cappuccio
- University of Warwick, Warwick Medical School, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - M Burnier
- Service of Nephrology and Hypertension, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - A Coca
- Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - A Persu
- Division of Cardiology, Cliniques Universitaires Saint-Luc and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - C Borghi
- Medical and Surgical Sciences Department, University of Bologna, Bologna, Italy
| | - R Kreutz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institut für Klinische Pharmakologie und Toxikologie, Berlin, Germany
| | - B Sanner
- Department of Internal Medicine, Agaplesion Bethesda, Wuppertal, Germany
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Manolis AJ, Kallistratos MS, Camafort M, Coca A. How low should blood pressure be in patients with chronic coronary and cerebrovascular diseases. Eur J Intern Med 2023; 109:22-29. [PMID: 36631307 DOI: 10.1016/j.ejim.2023.01.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 01/11/2023]
Abstract
Over the last three decades, there are an increasing number of investigators and meta-analyses focusing on the fact that lowering blood pressure levels below a critical point is no longer beneficial and possibly even deleterious. In recent years, several trials and meta-analyses assessing intensive blood pressure (BP) lowering found that intensive treatment and lower blood pressure levels are associated with a reduction in CV events and mortality. However, a careful examination of the results shows that current data are not easily applicable to the general hypertensive population. In addition, recommendations of different guidelines since 2017 so far suggest different BP levels regarding the systolic and diastolic thresholds to be achieved and maintained, particularly in specific clinical situations such as patients with coronary artery disease and stroke. The challenge is to better define the limits of intervention and to define phenotypes of patients who are particularly vulnerable to over-aggressive lowering of blood pressure. This article reviews the evidence, controversies and current state of knowledge regarding intensive BP lowering and the lower thresholds of BP to be achieved in patients with chronic coronary or cerebrovascular diseases.
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Affiliation(s)
- A J Manolis
- Cardiology Department, Metropolitan Hospital, Piraeus, Greece
| | | | - M Camafort
- Hypertension and Vascular Risk Unit, Department of Internal Medicine. Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - A Coca
- Hypertension and Vascular Risk Unit, Department of Internal Medicine. Hospital Clínic, University of Barcelona, Barcelona, Spain
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6
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Wyss F, Valdez O, Camafort M, Coca A. [Comprehensive Therapeutic Approach to Hypertension. Recommendations for Central America and the Caribbean]. Hipertens Riesgo Vasc 2023; 40:40-47. [PMID: 35697633 DOI: 10.1016/j.hipert.2022.05.004] [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: 03/14/2022] [Revised: 05/04/2022] [Accepted: 05/08/2022] [Indexed: 11/30/2022]
Abstract
Latin American hypertension guidelines, tailored to the needs of countries of Central and South America, should be applied and known by most Latin American physicians. The knowledge and implementation of the Guidelines is one of the greatest challenges of hypertension societies in Latin America such as the Central American and Caribbean Society of Arterial Hypertension (SCCH), the Latin American Society of Hypertension (LASH) and the Inter-American Society of Cardiology (SIAC). In 2020, the Inter-American Society of Cardiology (SIAC) published its position on the current Guidelines for Arterial Hypertension due to the need to standardize the evaluation, diagnosis, treatment and control of hypertension, establishing recommendations that should be adopted in all Latin American countries, aimed at optimizing the management of cardiovascular risk and achieving a substantial improvement in the reduction of cardiovascular events and mortality. This document intends to reinforce all proposals by the LASH guidelines and the position of the SIAC in relation to the therapeutic approach and pharmacological recommendations for patients with hypertension (HT), in order to achieve better HT control in the Central American and Caribbean area, and the consequently prognosis improvement of cardiovascular disease in the area.
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Affiliation(s)
- F Wyss
- Servicios y Tecnología Cardiovascular de Guatemala, Sociedad Centroamericana y del Caribe de Hipertensión Arterial y Prevención Cardiovascular, Ciudad de Guatemala, Guatemala.
| | - O Valdez
- Unidad de Cardiología, Hospital Central Romana, y Centro Especialidades Médicas Romana (CEMER), Sociedad Centroamericana y del Caribe de Hipertensión Arterial y Prevención Cardiovascular, Santo Domingo, República Dominicana
| | - M Camafort
- Unidad de Hipertensión, Unidad de Insuficiencia Cardiaca, Servicio de Medicina Interna, ICMID, Hospital Clínic IDIBAPS, Universidad de Barcelona, Barcelona, España; CIBER-OBN, Instituto de Salud Carlos III, Madrid, España
| | - A Coca
- Unidad de Hipertensión, Unidad de Insuficiencia Cardiaca, Servicio de Medicina Interna, ICMID, Hospital Clínic IDIBAPS, Universidad de Barcelona, Barcelona, España; Sociedad Europea de Hipertensión, Zug, Suiza
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7
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Camafort M, Alcocer L, Coca A, Lopez-Lopez J, López-Jaramillo P, Ponte-Negretti C, Sebba-Barroso W, Valdéz O, Wyss F. Registro Latinoamericano de monitorización ambulatoria de la presión arterial (MAPA-LATAM): una necesidad urgente. Rev Clin Esp 2021. [DOI: 10.1016/j.rce.2021.02.002] [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: 10/21/2022]
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8
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Batista SR, Vitorino PVO, Silva RR, Sousa ALL, Barroso WKS, Coca A. Cardiovascular multimorbidity and associated factors: the first Brazilian Registry of patients with hypertension. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2337] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiometabolic multimorbidity (CM-MM) defined by the occurrence of at least two of morbidities (diabetes mellitus, stroke, acute myocardial infarction) is a important issue for health systems and it was associated with several health negative outcomes, especially decreasing of the life expectancy.
Purpose
To analyze the occurrence of CM-MM and associated factors among Brazilian patients with hypertension.
Methods
Cross-sectional study with participants of The First Brazilian Registry of Patients with Hypertension (BRH) from 45 sites in all regions of Brazil (n=2,646). For this study we select the individuals with ≥65 years (n=1,033) and CM-MM was defined with the presence of ≥2 of the following: diabetes mellitus, stroke, acute myocardial infarction evaluated by self related. CM-MM was analyzed according to sex, age, race, presence of others morbidities (dyslipidemia, myocardial revascularization, heart failure and chronic kidney disease), control of blood pressure, obesity, physical activity, actual smoking and alcohol consumption. The numerical variables were presented by median and interquartile range, the categorical variables by absolute and relative frequency. To verify the variables associated with the outcome, simple logistic regression was performed.
Results
CM-MM was present in 8.9% of participants. The median age was 71.6 (IQ: 67.9–76.8), female (59.7%), 65–70 years of age (39.6%), and 59.8% were white. Obesity was present in 55.8% and 48.4% of individuals have no blood pressure controlled. The occurrence of diabetes mellitus, stroke, and acute myocardial infarction was, respectively, 32.7%, 14.7% and 6.7%. A higher occurrence of CM-MM was observed in males, aged between 70 and 75 years old and with 75 years old or more, the presence of dyslipidemia; myocardial revascularization (MR); heart failure (HF) and kidney disease. The intersection size among diseases is represented in Figure 1. After multiple analysis, the following variables were associated with the presence of cardiovascular multimorbidity: male gender; age equal to or greater than 75 years and report of dyslipidemia, MR and HF.
Conclusions
The prevalence of CM-MM was high and an approach based on the clusters of cardiometabolic diseases can be a potent care strategy.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Intersection size among diseases CM-MM
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Affiliation(s)
- S R Batista
- Federal University of Goias, Department of Internal Medicine, Goiania, Brazil
| | | | - R R Silva
- Federal University of Goias, Goiania, Brazil
| | - A L L Sousa
- Federal University of Goias, Goiania, Brazil
| | - W K S Barroso
- Federal University of Goias, Department of Internal Medicine, Goiania, Brazil
| | - A Coca
- University of Barcelona, Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clínic (IDIBAPS), Barcelona, Spain
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Coca A. Marcadores pronósticos fiables de la evolución de la insuficiencia cardíaca del anciano: ¿es la monitorización ambulatoria de la presión arterial uno de ellos? Rev Clin Esp 2021. [DOI: 10.1016/j.rce.2021.01.005] [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: 10/21/2022]
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10
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Camafort M, Alcocer L, Coca A, Lopez-Lopez JP, López-Jaramillo P, Ponte-Negretti CI, Sebba-Barroso W, Valdéz O, Wyss F. Latin-American Ambulatory Blood Pressure Registry (MAPA-LATAM): An urgent need. Rev Clin Esp 2021; 221:547-552. [PMID: 34509417 DOI: 10.1016/j.rceng.2021.02.004] [Citation(s) in RCA: 1] [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] [Received: 01/09/2021] [Accepted: 02/02/2021] [Indexed: 11/27/2022]
Abstract
Hypertension (HT) is one of the main risk factors for cardiovascular disease (CVD). Although it is a global problem, independently of economic situation, region, race or culture, the data available on Latin America are limited. Clinical guidelines emphasise the importance of obtaining reliable blood pressure readings. For this reason, the use of ambulatory blood pressure monitoring (ABPM) is recommended. This improves precision and reproducibility, resulting in better diagnosing and therapeutic decision-making, and constitutes a better estimation of prognosis than office measurements. Unfortunately, there is no global prospective ABPM registry for all of Latin America that analyses HT prevalence, the level of knowledge about it, treatment percentage and the degree of control. Consequently, the authors of this article consider its implementation a priority.
