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Ferreira VR, Brayne C, Ragonese P, Ketzoian C, Piccioli M, Tinti L, Casali C, di Lorenzo C, Ramos C, Azevedo J, Gomes A, Stewart R, Haas H, Hoppenbrouwer S, Metting E, Gallo V. A Delphi consensus to identify the key screening tests/questions for a digital neurological examination for epidemiological research. J Neurol 2024; 271:2694-2703. [PMID: 38378908 PMCID: PMC11055750 DOI: 10.1007/s00415-024-12254-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Most neurological diseases have no curative treatment; therefore, focusing on prevention is key. Continuous research to uncover the protective and risk factors associated with different neurological diseases is crucial to successfully inform prevention strategies. eHealth has been showing promising advantages in healthcare and public health and may therefore be relevant to facilitate epidemiological studies. OBJECTIVE In this study, we performed a Delphi consensus exercise to identify the key screening tests to inform the development of a digital neurological examination tool for epidemiological research. METHODS Twelve panellists (six experts in neurological examination, five experts in data collection-two were also experts in the neurological examination, and three experts in participant experience) of different nationalities joined the Delphi exercise. Experts in the neurological examination provided a selection of items that allow ruling out neurological impairment and can be performed by trained health workers. The items were then rated by them and other experts in terms of their feasibility and acceptability. RESULTS Ten tests and seven anamnestic questions were included in the final set of screening items for the digital neurological examination. Three tests and five anamnestic questions were excluded from the final selection due to their low ratings on feasibility. CONCLUSION This work identifies the key feasible and acceptable screening tests and anamnestic questions to build an electronic tool for performing the neurological examination, in the absence of a neurologist.
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Affiliation(s)
- Vasco Ribeiro Ferreira
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Wirdumerdijk 34, 8911 CE, Leeuwarden, The Netherlands.
| | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Paolo Ragonese
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, Palermo, Italy
| | - Carlos Ketzoian
- Institute of Neurology, School of Medicine, Neuroepidemiology Section, University of the Republic, Montevideo, Uruguay
| | - Marta Piccioli
- UOC of Neurology, PO San Filippo Neri, ASL Roma 1, Rome, Italy
| | - Lorenzo Tinti
- Laboratory of Neurology, Mario Negri Institute for Pharmacological Research (IRCCS), Milan, Italy
| | - Carlo Casali
- Department of Medico-Surgical Sciences and Biotechnologies (SBMC), University Rome Sapienza, Rome, Italy
| | - Cherubino di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies (SBMC), University Rome Sapienza, Rome, Italy
| | - Claudia Ramos
- Grupo de Neurociencias de Antioquia (GNA), Faculty of Medicine, University of Antioquia, Medellín, Colombia
- Grupo de Neuropsicología y Conducta (GRUNECO), Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | - João Azevedo
- Agrupamento de Centros de Saúde de Gaia, Unidade de Saúde Familiar Nova Salus, Vila Nova de Gaia, Portugal
| | | | | | - Hein Haas
- Parkinson Vereniging, Bunnik, The Netherlands
| | | | - Esther Metting
- University Medical Center Groningen, Groningen, The Netherlands
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
| | - Valentina Gallo
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Wirdumerdijk 34, 8911 CE, Leeuwarden, The Netherlands
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Lopera F, Custodio N, Rico-Restrepo M, Allegri RF, Barrientos JD, Garcia Batres E, Calandri IL, Calero Moscoso C, Caramelli P, Duran Quiroz JC, Jansen AM, Mimenza Alvarado AJ, Nitrini R, Parodi JF, Ramos C, Slachevsky A, Brucki SMD. A task force for diagnosis and treatment of people with Alzheimer's disease in Latin America. Front Neurol 2023; 14:1198869. [PMID: 37497015 PMCID: PMC10367107 DOI: 10.3389/fneur.2023.1198869] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/21/2023] [Indexed: 07/28/2023] Open
Abstract
Alzheimer's disease (AD) represents a substantial burden to patients, their caregivers, health systems, and society in Latin America and the Caribbean (LAC). This impact is exacerbated by limited access to diagnosis, specialized care, and therapies for AD within and among nations. The region has varied geographic, ethnic, cultural, and economic conditions, which create unique challenges to AD diagnosis and management. To address these issues, the Americas Health Foundation convened a panel of eight neurologists, geriatricians, and psychiatrists from Argentina, Brazil, Colombia, Ecuador, Guatemala, Mexico, and Peru who are experts in AD for a three-day virtual meeting to discuss best practices for AD diagnosis and treatment in LAC and create a manuscript offering recommendations to address identified barriers. In LAC, several barriers hamper diagnosing and treating people with dementia. These barriers include access to healthcare, fragmented healthcare systems, limited research funding, unstandardized diagnosis and treatment, genetic heterogeneity, and varying social determinants of health. Additional training for physicians and other healthcare workers at the primary care level, region-specific or adequately adapted cognitive tests, increased public healthcare insurance coverage of testing and treatment, and dedicated search strategies to detect populations with gene variants associated with AD are among the recommendations to improve the landscape of AD.
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Affiliation(s)
- Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Nilton Custodio
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | | | - Ricardo F. Allegri
- Department of Cognitive Neurology, Instituto Neurológico Fleni, Buenos Aires, Argentina
| | | | - Estuardo Garcia Batres
- Geriatric Unit, New Hope, Interior Hospital Atención Medica Siloé, Ciudad de Guatemala, Guatemala
| | - Ismael L. Calandri
- Department of Cognitive Neurology, Instituto Neurológico Fleni, Buenos Aires, Argentina
| | - Cristian Calero Moscoso
- Department of Neurology, HCAM Memory and Behavior Unit, University of Hospital Carlos Andrade Marin HCAM, Quito, Ecuador
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Faculty of Medicine, University of Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Juan Carlos Duran Quiroz
- Faculty of Medicine, Department of Functional Sciences, Physiology Division, Universidad Mayor de San Andres, La Paz, Bolivia
| | | | - Alberto José Mimenza Alvarado
- Memory Disorders Clinic, Neurological Geriatrics Program, Department of Geriatrics, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Ricardo Nitrini
- Cognitive and Behavioral Neurology Group, Department of Neurology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Jose F. Parodi
- Centro de Investigación del Envejecimiento, Facultad de Medicina, Universidad de San Martín de Porres, Lima, Peru
| | - Claudia Ramos
- Antioquia Neurosciences Group, University of Antioquia, Medellin, Colombia
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), University of Chile, Santiago, Chile
| | - Sonia María Dozzi Brucki
- Cognitive and Behavioral Neurology Group, Department of Neurology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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Araújo D, Castro J, Matos F, Oliveira R, Ramos C, Almeida C, Silva S. Exploring the prevalence and antibiotic resistance profile of Klebsiella pneumoniae and Klebsiella oxytoca isolated from clinically ill companion animals from North of Portugal. Res Vet Sci 2023; 159:183-188. [PMID: 37148737 DOI: 10.1016/j.rvsc.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 05/08/2023]
Abstract
Klebsiella spp. is an important pathogen in humans and animals and due to the indiscriminate use of antibiotics, its prevalence and antibiotic resistance has increased in companion animals. The main goal of this study was to investigate the prevalence and antibiotic resistance of Klebsiella spp. isolated from clinically ill cats and dogs admitted in veterinary clinics in the North of Portugal. A total of 255 clinical specimens were collected and, after isolation, the identification of Klebsiella strains was performed using the BBL Crystal™ identification system and confirmed by PCR-based sequencing with specific primers. Antibiotic resistance profile was determined through the disc diffusion method. Beta-lactam resistance genes were screened through a multiplex PCR assay. Fifty Klebsiella strains were isolated and, 39 were identified as Klebsiella pneumoniae and 11 as Klebsiella oxytoca. Thirty-one were recovered from dogs and 19 from cats. The Klebsiella isolates were recovered mainly from skin wounds, respiratory tract, and from urine. Fifty percent of K. oxytoca and K. pneumoniae isolates revealed to be Multidrug Resistant (MDR) strains, with most of them positive for the presence of blaTEM-like and blaSHV genes. This data shows that MDR Klebsiella are highly disseminated in companion animals and that extended-spectrum beta-lactamases can be easily found among these isolates. This highlights the potential role of dogs and cats as a reservoir of resistant Klebsiella spp. that have the potential to be transmitted to humans.
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Affiliation(s)
- D Araújo
- INIAV, IP - National Institute for Agrarian and Veterinary Research, Rua dos Lagidos, Lugar da Madalena, 4485-655 Vairão, Portugal
| | - J Castro
- INIAV, IP - National Institute for Agrarian and Veterinary Research, Rua dos Lagidos, Lugar da Madalena, 4485-655 Vairão, Portugal; Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal
| | - F Matos
- INIAV, IP - National Institute for Agrarian and Veterinary Research, Rua dos Lagidos, Lugar da Madalena, 4485-655 Vairão, Portugal
| | - R Oliveira
- INIAV, IP - National Institute for Agrarian and Veterinary Research, Rua dos Lagidos, Lugar da Madalena, 4485-655 Vairão, Portugal; LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal; ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
| | - C Ramos
- Clínica Veterinária das Glicínias - Vets On The Road, Rua Dr. Edgardo Sá Malheiro 175, 4705-267 Braga, Portugal
| | - C Almeida
- INIAV, IP - National Institute for Agrarian and Veterinary Research, Rua dos Lagidos, Lugar da Madalena, 4485-655 Vairão, Portugal; Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
| | - S Silva
- INIAV, IP - National Institute for Agrarian and Veterinary Research, Rua dos Lagidos, Lugar da Madalena, 4485-655 Vairão, Portugal; Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal.
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Overman MJ, Melhem R, Blum-Murphy MA, Ramos C, Petrosyan L, Li J, Perer JK, Zou H, Wang M, Wright HM. A phase I, first-in-human, open-label, dose escalation and expansion study of PT886 in adult patients with advanced gastric, gastroesophageal junction, and pancreatic adenocarcinomas. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.tps765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
TPS765 Background: PT886 is a novel bispecific antibody that targets Claudin 18.2 (CLDN18.2) and CD47. CLDN18.2 is overexpressed in a significant proportion of gastric and pancreatic adenocarcinomas and its restricted expression makes it a promising therapeutic target for the treatment of these carcinomas. Moreover, studies have found that immunoglobulin superfamily CD47 is overexpressed widely across tumor types, and CD47 plays an important role in suppressing phagocytes activity through binding to the transmembrane protein SIRPα in phagocytic cells. Hence, by targeting both pathways, one can direct macrophage-mediated phagocytotic activity to tumor cells by blocking the “don’t eat me” signal mediated by CD47/ SIRPα interaction, potentially offering a better safety profile than anti-CD47 monoclonal antibodies. Additionally, PT886 utilizes IgG1 to enhance antibody-dependent cellular cytotoxicity (ADCC) by NK cells and antibody-dependent cellular phagocytosis (ADCP) by macrophages and thus increases the antitumor activity. The combined cancer killing effects by the above mechanisms therefore represent a novel approach in treating CLDN18.2-positive malignancies. Methods: This is an open label, Phase I study to evaluate the safety, tolerability, pharmacokinetics (PK) and preliminary efficacy of PT886 in subjects with unresectable or metastatic gastric adenocarcinoma, gastroesophageal junction adenocarcinoma, and pancreatic ductal adenocarcinoma (PDAC) for which there is no available standard therapy. Approximately 34-58 patients will be enrolled. The study consists of 2 parts: Dose Escalation, and Dose Expansion. The dose escalation study of PT886 will be guided by a standard 3+3 dose escalation study design to determine the maximum tolerated dose (MTD) and/or the optimal biological doses for expansion. The MTD or the optimal biological dose and a lower dose level will be further evaluated in a dose expansion cohort to determine a recommended phase II dose (RP2D). Each enrolled patient will receive PT886 as a monotherapy (0.1, 0.3, 1, 3 or 6 mg/kg QW) as an intravenous infusion continuously (over 60 minutes) in 28-day cycles. The primary endpoints are Dose Limiting Toxicity (DLT) and MTD, if reached, and RP2D of PT886 as a single agent. PD markers of PT886 biological activity will be measured, including T-cell receptor sequencing on circulating T cells, T-cell activation studies, serum cytokines and assessing CLDN18.2 expression in tumor tissues. PT886, which was recently granted orphan drug designation by the FDA for the treatment of pancreatic cancer, has the potential to be a new treatment option for pancreatic and gastric cancer patients whose current standard of care is limited. Preliminary safety and efficacy data are anticipated in the second quarter of 2023. Clinical trial information: NCT02178241 .
