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Alcázar Artero PM, Greif R, Cerón Madrigal JJ, Escribano D, Pérez Rubio MT, Alcázar Artero ME, López Guardiola P, Mendoza López M, Melendreras Ruiz R, Pardo Ríos M. Teaching cardiopulmonary resuscitation using virtual reality: A randomized study. Australas Emerg Care 2024; 27:57-62. [PMID: 37666723 DOI: 10.1016/j.auec.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/17/2023] [Accepted: 08/14/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND The main functions of healthcare professionals include training and health education. In this sense, we must be able to incorporate new technologies and serious game to the teaching cardiopulmonary resuscitation. METHODS a multicenter, comparative and cross-sectional study was carried out to assess the learning of resuscitation of a group that was trained with the use of serious gaming with virtual reality, as compared to a control group trained with conventional classroom teaching. RESULTS the mean quality obtained in chest compressions for the virtual reality group was 86.1 % (SD 9.3), and 74.8 % (SD 9.5) for the control group [mean difference 11.3 % (95 % CI 6.6-16.0), p < 0.001]. Salivary Alpha-Amylase was 218.882 (SD 177.621) IU/L for the virtual reality group and 155.190 (SD 116.746) IU/L for the control group [mean difference 63.691 (95 % CI 122.998-4.385), p = 0.037]. CONCLUSION using virtual reality and serious games can improve the quality parameters of chest compressions as compared to traditional training.
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Affiliation(s)
- P M Alcázar Artero
- UCAM Universidad Católica de Murcia, New Technologies in Health Research Group (NT4H), Spain; Health Emergencies Service 061 from the Region de Murcia, Spain
| | - R Greif
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; School of Medicine, Sigmund Freud Private University Vienna, Vienna, Austria
| | - J J Cerón Madrigal
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, University of Murcia, Spain
| | - D Escribano
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, University of Murcia, Spain
| | - M T Pérez Rubio
- UCAM Universidad Católica de Murcia, New Technologies in Health Research Group (NT4H), Spain
| | - M E Alcázar Artero
- UCAM Universidad Católica de Murcia, New Technologies in Health Research Group (NT4H), Spain
| | - P López Guardiola
- UCAM Universidad Católica de Murcia, New Technologies in Health Research Group (NT4H), Spain
| | - M Mendoza López
- UCAM Universidad Católica de Murcia, New Technologies in Health Research Group (NT4H), Spain
| | - R Melendreras Ruiz
- UCAM Universidad Católica de Murcia, New Technologies in Health Research Group (NT4H), Spain
| | - M Pardo Ríos
- UCAM Universidad Católica de Murcia, New Technologies in Health Research Group (NT4H), Spain; Health Emergencies Service 061 from the Region de Murcia, Spain.
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2
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Botía M, López-Arjona M, Escribano D, Contreras-Aguilar MD, Vallejo-Mateo PJ, Cerón JJ, Martínez-Subiela S. Measurement of haptoglobin in saliva of cows: Validation of an assay and a pilot study of its potential application. Res Vet Sci 2023; 158:44-49. [PMID: 36924634 DOI: 10.1016/j.rvsc.2023.03.005] [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: 02/01/2023] [Accepted: 03/06/2023] [Indexed: 03/17/2023]
Abstract
In recent years, the use of saliva as a matrix for the measurement of biomarkers of health and welfare is gaining importance due to its non-invasive collection. Haptoglobin (Hp) is an acute-phase protein involved in the inflammatory response and changes in its concentration can provide information about the health status of the animals. This study aimed to develop and validate an assay based on luminescent amplification (AlphaLISA technology) for the measurement of Hp in bovine saliva and to study the possible changes in different inflammatory situations such as peripartum period and lameness. The assay proved to be accurate, reliable, and sensitive for the measurement of Hp in cow saliva (coefficient of variation (CV) 7.57%; coefficient of determination (R2) 0.992; recovery test 105.15%; lower limit of quantification (LLQ) 7.9 ng/ml). Significant differences were observed between Hp levels in saliva of cows before (13 days before) and after (7 and 20 days after) calving and at the moment of calving (p < 0.0001), and between lame and healthy cows (p < 0.008). In conclusion, this assay can detect Hp in a precise, sensitive, and accurate way in saliva of cows. Future studies with a larger population and different disease conditions should be conducted to determine the potential of Hp as an inflammatory biomarker in cow saliva.
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Affiliation(s)
- M Botía
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence Campus Mare Nostrum, University of Murcia, 30100 Murcia, Spain
| | - M López-Arjona
- Department of Animal and Food Science, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - D Escribano
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence Campus Mare Nostrum, University of Murcia, 30100 Murcia, Spain; Department of Animal Production, Veterinary School, Regional Campus of International Excellence Campus Mare Nostrum, University of Murcia, 30100 Murcia, Spain
| | - M D Contreras-Aguilar
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence Campus Mare Nostrum, University of Murcia, 30100 Murcia, Spain
| | - P J Vallejo-Mateo
- Department of Animal Medicine and Surgery, Veterinary School, Regional Campus of International Excellence Campus Mare Nostrum, University of Murcia, 30100 Murcia, Spain
| | - J J Cerón
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence Campus Mare Nostrum, University of Murcia, 30100 Murcia, Spain
| | - S Martínez-Subiela
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence Campus Mare Nostrum, University of Murcia, 30100 Murcia, Spain.
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3
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Cordero A, Escribano D, Alvarez-Alvarez B, Martinon J, Garcia-Rondeja F, Rodriguez-Manero M, Bertomeu-Gonzalez V, Cazorla D, Moreno-Arribas J, Quintanilla MA, Lopez Ayala JM, Zuazola P, Gonzalez-Juanatey JR. Cholesterol remnants distribution in patients admitted for acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2340] [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
Background
Cholesterol remnants have been identified as one of leading lipid measurements associated with the incidence of coronary heart diseases. Nonetheless, there is scarce evidence on cholesterol remnants distribution in patients with acute coronary syndrome (ACS).
Methods
We included all consecutive patients admitted for ACS in two different centers. Cholesterol remnants were calculated by the equation: total cholesterol minus low-density lipoprotein cholesterol (LDLc) minus high-density lipoprotein cholesterol (HDLc) and values ≥30 were considered high. Premature ACS was defined in patients presenting with age <55 for men or <65 for women. Correlation weres assessed by linear regression and predictive models were obtained after logistic binary regression.
Results
We included 7,479 patients, mean age 66.68 (13.02), 2,062 (27.57%) women, mean body mass index (BMI) 28.60 (4.64) kg/m2, 2088 (27,92%) with diabetes and 2,726 (36.45%) admitted for ST-elevation ACS. Median (interquartile range) remnants level was 28 mg/dl (21–39) and 3,429 (45.85%) patients had levels ≥30 mg/dl. Significantly higher levels of remnants were observed in patients with diabetes, current smokers, BMI >30 kg/m2, absence of previous cardiovascular disease or premature ACS. No gender differences were observed in remnants level. Age (r: −0.29) and BMI (r: 0.44) were the variables more strongly correlated. As shown in the figures, at any given age, the risk of having cholesterol remnants ≥30 increased with higher BMI.
In-hospital mortality was 3.75% (280 patients). After adjustment by age, gender, previous cardiovascular disease and GRACE score, cholesterol remnants were not associated to higher mortality risk (OR: 0.89 95% CI 0.64–1.10; p=0.21)
Conclusions
Elevated cholesterol remnants is highly prevalent in patients admitted for ACS and their levels inversely correlate with age and positively with body mass index. We propose a risk matrix for estimating the probability of having cholesterol remnants ≥30. Elevated cholesterol remnants were not associated to higher in-hospital mortality risk.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Cordero
- University Hospital of San Juan , Alicante , Spain
| | - D Escribano
- University Hospital of San Juan , Alicante , Spain
| | - B Alvarez-Alvarez
- University Hospital of Santiago de Compostela , Santiago de Compostela , Spain
| | - J Martinon
- University Hospital of Santiago de Compostela , Santiago de Compostela , Spain
| | - F Garcia-Rondeja
- University Hospital of Santiago de Compostela , Santiago de Compostela , Spain
| | - M Rodriguez-Manero
- University Hospital of Santiago de Compostela , Santiago de Compostela , Spain
| | | | - D Cazorla
- University Hospital of San Juan , Alicante , Spain
| | | | | | | | - P Zuazola
- University Hospital of San Juan , Alicante , Spain
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4
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Cordero A, Escribano D, Quintanilla MA, Monteagudo M, Lopez-Ayala JM, Moreno-Arribas J, Martinez Rey-Ranal E, Masia MD, Zuazola P, Bertomeu-Gonzalez V. Differential prognosis of patients candidates for standard, short or prolonged dual antiplatelet treatment discharged after an acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Current evidence supports the efficacy of prolonged dual antiplatelet treatment prolonged (DAPT) patients at high-ischemic risk and low bleeding risk. In contrast, several trials have demonstrated the efficacy and safety of short DAPT (1,3 o6 months) in high-bleeding risk (HBR) patients. Nonetheless, 12 months of DAPT is the most commonly strategy recommended in patients discharged after an ACS.
Methods
We evaluated patterns of DAPT candidates in all patients discharged in single center between 2009 and 2019 after an acute coronary syndrome (ACS). Patients categorized in 3 groups: 1) short-DAPT candidates if they met 1 major o 2 minor criteria for HBR, by the 2019 ARC-HBR criteria; 2) prolonged-DAPT candidates if were not HBR and had recurrent ACS, complex percutaneous coronary interventions or diabetes; 3) standard 12 months DAPT if were not include in the previous 2 groups. We evaluated all-cause and cardiovascular mortality, mayor bleeding (MB), and major cardiovascular events (MACE) after discharge.
Results
We assessed 3,155 patients discharged after an ACS, mean age was 68.4 (13.0), 25.9% were women, 32.5% had diabetes, 13.2% received complex percutaneous coronary interventions and 40.5% were categorized as HBR. After categorization, 1,277 (40.48%) were candidates for short DAPT, 1,203 (38.1%) for standard 12m DAPT and 675 (21.39%) for prolonged DAPT.