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Affiliation(s)
- M Camafort
- Unidad de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Hospital Clínic, IDIBAPS, Universidad de Barcelona, Barcelona, Spain.
| | - L Alcocer
- Instituto Mexicano de Salud Cardiovascular, Hospital General de México, Instituto Superior de Estudios en Salud Pública, Ciudad de México, Mexico
| | - A Coca
- Unidad de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Hospital Clínic, IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - J P Lopez-Lopez
- Centro Integral para la Prevención Cardiometabólica (CIPCA), FOSCAL Internacional, Floridablanca, Santander, Colombia
| | - P López-Jaramillo
- Instituto Masira, Escuela de Medicina, Universidad de Santander, Bucaramanga, Santander, Colombia
| | - C I Ponte-Negretti
- Unidad de Medicina Cardiometabólica, Instituto Clínico La Floresta, Caracas, Venezuela
| | - W Sebba-Barroso
- Departamento de Clínica Médica, Universidad Federal de Goiás, Goiás, Brasil
| | - O Valdéz
- Centro Médico Central Romana, La Romana, Dominican Republic
| | - F Wyss
- Servicios y Tecnología Cardiovascular de Guatemala-Cardiosolutions, Ciudad de Guatemala, Guatemala
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Lhermitte B, Blandin AF, Coca A, Guerin E, Durand A, Entz-Werlé N. Signaling pathway deregulation and molecular alterations across pediatric medulloblastomas. Neurochirurgie 2021; 67:39-45. [PMID: 29776650 DOI: 10.1016/j.neuchi.2018.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 10/27/2017] [Revised: 01/06/2018] [Accepted: 01/13/2018] [Indexed: 12/21/2022]
Abstract
Medulloblastomas (MBs) account for 15% of brain tumors in children under the age of 15. To date, the overall 5-year survival rate for all children is only around 60%. Recent advances in cancer genomics have led to a fundamental change in medulloblastoma classification and is evolving along with the genomic discoveries, allowing to regularly reclassify this disease. The previous molecular classification defined 4 groups (WNT-activated MB, SHH-activated MB and the groups 3 and 4 characterized partially by NMYC and MYC driven MBs). This stratification moved forward recently to better define these groups and their correlation to outcome. This new stratification into 7 novel subgroups was helpful to lay foundations and complementary data on the understanding regarding molecular pathways and gene mutations underlying medulloblastoma biology. This review was aimed at answering the recent key questions on MB genomics and go further in the relevance of those genes in MB development as well as in their targeted therapies.
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Affiliation(s)
- B Lhermitte
- Laboratoire de Pathologie, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg, France
| | - A F Blandin
- EA3430, Progression tumorale et microenvironnement, approches translationnelles et épidémiologie, université de Strasbourg, 3, avenue Molière, 67000 Strasbourg, France
| | - A Coca
- Service de Neurochirurgie, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg, France
| | - E Guerin
- Laboratoire de biologie moléculaire et plateforme régionale d'oncobiologie d'Alsace, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg, France
| | - A Durand
- EA3430, Progression tumorale et microenvironnement, approches translationnelles et épidémiologie, université de Strasbourg, 3, avenue Molière, 67000 Strasbourg, France
| | - N Entz-Werlé
- EA3430, Progression tumorale et microenvironnement, approches translationnelles et épidémiologie, université de Strasbourg, 3, avenue Molière, 67000 Strasbourg, France; Service de pédiatrie onco-hématologie, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg, France.
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12
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Coca A. Reliable prognostic markers for the progression of heart failure in older adults: Is ambulatory blood pressure monitoring one of them? Rev Clin Esp 2021; 221:470-472. [PMID: 34154975 PMCID: PMC8464162 DOI: 10.1016/j.rceng.2021.01.005] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 11/29/2022]
Affiliation(s)
- A Coca
- Unidad de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Hospital Clínic, Universidad de Barcelona, Barcelona, Spain.
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13
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Morales-Salinas A, Olsen MH, Kones R, Kario K, Wang JG, Beilin L, Weber MA, Yano Y, Burrell LM, Orias M, Dzudie A, Lavie C, Ventura H, Sundström J, de Simone G, Coca A, Rumana U, Marrugat J. Erratum to "Second Consensus on Treatment of Patients Recently Diagnosed with Mild Hypertension and Low Cardiovascular Risk". [YMCD 45/10 (October 2020) 100653]. Curr Probl Cardiol 2021; 46:100877. [PMID: 34148707 DOI: 10.1016/j.cpcardiol.2021.100877] [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] [Indexed: 11/18/2022]
Affiliation(s)
- A Morales-Salinas
- Associate Professsor, Universidad de Ciencias Médicas de Villa Clara, Villa Clara, Cuba.
| | - M H Olsen
- Professor, Cardiology Section, Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
| | - R Kones
- Director, Cardiometabolic Research Institute, Houston, TX, USA. Chief Medical Officer, Community Diabetes Prevention Program, Houston, TX, USA. Editor-in-Chief, Research Reports in Clinical Cardiology.
| | - K Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
| | - J G Wang
- The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Tel: +86-21-64662193 ext 610911).
| | - L Beilin
- Professor of Medicine in the School of Medicine & Pharmacology at the Royal Perth Hospital Campus, University of Western Australia.
| | - M A Weber
- Professor of Medicine, Division of Cardiovascular Medicine, State University of New York, Downstate Medical Center.
| | - Y Yano
- Assistant Professor in Family Medicine and Community Health, Duke University, Durham, NC.
| | - L M Burrell
- Departments of Medicine and Cardiology, The University of Melbourne, Austin Health, Victoria, 3084, Australia.
| | - M Orias
- Department of Nephrology, Sanatorio Allende, Independencia 768, 5000 Córdoba, Argentina.
| | - A Dzudie
- Hôpital Général de Douala Douala, Cameroon.
| | - C Lavie
- Medical Director Cardiac Rehabilitation and Prevention, Director Exercise Laboratories, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, Editor in Chief, Progress in Cardiovascular Diseases, New Orleans, Louisiana.
| | - H Ventura
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, Louisiana.
| | - J Sundström
- Professor of Epidemiology, Uppsala University, +4670422522.
| | - G de Simone
- Professor of Medicine, Chair, Council on Hypertension, European Society of Cardiology, Hypertension Research Cente & Dprt of Translational Biomedical Sciences, Federico II University Hospital, via S. Pansini 5, bld # 1, 80131 Napoli, Italy.
| | - A Coca
- Honorary Professor of Medicine. Department of Internal Medicine, Hospital Clínic, University of Barcelona, Spain, Phone: +34 618 769 035.
| | - U Rumana
- New York Institute of Technology, Old Westbury, NY.
| | - J Marrugat
- Institut Hospital del Mar d'investigacions Mèdiques (IMIM) - CIBERCV, Barcelona, Catalonia, Spain.