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Affiliation(s)
| | | | | | | | | | - Jack Li
- Phanes Therapeutics, San Diego, CA
| | | | - Hui Zou
- Phanes Therapeutics, San Diego, CA
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Ramos C, Madrigal C, Aguirre – Acevedo DC, Giraldo-Chica M, Acosta-Baena N, Aponte C, Aguillón D, Gómez M, Espinosa A, Madrigal L, Uribe C, Saldarriaga A, Alzate D, Ruiz A, Andrade A, Lopez H, Langbaum JB, Sink KM, Reiman EM, Tariot PN, Ríos-Romenets S, Lopera F. Psychological Status of the Participants in Alzheimer's Prevention Initiative Autosomal Dominant Alzheimer's Disease Colombia. J Alzheimers Dis 2023; 95:1091-1106. [PMID: 37638430 PMCID: PMC10715735 DOI: 10.3233/jad-220941] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
BACKGROUND The SARS-CoV2 global pandemic impacted participants in the Alzheimer's Prevention Initiative (API) Autosomal Dominant Alzheimer's Disease (ADAD) clinical trial, who faced three stressors: 1) fear of developing dementia; 2) concerns about missing treatment; and 3) risk of SARS-CoV2 infection. OBJECTIVE To describe the frequency of psychological disorders among the participants of the API ADAD Colombia clinical study, treated by a holistic mental health team during the COVID-19 pandemic. The extent of use of mental health team services was explored considering different risk factors, and users and non-users of these services were compared. METHODS Participants had free and optional access to psychology and psychiatry services, outside of the study protocol. Descriptive statistics was used to analyze the frequency of the mental health difficulties. A multivariable logistic regression model has been used to assess associations with using this program. RESULTS 66 participants were treated by the Mental Health Team from March 1, 2020, to December 31, 2020. Before and after the start of the pandemic, the most common psychological problems were anxiety (36.4% before, 63.6% after) and depression (34.8% before, 37.9% after). 70% of users assisted by psychology and 81.6% of those assisted by psychiatry felt that the services were useful for them. Female sex, depression, and anxiety before the pandemic were positively associated with being assisted by either psychology or psychiatry, while the association with hyperlipidemia was negative. CONCLUSIONS A holistic mental health program, carried out in the context of a study, could mitigate psychopathology during pandemics such as COVID-19.
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Affiliation(s)
- Claudia Ramos
- Neuroscience Group of Antioquia, University of Antioquia, Medellin, CO
- University of Antioquia, Medellin, CO
| | - Claudia Madrigal
- Neuroscience Group of Antioquia, University of Antioquia, Medellin, CO
| | | | | | | | - Claudia Aponte
- Neuroscience Group of Antioquia, University of Antioquia, Medellin, CO
| | - David Aguillón
- Neuroscience Group of Antioquia, University of Antioquia, Medellin, CO
- University of Antioquia, Medellin, CO
| | - Manuela Gómez
- Neuroscience Group of Antioquia, University of Antioquia, Medellin, CO
| | | | - Lucia Madrigal
- Neuroscience Group of Antioquia, University of Antioquia, Medellin, CO
| | - Claramonika Uribe
- Neuroscience Group of Antioquia, University of Antioquia, Medellin, CO
| | | | - Diana Alzate
- Neuroscience Group of Antioquia, University of Antioquia, Medellin, CO
| | - Alejandra Ruiz
- Neuroscience Group of Antioquia, University of Antioquia, Medellin, CO
| | - Angela Andrade
- Neuroscience Group of Antioquia, University of Antioquia, Medellin, CO
| | - Hugo Lopez
- Neuroscience Group of Antioquia, University of Antioquia, Medellin, CO
| | | | | | | | | | | | - Francisco Lopera
- Neuroscience Group of Antioquia, University of Antioquia, Medellin, CO
- University of Antioquia, Medellin, CO
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Giraldo‐Chica M, Acosta‐Baena N, Espinosa A, Ramos C, Langbaum JB, Sink KM, Tariot PN, Reiman EM, Lopera F, Ríos‐Romenets S. Clinical Profiles of Persons Who Progress to Cognitive Impairment in the Alzheimer’s Prevention Initiative (API) ADAD Colombia Trial. Alzheimers Dement 2022. [DOI: 10.1002/alz.069107] [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: 12/24/2022]
Affiliation(s)
| | | | - Alejandro Espinosa
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | - Claudia Ramos
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | | | | | | | | | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
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Vera Sainz A, Cecconi A, Ximenez Carrillo A, Ramos C, Martinez Vives P, Lopez Melgar B, Sanz Garcia A, Ortega G, Montes A, Aguirre C, Vivancos J, Alfonso F, Jimenez-Borreguero LJ. Advanced echocardiography with left atrial strain and indexed left atrial 3D volume for predicting underlying atrial fibrillation after cryptogenic stroke. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.093] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Cryptogenic stroke (CS) represents one-third of ischemic strokes. Atrial fibrillation (AF) can be detected in up to 30% of CS. Therefore, there is a clinical need for predicting AF to guide the optimal secondary prevention strategy. The evidence about the role of advanced echocardiography, including left atrial 3D index volume and left atrial strain (LAS) techniques, to predict underlying AF in this setting is lacking.
Methods
From April 2019 to November 2021 seventy-eight consecutive patients with ischemic stroke or transient ischemic attack with ABCD2 scale ≥4 of unknown etiology were prospectively recruited. Echocardiography was performed during admission. All patients underwent 15 days wearable Holter monitoring. The primary outcome measure was AF detection during follow-up.
Results
Twenty -two patients (28%) developed AF. Patients in the AF group were older (81±6.3 vs 76.5±7.8 years; p=0.012). Left atrial (LA) diastolic indexed volume was higher in AF group (37.2±12.8 vs 29.7±11 ml/m2 p=0.01). 3D LA indexed volume were also higher in patients with AF (41.4±14 vs 32.2±10 ml/m2 p=0.009). LAS reservoir, LAS conduct and LAS contraction (LASct) were significantly lower in patients with AF (19±5.6 vs 32±10.3%; 9±4.5 vs 15±7.6; 10±5.3 vs 17±6.4, respectively, all p<0.001). On multivariate analysis LASct <13.5% and LA 3D indexed volume >44.5 ml/m2 were independent predictors of AF (OR 10.9 [95% CI 1.09–108.2], p=0.042) (Table 1, Figure 1)
Conclusion
LASct <13.5% and LA 3D indexed volume >44.5 ml/m2 are independent predictors of underlying AF in patients with CS. Our results demonstrate the usefulness of advanced echocardiography in this challenging clinical setting.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Spanish Society of Cardiology
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Affiliation(s)
- A Vera Sainz
- Navarra University Hospital, Pamplona , Navarra , Spain
| | - A Cecconi
- University Hospital of La Princesa , Madrid , Spain
| | | | - C Ramos
- University Hospital of La Princesa , Madrid , Spain
| | | | | | | | - G Ortega
- University Hospital of La Princesa , Madrid , Spain
| | - A Montes
- University Hospital of La Princesa , Madrid , Spain
| | - C Aguirre
- University Hospital of La Princesa , Madrid , Spain
| | - J Vivancos
- University Hospital of La Princesa , Madrid , Spain
| | - F Alfonso
- University Hospital of La Princesa , Madrid , Spain
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Moreira A, Bernardo C, Ramos C, Aguiar P, Alves da Costa F. National trends in the use of oral chemotherapy over 13 years. Front Pharmacol 2022; 13:909948. [PMID: 36034797 PMCID: PMC9399396 DOI: 10.3389/fphar.2022.909948] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/05/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Systemic cancer therapy has traditionally been administered using an intravenous (IV) route, implying patients’ frequent visits to hospitals to access to their therapy. If we consider the actual pipeline in oncology, oral chemotherapy will be the main component of cancer treatment in the next few years. This shift in the administration route requires different care models in order to guarantee treatment efficacy and safety. Objective: To analyze time trends in oral chemotherapy consumption in Portugal. Method: Oral chemotherapy consumption over a 13-year period (2008–2020) was analyzed, considering dispensed units by the administration route with respective costs, resorting to the drug regulatory agency (INFARMED I.P.) database. Oral consumption patterns were further explored using common daily doses (CDD) for three conditions, including chronic myeloid leukemia (CML), non-small-cell lung cancer (NSCLC), and breast cancer (BC), to adjust for the effect of varying doses. Data were analyzed descriptively resorting to Microsoft Office Excel 2010. Results: Overall chemotherapy consumption increased +Δ54.7%, with the highest contribution in units observed in oral forms (+Δ58.8%). The total expenditure increased +Δ96.5%, and despite the increase in oral forms (+Δ221.6%), intravenous forms continued to be the major cost driver, with an important contribution from immunotherapy. Much of the increase was led by the approval of 40 new IV and 48 new oral cancer medications with higher costs introduced in the market. Using CDD as an alternative metric to units had varying impacts by indication. The observed increases seemed to focus on specific cancer sites with varying effect; in CML, there was a 2.39-fold increase, compared to 4.41 for NSCLC and 1.86 for BC. However, for BC, two distinct sub-patterns were observed for hormone therapy (increasing 1.83) and for the novel tyrosine kinase inhibitors (increasing 40.8). Conclusion: The growing use of oral chemotherapy is obvious and calls for investments in supporting patients in managing medication adherence and adverse events. The shifts in the healthcare system are complex and need to be prioritized. Our data suggest that priority could be attributed to cancer sites driving innovation, namely, advanced breast cancer.
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Affiliation(s)
- A. Moreira
- Medical Oncology Department, Portuguese Oncology Institute of Lisbon Francisco Gentil, Lisbon, Portugal
- National School of Public Health, Nova University Lisbon, Lisbon, Portugal
| | - C. Bernardo
- South-Regional Cancer Registry and Epidemiology Research Unit, Institute of Lisbon Francisco Gentil, Lisbon, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
| | - C. Ramos
- South-Regional Cancer Registry and Epidemiology Research Unit, Institute of Lisbon Francisco Gentil, Lisbon, Portugal
| | - P. Aguiar
- National School of Public Health, Nova University Lisbon, Lisbon, Portugal
| | - F. Alves da Costa
- South-Regional Cancer Registry and Epidemiology Research Unit, Institute of Lisbon Francisco Gentil, Lisbon, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
- *Correspondence: F. Alves da Costa,
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Pratas Penedos S, Freire M, Fonseca I, Franco A, Ribeiro N, Moreno L, Magalhães M, Afonso P, Alves I, Paulino L, Ramos C, Figueiredo M, Madruga L, Gamito A. MDMA-Assisted Therapy for Treatment-Resistant Posttraumatic Stress Disorder (PTSD) – One step further toward a patient-centered treatment pathway. Eur Psychiatry 2022. [PMCID: PMC9567733 DOI: 10.1192/j.eurpsy.2022.1731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction PTSD is a chronic, debilitating condition with limited treatment efficacy. Accessing traumatic memories often leads to overwhelming distress, impacting treatment process. Current approved pharmacological treatments have exhibited small to moderate effects when compared with placebo. Evidence suggests 3,4,-methylene-dioxymethamphetamine(MDMA)-assisted psychotherapy as a viable option for refractory PTSD. Objectives Comprehensive review of early clinical research, proposed mechanisms, safety and emerging therapeutic models. Methods Eligible studies will be identified through strategic search of MEDLINE. Results Pre-clinical and imaging studies suggest memory reconsolidation and fear extinction as candidate psychological and neurological mechanisms, involving MDMA’s combined effects of increasing serotonergic activity, as well the release of oxytocin and brain-derived neurotrophic factor in key memory and emotional circuits. Resulting reduction in amygdala and insula activation and increasing connectivity between the amygdala and hippocampus may create a “tolerance window” of neuroplasticity for emotional engagement and reprocessing of traumatic memories during psychotherapy. Early clinical trials report impressive and durable reduction in PTSD symptoms, with a safety profile comparable to that of SSRIs. A recently completed randomized, double-blind, placebo-controlled phase 3 trial reported full remission of PTSD symptoms in 67% of patients at 2 months, with no increase in suicidality, cardiovascular events or abuse behavior. Emerging treatment models underline the importance of unmedicated therapeutic sessions for preparation for the experience and subsequent integration as essential for full benefit and safety of the clinical context. Conclusions The psychological impact associated with the COVID-19 pandemic is an reminder of the emotional and economic burden associated with PTSD. MDMA-assisted therapy may be a breakthrough approach meriting further multidisciplinary investment and clinical research. Disclosure No significant relationships.
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Londral A, Azevedo S, Dias P, Ramos C, Santos J, Martins F, Silva R, Semedo H, Vital C, Gualdino A, Falcão J, Lapão LV, Coelho P, Fragata JG. Developing and validating high-value patient digital follow-up services: a pilot study in cardiac surgery. BMC Health Serv Res 2022; 22:680. [PMID: 35597936 PMCID: PMC9123610 DOI: 10.1186/s12913-022-08073-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 10/27/2021] [Accepted: 05/06/2022] [Indexed: 11/22/2022] Open
Abstract
Background The existing digital healthcare solutions demand a service development approach that assesses needs, experience, and outcomes, to develop high-value digital healthcare services. The objective of this study was to develop a digital transformation of the patients’ follow-up service after cardiac surgery, based on a remote patient monitoring service that would respond to the real context challenges. Methods The study followed the Design Science Research methodology framework and incorporated concepts from the Lean startup method to start designing a minimal viable product (MVP) from the available resources. The service was implemented in a pilot study with 29 patients in 4 iterative develop-test-learn cycles, with the engagement of developers, researchers, clinical teams, and patients. Results Patients reported outcomes daily for 30 days after surgery through Internet-of-Things (IoT) devices and a mobile app. The service’s evaluation considered experience, feasibility, and effectiveness. It generated high satisfaction and high adherence among users, fewer readmissions, with an average of 7 ± 4.5 clinical actions per patient, primarily due to abnormal systolic blood pressure or wound-related issues. Conclusions We propose a 6-step methodology to design and validate a high-value digital health care service based on collaborative learning, real-time development, iterative testing, and value assessment.