After a median follow-up was 1032 days (interquartile range 555–1950), all-cause mortality was 15.8%, cardiovascular mortality 10.5%, 35.9% had a first MACE and 6.2% had at least one MB. As shown in figure 1, patients candidates for short or prolonged DAPT had significantly higher rates of all-cause and cardiovascular mortality as well as MACE. In contrast, higher rate of MB was only increased in patients candidates for short-DAPT (figure 2). Multivariate analysis demonstrated higher risk of MB (sHR: 1.60 95% CI 1.10–2.60; p=0.030) only in patients candidates for short-DAPT. In contrast, candidates for short-DAPT has higher risk of all-cause mortality (HR: 2.92 95% CI 1.95–4.37; p<0.01) and cardiovascular mortality (HR: 3.01 95% CI 1.78–5.32; p<0.01) and MACE (HR: 2.22, 95% CI 1.82–2.70; p<0.01). Similarly, patients candidates for prolonged DAPT had higher risk of all-cause mortality (HR: 1.72 95% CI 1.10–2.69; p=0.002), cardiovascular mortality (HR: 2.47 95% CI 1.39–4.40; p=0.017) and MACE (HR: 1.58 95% CI 1.28–1.95; p<0.001).
Conclusions
Almost two thirds of patients discharged after an ACS would be candidates for short or prolonged DAPT and these patients are at higher risk of MACE and mortality. Patients candidates for short-DAPT had higher risk of MB through the follow-up. These results might reinforce the need of individual assessment of most optimal DAPT duration in all patients discharged after an ACS.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Cordero
- University Hospital of San Juan , Alicante , Spain
| | - D Escribano
- University Hospital of San Juan , Alicante , Spain
| | | | - M Monteagudo
- University Hospital of San Juan , Alicante , Spain
| | | | | | | | - M D Masia
- University Hospital of San Juan , Alicante , Spain
| | - P Zuazola
- University Hospital of San Juan , Alicante , Spain
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5
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Cordero A, Escribano D, Monteagudo M, Zuazola P, Frutos A, Bertomeu-Gonzalez V. Predictors of no-reflow in patients with myocardial infarction and ST-segment elevation treated with primary angioplasty. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2062] [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
The no-reflow phenomenon is a serious complication of coronary intervention, especially in primary angioplasty and effective preventive measures are unknown.
Methods
Retrospective study of all patients treated by primary angioplasty in a single center through 4 years. We define no-reflow as the absence of flow immediately after stent angioplasty. The variables associated with this phenomenon were analyzed using binary logistic regression. The delay to primary angioplasty was calculated as the sum of the time to the first medical contact, activation, transfer until arterial puncture.
Results
We included 1453 patients, mean age 64.1 years, 21% women, 16.1% Killip >1. The mean delay to primary angioplasty was 180 minutes (interquartile range 125–323). No-reflow was recorded in 81 (5.57%) patients and these patients had a higher mean age (69.37±12.51 vs. 63.76±13.52; p<0.001), higher delay to primary angioplasty (770.93±2056.91 vs. 348.80±749.73; p<0.001), presentation with Killip grade >1 (29.0% 15.36%; p=0.002), in addition to lower systolic blood pressure (121.18±28.63 vs. 113.37±28.22; p=0.021). Regarding coronary angiography, patients who developed no-reflow presented more frequently TIMI-0 (88.89% vs. 70.32%; p<0.001) and a tendency to being the left anterior descending the culprit vessel (46.91% vs. 36.88, p=0.07). In 59.3% of the patients who presented no-reflow, a final TIMI 3 was achieved, with the measurements carried out, compared to (94.9%) of the patients who did not have no-reflow (p<0.001).
Multivariate analysis identified the following variables associated with no-reflow: age (OR: 1.03 95% CI 1.01–1.05; p=0.008), delay to primary angioplasty >120 min (OR: 2.70, 95% CI 1.21–6.00; p=0.015), initial TIMI-0 (OR: 3.22, 95% CI 1.57–6.58; p=0.001). In fact, patients aged >40 had a very low incidence of no-reflow (1.72%), regardless of delay to primary angioplasty; however, in patients >70 years of age, the incidence was much higher (figure)
Hospital mortality was 9.25% (125 patients) and was almost 4 times higher in patients who presented no-reflow (23.68% vs. 8.39%; p<0.001). Adjusted for age, sex, delay to primary angioplasty diabetes and final TIMI flow, the no-reflow phenomenon was associated with higher hospital mortality (OR: 2.34 95% CI 1.02 4.25; p=0.030)
Conclusions
The no-reflow phenomenon has a low incidence but high mortality in patients with ST-segment elevation myocardial infarction treated with primary angioplasty. Age, delay to primary angioplasty and initial TIMI 0 flow are the main predictors of no-reflow.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Cordero
- University Hospital of San Juan , Alicante , Spain
| | - D Escribano
- University Hospital of San Juan , Alicante , Spain
| | - M Monteagudo
- University Hospital of San Juan , Alicante , Spain
| | - P Zuazola
- University Hospital of San Juan , Alicante , Spain
| | - A Frutos
- University Hospital of San Juan , Alicante , Spain
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6
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Cazorla-Morallon D, Cordero A, Tomas-Simon FJ, Sanchez-Munuera S, Alvarez-Alvarez B, Cid-Alvarez B, Garcia-Acuna JM, Rodriguez-Manero M, Escribano D, Bertomeu-Gonzalez V, Zuazola P, Gonzalez-Juanatey JR. Age as a prognostic modifier in anemic patients discharged after acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1315] [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
The presence of anemia on admission is a poor long-term prognostic factor in patients diagnosed with acute coronary syndrome (ACS). However, it is unknown whether age is a factor modifying the effect of anemia on mortality.
Objective
To determine the effect of age on anemia in terms of long-term mortality in patients admitted for ACS.
Methods
This is an observational study in which we included all patients discharged from cardiology for ACS in two centers from 2003 to 2020. Patients with anemia were classified by hemoglobin values <13 g/dL in men and <12 g/dL in women in the first blood count performed during hospitalization. The interaction between age and anemia was analyzed using the Cox regression model and the chunk test. We analyzed the effect of anemia on mortality using the Cox regression model adjusted for several confounding variables and the interaction with age.
Results
We included 8872 patients diagnosed with ACS, with a mean age of 66.38 (SD ±12.76) years, 27.1% female and 34.3% diagnosed with ST-segment elevation ACS. The mean hemoglobin value was 13.88 (SD ±1.85) g/dL and 20.5% of patients were anemic on admission.
During follow-up (median 1764 days, IQR 694–2439 days) there was an increased risk of all-cause mortality in patients with anemia adjusted for age and other risk factors (sex, renal function, GRACE score, atrial fibrillation, LVEF and previous revascularization), HR 15.5 (CI 5.77–41.75; p>0.005). We found a significant interaction between age and anemia (p<0.01). As represented in the figure, the adjusted risk of mortality decreased at older ages; in patients whose age was >80 anemia was not associated to higher mortality risk. Similar results were observed for cardiovascular mortality, HR 21.36 (CI 6.13–74.43, p>0.005).
Conclusion
Age modifies the risk of mortality in patients discharged after an ACS being the risk of mortality higher in youngest ages and disappearing in octogenearians. There results should be taken under consideration for the treatment and management of ACS patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - A Cordero
- Hospital San Juan de Alicante , Alicante , Spain
| | | | | | - B Alvarez-Alvarez
- University Hospital of Santiago de Compostela, Cardiology , Santiago de Compostela , Spain
| | - B Cid-Alvarez
- University Hospital of Santiago de Compostela, Cardiology , Santiago de Compostela , Spain
| | - J M Garcia-Acuna
- University Hospital of Santiago de Compostela, Cardiology , Santiago de Compostela , Spain
| | - M Rodriguez-Manero
- University Hospital of Santiago de Compostela, Cardiology , Santiago de Compostela , Spain
| | - D Escribano
- Hospital San Juan de Alicante , Alicante , Spain
| | | | - P Zuazola
- Hospital San Juan de Alicante , Alicante , Spain
| | - J R Gonzalez-Juanatey
- University Hospital of Santiago de Compostela, Cardiology , Santiago de Compostela , Spain
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7
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Cerón JJ, Contreras-Aguilar MD, Escribano D, Martínez-Miró S, López-Martínez MJ, Ortín-Bustillo A, Franco-Martínez L, Rubio CP, Muñoz-Prieto A, Tvarijonaviciute A, López-Arjona M, Martínez-Subiela S, Tecles F. Basics for the potential use of saliva to evaluate stress, inflammation, immune system, and redox homeostasis in pigs. BMC Vet Res 2022; 18:81. [PMID: 35227252 PMCID: PMC8883734 DOI: 10.1186/s12917-022-03176-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [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: 09/24/2021] [Accepted: 02/15/2022] [Indexed: 11/30/2022] Open
Abstract
The use of saliva as a biological sample has many advantages, being especially relevant in pigs where the blood collection is highly stressful and painful, both for the animal and the staff in charge of the sampling. Currently one of the main uses of saliva is for diagnosis and detection of infectious diseases, but the saliva can also be used to measure biomarkers that can provide information of stress, inflammation, immune response and redox homeostasis. This review will be focused on the analytes that can be used for such evaluations. Emphasis will be given in providing data of practical use about their physiological basis, how they can be measured, and their interpretation. In addition, some general rules regarding sampling and saliva storage are provided and the concept of sialochemistry will be addressed. There is still a need for more data and knowledge for most of these biomarkers to optimize their use, application, and interpretation. However, this review provides updated data to illustrate that besides the detection of pathogens in saliva, additional interesting applicative information regarding pigs´ welfare and health can be obtained from this fluid. Information that can potentially be applied to other animal species as well as to humans.
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Affiliation(s)
- J J Cerón
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Murcia, Spain
| | - M D Contreras-Aguilar
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Murcia, Spain
| | - D Escribano
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Murcia, Spain.,Department of Animal Production, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Espinardo, Murcia, Spain
| | - S Martínez-Miró
- Department of Animal Production, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Espinardo, Murcia, Spain
| | - M J López-Martínez
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Murcia, Spain
| | - A Ortín-Bustillo
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Murcia, Spain
| | - L Franco-Martínez
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Murcia, Spain
| | - C P Rubio
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Murcia, Spain
| | - A Muñoz-Prieto
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Murcia, Spain
| | - A Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Murcia, Spain
| | - M López-Arjona
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Murcia, Spain
| | - S Martínez-Subiela
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Murcia, Spain.
| | - F Tecles
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, 30100, Murcia, Spain
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8
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Cordero A, Escribano D, Bertomeu-Gonzalez V, Lopez-Ayala JM, Monteagudo M, Quintanilla AM, Moreno-Arribas J, Perez-Berbell P, Zuazola P. LDLc reduction with fixed-dose combination rosuvastatin-ezetimibe in patients with coronary heart disease that are not candidates for PCSK9 inhibitors treatment. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2583] [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
Background
Statin plus ezetimibe combination has a recommendation class IIa, level of evidence B, for low-density lipoprotein cholesterol (LDLc) reduction. Since LDLc treatment target for patients with coronary heart disease (CHD) has been recently reduced to <55 mg/dl most patients might need lipid-lowering drugs combinations and fixed-dose combinations are known to increase adherence. Current indications for PCSK9 inhibitors accepted for reimbursement in Spain in patients with CHD are LDL >100 mg/dl despite maximal dose tolerated of statins or any of previous patients with statin intolerance and LDL >100 mg/dl.