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Scuteri A, Benetos A, Sierra C, Coca A, Chicherio C, Frisoni GB, Gasecki D, Hering D, Lovic D, Manios E, Petrovic M, Qiu C, Shenkin S, Tzourio C, Ungar A, Vicario A, Zaninelli A, Cunha PG. Routine assessment of cognitive function in older patients with hypertension seen by primary care physicians: why and how-a decision-making support from the working group on 'hypertension and the brain' of the European Society of Hypertension and from the European Geriatric Medicine Society. J Hypertens 2021; 39:90-100. [PMID: 33273363 DOI: 10.1097/hjh.0000000000002621] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 10/22/2022]
Abstract
: The guidelines on hypertension recently published by the European Societies of Hypertension and Cardiology, have acknowledged cognitive function (and its decline) as a hypertension-mediated organ damage. In fact, brain damage can be the only hypertension-mediated organ damage in more than 30% of hypertensive patients, evolving undetected for several years if not appropriately screened; as long as undetected it cannot provide either corrective measures, nor adequate risk stratification of the hypertensive patient.The medical community dealing with older hypertensive patients should have a simple and pragmatic approach to early identify and precisely treat these patients. Both hypertension and cognitive decline are undeniably growing pandemics in developed or epidemiologically transitioning societies. Furthermore, there is a clear-cut connection between exposure to the increased blood pressure and development of cognitive decline.Therefore, a group of experts in the field from the European Society of Hypertension and from the European Geriatric Medicine Society gathered together to answer practical clinical questions that often face the physician when dealing with their hypertensive patients in a routine clinical practice. They elaborated a decision-making approach to help standardize such clinical evaluation.
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Affiliation(s)
- Angelo Scuteri
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari
- Sardinia Aging Well Network, Reference Site of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA), Bologna, Italy
| | - Athanasios Benetos
- Department of Geriatrics, CHRU Nancy and INSERM DCAC, Université de Lorraine, Nancy, France
| | - Cristina Sierra
- Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clínic (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - António Coca
- Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clínic (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Christian Chicherio
- Department of Geriatrics and Rehabilitation, Memory Center, Geneva University Hospitals
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
| | - Giovanni B Frisoni
- Department of Geriatrics and Rehabilitation, Memory Center, Geneva University Hospitals
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
| | | | - Dagmara Hering
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland
| | - Dragan Lovic
- Cardiology Department, Clinic for Internal Disease, Hypertensive Centre Singidunum University, School of Medicine Nis, Nis, Serbia
| | - Efstathios Manios
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School of Athens, Alexandra Hospital, Athens, Greece
| | - Mirko Petrovic
- Department of Geriatrics, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Chengxuan Qiu
- Department of Neurobiology, Care Sciences and Society, Aging Research Center and Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Susan Shenkin
- Division of Geriatric Medicine, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Cristophe Tzourio
- University Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, CHU Bordeaux, Bordeaux, France
| | - Andrea Ungar
- Division Geriatrica UTIG, Azienda Ospedaliero Universitaria Careggi, University of Florence, Florence, Italy
| | - Augusto Vicario
- Heart and Brain Unit, Cardiovascular Institute of Buenos Aires (ICBA), Buenos Aires, Argentina
| | - Augusto Zaninelli
- Department of General Practice, School of Medicine, University of Florence, Florence, Italy
| | - Pedro G Cunha
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Serviço de Medicina Interna do Hospital da Senhora da Oliveira, Guimarães
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
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Virbel G, Cebula H, Coca A, Lhermitte B, Bauchet L, Noël G. [Choice optimisation of radiation therapy technique for central neurocytomas from literature data]. Cancer Radiother 2020; 24:882-891. [PMID: 32753237 DOI: 10.1016/j.canrad.2020.03.011] [Citation(s) in RCA: 1] [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] [Received: 02/10/2020] [Revised: 02/28/2020] [Accepted: 03/11/2020] [Indexed: 12/31/2022]
Abstract
Neurocytomas represent 0,25 to 0,5 of brain tumours. These tumours have neuronal differentiation. It's a young adult disease. The main treatment is neurosurgery. The place of other therapies is still unclear, noticeably with regards to radiotherapy. This review aim is to determine the place and the modalities of radiotherapy in the management of neurocytomas. A literature search using PubMed allowed to select the most relevant studies. Finally, 22 studies were selected according to pre-established criteria to answer the problem. All studies were retrospective studies except one. The analysis conclusion defined radiotherapy as a treatment of choice in selected patients, when surgical resection was incomplete or when tumour was atypical.
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Affiliation(s)
- G Virbel
- Département de radiothérapie, ICANS, 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - H Cebula
- Département de neurochirurgie, hôpital de Hautepierre, 1, rue Molière, 67200 Strasbourg, France
| | - A Coca
- Département de neurochirurgie, hôpital de Hautepierre, 1, rue Molière, 67200 Strasbourg, France
| | - B Lhermitte
- Service d'anatomopathologie, hôpital de Hautepierre, 1, rue Molière, 67200 Strasbourg, France
| | - L Bauchet
- Service de neurochirurgie, hôpital Gui-de-Chauliac, CHU de Montpellier, 80, avenue Augustin-Fliche, 34090 Montpellier, France; Inserm, U1051, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - G Noël
- Département de radiothérapie, ICANS, 17, rue Albert-Calmette, 67200 Strasbourg, France.
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Di Rocco F, Scavarda D, Vinchon M, Szathmari A, Riffaud L, Bohra A, Blauwblomme T, Boetto S, Gimbert E, Ferrand S, Coca A, Chivoret N, Coll G, Delion M, Roujeau T, Mottolese C, Zerah M. Impact de la pandémie COVID-19 sur la neurochirurgie pédiatrique en France. Neurochirurgie 2020; 66:192-194. [PMID: 32504645 PMCID: PMC7833797 DOI: 10.1016/j.neuchi.2020.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/24/2020] [Indexed: 12/24/2022]
Affiliation(s)
- F Di Rocco
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France.
| | - D Scavarda
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - M Vinchon
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - A Szathmari
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - L Riffaud
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - A Bohra
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - T Blauwblomme
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - S Boetto
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - E Gimbert
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - S Ferrand
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - A Coca
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - N Chivoret
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - G Coll
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - M Delion
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - T Roujeau
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - C Mottolese
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
| | - M Zerah
- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
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- Neurochirurgie pédiatrique, hôpital Femme-Mère-Enfant, université de Lyon, 59, boulevard Pinel, 69003 Lyon, France
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Sabio R, Parodi R, Coca A. [Impact of cognitive biases in therapeutic inertia in arterial hypertension: Not everything is as it seems]. Hipertens Riesgo Vasc 2020; 37:78-81. [PMID: 31542309 DOI: 10.1016/j.hipert.2019.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/11/2019] [Revised: 07/12/2019] [Accepted: 07/19/2019] [Indexed: 12/13/2022]
Abstract
Therapeutic inertia is defined as the failure to take therapeutic decisions, such as initiating, adding or increasing the dose of a drug during patient follow-up, despite there being an indication to do so. It is currently considered that therapeutic inertia is a considerable impediment to achieving adequate control of hypertension, and this has implications for the prognosis of the disease. Therapeutic inertia might be due to various factors involving physicians, patients and the health system. Many studies have attempted to find determinants for therapeutic inertia in hypertension and to explain the reasons why health professionals in charge of treatment are failing to make the appropriate modifications to therapy. The many reasons for therapeutic inertia on the part of physicians include the various cognitive and affective biases that influence clinical reasoning and decision-making during healthcare activity in doctors' surgeries. Identifying and recognising these cognitive and affective biases could be important for planning educational strategies for health professionals. This requires a multi-dimensional approach, including knowledge beyond that observed in terms of insufficient information and updating on the disease, and starting to analyse and consider other reasons. Preventing therapeutic inertia should be made a priority along with other important measures to control hypertension and minimise its consequences.
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Affiliation(s)
- R Sabio
- Servicio de Medicina Interna, Hospital SAMIC de Alta Complejidad, El Calafate, Argentina.