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Affiliation(s)
- A Londral
- Value for Health CoLAB, Lisbon, Portugal. .,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.
| | - S Azevedo
- Value for Health CoLAB, Lisbon, Portugal.,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.,CEG-IST, Instituto Superior Técnico, University of Lisbon, Lisbon, Portugal
| | - P Dias
- Value for Health CoLAB, Lisbon, Portugal.,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - C Ramos
- Value for Health CoLAB, Lisbon, Portugal.,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - J Santos
- Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.,Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - F Martins
- Value for Health CoLAB, Lisbon, Portugal.,NOVA-LINCS, NOVA School of Science and Technology, Nova University of Lisbon, Lisbon, Portugal
| | - R Silva
- Value for Health CoLAB, Lisbon, Portugal.,NOVA CLUNL - Center of Linguistics, Nova University of Lisbon, Lisbon, Portugal
| | - H Semedo
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - C Vital
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - A Gualdino
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - J Falcão
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - L V Lapão
- Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.,UNIDEMI, NOVA School of Science and Technology, Nova University of Lisboa, Lisbon, Portugal
| | - P Coelho
- Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.,Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - J G Fragata
- Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.,Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
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11
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Georges M, Perez T, Rabec C, Jacquin L, Finet-Monnier A, Ramos C, Patout M, Attali V, Amador M, Gonzalez-Bermejo J, Salachas F, Morelot-Panzini C. Proposals from a French expert panel for respiratory care in ALS patients. Respir Med Res 2022; 81:100901. [PMID: 35378353 DOI: 10.1016/j.resmer.2022.100901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/27/2021] [Revised: 02/18/2022] [Accepted: 02/25/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by progressive diaphragm weakness and deteriorating lung function. Bulbar involvement and cough weakness contribute to respiratory morbidity and mortality. ALS-related respiratory failure significantly affects quality of life and is the leading cause of death. Non-invasive ventilation (NIV), which is the main recognized treatment for alleviating the symptoms of respiratory failure, prolongs survival and improves quality of life. However, the optimal timing for the initiation of NIV is still a matter of debate. NIV is a complex intervention. Multiple factors influence the efficacy of NIV and patient adherence. The aim of this work was to develop practical evidence-based advices to standardize the respiratory care of ALS patients in French tertiary care centres. METHODS For each proposal, a French expert panel systematically searched an indexed bibliography and prepared a written literature review that was then shared and discussed. A combined draft was prepared by the chairman for further discussion. All of the proposals were unanimously approved by the expert panel. RESULTS The French expert panel updated the criteria for initiating NIV in ALS patients. The most recent criteria were established in 2005. Practical advice for NIV initiation were included and the value of each tool available for NIV monitoring was reviewed. A strategy to optimize NIV parameters was suggested. Revisions were also suggested for the use of mechanically assisted cough devices in ALS patients. CONCLUSION Our French expert panel proposes an evidence-based review to update the respiratory care recommendations for ALS patients in daily practice.
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Affiliation(s)
- M Georges
- Department of Respiratory Diseases and Intensive Care, Reference Center for Adult Rare Pulmonary Diseases, University Hospital of Dijon-Bourgogne, Dijon, France; University of Bourgogne Franche-Comté, Dijon France; Centre des Sciences du Goût et de l'Alimentation, UMR 6265 CNRS 1234 INRA, University of Bourgogne Franche-Comté, Dijon, France.
| | - T Perez
- Department of Respiratory Diseases, University Hospital of Lille, Lille, France; Centre for Infection and Immunity of Lille, INSERM U1019-UMR9017, University of Lille Nord de France, Lille, France
| | - C Rabec
- Department of Respiratory Diseases and Intensive Care, Reference Center for Adult Rare Pulmonary Diseases, University Hospital of Dijon-Bourgogne, Dijon, France; University of Bourgogne Franche-Comté, Dijon France
| | - L Jacquin
- Clinical Training Manager for ResMed SAS company, Saint-Priest, France
| | - A Finet-Monnier
- Department of Neuromuscular Disorders and ALS, University Hospital of Timone, Marseille, France
| | - C Ramos
- CRMR SLA-MNM, Hôpital Pasteur 2, University Hospital of Nice, Nice, France
| | - M Patout
- Service des Pathologies du Sommeil (Département R3S), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Neurophysiologie Respiratoire Expérimentale et Clinique, INSERM UMRS1158, Sorbonne Université, Paris, France
| | - V Attali
- Service des Pathologies du Sommeil (Département R3S), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Neurophysiologie Respiratoire Expérimentale et Clinique, INSERM UMRS1158, Sorbonne Université, Paris, France
| | - M Amador
- Neurology Department, Paris ALS center, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - J Gonzalez-Bermejo
- Neurophysiologie Respiratoire Expérimentale et Clinique, INSERM UMRS1158, Sorbonne Université, Paris, France; Service de Pneumologie (Département R3S), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - F Salachas
- Neurology Department, Paris ALS center, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - C Morelot-Panzini
- Neurophysiologie Respiratoire Expérimentale et Clinique, INSERM UMRS1158, Sorbonne Université, Paris, France; Service de Pneumologie (Département R3S), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
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12
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Vera Sainz A, Cecconi A, Ximenez-Carrillo A, Ramos C, Martinez-Vives P, Lopez Melgar B, Sanz A, Ortega G, Aguirre C, Gamarra A, Montes A, De Rueda C, Vivancos J, Alfonso F, Jimenez Borreguero LJ. CHA2DS2VASC score for predicting atrial fibrillation in patients with cryptogenic stroke. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.083] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spanish Society of Cardiology
Introduction
CHA2DS2-VASc Score is widely used to predict thromboembolic risk in patients with Atrial Fibrillation (AF). However the role of CHA2DS2-VASC score for predicting AF in patients with cryptogenic stroke (CS) remains unknown.
Methods
Sixty-three consecutive patients with ischemic stroke or transient ischemic attack with ABCD2 scale≥4 of unknown etiology, were prospectively recruited. They were classified according to
CHA2DS2-VASc Score: group 1 (score ≤ 5), and group 2 (score >5). The primary outcome measure was the occurrence of AF during clinical follow-up.
Results
Twenty-six (41%) patients had a CHA2DS2VASC score > 5 (group 2). Patients in this group were older (81 ± 5.5 vs 75 ± 8 years; p < 0.001) and more frequently female (73% vs 43% p = 0.019). Patients in group 2 present more often hypertension (84% vs 43% p = 0.001), diabetes (38% vs 11%, p = 0.009) , dyslipidemia 77% vs 49%, p = 0.024), and a prior history of coronary artery disease (27% vs 5%, p = 0.026). Notably, patients with higher CHA2DS2VASC showed worse left atrial ejection fraction (41.7 ± 13.1 vs 52.2 ± 15%, p = 0.009) and worse left atrial strain reservoir (21.5 ± 7.1 vs 33.8 ± 11%, p < 0.001), conduct (9.5 ± 4.8 vs 16.6 ± 8.4%;p < 0.001) and contraction (12 ± 4.6 vs 17.2 ± 7.3, p = 0.002). During follow-up AF was detected more often in group 2 (42% vs 11% p = 0.006). In multivariate analysis CHA2SD2VAS > 5 was an independent predictor of AF in patients with CS (HR 7.3 [95% CI 1.2-45.6] p = 0.032)
Conclusion
A CHA2DS2VASC score >5 is an independent predictor of AF in patients with CS. This score provides a new clinical tool to inform clinicians with regards to the optimal treatment of these challenging patients
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Affiliation(s)
- A Vera Sainz
- University Hospital De La Princesa, Madrid, Spain
| | - A Cecconi
- University Hospital De La Princesa, Madrid, Spain
| | | | - C Ramos
- University Hospital De La Princesa, Madrid, Spain
| | | | | | - A Sanz
- University Hospital De La Princesa, Madrid, Spain
| | - G Ortega
- University Hospital De La Princesa, Madrid, Spain
| | - C Aguirre
- University Hospital De La Princesa, Madrid, Spain
| | - A Gamarra
- University Hospital De La Princesa, Madrid, Spain
| | - A Montes
- University Hospital De La Princesa, Madrid, Spain
| | - C De Rueda
- University Hospital De La Princesa, Madrid, Spain
| | - J Vivancos
- University Hospital De La Princesa, Madrid, Spain
| | - F Alfonso
- University Hospital De La Princesa, Madrid, Spain
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13
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Ramos C, Villalba C, García J, Lanata S, López H, Aguillón D, Cordano C, Madrigal L, Aguirre-Acevedo DC, Lopera F. Substance Use-Related Cognitive Decline in Families with Autosomal Dominant Alzheimer's Disease: A Cohort Study. J Alzheimers Dis 2021; 85:1423-1439. [PMID: 34924385 DOI: 10.3233/jad-215169] [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] [Indexed: 01/22/2023]
Abstract
BACKGROUND Cigarette smoking is a known risk factor for Alzheimer's disease (AD). However, the association between neurodegeneration and other substances has not been fully determined. It is of vital importance to evaluate this relationship in populations at high risk of dementia. Since substance use possibly modifies the progression rate of cognitive decline, we studied this association in a unique and well-phenotyped cohort from the University of Antioquia: carriers of the PSEN1-E280A genetic variant. OBJECTIVE To determine the association between substance use and cognitive decline in carriers of the PSEN1-E280A genetic variant. METHODS A retrospective cohort study was conducted with 94 carriers and 69 noncarriers recruited between January 2019 and April 2020. A psychiatrist interviewed the participants using the Consumption of Alcohol, Cigarettes and other Substances questionnaire. The participants were also submitted to cognitive evaluation. The relationship between cognitive decline and substance use was explored through a mixed effects regression model. RESULTS There was an association between cigarettes and better performance on tasks related to perceptual organization, verbal fluency, and memory in carriers. Alcohol had a positive or negative effect on memory according to the type of alcoholic beverage. Results on marijuana use were no conclusive. Coffee was associated with progressive improvements in executive function and verbal fluency. CONCLUSION Cigarette and alcohol were associated with an improvement of some cognitive assessments, possibly by a survival bias. In addition, coffee was related to improvements in executive function and language; therefore, its short-term neuroprotective potential should be studied.
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Affiliation(s)
- Claudia Ramos
- Global Brain Health Institute, San Francisco, CA, USA.,Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellín, Colombia
| | - Camilo Villalba
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellín, Colombia
| | - Jenny García
- Facultad de Medicina of Universidad de Antioquia, Medellín, Colombia
| | - Serggio Lanata
- Global Brain Health Institute, San Francisco, CA, USA.,Memory and Aging Centerof University of California San Francisco, San Francisco, CA, USA
| | - Hugo López
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellín, Colombia
| | - David Aguillón
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellín, Colombia
| | - Christian Cordano
- Department of Neurology of the University ofCalifornia, San Francisco, San Francisco, CA, USA
| | - Lucía Madrigal
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellín, Colombia
| | | | - Francisco Lopera
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellín, Colombia
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14
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Ramos C, Madrigal C, Giraldo‐Chica M, Acosta‐Baena N, Aponte C, Aguillon D, Gómez M, Espinosa A, Madrigal L, Uribe C, Saldarriaga A, Alzate D, Ruiz A, Andrade‐Villegas AM, Lopez HE, Langbaum JB, Sink KM, Reiman EM, Tariot PN, Rios‐Romenets S, Lopera F. Psychological status in the participants of the API ADAD Colombia trial assisted by a comprehensive mental health program during COVID 19 pandemic. Alzheimers Dement 2021. [PMCID: PMC9011512 DOI: 10.1002/alz.057396] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Due to the global SARS‐CoV2 pandemic it has been hard to conduct research, including research related to prevention of neurodegenerative diseases. The Alzheimer’s Prevention Initiative (API) Autosomal Dominant Alzheimer’s Disease (ADAD) Colombia trial is being conducted in participants with family history of early‐onset dementia due to the PSEN1 E280A mutation who are cognitively unimpaired at baseline. Participants are enduring three stressors: 1) fear of developing dementia; 2) logistic changes to the study caused by the public health emergency due to the pandemic; and 3) concern about getting infected by SARS‐CoV2. Objective: To describe the frequency of new or exacerbated psychological disorders among the participants of the API ADAD Colombia trial assisted by a comprehensive mental health team during the COVID‐19 pandemic. Method Participants in the API ADAD Colombia trial have free access to psychology and psychiatry services, either in person or through teleassistance, as well as psychoeducational offerings. These mental health services are provided by the site, outside of the study protocol, and are supported by Health and Social plans which were created to support participants’ wellbeing during the trial. Descriptive statistics (mean, standard deviation and percentages) were used to analyze characteristics and frequency of mental health issues in the participants. Result 66 participants (53 women, 80.3%) were treated by the Mental Health Team from March 1st, 2020 through December 31st, 2020. Mean age was 44.09 (SD 6.97) y.o. Before and after the pandemic onset, the most common psychological problems were anxiety (before 36.4%, after 63.6%) and depression (before 34.8 %, after 37.9%). From people who received psychological and psychiatric services, 70% vs. 81.6% felt that those services helped them, respectively. Among participants who received psychological vs. psychiatric assistance, 71.4% vs. 86.9% of patients with depression, 70.3% vs 75% of patients with anxiety and 60% vs 76.2% of patients with other disorders, felt the services helped them with these conditions. Conclusion A comprehensive mental health program immersed in a trial to prevent or treat devastating diseases as dementia, could mitigate the psychological effects of the COVID‐19 pandemic in study participants.