Methods
Investigator-initiated retrospective analysis of patients with coronary heart disease that received fixed-dose combination with rosuvastatin-ezetimibe between 2019 and 2020 in a specialized unit for patients with CHD. Inclusion criteria were: CHD and LDLc <100 mg/dl despite statin treatment or >100 mg/dl without previous lipid-lowering treatments. We also analysed patients in whom treatment was initiated at discharge from and acute coronary syndrome (ACS) or with chronic coronary syndrome (CCS)
Results
We analyzed 137 patients, 79.4% males, mean age 62. (12.3) and 24.1% with ACS. Statin treatment before initiation fixed-dose combination was higher in patients with CCS (71.2% vs. 8.2%; p<0.01). Mean LDLc before treatment was 103.0 (30.5) mg/dl and it was higher in patients with ACS (121.3 (40.2) vs. 97.4 (24.4); p<0.001). Median time to second blood test was 203 days (IQR 122–300); mean post-treatment LDLc was 60.8 (21.2) mg/dl and no difference (p=0.18) was found in patients with ACS vs CCS: 56.0 (26.1) vs. 62.4 (19.2) mg/dl. Mean LDLc reduction was 38.5% and it was higher in was higher in ACS patients (49.9% vs. 34.7%) (figure). LDLc <55 mg/dl was achieved in 42.1% of the patients, more frequently in patients with ACS: 59.3% vs. 36.3% (p=0.036). No increase in transaminases was detected and a reduction in triglycerides was found (149.1 (100.4) to 124.7 (82.3) mg/dl; p=0.041).
Conclusions
Treatment with a fixed-dose combination with rosuvastatin-ezetimibe in patients with CHD not candidate for PCSK9 inhibitors is effective and safe for LDLc reduction especially in patients discharged after an ACS.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Cordero
- University Hospital of San Juan, Alicante, Spain
| | - D Escribano
- University Hospital of San Juan, Alicante, Spain
| | | | | | - M Monteagudo
- University Hospital of San Juan, Alicante, Spain
| | | | | | | | - P Zuazola
- University Hospital of San Juan, Alicante, Spain
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9
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Cordero A, Escribano D, Bertomeu-Gonzalez V, Moreno-Arribas J, Monteagudo M, Lopez Ayala JM, Perez-Berbell P, Quintanilla MA, Zuazola P. Trends in major bleeding events in patients with acute coronary syndrome. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Bleeding events incidence has gained a crucial role in acute coronary patients (ACS) due to its independent effect prognostic value.
Methods
We assessed the trend of in-hospital and first-year-after-discharge major bleeding events (MB) in all ACS admitted in a single center between January 2009 and Agoust 2019. MB was defined as those fitting definitions 3 or 5 of the BARC consortium. Patients were categorized as high-bleeding risk (HBR) if according to the 2019 Academic Research Consortium HBR consensus if they met at least one major or two minor criteria. Inclusion period was divided in 3 groups: 2009–2012 (n=884; 27.4%), 2013–2015 (n=1,047; 32.5%); 2016–2019 (n=1,294; 40.1%). Post-discharge MB was assessed by competing events regression models, taking all-cause mortality as a competing event, and results are presented as sub-hazard ratio (sHR).
Results
We included 3225 patients, mean age was 68.4 (29.7), 25.7% females, 1,108 32.1% had diabetes and 44.0% STEMI. Radial access was perfume in 92% of the angiographies in the 3 time-periods. A significant decrease in dual antiplatelet treatment (DAPT) before angiography was noted (69.0%; 56.3%; 53.6%; p=0.001) with a decreasing pattern in clopidogrel and increase in ticagrelor and prasugrel. A total of 1,591 (46.2%) were categorized as HBR patients. A non-significant trend to higher incidence of in-hospital MB was noted through the 3 time periods: 1.39%; 1.43%; 2.55% (p=0.056) and it was mainly driven by the significant increase only in HBR patients: 2.21%; 3.55%; 6.26% (p=0.003). Multivariate analysis identified age (OR: 1.06 95% CI 1.03–1.08, p<0.001) and the time period 2016–2019 (OR: 1.96 95% CI 1.01–3.84; p=0.031) as main variables associated to higher in-hospital MB.
In contrast, postdischarge MB did not change overtime (p=0.155) and trends were the same in HBR and non-HBR patients (figure). The competing risk regression analysis, adjusted by age, gender, previous cardiovascular disease, revascularization and medical treatments, identified that the leading factors for postdischarge MB were diabetes (sHR: 1.37; 95% CI 1.01–2.92), time-period 2016–2019 (sHR: 1.52; 95% CI 1.01–2.30), HBR patient (sHR: 1.91; 95% CI 1.28- 2.87) and and previous heart failure (sHR: 2.26; 95% CI 1.264.40)
Conclusions
This continuous 10-year registry highlights the increasing trend of in-hospital mainly driven by the incidence in HBR patients. In contrast, postdischarge MB increased in all patients.
Funding Acknowledgement
Type of funding sources: None. Post-discharge MB incidence
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Affiliation(s)
- A Cordero
- University Hospital of San Juan, Alicante, Spain
| | - D Escribano
- University Hospital of San Juan, Alicante, Spain
| | | | | | - M Monteagudo
- University Hospital of San Juan, Alicante, Spain
| | | | | | | | - P Zuazola
- University Hospital of San Juan, Alicante, Spain
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10
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Escribano D, Cordero A, Bertomeu-Gonzalez V, Moreno-Arribas J, Monteagudo M, Lopez Ayala JM, Perez-Berbell P, Quintanilla M, Zuazola P. Clinical outcomes in percutaneous coronary interventions with polymer-free vs. durable-polymer stents: a metanalysis of randomized clinical trials. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Polymer-free (PF) stents were designed as an alternative to durable-polymer (DP) drug-eluting stents to minimize the time on dual antiplatelet treatment for patients at high-risk of bleeding. Nonetheless, the efficacy and safety of PF vs. DP stents in patients undergoing percutaneous coronary intervention (PCI) remain controversial.
Methods
We performed a metanalysis with currently available studies that assessed the effect of PF-stents vs. DP-stents after performing a systematic search. The endpoints analyzed were all-cause death, myocardial infarction, target lesion revascularization (TLR) and probable or definite stent thrombosis. The raw numbers of incident end-points reported in each study were used. We performed analyses in short and long term (<1 or >1 year follow-up) studies.
Results
We included 12464 patients from 8 studies (5 short-term and 3 long-term): 6723 treated with PF-stents and 5741 with DP stents. Females represented 23.3% (n=3284) and 33.7% (n=4202) were included in the setting of acute coronary syndromes. As shown in the figure, PF-stents were associated to lower incidence of all-cause mortality (HR: 0.91 95% CI 0.84–0.98; p=0.016) and TLR (HR: 0.88 95% CI 0.80–0.96; p=0.003). No differences were observed in the risk of cardiovascular death (HR: 0.96 95% CI 0.86–1.06 p=0.415), myocardial infarction (HR: 0.90 95% CI 0.80–1.01; p=0.061) or probable-definite stent thrombosis (HR: 0.92 95% CI 0.74–1.14; p=0.447). Finally, no differences in the primary end-point (HR: 0.92 95% CI 0.83–1.03; p=0.143) were detected with PF-stents vs. DP-stents. No significant heterogenicity was observed in any of the endpoints, except for the incidence of stent thrombosis.
Conclusions
Under current PCI techniques the use of PF-stent might be associated to better outcomes, especially in terms of all-cause mortality and TLR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Escribano
- University Hospital of San Juan, Alicante, Spain
| | - A Cordero
- University Hospital of San Juan, Alicante, Spain
| | | | | | - M Monteagudo
- University Hospital of San Juan, Alicante, Spain
| | | | | | | | - P Zuazola
- University Hospital of San Juan, Alicante, Spain
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11
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Franco-Martínez L, Muñoz-Prieto A, Contreras-Aguilar MD, Želvytė R, Monkevičienė I, Horvatić A, Kuleš J, Mrljak V, Cerón JJ, Escribano D. Changes in saliva proteins in cows with mastitis: A proteomic approach. Res Vet Sci 2021; 140:91-99. [PMID: 34418789 DOI: 10.1016/j.rvsc.2021.08.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 03/01/2021] [Revised: 07/05/2021] [Accepted: 08/06/2021] [Indexed: 11/29/2022]
Abstract
This study aimed to evaluate the possible saliva proteome changes in cows with mastitis using a Tandem Mass Tags (TMT) proteomics approach. For this purpose, the salivary proteomes from healthy cows and cows with mastitis were analysed, and their serum proteomes were also studied for comparative purposes. A total of eight saliva and serum paired samples for each group were used for the proteomic study, and eight additional samples for each group were analysed in the analytical and overlap performance studies. In saliva samples, 2192 proteins were identified, being sixty-three differentially modulated in mastitis. In serum, 1299 proteins were identified, being twenty-nine differentially modulated in mastitis. Gamma glutamyl transferase (γGT) in saliva and serum amyloid A (SAA) were validated by commercially available automated assays. In conclusion, there are changes in protein expression and metabolic pathways in saliva and serum proteomes of cows with mastitis, showing different response patterns but complementary information.