| | - R Parodi
- Servicio de Medicina Interna, Hospital Provincial Centenario, Rosario, Argentina
| | - A Coca
- Unidad de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Hospital Clínico, Universidad de Barcelona, Barcelona, España
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Coca A. Reflexiones acerca del posicionamiento de SEMERGEN sobre las más recientes guías de hipertensión arterial de Estados Unidos y Europa. Semergen 2019; 45:213-214. [DOI: 10.1016/j.semerg.2019.05.001] [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: 11/26/2022]
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Morales-Salinas A, Coca A, Alcocer L, Barbosa E. [Contributions of the First International Consensus on grade 1 Hypertension with low to moderate cardiovascular risk]. Hipertens Riesgo Vasc 2018; 35:199-200. [PMID: 29503008 DOI: 10.1016/j.hipert.2018.01.005] [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] [Received: 01/19/2018] [Accepted: 01/23/2018] [Indexed: 11/22/2022]
Affiliation(s)
| | - A Coca
- Hospital Clínic, Universidad de Barcelona, Barcelona, España
| | - L Alcocer
- Instituto Mexicano de Salud Cardiovascular, Ciudad de México, México
| | - E Barbosa
- Hospital Moinhos de Vento, Goiana, Pernambuco, Brasil
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20
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Fath L, Cebula H, Santin MN, Coca A, Debry C, Proust F. The Grisel's syndrome: A non-traumatic subluxation of the atlantoaxial joint. Neurochirurgie 2018; 64:327-330. [PMID: 29731316 DOI: 10.1016/j.neuchi.2018.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 12/18/2017] [Accepted: 02/05/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Grisel's syndrome consists in rotational subluxation of C1-C2 following ENT infection or surgery. There is no consensus on management. We present 2 cases requiring surgical treatment in our center. CASE REPORTS Two 10-year-old patients presented torticollis with cervical pain resistant to medical treatment, with onset a few months after tonsillectomy. In both cases, radiological assessment, comprising CT scan and MRI, showed Fielding-Hawkins type-3 C1-C2 rotational subluxation, without ligament lesion. After failure of conservative treatment, posterior reaming, realignment, C1-C2 arthrodesis using lateral masses and pars interarticularis screws and bone graft achieved good fusion and immediate spinal stability in all planes of the atlantoaxial complex. DISCUSSION Grisel's syndrome consists in non-traumatic subluxation of the atlantoaxial joint with intact atlantoaxial ligaments. Initial pharyngeal inflammation spreads to the prevertebral fascia via direct connections between the periodontoidal venous plexus and pharyngovertebral veins, inducing fasciitis that leads to abnormal relaxation of the atlantoaxial ligaments and reactional muscle contraction with ankylosis. This phenomenon, appearing gradually and insidiously over a period of a few weeks, creates a frozen joint with ankylosis. Medical treatment with NSAIDs, muscle relaxants, and immobilization is usually sufficient; cervical traction may be needed. Surgical treatment by C1-C2 arthrodesis is indicated in case of failure of medical management or onset of neurologic signs. CONCLUSION Close collaboration between pediatricians, ENT surgeons and neurosurgeons is essential for early diagnosis and management, which is the main prognostic factor for successful medical treatment, avoiding surgery.
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Affiliation(s)
- L Fath
- CHU de Strasbourg, hôpital de Hautepierre, service d'ORL et chirurgie cervico-faciale, 67200 Strasbourg, France.
| | - H Cebula
- CHU de Strasbourg, hôpital de Hautepierre, service de neurochirurgie, 67200 Strasbourg, France
| | - M N Santin
- CHU de Strasbourg, hôpital de Hautepierre, service de neurochirurgie, 67200 Strasbourg, France
| | - A Coca
- CHU de Strasbourg, hôpital de Hautepierre, service de neurochirurgie, 67200 Strasbourg, France
| | - C Debry
- CHU de Strasbourg, hôpital de Hautepierre, service d'ORL et chirurgie cervico-faciale, 67200 Strasbourg, France
| | - F Proust
- CHU de Strasbourg, hôpital de Hautepierre, service de neurochirurgie, 67200 Strasbourg, France
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Gijón-Conde T, Gorostidi M, Camafort M, Abad-Cardiel M, Martín-Rioboo E, Morales-Olivas F, Vinyoles E, Armario P, Banegas JR, Coca A, de la Sierra A, Martell-Claros N, Redón J, Ruilope LM, Segura J. [Spanish Society of Hypertension position statement on the 2017 ACC/AHA hypertension guidelines]. Hipertens Riesgo Vasc 2018; 35:S1889-1837(18)30033-3. [PMID: 29699926 DOI: 10.1016/j.hipert.2018.04.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 04/03/2018] [Accepted: 04/05/2018] [Indexed: 01/14/2023]
Abstract
The American College of Cardiology (ACC) and the American Heart Association (AHA) have recently published their guidelines for the prevention, detection, evaluation, and management of hypertension in adults. The most controversial issue is the classification threshold at 130/80mmHg, which will allow a large number of patients to be diagnosed as hypertensive who were previously considered normotensive. Blood pressure (BP) is considered normal (<120mmHg systolic and <80mmHg diastolic), elevated (120-129 and <80mmHg), stage 1 (130-139 or 80-89mmHg), and stage 2 (≥140 or ≥90mmHg). Out-of-office BP measurements are recommended to confirm the diagnosis of hypertension and for titration of BP-lowering medication. In management, cardiovascular risk would be determinant since those with grade 1 hypertension and an estimated 10-year risk of atherosclerotic cardiovascular disease ≥10%, and those with cardiovascular disease, chronic kidney disease and/or diabetes will require pharmacological treatment, the rest being susceptible to non-pharmacological treatment up to the 140/90mmHg threshold. These recommendations would allow patients with level 1 hypertension and high atherosclerotic cardiovascular disease to benefit from pharmacological therapies and all patients could also benefit from improved non-pharmacological therapies. However, this approach should be cautious because inadequate BP measurement and/or lack of systematic atherosclerotic cardiovascular disease calculation could lead to overestimation in diagnosing hypertension and to overtreatment. Guidelines are recommendations, not impositions, and the management of hypertension should be individualized, based on clinical decisions, preferences of the patients, and an adequate balance between benefits and risks.
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Affiliation(s)
- T Gijón-Conde
- Centro de Salud Universitario Cerro del Aire, Majadahonda (Madrid), España; Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma Madrid/IdiPAZ y CIBERESP, Madrid, España.
| | - M Gorostidi
- Servicio de Nefrología, Hospital Universitario Central de Asturias, RedinRen, Universidad de Oviedo, Oviedo (Asturias), España
| | - M Camafort
- Unidad de Hipertensión y Riesgo Cardiovascular, Servicio de Medicina Interna, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona, España
| | - M Abad-Cardiel
- Unidad de Hipertensión, Área de Prevención Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - E Martín-Rioboo
- Centro de Salud Poniente, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, España
| | - F Morales-Olivas
- Departamento de Farmacología, Facultad de Medicina y Odontología, Universidad de Valencia, Valencia, España
| | - E Vinyoles
- Centre d'Atenció Primària La Mina, Departamento de Medicina, Universidad de Barcelona, Barcelona, España
| | - P Armario
- Área Atención Integrada de Riesgo Vascular, Departamento de Medicina Interna, Hospital Moisès Broggi Sant Joan Despi, Universidad de Barcelona, Barcelona, España
| | - J R Banegas
- Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma Madrid/IdiPAZ y CIBERESP, Madrid, España
| | - A Coca
- Unidad de Hipertensión y Riesgo Cardiovascular, Servicio de Medicina Interna, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona, España
| | - A de la Sierra
- Departamento de Medicina Interna, Hospital Mutua Terrassa, Universidad de Barcelona, Terrassa (Barcelona), España
| | - N Martell-Claros
- Unidad de Hipertensión, Área de Prevención Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - J Redón
- Instituto de Investigación INCLIVA, Universidad de Valencia, Valencia, CIBERObn, Valencia, España; Instituto de Salud Carlos III, Madrid, España
| | - L M Ruilope
- Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma Madrid/IdiPAZ y CIBERESP, Madrid, España; Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, España; Escuela de Estudios de Doctorado e Investigación, Universidad Europea de Madrid, Madrid, España
| | - J Segura
- Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, España; Unidad de Hipertensión, Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, España
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Aguirre P F, Coca A, Aguirre MF, Celis G. Waist-to-height ratio and sedentary lifestyle as predictors of metabolic syndrome in children in Ecuador. Hipertens Riesgo Vasc 2017; 35:S1889-1837(17)30079-X. [PMID: 29108814 DOI: 10.1016/j.hipert.2017.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 05/02/2017] [Revised: 09/19/2017] [Accepted: 09/20/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To determine the predictors and prevalence of metabolic syndrome (MS) and the presence of vascular inflammation in apparently-normal children (10-15 years) of both sexes in Guayaquil, Ecuador. STUDY DESIGN AND METHODS We included 395 apparently-healthy students from a middle-income school in a cross-sectional survey. Informed consent was obtained from students and parents. Anthropometric measurements including blood pressure (BP), body mass index (BMI) and waist-to-height ratio (WHtR), and blood tests were recorded. Vascular inflammation parameters were assessed. Percentiles of the different parameters were used, and MS was defined according to National Cholesterol Education Program Adult Treatment Panel III criteria (NCEP-ATPIII). Waist circumference>P 75, blood pressure>P 90, glucose>100mg/dl, triglycerides>100mg/dl, HDL<45mg/dl. If 3 of the 5 criteria were present, this was considered MS. RESULTS The mean age was 12 years (186 boys, 209 girls). The overall prevalence of MS was 9.37% (6.33% in girls, 3.04% in boys). Sustained hypertension was detected in 6.6% of children and pre-hypertension in 7.1%. Obesity was found in 1.8% of subjects, and overweight in 15.2%. Triglycerides has a RR 2.34 (1.97-2.76); HOMA index has a RR 1.97(1.62-2.40); HDL cholesterol has a RR 1.84(1.58-2.13); Insulin level has a RR 1.53(1.40-1.67) and interleukin 6 has RR 1.83(1.20-2.79). Serum glucose, total cholesterol and LDL-Cholesterol had no association with the metabolic syndrome. HDL-Cholesterol<45mg/dl and triglyceride>100mg/dl were present in 70% of subjects with MS. The WHtR threshold≥0.5 was 100% sensitive in both sexes (67% specificity in boys and 69% in girls). There were significant associations between the WHtR and pre-hypertension and sedentary lifestyle (P<0.001 and P<0.003 respectively). A WHtR value of ≥0.50 indicated a 2.2-fold increased risk of MS compared with normal WHtR, and normal weight. CONCLUSIONS A WHtR≥0.5 was 100% sensitive in detecting MS in 10-15 year-old boys and girls in the normal or overweight range of the BMI. This assessment is a simple and practical tool for use in population-based studies of cardiovascular risk. When combined with pre-hypertension and a sedentary lifestyle, the WHtR is highly sensitive in predicting MS.