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Affiliation(s)
- Claudia Ramos
- Neurosciences Group of Antioquia, University of Antioquia Medellin Colombia
| | | | | | | | | | - David Aguillon
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | - Manuela Gómez
- Neurosciences Group of Antioquia, University of Antioquia Medellín Colombia
| | - Alejandro Espinosa
- Neurosciences Group of Antioquia, University of Antioquia Medellin Colombia
| | - Lucia Madrigal
- Neurosciences Group of Antioquia, University of Antioquia Medellin Colombia
| | - Claramonika Uribe
- Neurosciences Group of Antioquia, University of Antioquia Medellin Colombia
| | - Amanda Saldarriaga
- Neurosciences Group of Antioquia, University of Antioquia Medellin Colombia
| | - Diana Alzate
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | - Alejandra Ruiz
- Neurosciences Group of Antioquia, University of Antioquia Medellin Colombia
| | | | | | | | | | | | | | | | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
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15
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Andrade‐Villegas AM, Aguillon D, Gómez M, Gómez‐Henck C, Zuluaga M, Rassi S, Ramos C, Madrigal C, Uribe C, Saldarriaga A, Alzate D, Ruiz A, Giraldo A, Giraldo‐Chica M, Reiman EM, Sink KM, Rios‐Romenets S, Madrigal L, Lopera F. Strategies for activity maintenance in patient and family care and clinical trial adherence of GNA social plan in context of COVID‐19 health emergency. Alzheimers Dement 2021. [PMCID: PMC9011742 DOI: 10.1002/alz.053105] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Background Methods Results Conclusion
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Affiliation(s)
| | - David Aguillon
- Neurosciences Group of Antioquia, University of Antioquia Medellin Colombia
| | - Manuela Gómez
- Neurosciences Group of Antioquia, University of Antioquia Medellín Colombia
| | - Clara Gómez‐Henck
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellín Colombia
| | - Maria Zuluaga
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellín Colombia
| | - Sofia Rassi
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellín Colombia
| | - Claudia Ramos
- Neurosciences Group of Antioquia, University of Antioquia Medellin Colombia
| | - Claudia Madrigal
- Neurosciences Group of Antioquia, University of Antioquia Medellín Colombia
| | - Claramonika Uribe
- Neurosciences Group of Antioquia, University of Antioquia Medellin Colombia
| | - Amanda Saldarriaga
- Neurosciences Group of Antioquia, University of Antioquia Medellin Colombia
| | - Diana Alzate
- Neurosciences Group of Antioquia, University of Antioquia Medellin Colombia
| | - Alejandra Ruiz
- Neurosciences Group of Antioquia, University of Antioquia Medellin Colombia
| | - Andrea Giraldo
- Neurosciences Group of Antioquia, University of Antioquia Medellín Colombia
| | | | | | | | | | - Lucia Madrigal
- Neurosciences Group of Antioquia, University of Antioquia Medellin Colombia
| | - Francisco Lopera
- Neurosciences Group of Antioquia, University of Antioquia Medellin Colombia
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16
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Cecconi A, Vera A, Ximenez-Carrillo A, Ramos C, Martinez-Vives P, Lopez Melgar C, Roquero Gimenez P, Martinez-Avial Silva M, Sanz-Garcia A, Ortega G, Aguirre C, Vivancos J, Alfonso F, Jimenez-Borreguero L. A comprehensive model to estimate underlying atrial fibrillation in cryptogenic stroke: the decrypting score. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.009] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Cryptogenic stroke (CS) represents up to 30% of ischemic strokes. Since atrial fibrillation (AF) can be detected in up to one-third of CS, there is a clinical need for estimating the probability of underlying AF in CS to guide the optimal secondary prevention strategy.
Surrogate markers of left atrial dysfunction such as left atrial size, left atrial strain (LAS) and NTproBNP has been described as predictors of AF in patients with CS. However the evidence about AF markers in comprehensive and prospective studies in CS is still limited.
Purpose
The present study was designed to develop the first score to predict underlying AF in CS patients that includes markers of atrial dysfunction. To reach our aim we developed a comprehensive analysis including clinical, laboratory, electrocardiografic and advanced echocardiographic variables in patients with CS.
Methods
Sixty-three consecutive patients with ischemic stroke or transient ischemic attack with ABCD2 scale ≥4 of unknown etiology were prospectively recruited. Clinical, laboratory, electrocardiografic and echocardiographic variables were collected. All patients underwent 15 days wearable Holter monitoring. Main objective was the Decryptoring score creation to predict AF in CS. Score variables were initially selected by a univariate logistic regression and, thereafter, the score points were derived according to a multivariant analysis.
Results
AF was detected in 15 patients (24%). Patients in the AF group were older (81.4±6.9 vs 76.5±7.8 years; p=0.035. There was no difference in sex between groups. Regarding cardiovascular risk factors patients who developed AF had more often hypertension (87% vs 52%; p=0.018) without differences in diabetes, dyslipidemia and tobacco consumption. T troponin and NTproBNP were higher in the AF group (47±55.9 vs 16.8±12.4 ng/L; p=0.018 and 1379±1650 vs 317±496 ng/ml; p=0.001 respectively). There were no differences in ECG parameters such as p wave voltage, interatrial block, PR interval or QRS.
LAS reservoir, LAS conduct and LAS contraction were lower in patients with AF (18.6±4.6 vs 32.1±10.9%; 8±4.3 vs 15.6±8%; 10.5±3.4 vs 16.6±7 respectively, all p<0.001).
Age >75 (9 points), hypertension (1 point), Troponin T >40 ng/L (8.5 points), NTproBNP >200 pg/ml (0.5 points), LAS reservoir <25.3% (24.5 points) and LAS conduct <10.4% (0.5 points) were included in the score. The rate of AF detection was 0% among patients with a score of <10 and 80% among patients with a score >35.
Conclusion
The proposed score offers an accurate AF prediction in patients with CS providing a new clinical tool to orient the optimal treatment in these patients.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Spanish Society of Cardiology
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Affiliation(s)
- A Cecconi
- Hospital Universitario La Princesa, Madrid, Spain
| | - A Vera
- Hospital Universitario La Princesa, Madrid, Spain
| | | | - C Ramos
- Hospital Universitario La Princesa, Madrid, Spain
| | | | | | | | | | | | - G Ortega
- Hospital Universitario La Princesa, Madrid, Spain
| | - C Aguirre
- Hospital Universitario La Princesa, Madrid, Spain
| | - J Vivancos
- Hospital Universitario La Princesa, Madrid, Spain
| | - F Alfonso
- Hospital Universitario La Princesa, Madrid, Spain
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17
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Simon E, Crouse B, Sayles S, Muir M, Ramos C, Phelan M. 331 Evaluation of Triage Screening for Influenza Vaccination Status in the Emergency Department. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.345] [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: 12/01/2022]
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18
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Simon E, Crouse B, Karamchandani J, Ramos C, Muir M, Sayles S, Phelan M. 174 Modeling the Value of an Emergency Department Influenza Vaccination Program. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.185] [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: 10/20/2022]
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19
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Verdugo J, Mena A, Cavada G, Silva C, Ramos C, Varela C, Diaz J, Alegria J. Correlation Between Non-contrast Chest CT Findings And Clinical Outcomes In Hospitalized Patients With Covid-19 Pneumonia With Positive PCR For SARS-Cov-2 During The First Wave. J Cardiovasc Comput Tomogr 2021. [PMCID: PMC8280283 DOI: 10.1016/j.jcct.2021.06.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Fernández Hevia M, García Alonso L, Alonso Batanero E, Ramos C, Suárez Sánchez A, Rodríguez García JI, García Flórez LJ, Granero Trancón JE. SURGICAL DIFFICULTY AND PELVIMETRY IN RECTAL CANCER. IS IT USEFUL? Br J Surg 2021. [DOI: 10.1093/bjs/znab160.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
INTRODUCTION
Different difficulty factors have been described in rectal cancer surgery as BMI, male gender, tumor height, neoadjuvant treatment or narrow pelvis. Pelvimetry is not a routine preoperative study in rectal cancer.
MATERIAL AND METHODS
Retrospective observational study in 228 patients. Operative time was evaluated as a difficult surgical parameter and its relationship with pelvimetric variables was studied.
RESULTS
Our average operative time was 255,4 ± 65,8 minutes. Significant results were found with regard to patients’ BMI, distance to the anal margin, type of approach, need for neoadjuvant therapy and the following pelvimetry parameters. In the univariate analysis, the parameters were pubis height, pelvis depth, angle of the right levator in coronal plane, the ratio of the pelvis inlet diameter with respect to its depth, the ratio of the angle promontory-S3-coccyx with respect to the angle S3-coccyx-lower border of the pubis and the ratio of the area of the mesorectum to the area of the pelvis in the sagittal plane. In multivariate analysis, the variables that most influenced the surgical time were the type of approach, the BMI, the location of the tumor, the intraoperative complications and the ratio of the mesorectum area to the area of the pelvis in the sagittal plane.
CONCLUSION
Pelvimetry is a simple tool that completes preoperative studies and also obtains better surgical planning in complex pelvises.
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Affiliation(s)
| | | | | | - C Ramos
- Hospital Universitario Central de Asturias
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21
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Msaouel P, Gao J, Yuan Y, Siefker-Radtke AO, Jonasch E, Goswami S, Zurita AJ, Campbell MT, Shah AY, Corn PG, Ramos C, Yan X, Chin C, Der-Torossian H, Tannir NM. Phase I/IB trial of sitravatinib (Sitra) + nivolumab (Nivo) + ipilimumab (Ipi) in patients (pts) with advanced clear cell renal cell carcinoma (accRCC) or other solid malignancies. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.6_suppl.tps365] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS365 Background: Sitra is a spectrum-selective receptor tyrosine kinase inhibitor (TKI) that targets TAM receptors (TYRO3, AXL, MERTK), VEGFR2, c-Kit, and c-MET. Sitra has shown antitumor activity in accRCC, and reduces type 2 tumor-associated macrophages, regulatory T-cells and myeloid-derived suppressor cells and enhances T cell–mediated antitumor immune responses. The combination of sitra with anti-PD1 immune checkpoint inhibitors (ICIs), such as nivo, has an acceptable safety profile and demonstrates efficacy across multiple tumor types, including accRCC (Msaouel et al. J Clin Oncol, 2020, abstr 612). Ipi enhances the efficacy of nivo through distinct but complementary pathways to those targeted by sitra. We hypothesize that the triple combination of sitra + nivo + ipi will lead to more potent antitumor responses. This study is designed to determine the optimal dose of sitra when combined with nivo + ipi, and assess the safety as well as the preliminary efficacy of this combination in accRCC, and potentially other cancers, that have shown favorable responses to nivo + ipi. Methods: This phase I/Ib study (NCT04518046) is evaluating sitra + nivo + ipi in frontline advanced or metastatic ccRCC or other solid malignancies. The primary endpoint of the trial is safety and tolerability of this regimen. Secondary endpoints include: objective response rate (RECIST 1.1), duration of response, progression-free survival, overall survival, and pharmacokinetic measurements. The phase I dose escalation portion of the trial will enroll approximately 30 pts with intermediate- or poor-risk accRCC by International Metastatic RCC Database Consortium (IMDC) criteria, who will receive escalating doses of sitra (starting dose 35 mg orally QD) following the Time-to-Event Bayesian Optimal Interval (TITE-BOIN) design (Yuan et al. Clin Cancer Res, 2018), combined with nivo 3 mg/kg and ipi 1 mg/kg (NIVO3/IPI1) every 3 weeks (wks) for up to 4 doses, followed by maintenance nivo (240 mg every 2 wks or 480 mg every 4 wks). The phase Ib dose expansion cohorts will be initiated following identification of the recommended dose of sitra in combination with NIVO3/IPI1 and will enroll up to 31 pts for each of 2 cohorts: pts with intermediate-/poor-risk accRCC (Cohort A) and pts with favorable-risk accRCC (Cohort B). Pts will receive study treatment until disease progression, unacceptable adverse events, or pt withdrawal of consent. Future dose expansion cohorts may be added to include other solid tumors in which favorable activity has been previously demonstrated with nivo + ipi, such as metastatic urothelial carcinoma, melanoma, non–small-cell lung cancer, hepatocellular carcinoma, and colorectal cancer. The study is currently enrolling at 1 US site and additional sites may be added at dose expansion. At the time of the abstract submission, 3 pts have been enrolled. Clinical trial information: NCT04518046 .
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Affiliation(s)
- Pavlos Msaouel
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jianjun Gao
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ying Yuan
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Eric Jonasch
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Amado J. Zurita
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Paul G. Corn
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | - Nizar M. Tannir
- The University of Texas MD Anderson Cancer Center, Houston, TX
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22
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Vera Sainz A, Cecconi A, Martinez Vives P, Ximenez Carrillo A, Aguirre C, Ramos C, Benedicto A, Diego G, Dominguez L, Lopez B, Rojas A, Gamarra A, Vivancos J, Jimenez Borreguero LJ, Alfonso F. Predictors of atrial fibrillation in patients with cryptogenic stroke and fifteen-days electrocardiographic monitoring. Preliminary results of the DECRYPTORING study. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.121] [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: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
onbehalf
DECRYPTORING study
Introduction
Cryptogenic stroke (CS) represents up to 30% of all stroke types. In one third of CS, atrial fibrillation (AF) is identified as the underlying cause. Predictors of AF in the setting of CS have been described, however these findings were based on retrospective studies and with maximum ECG monitoring of 72 hours. To overcome these limitations, we designed the prospective Decryptoring study whose objective is to create a comprehensive predictive model for AF in patients with CS.
Methods
From April 2019, 41 consecutive patients with a CS and age > 60 years were included. On admission, a transthoracic echocardiogram with 3D volume and left atrial (LA) strain was performed. All patients were monitored with a 15-day ECG-Holter after discharge. Patients were classified according to AF detection.