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Affiliation(s)
- L Franco-Martínez
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, 30100, Espinardo, Murcia, Spain
| | - A Muñoz-Prieto
- Internal Diseases Clinic, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, 10 000 Zagreb, Croatia
| | - M D Contreras-Aguilar
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, 30100, Espinardo, Murcia, Spain
| | - R Želvytė
- Department of Anatomy and Physiology, Research Center of Digestive Physiology and Pathology, Veterinary Academy, Lithuanian University of Health Sciences, Tilzes str. 18, LT-47181 Kaunas, Lithuania
| | - I Monkevičienė
- Department of Anatomy and Physiology, Research Center of Digestive Physiology and Pathology, Veterinary Academy, Lithuanian University of Health Sciences, Tilzes str. 18, LT-47181 Kaunas, Lithuania
| | - A Horvatić
- Department of Chemistry and Biochemistry, Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10 000 Zagreb, Croatia
| | - J Kuleš
- Internal Diseases Clinic, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, 10 000 Zagreb, Croatia
| | - V Mrljak
- Internal Diseases Clinic, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, 10 000 Zagreb, Croatia
| | - J J Cerón
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, 30100, Espinardo, Murcia, Spain
| | - D Escribano
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, 30100, Espinardo, Murcia, Spain; Department of Animal Production, Veterinary School, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, 30100, Espinardo, Murcia, Spain.
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12
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López-Arjona M, Mateo SV, Escribano D, Tecles F, Cerón JJ, Martínez-Subiela S. Effect of reduction and alkylation treatment in three different assays used for the measurement of oxytocin in saliva of pigs. Domest Anim Endocrinol 2021; 74:106498. [PMID: 32653738 DOI: 10.1016/j.domaniend.2020.106498] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 05/03/2020] [Accepted: 05/11/2020] [Indexed: 12/11/2022]
Abstract
Oxytocin is a hormone that is increasingly being used for welfare evaluation in animals. Although several types of samples have been used for oxytocin measurement, saliva can be a suitable option for pigs producing less stress than blood sampling. In this study, 3 different methods for oxytocin measurements, 2 based on alphaLISA technology (one with a monoclonal and other with a polyclonal antibody) and one commercially available kit, were compared in saliva of pigs. These methods were used in saliva samples obtained from female pigs at 3 different days during gestation and lactation, with and without a reduction/alkylation (R/A), which is a procedure for breaking the links between oxytocin and proteins of the sample. The assays showed a different behavior after the R/A procedure, with no significant changes in the oxytocin results in case of the alphaLISA monoclonal method, a significant decrease with the alphaLISA polyclonal method, and a significant increase with the commercial kit. Although all assays showed a similar tendency in detecting the changes in oxytocin during gestation and lactation, they showed changes of different magnitude and statistical signification. This report indicates that different assays can measure different forms of oxytocin present in saliva and can have a different behavior after R/A of the sample and when are used to measure oxytocin in gestation and lactation.
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Affiliation(s)
- M López-Arjona
- Interdisciplinary Laboratory of Clinical Analysis of the University of Murcia (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Espinardo, Murcia, Spain
| | - S V Mateo
- Interdisciplinary Laboratory of Clinical Analysis of the University of Murcia (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Espinardo, Murcia, Spain
| | - D Escribano
- Interdisciplinary Laboratory of Clinical Analysis of the University of Murcia (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Espinardo, Murcia, Spain
| | - F Tecles
- Interdisciplinary Laboratory of Clinical Analysis of the University of Murcia (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Espinardo, Murcia, Spain
| | - J J Cerón
- Interdisciplinary Laboratory of Clinical Analysis of the University of Murcia (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Espinardo, Murcia, Spain.
| | - S Martínez-Subiela
- Interdisciplinary Laboratory of Clinical Analysis of the University of Murcia (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Espinardo, Murcia, Spain
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13
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Cordero A, Cid B, Monteiro P, Garcia-Acuna J, Rodriguez-Manero M, Trillo Noche R, Lopez Otero D, Sanmartin Pena J, Bertomeu-Gonzalez V, Escribano D, Goncalvez F, Goncalves L, Zuazola P, Gonzalez-Juanatey J. Validation of the Zwolle score for selection of very low-risk STEMI patients treated with primary angioplasty. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1840] [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
Background
The Zwolle risk score was designed to stratify the actual in-hospital mortality risk of ST-elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (p-PCI) but, also, for decision-making related to patients location in an intensive care unit or not. Since the GRACE score continues being the gold-standard for individual risk assessment in STEMI in most institutions we assessed the specificity of both scores for in-hospital mortality.
Methods
We assessed the accuracy of Zwolle risk score for in-hospital mortality estimation as compared to the GRACE score in all patients admitted for STEMI in 3 tertitary hospitals. Patients with Zwolle risk score <3 would qualify as “low risk”, 3–5 as “intermediate risk” and ≥6 as “high risk”. Patients with GRACE score <140 were classified as low-risk. Specificity, sensitivity and classification were assessed by ROC curves and the area under the curve (AUC).
Results
We included 4,446 patients, mean age 64.7 (13.6) years, 24% women and 39% with diabetes. Mean GRACE score was 157.3 (4.9) and Zwolle was 2.8 (3.3). In-hospital mortality was 10.6% (471 patients). Patients who died had higher GRACE score (218.4±4.9 vs. 149.6±37.5; p<0.001) and Zwolle score (7.6±4.3 vs. 2.3±2.18; p<0.001); a statistically significant increase of in-hospital mortality risk, adjusted adjusted by age, gender and revascularization, was observed with both scores (figure). A total of 1,629 patients (40.0%) were classified as low risk by the GRACE score and 2,962 (66.6%) by the Zwolle score; in-hospital mortality was 1.6% and 2.7%, respectively. Moreover, the was a significant increase of in-hospital mortality rate according to Zwolle categories (2.7%; 13.0%; 41.6%)The AUC of both score was the same (p=0.49) but the specificity of GRACE score <140 was 43.1% as compared to 72.6% obtained by Zwolle score <3; patients accurately classified was also lower with the GRACE score threshold (48.8% vs. 73.7%).
Conclusions
Selection of low-risk STEMI patients treated with p-PCI based on the Zwolle risk score has higher specificity than the GRACE score and might be useful for the care organization in clinical practice.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Cordero
- University Hospital of San Juan, Alicante, Spain
| | - B Cid
- University Hospital of Santiago de Compostela, Cardiology, Santiago de Compostela, Spain
| | - P Monteiro
- University Hospitals of Coimbra, Cardiology, Coimbra, Portugal
| | - J.M Garcia-Acuna
- University Hospital of Santiago de Compostela, Cardiology, Santiago de Compostela, Spain
| | - M Rodriguez-Manero
- University Hospital of Santiago de Compostela, Cardiology, Santiago de Compostela, Spain
| | - R Trillo Noche
- University Hospital of Santiago de Compostela, Cardiology, Santiago de Compostela, Spain
| | - D Lopez Otero
- University Hospital of Santiago de Compostela, Cardiology, Santiago de Compostela, Spain
| | - J.C Sanmartin Pena
- University Hospital of Santiago de Compostela, Cardiology, Santiago de Compostela, Spain
| | | | - D Escribano
- University Hospital of San Juan, Alicante, Spain
| | - F Goncalvez
- University Hospitals of Coimbra, Cardiology, Coimbra, Portugal
| | - L Goncalves
- University Hospitals of Coimbra, Cardiology, Coimbra, Portugal
| | - P Zuazola
- University Hospital of Santiago de Compostela, Cardiology, Santiago de Compostela, Spain
| | - J.R Gonzalez-Juanatey
- University Hospital of Santiago de Compostela, Cardiology, Santiago de Compostela, Spain
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14
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Cordero A, Garcia-Acuna J, Rodriguez-Manero M, Cid B, Alvarez Alvarez B, Agra-Bermejo R, Escribano D, Bertomeu-Gonzalez V, Moreno-Arribas J, Zuazola P, Gonzalez-Juanatey J. Acute coronary syndrome patients with two minor high-bleeding risk criteria have the same bleeding rate that patients with one major criteria. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In 2019 the Academic Research Consortium of high-bleeding risk (ARC-HBR) proposed a new and binary definition of high-bleeding risk (HBR) patients based on the presence of 1 major or 2 minor criteria.
Methods
Prospective study of all consecutive patients admitted for ACS in two different centers. We analyzed bleeding incidence in patients with 1 major criteria (1MC) vs. 2 minor criteria (2mC) using the 2019 ARC-HBR consensus. Bleeding events were collected according those fitting definitions 3 or 5 of the BARC consortium.
Results
We included 8,724 patients included and 40.9% we classified as HBR; 20.9% for 1MC and 20.0% for 2mC. In-hospital mayor bleeding rate was 8.6%; no-HBR patients had 0.3%, 2mC 15.1% and 1MC 29.7% (p<0.001 for the comparison). In contrast, the statistically highest in-hospital mortality was observed in patients with 2mC (11.4%), followed by patients with 1MC (8.0%) and no-HBR patients (2.0%).
During follow-up (median time 57.8 months) all-cause mortality rate was 21.0% and cardiovascular dead 14.2%. The incidence of post-discharge major bleeding was 10.5%. No-HBR patients had the lowest bleeding rate (7.4%) and no difference was observed in patients with 1MC (14.6%) or 2mC (15.8%) (figure). The multivariate analysis, adjusted by age, gender, medical treatment, atrial fibrillation and revascularization and considering all-cause mortality as competing risk, showed independent association of 1MC (sHR: 1.46, 95% 1.22–1.75) and 2mC (sHR: 1.31, 95% CI 1.05–1.63) with post-discharge major bleeding.