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Affiliation(s)
- F Aguirre P
- Hospital Clínica Kennedy Policentro, Guayaquil, Ecuador.
| | - A Coca
- Unidad de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Hospital Clínic (IDIBAPS), Universidad de Barcelona, Barcelona, Spain
| | - M F Aguirre
- Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - G Celis
- Epidemiology and Clinical Investigation Center, Quito, Ecuador
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Coca A. [Physician knowledge and attitudes on the clinical evaluation and treatment of resistant hypertension: The RESIST study]. Hipertens Riesgo Vasc 2016; 34:4-16. [PMID: 27650946 DOI: 10.1016/j.hipert.2016.07.001] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 07/06/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Resistant hypertension (RH) is associated with a high risk of cardiovascular and renal complications. The purpose of this study was to assess the knowledge and attitudes of Primary Care physicians, general medicine doctors, and clinical cardiologists on the management of this condition. MATERIAL AND METHODS A multicentre, descriptive, observational study based on an ad hoc questionnaire distributed to Primary Care physicians (n=1017) and general medicine physicians/clinical cardiologists (n=457). RESULTS To establish the diagnosis of resistant hypertension, 69.1% of physicians confirm that systolic/diastolic blood pressure is above 140/90 mmHg, despite treatment. Furthermore, 64.9% only consider this diagnosis if the patient is treated with at least 3 medications, and 50.3% also requires that one of them is a thiazide diuretic (56.7% among specialists, P=.0004). To establish a definite diagnosis of true RH, 89.6% perform 24-h ambulatory blood pressure monitoring (93.3% of specialists, P=.0017), looking specifically for «white-coat» effect in 70.2% of cases. In addition, 79.3% verify that adherence to treatment is adequate. Between 87 and 95% of physicians indicate examinations to exclude causes of secondary hypertension. Up to 54.3% of physicians (71.3% specialists, P<.0001) consider adding a fourth drug and insisting on lifestyle interventions as a priority therapeutic measure. CONCLUSION These data show that physician knowledge regarding the management of patients with RH is good. Interestingly, this knowledge is somewhat higher among specialists than among Primary Care physicians.
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Affiliation(s)
- A Coca
- Hospital Clínic, Universidad de Barcelona, Barcelona, España.
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Vigneron C, Antoni D, Coca A, Entz-Werlé N, Lutz P, Spiegel A, Jannier S, Niederst C, Jarnet D, Meyer P, Kehrli P, Noël G. [Pediatric medulloblastoma: Retrospective series of 52 patients]. Cancer Radiother 2016; 20:104-8. [PMID: 26996790 DOI: 10.1016/j.canrad.2015.11.004] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 11/22/2015] [Accepted: 11/25/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Retrospective analysis of the results of 52 children irradiated for a medulloblastoma. PATIENTS AND METHODS Between 1974 and 2012, 52 children with an average age of 6 years and a half (11 months-17 years and a half) were treated with surgery then with radiotherapy at the Comprehensive Cancer Centre of Strasbourg (France). For 44 children, the treatment consisted of a chemotherapy. RESULTS After a mean follow-up of 106.6 months (7-446 months), 13 relapses and 24 deaths were observed. Overall survival at 5 years and 10 years were 62% and 57%, respectively. Disease-free survival at 5 years and 10 years were 80% and 63%, respectively. Univariate analysis found the following adverse prognostic factors: the existence of a postoperative residue, the positivity of the cerebrospinal fluid, the metastatic status and medulloblastoma of high-risk. Positivity of the cerebrospinal fluid remains a negative factor in multivariate analysis. CONCLUSION These results confirm the survival rate obtained by a conventional approach (surgery then irradiation). Insufficiency of results and rarity of medulloblastoma require the establishment of international protocols.
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Affiliation(s)
- C Vigneron
- Département de radiothérapie, CLCC Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France
| | - D Antoni
- Département de radiothérapie, CLCC Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France
| | - A Coca
- Service de neurochirurgie, CHU Hautepierre, 67000 Strasbourg, France
| | - N Entz-Werlé
- Service d'oncologie pédiatrique, CHU Hautepierre, 67000 Strasbourg, France
| | - P Lutz
- Service d'oncologie pédiatrique, CHU Hautepierre, 67000 Strasbourg, France
| | - A Spiegel
- Service d'oncologie pédiatrique, CHU Hautepierre, 67000 Strasbourg, France
| | - S Jannier
- Service d'oncologie pédiatrique, CHU Hautepierre, 67000 Strasbourg, France
| | - C Niederst
- Département de radiothérapie, CLCC Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France
| | - D Jarnet
- Département de radiothérapie, CLCC Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France
| | - P Meyer
- Département de radiothérapie, CLCC Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France
| | - P Kehrli
- Service de neurochirurgie, CHU Hautepierre, 67000 Strasbourg, France
| | - G Noël
- Département de radiothérapie, CLCC Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg, France; Laboratoire EA 3430, fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, 67000 Strasbourg, France.
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Vigneron C, Antoni D, Coca A, Niederst C, Jarnet D, Meyer P, Kehrli P, Noël G. Médulloblastomes de l’adulte : étude rétrospective portant sur 21 patients. Cancer Radiother 2016; 20:14-7. [DOI: 10.1016/j.canrad.2015.07.156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/06/2015] [Accepted: 07/22/2015] [Indexed: 10/22/2022]
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Vigneron C, Entz-Werlé N, Lutz P, Spiegel A, Jannier S, Helfre S, Alapetite C, Coca A, Kehrli P, Noël G. Évolution de la prise en charge des médulloblastomes de l’enfant et de l’adulte. Cancer Radiother 2015. [DOI: 10.1016/j.canrad.2015.06.001] [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: 10/23/2022]
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Vigneron C, Entz-Werlé N, Lutz P, Spiegel A, Jannier S, Helfre S, Alapetite C, Coca A, Kehrli P, Noël G. Évolution de la prise en charge des médulloblastomes de l’enfant et de l’adulte. Cancer Radiother 2015. [DOI: 10.1016/j.canrad.2015.06.002] [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: 10/23/2022]
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Vigneron C, Entz-Werlé N, Lutz P, Spiegel A, Jannier S, Helfre S, Alapetite C, Coca A, Kehrli P, Noël G. [Evolution of the management of pediatric and adult medulloblastoma]. Cancer Radiother 2015; 19:347-57; quiz 358-9, 362. [PMID: 26141663 DOI: 10.1016/j.canrad.2015.03.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 01/05/2015] [Accepted: 03/02/2015] [Indexed: 10/23/2022]
Abstract
Medulloblastoma are cerebellar tumours belonging to the group of primitive neuroectodermal tumours (PNET) and are the most common malignant brain tumours of childhood. These tumours are rare and heterogeneous, requiring some multicentric prospective studies and multidisciplinary care. The classical therapeutic approaches are based on clinical, radiological and surgical data. They involve surgery, radiation therapy and chemotherapy. Some histological features were added to characterize risk. More recently, molecular knowledge has allowed to devise risk-adapted strategies and helped to define groups with good outcome and reduce long-term sequelae, improve the prognostic of high-risk medulloblastoma and develop new therapeutic tools.