Results
AF was detected in 9 patients (22%). Patients with AF were older (75.9 ± 8 vs. 81.9 ± 4.3 years, p = 0.041). There was no difference in T-troponin levels. NTproBNP was higher in the group with AF (350 ± 586 pg / ml vs. 1084 ± 1416 pg / ml, p = 0.018). Regarding LA strain, patients with AF presented reservoir LA strain (25.5 ± 8.2% vs 17.4 ± 4.3%; p = 0.006) and conduct LA strain (12 ± 5.2% vs 7.2 ± 1.5%; p = 0.01) lower than patients without AF. There were no differences in contraction LA strain or other echocardiographic variables. The risk of developing AF was higher in patients with NTproBNP> 165 pg / ml (OR 11.3 [95% CI 1.2-102.9] p = 0.031), LA reservoir strain <19.1% (OR 7.7 [IC 95 % 1.5-40.0] p = 0.016) and LA conduct strain <9.1% (OR 7.8 [95% CI 1.3-45.0] p = 0.022) (Table).
Conclusions
This prospective study, demonstrates that high NTproBNP, low reservoir LA strain and low conduct LA strain are associated with underlying AF in patients with cryptogenic stroke.
No AF (n = 32) AF (n = 9) P value Age (years) 75.9 ± 8 81.9 ± 4.3 p = 0.041 NTPROBNP (pg/ml) 350 ± 586 1084 ± 1416 P = 0.018 LA indexed diastolic volume (ml/m2) 30 ± 11.8 33.8 ± 9.8 P = 0.35 LA EF (%) 45 ± 16.7 45 ± 12.8 P = 1 Reservoir LA strain (%) 25.5± 8.2 17.4± 4.3 P = 0.006 Conduct LA strain (%) 12 ± 5.2 7.2 ± 1.5 P = 0.01 Contraction LA strain (%) 13.5 ±5.3 10.2± 3.9 P = 0.10 NTPROBNP > 165 pg/ml 12 (41%) 8 (89%) OR 11.3 [IC 95% 1.2-102.9]; p = 0.031 Reservoir LA strain <19.1% 6 (20%) 6 (67%) OR 7.7 [IC 95% 1.5-40.0]; p = 0.016 Conduct LA strain <9.1% 9 (31%) 7 (78%) OR 7.8 [IC 95% 1.3-45.1]; p = 0.022
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Affiliation(s)
- A Vera Sainz
- University Hospital De La Princesa, Madrid, Spain
| | - A Cecconi
- University Hospital De La Princesa, Madrid, Spain
| | | | | | - C Aguirre
- University Hospital De La Princesa, Madrid, Spain
| | - C Ramos
- University Hospital De La Princesa, Madrid, Spain
| | - A Benedicto
- University Hospital De La Princesa, Madrid, Spain
| | - G Diego
- University Hospital De La Princesa, Madrid, Spain
| | - L Dominguez
- University Hospital De La Princesa, Madrid, Spain
| | - B Lopez
- University Hospital De La Princesa, Madrid, Spain
| | - A Rojas
- University Hospital De La Princesa, Madrid, Spain
| | - A Gamarra
- University Hospital De La Princesa, Madrid, Spain
| | - J Vivancos
- University Hospital De La Princesa, Madrid, Spain
| | | | - F Alfonso
- University Hospital De La Princesa, Madrid, Spain
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23
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Parra MA, Baez S, Sedeño L, Gonzalez Campo C, Santamaría‐García H, Aprahamian I, Bertolucci PHF, Bustin J, Camargos Bicalho MA, Cano‐Gutierrez C, Caramelli P, Chaves MLF, Cogram P, Beber BC, Court FA, de Souza LC, Custodio N, Damian A, de la Cruz M, Diehl Rodriguez R, Brucki SMD, Fajersztajn L, Farías GA, De Felice FG, Ferrari R, de Oliveira FF, Ferreira ST, Ferretti C, Figueredo Balthazar ML, Ferreira Frota NA, Fuentes P, García AM, Garcia PJ, de Gobbi Porto FH, Duque Peñailillo L, Engler HW, Maier I, Mata IF, Gonzalez‐Billault C, Lopez OL, Morelli L, Nitrini R, Quiroz YT, Guerrero Barragan A, Huepe D, Pio FJ, Suemoto CK, Kochhann R, Kochen S, Kumfor F, Lanata S, Miller B, Mansur LL, Hosogi ML, Lillo P, Llibre Guerra J, Lira D, Lopera F, Comas A, Avila‐Funes JA, Sosa AL, Ramos C, Resende EDPF, Snyder HM, Tarnanas I, Yokoyama J, Llibre J, Cardona JF, Possin K, Kosik KS, Montesinos R, Moguilner S, Solis PCL, Ferretti‐Rebustini REDL, Ramirez JM, Matallana D, Mbakile‐Mahlanza L, Marques Ton AM, Tavares RM, Miotto EC, Muniz‐Terrera G, Muñoz‐Nevárez LA, Orozco D, Okada de Oliveira M, Piguet O, Pintado Caipa M, Piña Escudero SD, Schilling LP, Rodrigues Palmeira AL, Yassuda MS, Santacruz‐Escudero JM, Serafim RB, Smid J, Slachevsky A, Serrano C, Soto‐Añari M, Takada LT, Grinberg LT, Teixeira AL, Barbosa MT, Trépel D, Ibanez A. Dementia in Latin America: Paving the way toward a regional action plan. Alzheimers Dement 2021; 17:295-313. [PMID: 33634602 PMCID: PMC7984223 DOI: 10.1002/alz.12202] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/28/2020] [Accepted: 08/30/2020] [Indexed: 12/12/2022]
Abstract
Across Latin American and Caribbean countries (LACs), the fight against dementia faces pressing challenges, such as heterogeneity, diversity, political instability, and socioeconomic disparities. These can be addressed more effectively in a collaborative setting that fosters open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking, and translational research) and align them to current global strategies to translate regional knowledge into transformative actions. Then we characterize key sources of complexity (genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions), map them to the above challenges, and provide the basic mosaics of knowledge toward a KtAF. Finally, we describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF.
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Affiliation(s)
- Mario Alfredo Parra
- School of Psychological Sciences and HealthGraham Hills BuildingGlasgow, G1 1QE, UK, Universidad Autónoma del CaribePrograma de PsicologíaUniversity of StrathclydeBarranquillaColombia
| | | | - Lucas Sedeño
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET)Buenos AiresArgentina
| | - Cecilia Gonzalez Campo
- Cognitive Neuroscience Center (CNC)Universidad de San AndresConsejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET)Buenos AiresArgentina
| | - Hernando Santamaría‐García
- Pontificia Universidad JaverianaMedical School, Physiology and Psychiatry DepartmentsMemory and Cognition Center IntellectusHospital Universitario San IgnacioBogotáColombia
| | - Ivan Aprahamian
- Department of Internal MedicineFaculty of Medicine of JundiaíGroup of Investigation on Multimorbidity and Mental Health in Aging (GIMMA)JundiaíState of São PauloBrazil
| | - Paulo HF Bertolucci
- Department of Neurology and NeurosurgeryEscola Paulista de MedicinaFederal University of São Paulo ‐ UNIFESPSão PauloBrazil
| | - Julian Bustin
- INECO FoundationInstitute of Cognitive and Translational Neuroscience (INCYT)Favaloro UniversityBuenos AiresArgentina
| | | | - Carlos Cano‐Gutierrez
- Medical SchoolGeriatric Unit, Memory and Cognition Center‐IntellectusAging InstituteHospital Universitario San IgnacioPontificia Universidad JaverianaBogotáColombia
| | - Paulo Caramelli
- Faculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteBrazil
| | - Marcia L. F. Chaves
- Neurology ServiceHospital de Clínicas de Porto Alegre e Universidade Federal do Rio Grande do SulBrazil
| | - Patricia Cogram
- Laboratory of Molecular NeuropsychiatryINECO FoundationNational Scientific and Technical Research CouncilInstitute of Cognitive and Translational Neuroscience (INCyT)Favaloro UniversityBuenos AiresArgentina
| | - Bárbara Costa Beber
- Department of Speech and Language PathologyAtlantic Fellow for Equity in Brain HealthFederal University of Health Sciences of Porto Alegre (UFCSPA)Porto AlegreBrazil
| | - Felipe A. Court
- Center for Integrative BiologyFaculty of SciencesFONDAP Center for GeroscienceBrain Health and Metabolism, Santiago, Chile, The Buck Institute for Research on AgingUniversidad Mayor, ChileNovatoCAUSA
| | | | - Nilton Custodio
- Unit Cognitive Impairment and Dementia PreventionCognitive Neurology CenterPeruvian Institute of NeurosciencesLimaPerú
| | - Andres Damian
- Centro Uruguayo de Imagenología Molecular (CUDIM)Centro de Medicina Nuclear e Imagenología MolecularHospital de ClínicasUniversidad de la RepúblicaMontevideoUruguay
| | - Myriam de la Cruz
- Global Brain Health Institute, University of CaliforniaSan FranciscoUSA
| | - Roberta Diehl Rodriguez
- Behavioral and Cognitive Neurology UnitDepartment of Neurology and LIM 22University of São PauloSão PauloBrazil
| | | | - Lais Fajersztajn
- Laboratory of Experimental Air Pollution (LIM05)Department of PathologySchool of MedicineGlobal Brain Health Institute, University of CaliforniaSan Francisco (UCSF)University of São PauloSão PauloSao PauloBrazil
| | - Gonzalo A. Farías
- Department Neurology and Neurosurgery North/Department of NeurosciencesCenter for Advanced Clinical Research (CICA)Faculty of MedicineUniversidad de ChileSantiagoChile
| | | | - Raffaele Ferrari
- Department of Neurodegenerative DiseaseUniversity College LondonLondonESUK
| | - Fabricio Ferreira de Oliveira
- Department of Neurology and NeurosurgeryEscola Paulista de MedicinaFederal University of São Paulo ‐ UNIFESPSão PauloBrazil
| | - Sergio T. Ferreira
- Institute of Medical Biochemistry Leopoldo de Meis & Institute of Biophysics Carlos Chagas FilhoFederal University of Rio de JaneiroRio de JaneiroRJBrazil
| | - Ceres Ferretti
- Division of NeurologyUniversity of São PauloSão PauloBrazil
| | | | | | - Patricio Fuentes
- Geriatrics Section Clinical Hospital University of Chile, Santos Dumont 999 IndependenciaSantiagoChile
| | - Adolfo M. García
- Cognitive Neuroscience Center (CNC)Faculty of EducationNational University of Cuyo (UNCuyo)Universidad de San Andres. National Scientific and Technical Research Council (CONICET)MendozaArgentina
| | | | - Fábio Henrique de Gobbi Porto
- Laboratory of Psychiatric Neuroimaging (LIM‐21)Instituto de PsiquiatriaHospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao PauloSao PauloBrazil
| | | | | | | | - Ignacio F. Mata
- Department of Genomic MedicineLerner Research InstituteCleveland ClinicOHUSA
| | - Christian Gonzalez‐Billault
- Center for GeroscienceBrain Health and Metabolism (GERO), Santiago, Chile, and Department of Biology, Faculty of SciencesUniversity of ChileSantiagoChile
| | - Oscar L. Lopez
- Alzheimer's Disease Research CenterUniversity of PittsburghPittsburghPAUSA
| | - Laura Morelli
- Fundacion Instituto Leloir‐IIBBA‐CONICET. AveArgentina
| | - Ricardo Nitrini
- Department of NeurologyUniversity of São Paulo Medical SchoolSão PauloBrazil
| | | | - Alejandra Guerrero Barragan
- Trinity College Dublin, Dublin, Departamento de Neurologia Hospital Occidente de KennedyGlobal Brain Health InstituteUniversidad de la SabanaBogotaColombia
| | - David Huepe
- Center for Social and Cognitive Neuroscience (CSCN)School of PsychologyUniversidad Adolfo IbañezSantiagoChile
| | - Fabricio Joao Pio
- Department of NeurologyHospital Governador Celso RamosFlorianopolisBrazil
| | | | - Renata Kochhann
- Graduate Program in PsychologySchool of Health SciencesHospital Moinhos de VentoPontifical Catholic University of Rio Grande do Sul—PUCRS and Researcher OfficePorto AlegreBrazil
| | - Silvia Kochen
- Neurosciences and Complex Systems Unit (EnyS), CONICET, Hosp, El Cruce “N. Kirchner”, Univ. National A, Jauretche (UNAJ), F. Varela, Prov. Buenos Aires. Fac. MedicineUniv Nacional de Buenos Aires (UBA)Buenos AiresArgentina
| | - Fiona Kumfor
- Brain and Mind Centre and School of PsychologyUniversity of SydneySydneyNSWAustralia
| | - Serggio Lanata
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | - Bruce Miller
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | | | - Mirna Lie Hosogi
- Behavioral and Cognitive Unit of Department of NeurologyUniversity of São Paulo School of MedicineSao PauloBrazil
| | - Patricia Lillo
- Geroscience Center for Brain Health and Metabolism, Santiago, Chile, Departamento de Neurología Sur/Departamento de Neurociencia, Facultad de MedicinaUniversidad de ChileSantiagoChile
| | | | - David Lira
- Unit Cognitive Impairment and Dementia PreventionCognitive Neurology CenterPeruvian Institute of NeurosciencesLimaPerú
| | - Francisco Lopera
- Neuroscience Research GroupUniversidad de AntioquiaMedellínColombia
| | - Adelina Comas
- Department of Health Policy at the London School of Economics and Political ScienceLondonUK
| | | | - Ana Luisa Sosa
- Instituto Nacional de Neurología y NeurocirugíaCiudad de MéxicoMéxico
| | - Claudia Ramos
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | | | | | - Ioannis Tarnanas
- Global Brain Health Institute, University of CaliforniaSan FranciscoUSA
- Altoida Inc.HoustonTexasUSA
| | - Jenifer Yokoyama
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | | | | | - Kate Possin
- UCSF Department of NeurologyMemory and Aging CenterUCSFSan FranciscoCaliforniaUS
| | - Kenneth S. Kosik
- Neuroscience Research Institute and Dept of Molecular Cellular and Developmental BiologyUniversity of California SantaBarbaraCaliforniaUSA