Conclusions
HBR patients according to the 2019 ARC-HBR containing 2mC or 1MC are at similar and higher risk of in-hospital or post-discharge bleeding events
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Cordero
- University Hospital of San Juan, Alicante, Spain
| | - J.M Garcia-Acuna
- University Hospital of Santiago de Compostela, Cardiology, Santiago de Compostela, Spain
| | - M Rodriguez-Manero
- University Hospital of Santiago de Compostela, Cardiology, Santiago de Compostela, Spain
| | - B Cid
- University Hospital of Santiago de Compostela, Cardiology, Santiago de Compostela, Spain
| | - B Alvarez Alvarez
- University Hospital of Santiago de Compostela, Cardiology, Santiago de Compostela, Spain
| | - R Agra-Bermejo
- University Hospital of Santiago de Compostela, Cardiology, Santiago de Compostela, Spain
| | - D Escribano
- University Hospital of San Juan, Alicante, Spain
| | | | | | - P Zuazola
- University Hospital of San Juan, Alicante, Spain
| | - J.R Gonzalez-Juanatey
- University Hospital of Santiago de Compostela, Cardiology, Santiago de Compostela, Spain
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15
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López-Martínez MJ, Escribano D, Contreras-Aguilar MD, García-Martínez JD, Martínez-Subiela S, Cerón JJ. Salivary D-dimer in pigs: Validation of an automated assay and changes after acute stress. Vet J 2020; 259-260:105472. [PMID: 32553235 DOI: 10.1016/j.tvjl.2020.105472] [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: 12/02/2019] [Revised: 05/13/2020] [Accepted: 05/13/2020] [Indexed: 11/27/2022]
Abstract
D-dimer is a peptide found in serum and is derived from the degradation of blood clots. Even though it has been analysed in human saliva, D-dimer has not been previously evaluated in the saliva of any veterinary species, and its source and role remain unknown. The objectives of this research were firstly, to validate the use of an automated method for the measurement of D-dimer in porcine saliva, and secondly, to evaluate whether D-dimer concentration changes in pig saliva after an acute stress stimulus. For this purpose, a complete analytical validation of a commercially-available immunoturbidimetric assay was carried out. In addition, an experimental acute stress model was induced in 11 pigs based on a technique involving restraint by nose-snare immobilisation for 1 min. Saliva samples were subsequently collected at different times and D-dimer, salivary alpha-amylase (sAA) and cortisol were assessed in order to evaluate changes in its concentrations after the stress induction. The D-dimer automated assay showed adequate reproducibility and sensitivity, with coefficients of variation below 10% and a limit of quantification of 0.167 μg/mL fibrinogen equivalent units (FEU). It also showed a high accuracy, determined by linearity under dilution and recovery tests. In the stress model, a significant increase (P < 0.05) in salivary D-dimer 15 min after the stress stimulus and a positive correlation between D-dimer and sAA (r = 0.51; P < 0.001) were observed. These results indicate that D-dimer can be measured in porcine saliva with an automated method and suggest that its concentration can be influenced by stressful conditions.
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Affiliation(s)
- M J López-Martínez
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, 30100, Espinardo, Murcia, Spain
| | - D Escribano
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, 30100, Espinardo, Murcia, Spain
| | - M D Contreras-Aguilar
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, 30100, Espinardo, Murcia, Spain
| | - J D García-Martínez
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, 30100, Espinardo, Murcia, Spain
| | - S Martínez-Subiela
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, 30100, Espinardo, Murcia, Spain.
| | - J J Cerón
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, 30100, Espinardo, Murcia, Spain
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16
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Manrique JA, Lopez-Reyes G, Cousin A, Rull F, Maurice S, Wiens RC, Madsen MB, Madariaga JM, Gasnault O, Aramendia J, Arana G, Beck P, Bernard S, Bernardi P, Bernt MH, Berrocal A, Beyssac O, Caïs P, Castro C, Castro K, Clegg SM, Cloutis E, Dromart G, Drouet C, Dubois B, Escribano D, Fabre C, Fernandez A, Forni O, Garcia-Baonza V, Gontijo I, Johnson J, Laserna J, Lasue J, Madsen S, Mateo-Marti E, Medina J, Meslin PY, Montagnac G, Moral A, Moros J, Ollila AM, Ortega C, Prieto-Ballesteros O, Reess JM, Robinson S, Rodriguez J, Saiz J, Sanz-Arranz JA, Sard I, Sautter V, Sobron P, Toplis M, Veneranda M. SuperCam Calibration Targets: Design and Development. Space Sci Rev 2020; 216:138. [PMID: 33281235 PMCID: PMC7691312 DOI: 10.1007/s11214-020-00764-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 11/09/2020] [Indexed: 05/09/2023]
Abstract
SuperCam is a highly integrated remote-sensing instrumental suite for NASA's Mars 2020 mission. It consists of a co-aligned combination of Laser-Induced Breakdown Spectroscopy (LIBS), Time-Resolved Raman and Luminescence (TRR/L), Visible and Infrared Spectroscopy (VISIR), together with sound recording (MIC) and high-magnification imaging techniques (RMI). They provide information on the mineralogy, geochemistry and mineral context around the Perseverance Rover. The calibration of this complex suite is a major challenge. Not only does each technique require its own standards or references, their combination also introduces new requirements to obtain optimal scientific output. Elemental composition, molecular vibrational features, fluorescence, morphology and texture provide a full picture of the sample with spectral information that needs to be co-aligned, correlated, and individually calibrated. The resulting hardware includes different kinds of targets, each one covering different needs of the instrument. Standards for imaging calibration, geological samples for mineral identification and chemometric calculations or spectral references to calibrate and evaluate the health of the instrument, are all included in the SuperCam Calibration Target (SCCT). The system also includes a specifically designed assembly in which the samples are mounted. This hardware allows the targets to survive the harsh environmental conditions of the launch, cruise, landing and operation on Mars during the whole mission. Here we summarize the design, development, integration, verification and functional testing of the SCCT. This work includes some key results obtained to verify the scientific outcome of the SuperCam system.
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Affiliation(s)
- J. A. Manrique
- Unidad Asocida UVA-CSIC-CAB, University of Valladolid (UVA), Valladolid, Spain
| | - G. Lopez-Reyes
- Unidad Asocida UVA-CSIC-CAB, University of Valladolid (UVA), Valladolid, Spain
| | - A. Cousin
- Institut de Recherche en Astrophysique et Planétologie (IRAP), CNRS, CNES, Université de Toulouse, Toulouse, France
| | - F. Rull
- Unidad Asocida UVA-CSIC-CAB, University of Valladolid (UVA), Valladolid, Spain
| | - S. Maurice
- Institut de Recherche en Astrophysique et Planétologie (IRAP), CNRS, CNES, Université de Toulouse, Toulouse, France
| | - R. C. Wiens
- Los Alamos National Laboratory, Los Alamos, NM USA
| | - M. B. Madsen
- Niels Bohr Institute (NBI), University of Copenhagen, Copenhagen, Denmark
| | | | - O. Gasnault
- Institut de Recherche en Astrophysique et Planétologie (IRAP), CNRS, CNES, Université de Toulouse, Toulouse, France
| | - J. Aramendia
- University of the Basque Country (UPV/EHU), Leioa, Spain
| | - G. Arana
- University of the Basque Country (UPV/EHU), Leioa, Spain
| | - P. Beck
- CNRS, Institut de Planetologie et d’Astrophysique de Grenoble (IPAG), Universite Grenoble Alpes, Saint-Martin d’Heres, France
| | - S. Bernard
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie (IMPMC), CNRS, MNHN, Sorbonne Université, Paris, France
| | - P. Bernardi
- Laboratoire d’Etudes Spatiales et d’Instrumentation en Astrophysique, Observatoire de Paris-PSL, CNRS, Sorbonne Université, Université de Paris, Meudon, France
| | - M. H. Bernt
- Niels Bohr Institute (NBI), University of Copenhagen, Copenhagen, Denmark
| | - A. Berrocal
- Ingeniería de Sistemas para la Defensa de España S.A. (ISDEFE), Madrid, Spain
| | - O. Beyssac
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie (IMPMC), CNRS, MNHN, Sorbonne Université, Paris, France
| | - P. Caïs
- Laboratoire d’astrophysique de Bordeaux, CNRS, Univ. Bordeaux, Bordeaux, France
| | - C. Castro
- Added Value Solutions (AVS), Elgóibar, Spain
| | - K. Castro
- University of the Basque Country (UPV/EHU), Leioa, Spain
| | - S. M. Clegg
- Los Alamos National Laboratory, Los Alamos, NM USA
| | | | - G. Dromart
- Univ Lyon, ENSL, CNRS, LGL-TPE, Univ Lyon 1, 69007 Lyon, France
| | - C. Drouet
- CIRIMAT, Université de Toulouse, CNRS/UT3/INP, Ensiacet, Toulouse, France
| | - B. Dubois
- Observatoire Midi-Pyrénées, Toulouse, France
| | - D. Escribano
- Instituto Nacional de Técnica Aeroespacial, Torrejón de Ardoz, Spain
| | - C. Fabre
- GeoRessources, Vandoeuvre les Nancy, France
| | | | - O. Forni
- Institut de Recherche en Astrophysique et Planétologie (IRAP), CNRS, CNES, Université de Toulouse, Toulouse, France
| | - V. Garcia-Baonza
- Instituto de Geociencias CSIC, Universidad Complutense de Madrid, Madrid, Spain
| | - I. Gontijo
- Jet Propulsion Laboratory, Pasadena, CA USA
| | - J. Johnson
- Applied Physics Laboratory, Johns Hopkins University, Laurel, MD USA
| | - J. Laserna
- University of Malaga (UMA), Málaga, Spain
| | - J. Lasue
- Institut de Recherche en Astrophysique et Planétologie (IRAP), CNRS, CNES, Université de Toulouse, Toulouse, France
| | - S. Madsen
- Jet Propulsion Laboratory, Pasadena, CA USA
| | - E. Mateo-Marti
- Centro de Astrobiología-CSIC-INTA, Torrejón de Ardoz, Spain
| | - J. Medina
- Unidad Asocida UVA-CSIC-CAB, University of Valladolid (UVA), Valladolid, Spain
| | - P.-Y. Meslin
- Institut de Recherche en Astrophysique et Planétologie (IRAP), CNRS, CNES, Université de Toulouse, Toulouse, France
| | - G. Montagnac
- Univ Lyon, ENSL, CNRS, LGL-TPE, Univ Lyon 1, 69007 Lyon, France
| | - A. Moral
- Instituto Nacional de Técnica Aeroespacial, Torrejón de Ardoz, Spain
| | - J. Moros
- University of Malaga (UMA), Málaga, Spain
| | - A. M. Ollila
- Los Alamos National Laboratory, Los Alamos, NM USA
| | - C. Ortega
- Added Value Solutions (AVS), Elgóibar, Spain
| | | | - J. M. Reess
- Laboratoire d’Etudes Spatiales et d’Instrumentation en Astrophysique, Observatoire de Paris-PSL, CNRS, Sorbonne Université, Université de Paris, Meudon, France
| | - S. Robinson
- Los Alamos National Laboratory, Los Alamos, NM USA
| | - J. Rodriguez
- Ingeniería de Sistemas para la Defensa de España S.A. (ISDEFE), Madrid, Spain
| | - J. Saiz
- Unidad Asocida UVA-CSIC-CAB, University of Valladolid (UVA), Valladolid, Spain
| | - J. A. Sanz-Arranz
- Unidad Asocida UVA-CSIC-CAB, University of Valladolid (UVA), Valladolid, Spain
| | - I. Sard
- Added Value Solutions (AVS), Elgóibar, Spain
| | - V. Sautter
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie (IMPMC), CNRS, MNHN, Sorbonne Université, Paris, France
| | - P. Sobron
- SETI Institute, Mountain View, CA USA
| | - M. Toplis
- Observatoire Midi-Pyrénées, Toulouse, France
| | - M. Veneranda
- Unidad Asocida UVA-CSIC-CAB, University of Valladolid (UVA), Valladolid, Spain
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López-Arjona M, Mateo SV, Manteca X, Escribano D, Cerón JJ, Martínez-Subiela S. Oxytocin in saliva of pigs: an assay for its measurement and changes after farrowing. Domest Anim Endocrinol 2020; 70:106384. [PMID: 31569032 DOI: 10.1016/j.domaniend.2019.106384] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 07/04/2019] [Accepted: 08/05/2019] [Indexed: 10/26/2022]
Abstract
Oxytocin is a hormone of interest in reproduction, but also in the field of psychology and behavior, being considered as a biomarker of positive emotions. Saliva can be a noninvasive way to measure oxytocin, which is very useful in species such as the pig where blood collection can produce a high degree of stress. In this study, a new assay for oxytocin measurement was developed, analytically validated, and used to measure possible changes in oxytocin in saliva of female pigs at different days after farrowing. The assay showed an adequate accuracy and precision and does not need a previous extraction step. In addition, oxytocin concentrations were significantly higher at day 1 of lactation than at day 9 after farrowing, but levels increased at day 20 again. This assay can contribute to a wider use of oxytocin measurements in pigs as it is a noninvasive sampling procedure that minimizes stress.