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Affiliation(s)
- C Vigneron
- Département de radiothérapie, centre de lutte contre le cancer Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, BP 42, 67065 Strasbourg cedex, France
| | - N Entz-Werlé
- Service d'oncologie pédiatrique, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - P Lutz
- Service d'oncologie pédiatrique, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - A Spiegel
- Service d'oncologie pédiatrique, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - S Jannier
- Service d'oncologie pédiatrique, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - S Helfre
- Département de radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - C Alapetite
- Département de radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - A Coca
- Service de neurochirurgie, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - P Kehrli
- Service de neurochirurgie, CHU Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - G Noël
- Département de radiothérapie, centre de lutte contre le cancer Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, BP 42, 67065 Strasbourg cedex, France; Laboratoire EA 3430, fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, 4, rue Kirschleger, 67085 Strasbourg cedex, France.
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Chaussemy D, Cebulla H, Coca A, Chibarro S, Proust F, Kehrli P. Interest and limits of endoscopic approaches for pineal region tumours. Neurochirurgie 2015; 61:160-3. [PMID: 25911532 DOI: 10.1016/j.neuchi.2015.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 02/10/2015] [Revised: 03/07/2015] [Accepted: 03/16/2015] [Indexed: 10/23/2022]
Abstract
Endoscopy of pineal region tumours has been developed since the year 2000 either via a transventricular or extracerebral approach. The initial purpose of applying neuroendoscopy in the management of pineal region tumours was to resolve the obstructive hydrocephalus, and identify the pathological characteristics of the tumour. Based on this approach, a piecemeal resection of the tumour can be performed. The approaches, derived from the microsurgical pathway using an endoscope to expose the operative field, have been proposed either via an infratentorial supracerebellar approach or posterior transtentorial interhemispheric approach. Neuroendoscopic procedures can be considered as a therapeutic alternative to the microsurgical approach when CSF markers are negative. This procedure is considered mini-invasive for the approach along the surgical corridor access but extensive and in depth at the interface between the tumour and the surrounding neurological parenchyma. The limitations and complications are related to the type of procedure (mono- or bimanual) as well as the tumoral characteristics. Different approaches are presented in detail in order to avoid the occurrence of any surgical complications.
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Affiliation(s)
- D Chaussemy
- Department of neurosurgery, Strasbourg university hospital, hôpital Hautepierre, avenue Molière, 67000 Strasbourg cedex, France
| | - H Cebulla
- Department of neurosurgery, Strasbourg university hospital, hôpital Hautepierre, avenue Molière, 67000 Strasbourg cedex, France
| | - A Coca
- Department of neurosurgery, Strasbourg university hospital, hôpital Hautepierre, avenue Molière, 67000 Strasbourg cedex, France
| | - S Chibarro
- Department of neurosurgery, Strasbourg university hospital, hôpital Hautepierre, avenue Molière, 67000 Strasbourg cedex, France
| | - F Proust
- Department of neurosurgery, Strasbourg university hospital, hôpital Hautepierre, avenue Molière, 67000 Strasbourg cedex, France.
| | - P Kehrli
- Department of neurosurgery, Strasbourg university hospital, hôpital Hautepierre, avenue Molière, 67000 Strasbourg cedex, France
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Powell J, DiLeo T, Roberge R, Coca A, Kim JH. Salivary and serum cortisol levels during recovery from intense exercise and prolonged, moderate exercise. Biol Sport 2015; 32:91-5. [PMID: 26028807 PMCID: PMC4296213 DOI: 10.5604/20831862.1134314] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 07/19/2014] [Accepted: 10/09/2014] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to compare serum (SERc) and salivary cortisol (SALc) responses during recovery from two different exhaustive exercises to determine peak cortisol sampling time and the agreement between SERc and SALc levels. Twelve healthy men underwent a maximal treadmill graded exercise to exhaustion (MEx) and a prolonged, submaximal cycle exercise in the heat for 90 min (PEx) while SERc and SALc samples were taken in parallel at baseline, end of exercise, and 15 min intervals over one hour of recovery. MEx and PEx significantly increased SERc and SALc levels (p < 0.01) while absolute SERc levels were approximately 7-10 folds higher than SALc. SERc and SALc showed highly positive correlation (R = 0.667-0.910, p < 0.05) at most sampling times and only a few individual values were out of 95% limit of agreement when analyzed by Bland-Altman plots. However, peak SERc levels (MEx: 784.0±147, PEx: 705.5±212.0 nmol · L(-1)) occurred at 15 min of recovery, whereas peak SALc levels (MEx: 102.7±46.4, PEx: 95.7±40.9 nmol · L(-1)) were achieved at the end of exercise in MEx and PEx. The recovery trend of SERc and SALc also differed following MEx and PEx. Activity of 11β-hydroxysteroid dehydrogenase type 2 enzymes may be suppressed following MEx compared to PEx. In conclusion, sampling for peak SERc and SALc levels should take into account their evolution and clearance characteristics as well as type of exercise performed, whereas SALc appeared to be a more sensitive marker than SERc for the measurement of cortisol responses during exercise recovery.
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Affiliation(s)
- J Powell
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA, USA
| | - T DiLeo
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA, USA
| | - R Roberge
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA, USA
| | - A Coca
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA, USA
| | - J-H Kim
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA, USA
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Todeschi J, Cebula H, Chaussemy D, Benmekhbi M, Santin M, Coca A, Maitrot D, Chibbaro S. L’approche endoscopique trans-frontale trans-ventriculaire de la région postérieure du troisième ventricule, de la pinéale et du thalamus (présentation vidéo de cette technique chirurgicale). Neurochirurgie 2014. [DOI: 10.1016/j.neuchi.2014.10.037] [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: 10/24/2022]
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Coca A, Entzwerle N, Cebula H, Chaussemy D, Benmekhebi M, Chenard M. Biopsie des tumeurs infiltrantes du tronc cérébral sous neuronavigation assistée par robot ; expérience sur 8 cas en population pédiatrique. Neurochirurgie 2014. [DOI: 10.1016/j.neuchi.2014.10.102] [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: 10/24/2022]
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Vigneron C, Coca A, Entz-Werlé N, Lutz P, Spiegel A, Niederst C, Jarnet D, Meyer P, Kehrli P, Noël G. Médulloblastomes de l’enfant : étude rétrospective portant sur 52 patients. Cancer Radiother 2014. [DOI: 10.1016/j.canrad.2014.07.056] [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: 11/26/2022]
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Ramírez de Arellano A, Coca A, de la Figuera M, Rubio-Terrés C, Rubio-Rodríguez D, Gracia A, Boldeanu A, Puig-Gilberte J, Salas E. Economic evaluation of Cardio inCode®, a clinical-genetic function for coronary heart disease risk assessment. Appl Health Econ Health Policy 2013; 11:531-542. [PMID: 24078223 PMCID: PMC3825137 DOI: 10.1007/s40258-013-0053-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND A clinical–genetic function (Cardio inCode®) was generated using genetic variants associated with coronary heart disease (CHD), but not with classical CHD risk factors, to achieve a more precise estimation of the CHD risk of individuals by incorporating genetics into risk equations [Framingham and REGICOR (Registre Gironí del Cor)]. OBJECTIVE The objective of this study was to conduct an economic analysis of the CHD risk assessment with Cardio inCode®, which incorporates the patient’s genetic risk into the functions of REGICOR and Framingham, compared with the standard method (using only the functions). METHODS A Markov model was developed with seven states of health (low CHD risk, moderate CHD risk, high CHD risk, CHD event, recurrent CHD, chronic CHD, and death). The reclassification of CHD risk derived from genetic information and transition probabilities between states was obtained from a validation study conducted in cohorts of REGICOR (Spain) and Framingham (USA). It was assumed that patients classified as at moderate risk by the standard method were the best candidates to test the risk reclassification with Cardio inCode®. The utilities and costs (€; year 2011 values) of Markov states were obtained from the literature and Spanish sources. The analysis was performed from the perspective of the Spanish National Health System, for a life expectancy of 82 years in Spain. An annual discount rate of 3.5 % for costs and benefits was applied. RESULTS For a Cardio inCode® price of €400, the cost per QALY gained compared with the standard method [incremental cost-effectiveness ratio (ICER)] would be €12,969 and €21,385 in REGICOR and Framingham cohorts, respectively. The threshold price of Cardio inCode® to reach the ICER threshold generally accepted in Spain (€30,000/QALY) would range between €668 and €836. The greatest benefit occurred in the subgroup of patients with moderate–high risk, with a high-risk reclassification of 22.8 % and 12 % of patients and an ICER of €1,652/QALY and €5,884/QALY in the REGICOR and Framingham cohorts, respectively. Sensitivity analyses confirmed the stability of the study results. CONCLUSIONS Cardio inCode® is a cost-effective risk score option in CHD risk assessment compared with the standard method.