| | - Rosa Montesinos
- Unit Cognitive Impairment and Dementia PreventionCognitive Neurology CenterPeruvian Institute of NeurosciencesLimaPerú
| | - Sebastian Moguilner
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | - Patricia Cristina Lourdes Solis
- Neurosciences and Complex Systems Unit (EnyS), CONICET, Hosp, El Cruce “N. Kirchner”, Univ. National A, Jauretche (UNAJ), F. Varela, Prov. Buenos Aires. Fac. MedicineUniv Nacional de Buenos Aires (UBA)Buenos AiresArgentina
| | | | - Jeronimo Martin Ramirez
- Departamen de Admision Continua Adultos Hospital General La Raza Instituto Mexicano del Seguro SocialGlobal Brain Health Institute, Trinity College Dublin, DublinCiudad de MexicoMexico
| | - Diana Matallana
- Medical SchoolAging Institute and Psychiatry DepartmentPontificia Universidad Javeriana. Memory and Cognition Center‐IntellectusHospital Universitario San IgnacioBogotáColombia
| | - Lingani Mbakile‐Mahlanza
- Global Brain Health InstituteUniversity of California San Francisco, University of BotswanaGaboroneBotswana
| | | | | | - Eliane C Miotto
- Department of NeurologyUniversity of Sao PauloSao PauloBrazil
| | | | | | - David Orozco
- Cognitive Neuroscience Development LaboratoryAxis NeurocienciasUniversidad Nacional del Sur, Cognitive Impairment and Behavior Disorders UnitBahía BlancaArgentina
| | - Maira Okada de Oliveira
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | - Olivier Piguet
- School of Psychology and Brain and Mind CentreUniversity of SydneyCamperdownNSWAustralia
| | - Maritza Pintado Caipa
- Global Brain Health Institute, University of California, San Francisco (UCSF)San FranciscoUSA
| | | | - Lucas Porcello Schilling
- Department of NeurologyPontificia Universidade Catolica do Rio Grande do Sul (PUCRS)Porto AlegreBrazil
| | - André Luiz Rodrigues Palmeira
- Santa Casa de Misericórdia de Porto Alegre, Serviço de Neurologia, Porto Alegre, BrazilHospital Ernesto DornellesServiço de Neurologia e NeurocirurgiaPorto AlegreBrazil
| | | | - Jose Manuel Santacruz‐Escudero
- Medical School and Psychiatry DepartmentMemory and Cognition Center‐ IntellectusPontificia Universidad JaverianaHospital Universitario San IgnacioBogotáColombia
| | | | - Jerusa Smid
- Department of NeurologyUniversity of Sao PauloSão PauloBrazil
| | - Andrea Slachevsky
- Neurology DepartmentGeroscience Center for Brain Health and Metabolism, Santiago, Chile, Laboratory of Neuropsychology and Clinical Neuroscience (LANNEC), Physiopathology Program‐ICBM, East Neurologic and Neurosciences Departments, Faculty of MedicineHospital del Salvador and Faculty of Medicine University of Chile. Servicio de NeurologíaDepartamento de MedicinaClínica Alemana—Universidad del DesarrolloUniversity of Chile, Neuropsychiatry and Memory Disorders clinic (CMYN)SantiagoChile
| | | | | | | | - Lea Tenenholz Grinberg
- Departments of NeurologyPathology and Global Brain Health InstituteUCSF ‐ USA, Department of PathologyUniversity of São Paulo Medical SchoolSão PauloBrazil
| | - Antonio Lucio Teixeira
- Laboratório Interdisciplinar de Investigação MédicaFaculdade de MedicinaAv. Alfredo Balena, 110Universidade Federal de Minas GeraisBelo HorizonteBrazil
| | - Maira Tonidandel Barbosa
- Faculdade de Medicina da Universidade Federal de Minas Gerais e Faculdade deCiências Médicas de Minas GeraisBelo HorizonteBrazil
| | - Dominic Trépel
- Global Brain Health Institute (GBHI)Trinity College DublinDublin
| | - Agustin Ibanez
- Cognitive Neuroscience Center (CNC) Buenos Aires, Argentina; Universidad Autonoma del Caribe, Barranquilla, Colombia; Global Brain Health Institute (GBHI), USUniversidad de San AndresCONICETUniversidad Autonoma del CaribeUniversidad Adolfo IbanezUCSFUSA
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24
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Sanchez JS, Hanseeuw BJ, Lopera F, Sperling RA, Baena A, Bocanegra Y, Aguillon D, Guzmán-Vélez E, Pardilla-Delgado E, Ramirez-Gomez L, Vila-Castelar C, Martinez JE, Fox-Fuller JT, Ramos C, Ochoa-Escudero M, Alvarez S, Jacobs HIL, Schultz AP, Gatchel JR, Becker JA, Katz SR, Mayblyum DV, Price JC, Reiman EM, Johnson KA, Quiroz YT. Longitudinal amyloid and tau accumulation in autosomal dominant Alzheimer's disease: findings from the Colombia-Boston (COLBOS) biomarker study. Alzheimers Res Ther 2021; 13:27. [PMID: 33451357 PMCID: PMC7811244 DOI: 10.1186/s13195-020-00765-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/26/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Neuroimaging studies of autosomal dominant Alzheimer's disease (ADAD) enable characterization of the trajectories of cerebral amyloid-β (Aβ) and tau accumulation in the decades prior to clinical symptom onset. Longitudinal rates of regional tau accumulation measured with positron emission tomography (PET) and their relationship with other biomarker and cognitive changes remain to be fully characterized in ADAD. METHODS Fourteen ADAD mutation carriers (Presenilin-1 E280A) and 15 age-matched non-carriers from the Colombian kindred underwent 2-3 sessions of Aβ (11C-Pittsburgh compound B) and tau (18F-flortaucipir) PET, structural magnetic resonance imaging, and neuropsychological evaluation over a 2-4-year follow-up period. Annualized rates of change for imaging and cognitive variables were compared between carriers and non-carriers, and relationships among baseline measurements and rates of change were assessed within carriers. RESULTS Longitudinal measurements were consistent with a sequence of ADAD-related changes beginning with Aβ accumulation (16 years prior to expected symptom onset, EYO), followed by entorhinal cortex (EC) tau (9 EYO), neocortical tau (6 EYO), hippocampal atrophy (6 EYO), and cognitive decline (4 EYO). Rates of tau accumulation among carriers were most rapid in parietal neocortex (~ 9%/year). EC tau PET signal at baseline was a significant predictor of subsequent neocortical tau accumulation and cognitive decline within carriers. CONCLUSIONS Our results are consistent with the sequence of biological changes in ADAD implied by cross-sectional studies and highlight the importance of EC tau as an early biomarker and a potential link between Aβ burden and neocortical tau accumulation in ADAD.
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Affiliation(s)
- Justin S Sanchez
- Massachusetts General Hoospital, Harvard Medical School, Boston, MA, USA
| | - Bernard J Hanseeuw
- Massachusetts General Hoospital, Harvard Medical School, Boston, MA, USA
| | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellin, Colombia
| | - Reisa A Sperling
- Massachusetts General Hoospital, Harvard Medical School, Boston, MA, USA
- Brigham and Women's Hoospital, Harvard Medical School, Boston, MA, USA
| | - Ana Baena
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellin, Colombia
| | - Yamile Bocanegra
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellin, Colombia
| | - David Aguillon
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellin, Colombia
| | | | | | | | | | - Jairo E Martinez
- Massachusetts General Hoospital, Harvard Medical School, Boston, MA, USA
| | - Joshua T Fox-Fuller
- Massachusetts General Hoospital, Harvard Medical School, Boston, MA, USA
- Boston University, Boston, MA, USA
| | - Claudia Ramos
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellin, Colombia
| | | | | | - Heidi I L Jacobs
- Massachusetts General Hoospital, Harvard Medical School, Boston, MA, USA
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Aaron P Schultz
- Massachusetts General Hoospital, Harvard Medical School, Boston, MA, USA
| | - Jennifer R Gatchel
- Massachusetts General Hoospital, Harvard Medical School, Boston, MA, USA
| | - J Alex Becker
- Massachusetts General Hoospital, Harvard Medical School, Boston, MA, USA
| | - Samantha R Katz
- Massachusetts General Hoospital, Harvard Medical School, Boston, MA, USA
| | | | - Julie C Price
- Massachusetts General Hoospital, Harvard Medical School, Boston, MA, USA
| | | | - Keith A Johnson
- Massachusetts General Hoospital, Harvard Medical School, Boston, MA, USA
- Brigham and Women's Hoospital, Harvard Medical School, Boston, MA, USA
| | - Yakeel T Quiroz
- Massachusetts General Hoospital, Harvard Medical School, Boston, MA, USA.
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellin, Colombia.
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Ramos C, Rios‐Romenets S, Giraldo‐Chica M, Acosta‐Baena N, Tobon C, Lopez H, Aguirre‐Acevedo DC, Langbaum JB, Reiman EM, Tariot PN, Lopera F. Depression and anxiety disorder along life in familial Alzheimer’s disease in the API ADAD Colombia trial. Alzheimers Dement 2020. [DOI: 10.1002/alz.041314] [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: 11/11/2022]
Affiliation(s)
- Claudia Ramos
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia Medellin Colombia
| | | | | | - Natalia Acosta‐Baena
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia Medellin Colombia
| | - Carlos Tobon
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia Medellin Colombia
| | - Hugo Lopez
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia Medellin Colombia
| | | | | | | | | | - Francisco Lopera
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia Medellin Colombia
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Ramos C. M501 BAMBOO NODULES IN A RHEUMATOID PATIENT, RESPONSE TO INHALED CORTICOSTEROIDS. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.371] [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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Souza S, Delamain M, Tobar N, Castro V, Frasson F, Amorim B, Etchebehere E, Mariana K, Mengatti J, Araujo E, Perini E, Souza CD, Santos A, Lorant-Metze I, Ramos C. Comparison of 68ga-psma and 18f-fdg pet/ct uptake in different lymphoma. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.09.086] [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] Open
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Malaquias MJ, Pinto CM, Ramos C, Ferreira S, Gandara J, Almeida A, Cavaco S, Miranda HP, Magalhães M. Acquired hepatocerebral degeneration and hepatic encephalopathy: one or two entities? Eur J Neurol 2020; 27:2396-2404. [DOI: 10.1111/ene.14486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/13/2020] [Indexed: 12/31/2022]
Affiliation(s)
- M. J. Malaquias
- Neurology Department Centro Hospitalar Universitário do Porto Porto Portugal
| | - C. M. Pinto
- Neuroradiology Department Centro Hospitalar Universitário do Porto Porto Portugal
| | - C. Ramos
- Neuroradiology Department Centro Hospitalar Universitário do Porto Porto Portugal
| | - S. Ferreira
- Hepatic Pancreatic Transplantation Unit Centro Hospitalar Universitário do Porto Porto Portugal
| | - J. Gandara
- Hepatic Pancreatic Transplantation Unit Centro Hospitalar Universitário do Porto Porto Portugal
| | - A. Almeida
- Chemistry Science Department Faculdade de Farmácia Universidade do Porto Porto Portugal
| | - S. Cavaco
- Neuropsychology Unit Centro Hospitalar Universitário do Porto Porto Portugal
| | - H. P. Miranda
- Hepatic Pancreatic Transplantation Unit Centro Hospitalar Universitário do Porto Porto Portugal
| | - M. Magalhães
- Neurology Department Centro Hospitalar Universitário do Porto Porto Portugal
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Abstract
Alzheimer’s disease (AD) and frontotemporal dementia (FTD) are neurodegenerative
disorders that result in a significant burden to both patients and caregivers.
By 2050, the number of people with dementia in Latin America will increase
4-fold. A deep understanding of the relevant genetic factors of AD and FTD is
fundamental to tackle this reality through prevention. A review of different
genetic variants that cause AD or FTD in Latin America was conducted. We
searched Medline and PubMed databases using the keywords “Alzheimer’s disease,”
“frontotemporal dementia,” “mutation,” “America,” and “Latin America,” besides
specific Latin American countries. Forty-five items were chosen and analyzed.
PSEN1 mutations are the commonest cause of genetic
early-onset Alzheimer’s disease (EOAD), followed by PSEN2 and
APP mutations. Genetic FTD can be mainly explained by
GRN and MAPT mutations, as well as
C9orf72 G4C2 repeat expansion. APOE ε4 can
modify the prevalence and incidence of late-onset Alzheimer’s disease (LOAD), in
addition to the cognitive performance in affected carriers.