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Affiliation(s)
- M López-Arjona
- Interdisciplinary Laboratory of Clinical Analysis of the University of Murcia (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Murcia, Spain
| | - S V Mateo
- Interdisciplinary Laboratory of Clinical Analysis of the University of Murcia (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Murcia, Spain
| | - X Manteca
- Department of Animal and Food Science, School of Veterinary Science, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - D Escribano
- Department of Animal and Food Science, School of Veterinary Science, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J J Cerón
- Interdisciplinary Laboratory of Clinical Analysis of the University of Murcia (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Murcia, Spain.
| | - S Martínez-Subiela
- Interdisciplinary Laboratory of Clinical Analysis of the University of Murcia (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Murcia, Spain
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Contreras-Aguilar MD, Martínez-Subiela S, Cerón JJ, Martín-Cuervo M, Tecles F, Escribano D. Salivary alpha-amylase activity and concentration in horses with acute abdominal disease: Association with outcome. Equine Vet J 2019; 51:569-574. [PMID: 30623475 DOI: 10.1111/evj.13066] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 12/30/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Salivary biomarkers could be useful to objectively evaluate critical illness and prognosis for survival in horses with acute abdominal disease. OBJECTIVES To compare salivary alpha-amylase (sAA) activity and concentration in healthy horses and horses with acute abdominal disease, and evaluate the association between sAA activity and concentration with disease severity and outcome. STUDY DESIGN A prospective cohort. METHODS sAA activity, measured using a colorimetric commercial kit, and concentration, measured using a Time-resolved immunofluorometric assay, in 25 healthy horses and in 33 horses with acute abdominal disease was compared using an ANOVA. Associations between survival to discharge and sAA activity and concentration and other clinical parameters were examined using univariable logistic regression and Spearman correlation. RESULTS sAA activity and concentration were different between healthy (median = 4.3 [2.6-11.2] IU/L and 58.4 [53.4-80.6] ng/mL, respectively) and diseased (median = 29.8 [14.2-168.9] IU/L and 388.3 [189.1-675.8] ng/mL, respectively) (P<0.001). The sAA activity was higher in non-survivors (median = 479.0 [78.7-2064.0] IU/L, n = 8) compared to survivors (median = 19.3 [12.1-103.7] IU/L, n = 25, P<0.001) and sAA activity and concentration correlated (P<0.001) moderately with HR (r = 0.66 and r = 0.61, respectively). sAA activity correlated weakly with salivary cortisol (r = 0.45, P<0.001) and systemic inflammatory response syndrome score (r = 0.43, P<0.05), while activity and concentration correlated (P<0.001) moderately with plasma lactate concentration (r = 0.57 and r = 0.60, respectively). The sAA activity was significantly (P = 0.01) associated with increased risk of nonsurvival. MAIN LIMITATIONS Pain scores were not recorded. The sample population was small. CONCLUSIONS The sAA activity, but not concentration, shows potential as a biomarker of prognosis for survival in horses with acute abdominal disease. The summary is available in Spanish - see Supporting Information.
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Affiliation(s)
- M D Contreras-Aguilar
- Clinic Analysis Interdisciplinary Laboratory (Interlab-UMU), Campus of Excellence Mare Nostrum, Murcia, Spain
| | - S Martínez-Subiela
- Clinic Analysis Interdisciplinary Laboratory (Interlab-UMU), Campus of Excellence Mare Nostrum, Murcia, Spain
| | - J J Cerón
- Clinic Analysis Interdisciplinary Laboratory (Interlab-UMU), Campus of Excellence Mare Nostrum, Murcia, Spain
| | - M Martín-Cuervo
- Medice Animal, Faculty of Veterinary Medicine of Cáceres, University of Extremadura, Avenida de la Universidad S-N, Cáceres, Spain
| | - F Tecles
- Clinic Analysis Interdisciplinary Laboratory (Interlab-UMU), Campus of Excellence Mare Nostrum, Murcia, Spain
| | - D Escribano
- Clinic Analysis Interdisciplinary Laboratory (Interlab-UMU), Campus of Excellence Mare Nostrum, Murcia, Spain.,Department of Medicine and Animal Surgery, Veterinary School, Universitat Autònoma de Barcelona, Barcelona, Spain
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Muñoz-Prieto A, Escribano D, Cerón JJ, Martínez-Subiela S, Tvarijonaviciute A. Glucose, fructosamine, and insulin measurements in saliva of dogs: variations after an experimental glucose administration. Domest Anim Endocrinol 2019; 66:64-71. [PMID: 30472034 DOI: 10.1016/j.domaniend.2018.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 09/17/2018] [Accepted: 10/16/2018] [Indexed: 11/20/2022]
Abstract
The aim of this study was to evaluate if glucose, fructosamine, and insulin levels can be measured in saliva of dogs and assess the changes in these compounds after an experimental glucose administration. Automated spectrophotometric assays for glucose and fructosamine and an ELISA assay for insulin measurements were validated in saliva of dogs, by evaluating precision, accuracy, and limits of detection. In addition, an intravenous glucose bolus was administrated to 10 beagles and fasting serum and saliva samples were obtained immediately before and 5, 10, 20, 30, and 45 min after glucose infusion. The results of the between-run imprecision gave mean CVs of 6.16, 9.40, and 3.10% for glucose, fructosamine, and insulin, respectively. Linearity under dilution showed coefficient of correlation of 0.999, 0.994, and 0.990 for glucose, fructosamine, and insulin, respectively. The LDs were 0.04 mg/dL, 4.08 μmol/L, and 0.02 μg/mL for glucose, fructosamine, and insulin, respectively. The glucose administration caused an increase in serum and salivary levels of glucose with a peak in salivary levels at 30 min and of insulin with a peak in salivary levels at 45 min, while fructosamine did not change. No correlations between serum and salivary concentrations were found for any compound. It is concluded that glucose, fructosamine, and insulin can be measured in saliva of dogs, and an experimental administration of glucose in this species can lead to increases in glucose and insulin in saliva.
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Affiliation(s)
- A Muñoz-Prieto
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Espinardo, Murcia, Spain
| | - D Escribano
- Department of Food and Animal Science, School of Veterinary Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - J J Cerón
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Espinardo, Murcia, Spain
| | - S Martínez-Subiela
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Espinardo, Murcia, Spain.
| | - A Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Espinardo, Murcia, Spain
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Kaiser M, Jacobson M, Andersen PH, Bækbo P, Cerón JJ, Dahl J, Escribano D, Jacobsen S. Correction to: Inflammatory markers before and after farrowing in healthy sows and in sows affected with postpartum dysgalactia syndrome. BMC Vet Res 2018; 14:175. [PMID: 29859077 PMCID: PMC5984813 DOI: 10.1186/s12917-018-1471-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- M Kaiser
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, Copenhagen University, Højbakkegård Alle 5, 2630, Taastrup, Denmark.
| | - M Jacobson
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, p.o. Box 7054, SE-750 07, Uppsala, Sweden
| | - P H Andersen
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, p.o. Box 7054, SE-750 07, Uppsala, Sweden
| | - P Bækbo
- SEGES, Danish Pig Research Center, Danish Agriculture & Food Council, Agro Food Park 15, 8200, Aarhus N, Denmark
| | - J J Cerón
- Department of Animal Medicine and Surgery, Regional "Campus of Excellence Mare Nostrum", University of Murcia, 30100 Espinardo, Murcia, Spain
| | - J Dahl
- Danish Agriculture and Food Council, Axelborg, Axeltorv 3, 1709, Copenhagen V, Denmark
| | - D Escribano
- Department of Animal Medicine and Surgery, Regional "Campus of Excellence Mare Nostrum", University of Murcia, 30100 Espinardo, Murcia, Spain
| | - S Jacobsen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, Copenhagen University, Højbakkegård Alle 5, 2630, Taastrup, Denmark
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Tecles F, Escribano D, Contreras-Aguilar MD, Rubio CP, Szczubiał M, Cerón JJ, Dąbrowski R, Tvarijonaviciute A. Evaluation of adenosine deaminase in saliva and serum, and salivary α-amylase, in canine pyometra at diagnosis and after ovariohysterectomy. Vet J 2018; 236:102-110. [PMID: 29871742 DOI: 10.1016/j.tvjl.2018.04.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 04/24/2018] [Accepted: 04/25/2018] [Indexed: 01/18/2023]
Abstract
An assay for adenosine deaminase (ADA) was validated in serum and saliva in dogs. Changes in ADA and salivary α-amylase activities were analysed in 26 bitches diagnosed with pyometra and compared with activities in 19 healthy bitches. All animals were classified according to the American Society of Anaesthesiologists (ASA) scoring for physical status. In the validation study, the ADA assay had an imprecision<12% and determination coefficients>0.90 in linearity under dilution experiments, with recoveries of 99.2-114.4%. On the day of presentation, salivary ADA activity was significantly higher in dogs with pyometra than in healthy dogs (median values 7.1IU/L vs. 0.8IU/L, respectively; P<0.01). ADA had a moderate positive correlation with leucocyte and band neutrophil counts, haptoglobin, salivary α-amylase and ASA score, and a low positive correlation with C-reactive protein. There were no significant differences in salivary α-amylase activity between dogs with pyometra and healthy dogs (57.3IU/L vs. 27.4IU/L, respectively). Salivary α-amylase had a low correlation with ASA grade, and leucocyte and band neutrophil counts. In 7/26 bitches with pyometra that were sampled 3 and 10days after ovariohysterectomy, there were no significant changes in α-amylase or ADA activities. These results indicate that ADA activity is increased in the saliva of bitches with pyometra, probably related to systemic inflammation.