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Affiliation(s)
| | - A. Coca
- Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - C. Rubio-Terrés
- HEALTH VALUE, Virgen de Aránzazu, 21-5B, 28034 Madrid, Spain
| | | | - A. Gracia
- Departamento Científico, FERRER INCODE, Barcelona, Spain
| | - A. Boldeanu
- Departamento Científico, FERRER INCODE, Barcelona, Spain
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Camafort M, Vinyoles E, Sobrino J, Domenech M, Segarra A, Riera A, Oller G, Trias F, Coca A. Subclinical cardiac and renal damage among treated patients with masked hypertension: the ESTHEN study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5000] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Coca A, Sobrino J, Domenech M, Camafort M, Vinyoles E, Adrian MJ, Gamazo F, Guerrero FJ. Prevalence of masked and isolated clinical hypertension in relation to the methodology of office blood pressure measurements: The ESTHEN study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5651] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Grazioli G, Yzaguirre I, Domenech M, Comellas C, Cifuentes MJ, Coca A, Gutierrez J, Brugada J, Sitges M. Utility of blood pressure measured during an exercise as a risk factor for new-onset hypertension. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3381] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yzaguirre I, Domenech M, Grazioli G, Pi R, Gutierrez JA, Vinuesa A, Brugada J, Coca A, Sitges M. Exaggerated blood pressure response in young individuals during the stress test: which is the best methodology to predict the incidence of hypertension or cardiovascular disease? Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3402] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Haller M, Van Biesen W, Webster AC, Vanholder R, Nagler EV, Lee JE, Kim SK, Park SK, Yun GY, Choi HY, Ha SK, Park HC, Hernandez-Sevillano B, Rodriguez JR, Perez del Valle K, de Lorenzo A, Salas P, Bienvenido M, Sanchez-Heras M, Basterrechea MA, Tallon S, de Arriba G, Greenberg A, Verbalis J, Burst V, Haymann JP, Poch E, Chiodo J, Nagler EV, Vanmassenhove J, van der Veer SN, Nistor I, Van Biesen W, Webster AC, Vanholder R, Pignataro A, Alfieri V, Cesano G, Timbaldi M, Torta E, Boero R, Nagler EV, Haller MC, Van Biesen W, Vanholder R, Webster AC, Cucchiari D, Podesta M, Merizzoli E, Angelini C, Badalamenti S, Alves MT, Moyses RM, Jorgetti V, Heilberg I, Menon V, Lhotta K, Muendlein A, Meusburger E, Zitt E, Bijarnia R, Pasch A, Hwang SW, Lee CH, Kim GH, Leckstrom D, Pereira C, Bultitude M, McGrath A, Goldsmith DJ, Vasquez D, Fernandez B, Palomo S, Aller C, Gordillo R, Perez V, Bustamante J, Coca A, Vitale C, Bagnis C, Tricerri A, Gallo L, Dutto F, Migliardi M, Marangella M, Outerelo C, Figueiredo P, Freitas J, Teixeira Costa F, Ramos A, Rambod M, Melikterminas E, Atallah H, Saadi M, Connery S, Mulla Z, Tolouian R, Cristofaro R, Masola V, Ceol M, Priante G, Familiari A, Gambaro G, Anglani F. Acid-base / electrolytes / nephrolithiasis. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Borras M, Roig J, Betriu A, Vilar A, Hernandez M, Martin M, Fernandez ED, Dounousi E, Kiatou V, Papagianni A, Zikou X, Pappas K, Pappas E, Tatsioni A, Tsakiris D, Siamopoulos KC, Kim JK, Kim Y, Kim SG, Kim HJ, Ahn SY, Chin HJ, Oh KH, Ahn C, Chae DW, Yazici R, Altintepe L, Bakdik S, Guney I, Arslan S, Topal M, Karagoz A, Stefan G, Mircescu G, Capusa C, Stancu S, Petrescu L, Alecu S, Nedelcu D, Bennett AHL, Pham H, Garrity M, Magdeleyns E, Vermeer C, Zhang M, Ni Z, Zhu M, Yan J, Mou S, Wang Q, Qian J, Saade A, Karavetian M, ElZein H, de Vries N, de Haseth DE, Lay Penne E, van Dam B, Bax WA, Bots ML, Grooteman MPC, van den Dorpel RA, Blankenstijn PJ, Nube MJ, Wee PM, Park JH, Jo YI, Lee JH, Cianfrone P, Comi N, Lucisano G, Piraina V, Talarico R, Fuiano G, Toyonaga M, Fukami K, Yamagishi SI, Kaida Y, Nakayama Y, Ando R, Obara N, Ueda S, Okuda S, Granatova J, Havrda M, Hruskova Z, Tesar V, Viklicky O, Rysava R, Rychlik I, Kratka K, Honsova E, Vernerova Z, Maluskova J, Vranova J, Bolkova M, Borecka K, Benakova H, Zima T, Lu KC, Yang HY, Su SL, Cao YH, Lv LL, Liu BC, Zeng R, Gao XF, Deng YY, Boelaert J, t' Kindt R, Glorieux G, Schepers E, Jorge L, Neirynck N, Lynen F, Sandra P, Sandra K, Vanholder R, Yamamoto T, Nameta M, Yoshida Y, Uhlen M, Shi Y, Tang J, Zhang J, An Y, Liao Y, Li Y, Tao Y, Wang L, Koibuchi K, Tanaka K, Aoki T, Miyagi M, Sakai K, Aikawa A, Martins AR, Branco PQ, Serra FM, Matias PJ, Lucas CP, Adragao T, Duarte J, Oliveira MM, Saraiva AM, Barata JD, Masola V, Zaza G, Granata S, Proglio M, Pontrelli P, Abaterusso C, Schena F, Gesualdo L, Gambaro G, Lupo A, Pruijm M, Hofmann L, Stuber M, Zweiacker C, Piskunowicz M, Muller ME, Vogt B, Burnier M, Togashi N, Yamashita T, Mita T, Ohnuma Y, Hasegawa T, Endo T, Tsuchida A, Ando T, Yoshida H, Miura T, Bevins A, Assi L, Ritchie J, Jesky M, Stringer S, Kalra P, Hutchison C, Harding S, Cockwell P, Viccica G, Cupisti A, Chiavistelli S, Borsari S, Pardi E, Centoni R, Fumagalli G, Cetani F, Marcocci C, Scully P, O'Flaherty D, Sankaralingam A, Hampson G, Goldsmith DJ, Pallet N, Chauvet S, Beaune P, Nochy D, Thervet E, Karras A, Bertho G, Gallyamov MG, Saginova EA, Severova MM, Krasnova TN, Kopylova AA, Cho E, Jo SK, Kim MG, Cho WY, kim HK, Trivin C, Metzger M, Boffa JJ, Vrtovsnik F, Houiller P, Haymann JP, Flamant M, Stengel B, Thervet E, Roozbeh J, Yavari V, Pakfetrat M, Zolghadr AA, Kim CS, Kim MJ, Kang YU, Choi JS, Bae EH, Ma SK, Kim SW, Lemoine S, Guebre-Egziabher F, Dubourg L, Hadj-Aissa A, Blumberg S, Katzir Z, Biro A, Cernes R, Barnea Z, Vasquez D, Gordillo R, Aller C, Fernandez B, Jabary N, Perez V, Mendiluce A, Bustamante J, Coca A, Goek ON, Sekula P, Prehn C, Meisinger C, Gieger C, Suhre K, Adamski J, Kastenmuller G, Kottgen A, Kuzniewski M, Fedak D, Dumnicka P, Solnica B, Kusnierz-Cabala B, Kapusta M, Sulowicz W, Drozdz R, Zawada AM, Rogacev KS, Hummel B, Fliser D, Geisel J, Heine GH, Kretschmer A, Volsek M, Krahn T, Kolkhof P, Kribben A, Bruck H, Koh ES, Chung S, Yoon HE, Park CW, Chang YS, Shin SJ, Deagostini MC, Vigotti FN, Ferraresi M, Consiglio V, Scognamiglio S, Moro I, Clari R, Daidola G, Versino E, Piccoli GB, Mammadrahim Agayev M, Mehrali Mammadova I, Qarib Ismayilova S, Anguiano L, Riera M, Pascual J, Barrios C, Betriu A, Valdivielso JM, Fernandez E, Soler MJ, Tsarpali V, Liakopoulos V, Panagopoulou E, Kapoukranidou D, Spaia S, Kostopoulou M, Michalaki A, Nikitidou O, Dombros N, Zhu F, Abba S, Flores-Gama C, Williams C, Cartagena C, Carter M, Kotanko P, Levin NW, Kolesnyk M, Stepanova N, Driyanska V, Stashevska N, Kundin V, Shifris I, Dudar I, Zaporozhets O, Keda T, Ishchenko M, Khil M, Choe JY, Nam SA, Kim J, Cha JH, Gliga ML, Irimescu CG, Caldararu CD, Gliga MG, Toma LV, Gomotarceanu A, Park Y, Kim Y, Jeon J, Kwon SK, Kim SJ, Kim SM, Kim HY, Montero N, Soler MJ, Barrios C, Marquez E, Berrada A, Arias C, Prada JA, Orfila MA, Mojal S, Vilaplana C, Pascual J, Vigotti FN, Attini R, Parisi S, Fassio F, Deagostini MC, Ghiotto S, Ferraresi M, Clari R, Biolcati M, Todros T, Piccoli GB, Jin K, Vaziri ND, Tramonti G, Romiti N, Chieli E, Maksudova AN, Khusnutdinova LA, Tang J, Shi Y, Zhang J, Li Y, An Y, Tao Y, Wang L, Reque JE, Quiroga B, Lopez JM, Verdallez UG, Garcia de Vinuesa M, Goicoechea M, Nayara PG, Arroyo DR, Luno J, Tanaka H, Flores-Gama C, Abbas SR, Williams C, Cartagena C, Carter M, Thijssen S, Kotanko P, Levin NW, Zhu F, Berthoux FC, Azzouz L, Afiani A, Ziane A, Mariat C, Fournier H, Kusztal M, Dzierzek P, Witkowski G, Nurzynski M, Golebiowski T, Weyde W, Klinger M, Altiparmak MR, Seyahi N, Trabulus S, Bolayirli M, Andican ZG, Suleymanlar G, Serdengecti K, Niculae A, Checherita IA, Neagoe DN, Ciocalteu A, Seiler S, Rogacev KS, Pickering JW, Emrich I, Fliser D, Heine G, Bargnoux AS, Obiols J, Kuster N, Fessler P, Badiou S, Dupuy AM, Ribstein J, Cristol JP, Yanagisawa N, Ando M, Ajisawa A, Tsuchiya K, Nitta K, Bouquegneau A, Cavalier E, Krzesinski JM, Delanaye P, Tominaga N, Shibagaki Y, Kida K, Miyake F, Kimura K, Ayvazyan A, Rameev V, Kozlovskaya L, Simonyan A, Scholze A, Marckmann P, Tepel M, Rasmussen LM, Hara M, Ando M, Tsuchiya K, Nitta K, Kanai H, Harada K, Tamura Y, Kawai Y, Al-Jebouri MM, Madash SA, Leonidovna Berezinets O, Nicolaevich Rossolovskiy A. Lab methods / biomarkers. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft108] [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: 11/13/2022] Open
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Viigimaa M, Talvik A, Wojciechowska W, Kawecka-Jaszcz K, Toft I, Stergiou GS, Nasothimiou EG, Kotsis V, Agabiti Rosei E, Salvetti M, Dorobantu M, Martell-Claros N, Abad-Cardiel M, Hernández-Hernández R, Doménech M, Coca A. Identification of the hemodynamic modulators and hemodynamic status in uncontrolled hypertensive patients. Blood Press 2013; 22:362-70. [DOI: 10.3109/08037051.2013.782900] [Citation(s) in RCA: 7] [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: 11/13/2022]
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Coca A, Gómez P, Llisterri J, Camafort M. Riesgo cardiovascular percibido por el paciente hipertenso y grado de cumplimiento terapéutico en hipertensión arterial: estudio Cumplimenhta. Hipertensión y Riesgo Vascular 2012. [DOI: 10.1016/j.hipert.2012.09.001] [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: 01/13/2023]
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McMurray JJV, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez MA, Jaarsma T, Køber L, Lip GYH, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Rønnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F, Zeiher A, Bax JJ, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, McDonagh T, Sechtem U, Bonet LA, Avraamides P, Ben Lamin HA, Brignole M, Coca A, Cowburn P, Dargie H, Elliott P, Flachskampf FA, Guida GF, Hardman S, Iung B, Merkely B, Mueller C, Nanas JN, Nielsen OW, Orn S, Parissis JT, Ponikowski P. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 2012; 33:1787-847. [PMID: 22611136 DOI: 10.1093/eurheartj/ehs104] [Citation(s) in RCA: 3448] [Impact Index Per Article: 287.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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McMurray JJV, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez MA, Jaarsma T, Kober L, Lip GYH, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Ronnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F, Zeiher A, Bax JJ, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, McDonagh T, Sechtem U, Bonet LA, Avraamides P, Ben Lamin HA, Brignole M, Coca A, Cowburn P, Dargie H, Elliott P, Flachskampf FA, Guida GF, Hardman S, Iung B, Merkely B, Mueller C, Nanas JN, Nielsen OW, Orn S, Parissis JT, Ponikowski P. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 2012. [DOI: 78495111110.1093/eurheartj/ehs104' target='_blank'>'"<>78495111110.1093/eurheartj/ehs104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [78495111110.1093/eurheartj/ehs104','', 'António Coca')">Reference Citation Analysis] [78495111110.1093/eurheartj/ehs104', 44)">What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
78495111110.1093/eurheartj/ehs104" />
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Cabestrero Alonso D, Centella Hernández T, Lamas Hernández M, Coca A, Sánchez Pérez I, Gabaldón Rivilla M, Gómez González R. 213. Resultados de la cirugía en pacientes con cardiopatía congénita en la edad adulta durante los últimos 5 años. Cirugía Cardiovascular 2012. [DOI: 10.1016/s1134-0096(12)70592-2] [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: 11/27/2022] Open
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Giorgi M, Volman S, Pereira L, Coca A. Análisis de la persistencia de pacientes bajo tratamiento antihipertensivo en un programa de educación y administración de medicación. Hipertensión y Riesgo Vascular 2011. [DOI: 10.1016/j.hipert.2011.06.003] [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: 10/17/2022]
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Sierra C, Doménech M, Coca A, Muñoz G, Font B. EVALUATION OF DIFFERENCES IN BLOOD PRESSURE CONTROL AND ANTIHYPERTENSIVE STRATEGIES ACCORDING TO PATIENTS AGE. J Hypertens 2011. [DOI: 10.1097/00004872-201106001-01294] [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]
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Ching KH, Burbelo PD, Gonzalez-Begne M, Roberts MEP, Coca A, Sanz I, Iadarola MJ. Salivary anti-Ro60 and anti-Ro52 antibody profiles to diagnose Sjogren's Syndrome. J Dent Res 2011; 90:445-9. [PMID: 21212317 DOI: 10.1177/0022034510390811] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Simple and non-invasive saliva-based diagnostics may be useful for the identification, understanding, and monitoring of autoimmune and infectious diseases. Previously, Luciferase Immunoprecipitation Systems (LIPS) were used for sensitive detection of patient serum autoantibodies in Sjögren's Syndrome (SjS), a chronic autoimmune disease affecting the salivary and lacrimal glands. Here we explored the ability of LIPS to diagnose SjS based on IgG autoantibodies in patient saliva. From LIPS testing, anti-Ro60 autoantibodies were detected in the saliva of 70% (19/27) of SjS patients with 96% specificity. Positive anti-Ro60 autoantibodies were also found in 70% of the matched serum samples (96% specificity). LIPS detected Ro52 autoantibodies in the saliva and serum of 67% of SjS patients with 100% specificity. Overall, the autoantibody titers in saliva were approximately 4000-fold lower by volume than serum, but still distinguished seropositive patients from controls. These results suggest that LIPS salivary-based testing for SjS autoantibodies is a practical alternative to serum and compatible with point-of-care testing.
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Affiliation(s)
- K H Ching
- Neurobiology and Pain Therapeutics Section, Laboratory of Sensory Biology, National Institute of Dental and Craniofacial Research, Building 49, Room 1C20, 49 Convent Drive, Bethesda, MD 20892-4410, USA.
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Perez-Piaya M, Abarca E, Soler V, Coca A, Cruz M, Villagra F, Giannivelli S, Asensio A. Levels of N-terminal-pro-brain natriuretic peptide in congenital heart disease surgery and its value as a predictive biomarker. Interact Cardiovasc Thorac Surg 2010; 12:461-6. [DOI: 10.1510/icvts.2010.245803] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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