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Affiliation(s)
- Claudia Ramos
- Neurosciences Group of Antioquia, School of Medicine, Universidad de Antioquia - Medellín, Colombia
| | - David Aguillon
- Neurosciences Group of Antioquia, School of Medicine, Universidad de Antioquia - Medellín, Colombia
| | - Christian Cordano
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco - San Francisco, CA, United States
| | - Francisco Lopera
- Neurosciences Group of Antioquia, School of Medicine, Universidad de Antioquia - Medellín, Colombia
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Martínez R, Ruiz M, Ramos C, Cámara J, Diez V. Comparison of external and submerged membranes used in anaerobic membrane bioreactors: Fouling related issues and biological activity. Biochem Eng J 2020. [DOI: 10.1016/j.bej.2020.107558] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rios-Romenets S, Giraldo-Chica M, López H, Piedrahita F, Ramos C, Acosta-Baena N, Muñoz C, Ospina P, Tobón C, Cho W, Ward M, Langbaum JB, Tariot PN, Reiman EM, Lopera F. The Value of Pre-Screening in the Alzheimer's Prevention Initiative (API) Autosomal Dominant Alzheimer's Disease Trial. J Prev Alzheimers Dis 2019; 5:49-54. [PMID: 29405233 DOI: 10.14283/jpad.2017.44] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Alzheimer's Prevention Initiative (API) Autosomal Dominant Alzheimer's Disease (ADAD) trial evaluates the anti-amyloid-β antibody crenezumab in cognitively unimpaired persons who, based on genetic background and age, are at high imminent risk of clinical progression, and provides a powerful test of the amyloid hypothesis. The Neurosciences Group of Antioquia implemented a pre-screening process with the goals of decreasing screen failures and identifying participants most likely to adhere to trial requirements of the API ADAD trial in cognitively unimpaired members of Presenilin1 E280A mutation kindreds. The pre-screening failure rate was 48.2%: the primary reason was expected inability to comply with the protocol, chiefly due to work requirements. More carriers compared to non-carriers, and more males compared to females, failed pre-screening. Carriers with illiteracy or learning/comprehension difficulties failed pre-screening more than non-carriers. With the Colombian API Registry and our prescreening efforts, we randomized 169 30-60 year-old cognitively unimpaired carriers and 83 non-carriers who agreed to participate in the trial for at least 60 months. Our findings suggest multiple benefits of implementing a pre-screening process for enrolling prevention trials in ADAD.
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Affiliation(s)
- S Rios-Romenets
- Silvia Rios-Romenets, MD, Medical Director and Deputy API Colombia, Neuroscience Group of Antioquia, Calle 62 No. 52 - 59, Medellín, Antioquia, Colombia, Phone: 57-4-2196424, 2196425, Fax: 57-4-2196444,
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Ramos C, Frugoli A, Lee-Kim C, Porch-Curren C. M100 HERMES ITCH: MERCURY RELATED SYSTEMIC CONTACT DERMATITIS. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.139] [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: 10/25/2022]
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Coppola-Fasick G, Benitez Ortiz Y, Ramos C, Nazario S. M507 ALLERGIC CONTACT DERMATITIS ON THE EAR: NOT COMMONLY HEARD OF. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.457] [Citation(s) in RCA: 1] [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: 11/24/2022]
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Villalba AC, García J, Ramos C, Cuastumal AR, Aguillón D, Aguirre-Acevedo DC, Madrigal L, Lopera F. Mental Disorders in Young Adults from Families with the Presenilin-1 Gene Mutation E280A in the Preclinical Stage of Alzheimer's Disease. J Alzheimers Dis Rep 2019; 3:241-250. [PMID: 31754656 PMCID: PMC6839534 DOI: 10.3233/adr-190139] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background There are forms of Alzheimer's disease (AD) that have an autosomal dominant inheritance pattern; one of them is caused by the E280A mutation in the gene that codes for Presenilin-1 (PSEN1). Studying families of people with this mutation allows the evaluation of characteristics of the subjects before cognitive decline begins. Objective To determine whether having the mutation E280A in PSEN1 increases the risk of presenting mental disorders in adults under 30 years old who are in the preclinical stage of AD and may be eligible for primary prevention studies of AD. Methods A psychiatric evaluation was made to 120 people belonging to families with a history of early onset AD. Of these, 62 carried the E280A mutation in PSEN1. The occurrence of mental disorders between carriers and non-carriers of the mutation was compared. Results No statistically significant differences were found in the frequency of any mental disorder between the group of carriers and non-carriers of the mutation (Hazard Ratio: 0.80, 95% CI 0.49 to 1.31); nor were differences observed when evaluating specific disorders. Conclusion The E280A mutation does not increase the risk of mental disorders before the age of 30 in the relatives of people affected by familial AD. Studies with larger sample sizes are required to assess the risk of low incidence mental disorders.
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Affiliation(s)
- Arvey Camilo Villalba
- Department of Psychiatry, Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
| | - Jenny García
- Department of Psychiatry, Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia.,Academic Group in Clinical Epidemiology (GRAEPIC), Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
| | - Claudia Ramos
- Neuroscience Group of Antioquia (GNA), Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
| | - Amanda Rosario Cuastumal
- Neuroscience Group of Antioquia (GNA), Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
| | - David Aguillón
- Neuroscience Group of Antioquia (GNA), Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
| | - Daniel Camilo Aguirre-Acevedo
- Neuroscience Group of Antioquia (GNA), Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia.,Medical Research Institute, Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
| | - Lucia Madrigal
- Neuroscience Group of Antioquia (GNA), Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
| | - Francisco Lopera
- Neuroscience Group of Antioquia (GNA), Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
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Villalba AC, García J, Ramos C, Cuastumal AR, Aguillón D, Aguirre-Acevedo DC, Madrigal L, Lopera F. WITHDRAWN: Mental Disorders in Young Adults from Families with the Presenilin-1 Gene Mutation E280A in the Preclinical Stage of Alzheimer's Disease. J Alzheimers Dis 2019:JAD181013. [PMID: 31381509 DOI: 10.3233/jad-181013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ahead of Print article withdrawn by publisher.
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Affiliation(s)
- Arvey Camilo Villalba
- Department of Psychiatry, Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
| | - Jenny García
- Department of Psychiatry, Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
- Academic Group in Clinical Epidemiology (GRAEPIC), Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
| | - Claudia Ramos
- Neuroscience Group of Antioquia (GNA), Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
| | - Amanda Rosario Cuastumal
- Neuroscience Group of Antioquia (GNA), Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
| | - David Aguillón
- Neuroscience Group of Antioquia (GNA), Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
| | - Daniel Camilo Aguirre-Acevedo
- Neuroscience Group of Antioquia (GNA), Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
- Medical Research Institute, Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
| | - Lucia Madrigal
- Neuroscience Group of Antioquia (GNA), Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
| | - Francisco Lopera
- Neuroscience Group of Antioquia (GNA), Faculty of Medicine of the University of Antioquia, Medellín, Antioquia, Colombia
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de Frutos M, Medina R, Aragón R, López-Urrutia L, González-Sagrado M, Ramos C, Domínguez-Gil M, Garcinuño S, Viñuela L, Eiros JM. [Episodes of nontyphoidal salmonellosis in adult patients of the Valladolid West Area in 2017: Evaluation of the suitability of the microbiological culture request and the prescribed treatment]. Rev Esp Quimioter 2019; 32:224-231. [PMID: 30950256 PMCID: PMC6609942] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/04/2018] [Accepted: 01/28/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Gastroenteritic salmonellosis is still the second cause diagnosed of infectious diarrhea, most of these clinical pictures are mild and self-limited and therefore the use of antibiotics is limited to few cases. The aim of the study was to describe the episodes of diarrhea caused by Salmonella enterica subsp. enterica, assessing the suitability of the request and the use of antibiotics according to the criteria included in the methodology. METHODS A retrospective, descriptive, observational study was conducted, collecting data from the clinical history. RESULTS A total of 122 episodes were included. The reason for consultation was diarrhea, which generated a greater demand in the Hospital Emergency Services (42.6%). The most frequent serotypes isolated were Enteritidis (53.3%), and Typhimurium (40.2%). The adequate request of the stool was 90.2%. Antibiotic was prescribed in 64.6% (79) of the episodes, most patients under 65 years (58 episodes), the average age was 48.43 years. They were treated mainly with ciprofloxacin and azithromycin, in 57 and 14 episodes, respectively. The average duration of antibiotic treatment was 6 days. There was an adequate use of antibiotics in 49.1% of episodes. When the origin of the request was the Hospital Emergency Service, it was inadequate in 63.5% (33) of them. It was inadequate in 60.0% (39) of episodes when ser. Enteritidis was isolated. Almost half, 48.85% (42) of the 58 episodes in which antibiotics were prescribed among those under 65 (86), were treated without being indicated. CONCLUSIONS Training actions should be implemented focused on optimizing the management of antibiotics in this entity.
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Affiliation(s)
- M de Frutos
- Mónica de Frutos, Hospital Universitario Río Hortega, Calle Dulzaina, 2 - Valladolid 47012, Spain.
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Diez V, Iglesias A, Cámara JM, Ruiz MO, Ramos C. A novel anaerobic filter membrane bioreactor: prototype start-up and filtration assays. Water Sci Technol 2018; 78:1833-1842. [PMID: 30566087 DOI: 10.2166/wst.2018.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Anaerobic digestion allows efficient treatment of high loaded wastewater, and membrane technology allows obtaining high quality effluents with complete biomass retention. However, high biomass concentration interferes with membrane fouling. In the present work, a new bioreactor that integrates an attached biomass anaerobic culture on a fixed bed and a submerged membrane has been started up. The recirculation between the digestion and filtration chambers is coupled to the gas-lift effect of the bubbling employed for the scouring of the membranes, avoiding the use or electromechanical pumps that damage the suspended biomass. The support material retains the biomass in the digestion tank despite the downwards flow, avoiding the submerged membrane contacting with a high concentrated suspension. This novel system, called an anaerobic filter membrane bioreactor was immediately started up, achieving chemical oxygen demand (COD) removal efficiencies of 96% at an organic loading rate (OLR) of 7 kg COD/m3·d. In order to select filtration flux, specific gas demand and filtration cycle duration, the results of 15 short term assays, eight hours for each one, is presented for fluxes between 15.7 and 17.7 L/m2·h, cycle duration between 10 and 30 minutes, and three levels of scouring. It was checked that reversible and irreversible fouling were directly related when dTMP/dt > 2.5 mbar/min.
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Affiliation(s)
- V Diez
- Department of Biotechnology and Food Science, Chemical Engineering Division, University of Burgos, Plaza Misael Bañuelos, 09001 Burgos, Spain E-mail:
| | - A Iglesias
- Department of Biotechnology and Food Science, Chemical Engineering Division, University of Burgos, Plaza Misael Bañuelos, 09001 Burgos, Spain E-mail:
| | - J M Cámara
- Department of Electromechanical Engineering, Electronics Technology Division, University of Burgos, Avda. Cantabria s/n, 09006 Burgos, Spain
| | - M O Ruiz
- Department of Biotechnology and Food Science, Chemical Engineering Division, University of Burgos, Plaza Misael Bañuelos, 09001 Burgos, Spain E-mail:
| | - C Ramos
- Department of Biotechnology and Food Science, Chemical Engineering Division, University of Burgos, Plaza Misael Bañuelos, 09001 Burgos, Spain E-mail:
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Costa FA, Ramos C, Murteira R, Almodovar T, Passos-Coelho JL, Carvalho MI, Costa L, Brito MJ, Ramos S, Ferreira M, Miranda AC. The cancer registry as an ally in monitoring treatment effectiveness. Pulmonology 2018; 25:3-8. [PMID: 30361162 DOI: 10.1016/j.pulmoe.2018.05.007] [Citation(s) in RCA: 5] [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: 01/05/2018] [Revised: 04/25/2018] [Accepted: 05/18/2018] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To evaluate if the cancer registry database can be used to monitor treatment effectiveness using nivolumab treatment of non-small cell lung cancer (NSCLC) as an example. METHOD An observational inception cohort was used, where all registered cases of NSCLC with authorisation to initiate treatment with nivolumab were monitored retrospectively to evaluate disease characteristics and response to prior treatments. Current exposure to nivolumab was prospectively characterised and treatment outcomes classified based on the clinical information registered in the patient medical record. The main outcome measure used to assess treatment effectiveness was overall survival (OS). Secondary outcomes considered were progression free survival (PFS) as a measure of effectiveness and occurrence of Adverse Drug Reaction (ADRs) as a measure of safety. Data were analysed using SPSS, version 24. RESULTS A total of 115 patients received treatment with nivolumab for NSCLC, between November 1st 2015 and July 31st 2016, and were registered in the database. The majority were non-squamous type (n=107). The median OS was 11.4 months {CI95%: 11.1-11.7}, with a 1-year survival of 44%, in line with clinical trial data. Median PFS was 5.4 months {CI95%: 2.8-7.9}. Treatment was discontinued in 82 cases, most frequently due to disease progression. There were 38 cases of ADRs documented in the patient medical chart, 21 of which led to treatment discontinuation. CONCLUSION The analysed data suggest that the cancer registry is a powerful tool to monitor treatment effectiveness, although considerable investment is needed to improve the medical culture of recording treatment exposure, particularly documentation of ADRs.