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Affiliation(s)
- F Tecles
- Interdisciplinary Laboratory of Clinical Analysis of the University of Murcia (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Espinardo, Murcia, Spain
| | - D Escribano
- Department of Animal and Food Science, Faculty of Veterinary Medicine, Universitat Autonoma de Barcelona, 08193 Bellaterra, Spain
| | - M D Contreras-Aguilar
- Interdisciplinary Laboratory of Clinical Analysis of the University of Murcia (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Espinardo, Murcia, Spain
| | - C P Rubio
- Interdisciplinary Laboratory of Clinical Analysis of the University of Murcia (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Espinardo, Murcia, Spain
| | - M Szczubiał
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 20-612 Lublin, Poland
| | - J J Cerón
- Interdisciplinary Laboratory of Clinical Analysis of the University of Murcia (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Espinardo, Murcia, Spain
| | - R Dąbrowski
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 20-612 Lublin, Poland.
| | - A Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Analysis of the University of Murcia (Interlab-UMU), Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Campus de Espinardo s/n, 30100 Espinardo, Murcia, Spain
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Tecles F, Escribano D, Martínez-Miró S, Cerón J. Homocysteine measurement in pig saliva, assay validation and changes after acute stress and experimental inflammation models: A pilot study. Res Vet Sci 2017; 112:75-80. [DOI: 10.1016/j.rvsc.2017.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 12/04/2016] [Accepted: 01/13/2017] [Indexed: 10/20/2022]
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Escribano D, Santas E, Miñana G, Mollar A, García-Blas S, Valero E, Payá A, Chorro F, Sanchis J, Núñez J. High-sensitivity troponin T and the risk of recurrent readmissions after hospitalization for acute heart failure. Rev Clin Esp 2017. [DOI: 10.1016/j.rceng.2016.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Escribano D, Santas E, Miñana G, Mollar A, García-Blas S, Valero E, Payá A, Chorro F, Sanchis J, Núñez J. Troponina T de alta sensibilidad y riesgo de hospitalizaciones recurrentes tras un ingreso por insuficiencia cardíaca aguda. Rev Clin Esp 2017; 217:63-70. [DOI: 10.1016/j.rce.2016.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 07/24/2016] [Accepted: 10/18/2016] [Indexed: 11/28/2022]
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Domínguez-Manzano P, Herraiz I, Mendoza A, Aguilar JM, Escribano D, Toral B, Gómez-Montes E, Galindo A. Impact of prenatal diagnosis of transposition of the great arteries on postnatal outcome. J Matern Fetal Neonatal Med 2016; 30:2858-2863. [DOI: 10.1080/14767058.2016.1265934] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- P. Domínguez-Manzano
- Department of Pediatrics, Pediatric Heart Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - I. Herraiz
- Department of Obstetrics and Gynaecology, Fetal Medicine Unit, Hospital Universitario 12 de Octubre, Facultad de Medicina, Universidad Complutense de Madrid, Spain
| | - A. Mendoza
- Department of Pediatrics, Pediatric Heart Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J. M. Aguilar
- Department of Pediatrics, Pediatric Heart Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - D. Escribano
- Department of Obstetrics and Gynaecology, Fetal Medicine Unit, Hospital Universitario 12 de Octubre, Facultad de Medicina, Universidad Complutense de Madrid, Spain
| | - B. Toral
- Department of Pediatrics, Pediatric Heart Institute, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - E. Gómez-Montes
- Department of Obstetrics and Gynaecology, Fetal Medicine Unit, Hospital Universitario 12 de Octubre, Facultad de Medicina, Universidad Complutense de Madrid, Spain
| | - A. Galindo
- Department of Obstetrics and Gynaecology, Fetal Medicine Unit, Hospital Universitario 12 de Octubre, Facultad de Medicina, Universidad Complutense de Madrid, Spain
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Ilhao Moreira R, Cambronero Cortinas E, Giannakopoulos G, Wong CY, Maria Joao Vieira MJV, Neves Pestana G, Andjelkovic K, Pavon AG, Nunes A, Portero Portaz JJ, Stefan C, Namitokov A, Chivulescu M, Wojtkowska A, Gomes AC, Jurko T, Cazzoli I, Valente F, Moura Branco L, Coutinho Cruz M, Pinto Teixeira P, Almeida Morais L, Viveiros Monteiro A, Oliveira M, Ramos R, Agapito A, Cruz Ferreira R, Racugno P, Escribano D, Mendez J, Paya A, Bonanad C, Valle Munoz A, Corbi Pascual MJ, Chorro FJ, Bodi V, Mueller H, Catia Costa CC, Beatriz Saldanha Santos BSS, Kevin Domingues KD, Nuno Craveiro NC, Maria Luz Pitta MLP, Miguel Alves MA, Margarida Leal ML, Bernardo-Almeida P, Sousa C, Tavares-Silva M, Almeida R, Lima R, Amorim MJ, Almeida J, Macedo F, Maciel MJ, Kalimanovska Ostric D, Boricic Kostic M, Petrovic O, Petrovic M, Vujisic Tesic B, Mikic A, Kalangos A, Marini C, Rosa I, Stella S, Ancona F, Spartera M, Margonato A, Colombo A, Agricola E, Nascimento H, Maia Araujo P, Ferreira A, Pinho T, Andre Rodrigues R, Bernardo Almeida P, Campelo M, Dias P, Julia Maciel M, Tercero Martinez A, Corbi Pascual MJ, Prieto Mateos D, Urraca Espejel C, Calero Nunez S, Fuentes Manso R, Gallego Page JC, Garcia Lopez JC, Barambio Ruiz MJ, Iancovici S, Ianovici E, Zamfir D, Dorobantu M, Kizhvatova N, Kolodina M, Skaletsky K, Soroka N, Mayngart S, Kosmacheva E, Barbukhatti K, Porhanov V, Jurcut C, Enache R, Popescu BA, Ginghina C, Spirito P, Jurcut R, Tomaszewski A, Czekajska-Chehab E, Tomaszewski M, Stettner D, Wysokinski A, Fazendas P, Carvalho J, Ferreira F, Sousa L, Fiarresga A, Martins JD, Pereira H, Jurko A, Krsiakova J, Jurko AJR, Matasova K, Zibolen M, Babu-Narayan S, Senior R, Gatzoulis MA, Li W, Maldonado G, Cuellar H, Marti G, Roque A, Teixido G, Gonzalez-Alujas MT, Garcia-Dorado D, Evangelista A, Rodriguez-Palomares JF. Clinical Case Poster session 4P1046An unexpected findingP1047Coronary artery ectasia in the setting of subacute Inferior STEMIP1048Diagnosis through the back door: the utility of the subscapular acoustic windowP1049A challenging case of paravalvular leakage closureP1050A life-threatning asymptomatic incidental findingP1051Acute heart failure due to intermittent aortic prosthesis regurgitation - case reportP1052Role of echocardiography in a patient with sequels after surgical treatment of infective endocarditis on a bicuspid aortic valveP1053MitraClip to treat systolic anterior motion-induced outflow tract obstruction in hypertrophic obstructive cardiomyopathyP1054Acute heart failure by parvovirus B19P1055Multimodality assessment of myocardial involvement in female carriers of the Duchenne diseaseP1056Cardiovascular complications in hypereosinophilic syndrom-a case reportP1057Giant false left ventricle aneurysm in the myocardial infarction outcomeP1058From syncope to the diagnosis of systemic disease: the importance of a high index of suspicionP1059A total anomalous pulmonary venous return in 60-year-old patientP1060Atrial septal defect occluder fracture - diagnostic challenge in asymptomatic patientP1061Marfan syndrome in two newborn infantsP1062Isolated pulmonary valve regurgitation as a cause of severe right heart dilatation in an adult patientP1063Multimodality imaging - how to find the missing leak. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tecles F, Caldín M, Tvarijonaviciute A, Escribano D, Martínez-Subiela S, Cerón JJ. Serum biomarkers of oxidative stress in cats with feline infectious peritonitis. Res Vet Sci 2015; 100:12-7. [PMID: 25819115 PMCID: PMC7111829 DOI: 10.1016/j.rvsc.2015.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 02/11/2015] [Accepted: 02/13/2015] [Indexed: 02/05/2023]
Abstract
The purpose of this study was to elucidate the possible presence of oxidative stress in cats naturally affected by feline infectious peritonitis (FIP) by investigating two antioxidant biomarkers in serum: paraoxonase-1 (PON1) and total antioxidant capacity (TAC). PON1 was measured by spectrophotometric assays using three different substrates: p-nitrophenyl acetate (pNA), phenyl acetate (PA) and 5-thiobutil butyrolactone (TBBL), in order to evaluate possible differences between them. The PA and TBBL assays for PON1 and the assay for TAC were validated, providing acceptable precision and linearity although PA and TAC assays showed limit of detection higher than the values found in some cats with FIP. Cats with FIP and other inflammatory conditions showed lower PON1 values compared with a group of healthy cats with the three assays used, and cats with FIP showed significant decreased TAC concentrations. This study demonstrated the existence of oxidative stress in cats with FIP.