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Affiliation(s)
- F A Costa
- Registo Oncológico Nacional, Portugal.
| | - C Ramos
- Registo Oncológico Nacional, Portugal
| | | | - T Almodovar
- Instituto Português de Oncologia de Lisboa Francisco Gentil, Portugal
| | | | | | - L Costa
- Centro Hospitalar de Lisboa Norte, Portugal
| | | | - S Ramos
- Centro Hospitalar de Lisboa Ocidental, Portugal
| | - M Ferreira
- Hospital Prof. Doutor Fernando da Fonseca, Portugal
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Letrán A, Hueso S, González V, Ramos C, Amaya A. Eosinophilic Ascites: Singular Presentation of Eosinophilic Gastrointestinal Disorder. J Investig Allergol Clin Immunol 2018; 28:275-276. [PMID: 30073966 DOI: 10.18176/jiaci.0260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A Letrán
- Allergy Unit, Hospital HLA Jerez Puerta del Sur, Jerez de la Frontera, Spain
| | - S Hueso
- Internal Medicine Unit, Hospital HLA Jerez Puerta del Sur, Jerez de la Frontera, Spain
| | - V González
- Internal Medicine Unit, Hospital HLA Jerez Puerta del Sur, Jerez de la Frontera, Spain
| | - C Ramos
- Pathology Unit, Hospital HLA Jerez Puerta del Sur, Jerez de la Frontera, Spain
| | - A Amaya
- Digestive Unit, Hospital HLA Jerez Puerta del Sur, Jerez de la Frontera, Spain
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Gomes A, Fernandes A, Ribeiro R, Cardoso J, Ramos C. 678 Perceived addiction to online pornography and sexual attitudes in Portuguese college students. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.586] [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: 10/28/2022]
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Felix A, Silva F, Ramos C, Lopes-Coelho F, Nunes S, Serpa J. PO-468 LAMININ332 (α3; ß3;γ2) genes and protein expression in cervical carcinomas. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.975] [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: 11/04/2022] Open
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Ramos C, Duque-Grajales J, Rendón J, Montoya-Betancur A, Baena A, Pineda D, Tobón C. Changes in Resting EEG in Colombian Ex-combatants ith Antisocial Personality Disorder. Rev Colomb Psiquiatr (Engl Ed) 2018; 47:90-97. [PMID: 29754711 DOI: 10.1016/j.rcp.2017.02.001] [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] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 01/06/2017] [Accepted: 02/09/2017] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Although the social and economic consequences of Colombian internal conflicts mainly affected the civilian population, they also had other implications. The ex-combatants, the other side of the conflict, have been the subject of many studies that question their personality structures and antisocial features. Results suggest that ex-combatants usually have characteristics of an antisocial personality disorder (ASPD) that is related with their behaviour. METHODS Quantitative EEG (qEEG) was used to evaluate differences in cortical activity patterns between an ex-combatants group and a control group. The Psychopathy Checklist-Revised (PCL-R) was used to assess the presence of ASPD in the ex-combatants group, as well as the Diagnostic Interview for Genetic Studies (DIGS) for other mental disorders classified in the DCI-10. RESULTS There are significant differences in psychopathy levels between groups, as well as in alpha-2 and beta waves, especially in left temporal and frontal areas for alpha-2 waves and left temporal-central regions for beta waves. CONCLUSIONS qEEG measurements allow spectral resting potential to be differentiated between groups that are related with features typically involved in antisocial personality disorder, and to correlate them with patterns in the questionnaires and clinical interview.
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Affiliation(s)
- Claudia Ramos
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Jon Duque-Grajales
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación en Bioinstrumentación e Ingeniería Clínica (GIBIC), Universidad de Antioquia, Medellín, Colombia.
| | - Jorge Rendón
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia; Grupo de Neuropsicología y Conducta, Universidad de Antioquia, Medellín, Colombia
| | | | - Ana Baena
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - David Pineda
- Grupo de Neuropsicología y Conducta, Universidad de Antioquia, Medellín, Colombia
| | - Carlos Tobón
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia; Grupo de Neuropsicología y Conducta, Universidad de Antioquia, Medellín, Colombia
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Tariot PN, Lopera F, Langbaum JB, Thomas RG, Hendrix S, Schneider LS, Rios-Romenets S, Giraldo M, Acosta N, Tobon C, Ramos C, Espinosa A, Cho W, Ward M, Clayton D, Friesenhahn M, Mackey H, Honigberg L, Sanabria Bohorquez S, Chen K, Walsh T, Langlois C, Reiman EM. The Alzheimer's Prevention Initiative Autosomal-Dominant Alzheimer's Disease Trial: A study of crenezumab versus placebo in preclinical PSEN1 E280A mutation carriers to evaluate efficacy and safety in the treatment of autosomal-dominant Alzheimer's disease, including a placebo-treated noncarrier cohort. Alzheimers Dement (N Y) 2018; 4:150-160. [PMID: 29955659 PMCID: PMC6021543 DOI: 10.1016/j.trci.2018.02.002] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Introduction Autosomal-dominant Alzheimer's disease (ADAD) represents a crucial population for identifying prevention strategies that might modify disease course for cognitively unimpaired individuals at high imminent risk for developing symptoms due to Alzheimer's disease (AD), that is, who have "preclinical" AD. Crenezumab is an antiamyloid monoclonal antibody that binds monomeric and aggregated forms of amyloid β, with highest affinity for oligomers; it is in development for early stages of sporadic AD and for ADAD. Methods This is a prospective, randomized, double-blind, placebo-controlled phase 2 study of the efficacy of crenezumab versus placebo in asymptomatic PSEN1 E280A mutation carriers from family kindreds with ADAD in Colombia. Participants were randomized to receive either crenezumab or placebo for 260 weeks. The study was designed to enroll a planned total of 300 participants, including 200 preclinical mutation carriers (approximately 100 treatment, 100 placebo) and an additional control group of mutation noncarriers from the same family kindreds included to mask mutation carrier status (100 placebo only). The primary outcome is change in the Alzheimer's Prevention Initiative ADAD Composite Cognitive Test Score from baseline to week 260. Secondary outcomes include time to progression to mild cognitive impairment due to AD or dementia due to AD; changes in dementia severity, memory, and overall neurocognitive functioning; and changes in amyloid-positron emission tomography, fluorodeoxyglucose-positron emission tomography, magnetic resonance imaging volumes, and cerebrospinal fluid levels of β amyloid, tau, and p-tau. Safety and tolerability are assessed. Results Two hundred fifty-two participants were enrolled between December 2013 and February 2017. Discussion We describe the first large-scale, potentially label-enabling clinical trial of a preclinical treatment for ADAD. Results from this trial will inform on the efficacy of crenezumab for delaying onset of, slowing decline in, or preventing cognitive impairment in individuals with preclinical ADAD and will foster an improved understanding of AD biomarkers and their relationship to clinical outcomes.
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Affiliation(s)
| | - Francisco Lopera
- Grupo de Neurociencias, Universidad de Antioquia, SIU, Medellín, Colombia
| | | | - Ronald G Thomas
- Department of Neurosciences, University of California San Diego School of Medicine, La Jolla, CA, USA
| | | | - Lon S Schneider
- USC State of California Alzheimer's Disease Research and Clinical Center, Keck Medicine of USC, Los Angeles, CA, USA
| | | | - Margarita Giraldo
- Grupo de Neurociencias, Universidad de Antioquia, SIU, Medellín, Colombia
| | - Natalia Acosta
- Grupo de Neurociencias, Universidad de Antioquia, SIU, Medellín, Colombia
| | - Carlos Tobon
- Grupo de Neurociencias, Universidad de Antioquia, SIU, Medellín, Colombia
| | - Claudia Ramos
- Grupo de Neurociencias, Universidad de Antioquia, SIU, Medellín, Colombia
| | - Alejandro Espinosa
- Grupo de Neurociencias, Universidad de Antioquia, SIU, Medellín, Colombia
| | - William Cho
- Genentech, a Member of the Roche Group, South San Francisco, CA, USA
| | - Michael Ward
- Genentech, a Member of the Roche Group, South San Francisco, CA, USA
| | - David Clayton
- Genentech, a Member of the Roche Group, South San Francisco, CA, USA
| | | | - Howard Mackey
- Genentech, a Member of the Roche Group, South San Francisco, CA, USA
| | - Lee Honigberg
- Genentech, a Member of the Roche Group, South San Francisco, CA, USA
| | | | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ, USA
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Avila Novoa D, Cárdenas M, Cardona E, Cardona D, Grover F, Ramos C, Trujillo J. ASSOCIATION OF PULSE WAVE VELOCITY AND BODY MASS INDEX IN HEALTHY MEXICAN POPULATION. Artery Res 2018. [DOI: 10.1016/j.artres.2018.10.009] [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: 12/01/2022] Open
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Rivera Z, Ramos C. P175 Non-surgical management of intussusception in a pediatric patient with hereditary angioedema. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.08.162] [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: 11/28/2022]
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de Frutos M, López E, Aragón R, López-Urrutia L, Ramos C, Domínguez-Gil M, Viñuela L, Garcinuño S, Eiros JM. [A descriptive study of Hafnia alvei isolated from stool samples: an approach to its clinical assessment]. Rev Esp Quimioter 2017; 30:280-284. [PMID: 28537065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The importance in human diarrhoeal disease of Hafnia alvei is unclear. The objective of the study was to describe the population which was isolated H. alvei in stool cultures and the therapeutic management of these cases in our Health Area. METHODS A descriptive retrospective study was carried out in 2014 and 2015. Epidemiological, clinical, treatment and evolution variables were collected in the computerized clinical history. RESULTS A collection of 7,290 stool specimens were processed, 3,321 in 2014 and 3,969 in 2015, of which 58 (1.7%) and 53 (1.3%) were positive for H. alvei, respectively. A 60.4% of samples were isolated in women. The mean age was 38.68 years. A 68.5% of samples were from primary care. In 71.2% there was related clinic, diarrhoea in 57.7%. In 75.7% of the cases there was not associated underlying disease. A 43.2% of the cases received treatment. A 66.7% of treated patients came from Primary Care. The mean duration of treatment was 8 days. The evolution was favourable in 85.4% of the cases treated. All strains were susceptible to ciprofloxacin and trimethoprim/sulfamethoxazole. CONCLUSIONS More evidence is needed to support H. alvei as a cause of gastroenteritis.
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Affiliation(s)
- M de Frutos
- Mónica de Frutos, Hospital Universitario Río Hortega, Calle Dulzaina 2, Valladolid 47012, Spain.
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García S, Dominguez-Gil M, Gayete J, Rojo S, Muñoz JL, Salas JS, Echevarria C, Blanco M, Ramos C, De Frutos M, López-Urrutia L, Viñuela L, Tamames S, Redondo P, Jiménez JM, Eiros JM, Ortiz de Lejarazu R. [Prevalence of human papillomavirus in Spanish women from a population screening program]. Rev Esp Quimioter 2017; 30:177-182. [PMID: 28508620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The human papillomavirus (HPV), is necessary to cause a woman developing cervical cancer. The aim of the study was to estimate the prevalence of women with HPV infection, covered by the program of prevention and early detection of cervical cancer of Castile and León (Spain). METHODS Samples of women included in the screening program were analyzed. Including a total of 120,326 cervical swab samples, collected in the period from January 2012 to December 2014. RESULTS 12,183 HPV positive samples were detected, representing a prevalence of 9.6 ‰, (IC 95% 9.5%-9.8%) in the female population. High-risk HPV were found in higher proportion that HPV low-risk genotypes. HPV prevalence correlates inversely with women age. Coinfections of multiple genotypes were found in one third of screened women population. CONCLUSIONS Data showed in this study are the first and wider Spanish results from a cervical cancer screening program population non opportunistic based on HPV detection. These results would serve as a reference for future prevalence studies and to evaluate the future impact of HPV vaccination campaigns.
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Affiliation(s)
- S García
- Sara García. Servicio de Microbiología del Hospital Universitario Río Hortega. Calle Dulzaina nº2. Valladolid. Spain.
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Ayala YA, Arroyo-Flores E, Nazario S, Ramos C. P096 Hereditary angioedema in the puerto rican population: epidemiologic characteristics and burden of disease. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.105] [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: 10/20/2022]
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Coppola Fasick G, Ramos C. P336 Omalizumab for severe atopic dermatitis: a case report. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.350] [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: 11/30/2022]
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Morais H, Rodrigues P, Ramos C, Almeida V, Forgács E, Cserháti T, Oliveira J. Note. Effect of Blanching and Frozen Storage on the Stability of β-Carotene and Capsanthin in Red Pepper (Capsicum Annuum) Fruit. FOOD SCI TECHNOL INT 2016. [DOI: 10.1106/1082013022914] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The effect of blanching and frozen storage on the stability of pigments β-carotene and capsanthin in three cultivars of red pepper (Capsicum annuum) fruits was elucidated by the determination of pigments in samples treated by various blanching procedures. Pigment concentration was performed after different storage times by HPLC. The dependence of the concentration of pigments on the conditions of blanching and the storage time was assessed by stepwise regression analysis, and the similarities and dissimilarities among the cultivars and decomposition rates were calculated by principal component analysis. The stability of pigments depended significantly on the conditions of blanching, the storage time and the type of cultivar, the effect of storage time was higher than that of blanching conditions. The significant differences between the decomposition rate of pigments in various cultivars emphasizes the predominant importance of the selection of cultivars with advantageous storage characteristics.
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Affiliation(s)
- H. Morais
- National Agronomical Station, Quinta do Marques, 2784-505 Oeiras, Portugal, New University of Lisbon, 2825 Monte da Caparica, Portugal
| | - P. Rodrigues
- National Agronomical Station, Quinta do Marques, 2784-505 Oeiras, Portugal, New University of Lisbon, 2825 Monte da Caparica, Portugal
| | - C. Ramos
- National Agronomical Station, Quinta do Marques, 2784-505 Oeiras, Portugal, New University of Lisbon, 2825 Monte da Caparica, Portugal
| | - V. Almeida
- National Agronomical Station, Quinta do Marques, 2784-505 Oeiras, Portugal
| | - E. Forgács
- Institute of Chemistry, Chemical Research Center, Hungarian Academy of Sciences, P.O. Box 17, 1525 Budapest, Hungary,
| | - T. Cserháti
- Institute of Chemistry, Chemical Research Center, Hungarian Academy of Sciences, P.O. Box 17, 1525 Budapest, Hungary
| | - J.S. Oliveira
- New University of Lisbon, 2825 Monte da Caparica, Portugal
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