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Affiliation(s)
- F Tecles
- Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Veterinary School, Campus of Excellence Mare Nostrum, University of Murcia, 30100 Espinardo, Murcia, Spain
| | - M Caldín
- San Marco Veterinary Hospital, 35141 Padova, Italy
| | - A Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Veterinary School, Campus of Excellence Mare Nostrum, University of Murcia, 30100 Espinardo, Murcia, Spain
| | - D Escribano
- Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Veterinary School, Campus of Excellence Mare Nostrum, University of Murcia, 30100 Espinardo, Murcia, Spain
| | - S Martínez-Subiela
- Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Veterinary School, Campus of Excellence Mare Nostrum, University of Murcia, 30100 Espinardo, Murcia, Spain
| | - J J Cerón
- Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Veterinary School, Campus of Excellence Mare Nostrum, University of Murcia, 30100 Espinardo, Murcia, Spain.
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Ott S, Soler L, Moons CPH, Kashiha MA, Bahr C, Vandermeulen J, Janssens S, Gutiérrez AM, Escribano D, Cerón JJ, Berckmans D, Tuyttens FAM, Niewold TA. Different stressors elicit different responses in the salivary biomarkers cortisol, haptoglobin, and chromogranin A in pigs. Res Vet Sci 2014; 97:124-8. [PMID: 24957408 DOI: 10.1016/j.rvsc.2014.06.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [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: 03/17/2014] [Revised: 05/28/2014] [Accepted: 06/08/2014] [Indexed: 11/25/2022]
Abstract
Most commonly, salivary cortisol is used in pig stress assessment, alternative salivary biomarkers are scarcely studied. Here, salivary cortisol and two alternative salivary biomarkers, haptoglobin and chromogranin A were measured in a pig stress study. Treatment pigs (n = 24) were exposed to mixing and feed deprivation, in two trials, and compared to untreated controls (n = 24). Haptoglobin differed for feed deprivation vs control. Other differences were only found within treatment. Treatment pigs had higher salivary cortisol concentrations on the mixing day (P < 0.05). Chromogranin A concentrations were increased on the day of refeeding (P < 0.05). Haptoglobin showed a similar pattern to chromogranin A. Overall correlations between the salivary biomarkers were positive. Cortisol and chromogranin A were moderately correlated (r = 0.49, P < 0.0001), correlations between other markers were weaker. The present results indicate that different types of stressors elicited different physiological stress responses in the pigs, and therefore including various salivary biomarkers in stress evaluation seems useful.
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Affiliation(s)
- S Ott
- Biosystems, Faculty of Bioscience Engineering, University of Leuven, Kasteelpark Arenberg 30, B-3001 Leuven, Belgium; Animal Nutrition, Genetics and Ethology, Faculty of Veterinary Sciences, Ghent University, Heidestraat 19, B-9820 Merelbeke, Belgium
| | - L Soler
- Biosystems, Faculty of Bioscience Engineering, University of Leuven, Kasteelpark Arenberg 30, B-3001 Leuven, Belgium
| | - C P H Moons
- Animal Nutrition, Genetics and Ethology, Faculty of Veterinary Sciences, Ghent University, Heidestraat 19, B-9820 Merelbeke, Belgium
| | - M A Kashiha
- Biosystems, Faculty of Bioscience Engineering, University of Leuven, Kasteelpark Arenberg 30, B-3001 Leuven, Belgium
| | - C Bahr
- Biosystems, Faculty of Bioscience Engineering, University of Leuven, Kasteelpark Arenberg 30, B-3001 Leuven, Belgium
| | - J Vandermeulen
- Biosystems, Faculty of Bioscience Engineering, University of Leuven, Kasteelpark Arenberg 30, B-3001 Leuven, Belgium
| | - S Janssens
- Biosystems, Faculty of Bioscience Engineering, University of Leuven, Kasteelpark Arenberg 30, B-3001 Leuven, Belgium
| | - A M Gutiérrez
- Department of Animal Medicine and Surgery, University of Murcia, Espinardo, 30100 Murcia, Spain
| | - D Escribano
- Department of Animal Medicine and Surgery, University of Murcia, Espinardo, 30100 Murcia, Spain
| | - J J Cerón
- Department of Animal Medicine and Surgery, University of Murcia, Espinardo, 30100 Murcia, Spain
| | - D Berckmans
- Biosystems, Faculty of Bioscience Engineering, University of Leuven, Kasteelpark Arenberg 30, B-3001 Leuven, Belgium
| | - F A M Tuyttens
- Animal Nutrition, Genetics and Ethology, Faculty of Veterinary Sciences, Ghent University, Heidestraat 19, B-9820 Merelbeke, Belgium; Institute for Agricultural and Fisheries Research (ILVO), Animal Sciences Unit, Scheldeweg 68, B-9090 Melle, Belgium
| | - T A Niewold
- Biosystems, Faculty of Bioscience Engineering, University of Leuven, Kasteelpark Arenberg 30, B-3001 Leuven, Belgium.
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Gómez-Arriaga PI, Herraiz I, López-Jiménez EA, Escribano D, Denk B, Galindo A. Uterine artery Doppler and sFlt-1/PlGF ratio: prognostic value in early-onset pre-eclampsia. Ultrasound Obstet Gynecol 2014; 43:525-532. [PMID: 24185845 DOI: 10.1002/uog.13224] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [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: 06/21/2013] [Revised: 09/26/2013] [Accepted: 10/01/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To evaluate the performance of the mean uterine artery pulsatility index (UtA-PI) and the automated measurement of the soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) ratio for the prognostic assessment of both maternal and perinatal outcomes, and the time-to-delivery interval in early-onset (≤ 34 + 0 weeks) pre-eclampsia (PE) cases with attempted expectant management. METHODS Fifty-one singleton pregnancies with early-onset PE were enrolled in the study. Mean UtA-PI and sFlt/PlGF ratio were measured at diagnosis. The association of each marker and their combinations with adverse maternal and perinatal outcomes was assessed by univariable comparisons and multivariable logistic regression analysis and time-to-delivery interval by survival analysis. RESULTS Twenty-six (51%) had adverse maternal outcome and 14 (27%) had adverse perinatal outcome. At the time of onset of PE, only gestational age was significantly related to maternal complications. Gestational age at onset, mean UtA-PI and sFlt-1/PlGF ratio were significantly associated with perinatal complications, their combination reaching a sensitivity of 64% with 95% specificity, and an area under the receiver-operating characteristics curve of 0.89 (95% CI, 0.79-0.99). Regarding the time until delivery, 92% (12/13) of cases with sFlt-1/PlGF ratio > 655 and 39% (15/38) of cases with a ratio ≤ 655 delivered within the first 48 h, 8% (1/13) and 19% (7/38), respectively, delivered between 48 h and 7 days and 0% (0/13) and 42% (16/38), respectively, delivered after 7 days. CONCLUSION Mean UtA-PI and sFlt-1/PlGF ratio in combination with gestational age are useful for the prognostic assessment of perinatal complications at the time of diagnosis of early-onset PE, but this combination has limited value for the prediction of maternal complications. Moreover, sFlt-1/PlGF ratio > 655 is closely related to the need to deliver within 48 h. [[ArtCopyrightmsg]].
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Affiliation(s)
- P I Gómez-Arriaga
- Fetal Medicine Unit-SAMID, Department of Obstetrics and Gynaecology, Hospital Universitario '12 de Octubre', Madrid, Spain
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Gutiérrez A, Escribano D, Fuentes M, Cerón J. Circadian pattern of acute phase proteins in the saliva of growing pigs. Vet J 2013; 196:167-70. [DOI: 10.1016/j.tvjl.2012.10.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 09/17/2012] [Accepted: 10/01/2012] [Indexed: 12/19/2022]
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Gómez-Montes E, Herraiz I, Mendoza A, Escribano D, Galindo A. Prediction of coarctation of the aorta in the second half of pregnancy. Ultrasound Obstet Gynecol 2013; 41:298-305. [PMID: 22744957 DOI: 10.1002/uog.11228] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/18/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To determine which combination of cardiac parameters provides the best prediction of postnatal coarctation of the aorta (CoAo) in fetuses with cardiac asymmetry. METHODS We selected all cases of disproportion of the ventricles and great vessels prenatally diagnosed between 2003 and 2010 at the Hospital Universitario '12 de Octubre', Madrid, Spain. Only appropriate-for-gestational age liveborn fetuses with isolated cardiac asymmetry and with complete postnatal follow-up were included in the study. Eighty-five cases were retrieved and analyzed. Logistic regression analysis was used to select the best predictors of CoAo. Optimal cut-offs for these parameters were identified and the corresponding likelihood ratios used to calculate the post-test probability of CoAo in each fetus. RESULTS CoAo was confirmed in 41/85 neonates (48%). The parameters selected by logistic regression and their cut-off values were: gestational age at diagnosis ≤ 28 weeks, Z-score of diameter of the ascending aorta ≤ -1.5, pulmonary valve/aortic valve diameters ratio ≥ 1.6 and Z-score of the aortic isthmus diameter in the three vessels and trachea view ≤ -2. We divided the study group into two subgroups: Group A, in whom the diagnosis was made at ≤ 28 weeks' gestation (80% CoAo (32/40)); and Group B, in whom the diagnosis was made at > 28 weeks (20% CoAo (9/45)). The mean post-test probabilities of CoAo were higher in fetuses with CoAo than in normal fetuses in both subgroups (Group A, 82 vs 55%; P = 0.002 and Group B, 51 vs 20%; P < 0.001). In addition, a rate of growth of the aortic valve of ≤ 0.24 mm/week provided 80% sensitivity and 100% specificity for predicting CoAo in Group A. CONCLUSIONS We have derived a multiparametric scoring system, combining size-based cardiac parameters and gestational age at diagnosis, which may improve the accuracy of fetal echocardiography for the stratification of the risk of CoAo. The objectivity and simplicity of its components may allow its implementation in fetal cardiology units.
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Affiliation(s)
- E Gómez-Montes
- Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Madrid, Spain
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Herraiz I, Escribano D, Gómez-Arriaga PI, Herníndez-García JM, Herraiz MA, Galindo A. Predictive value of sequential models of uterine artery Doppler in pregnancies at high risk for pre-eclampsia. Ultrasound Obstet Gynecol 2012; 40:68-74. [PMID: 22102516 DOI: 10.1002/uog.10147] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To evaluate the performance of models described previously for the prediction of pre-eclampsia (PE), based on the sequential evaluation of uterine artery resistance at 11-13 weeks and 19-22 weeks, in a high-risk population. METHODS This was a prospective study in 135 women with singleton pregnancies and at least one of the following high-risk conditions: PE and/or intrauterine growth restriction in a previous pregnancy, chronic hypertension, pregestational diabetes, renal disease, body mass index > 30 kg/m(2) , autoimmune disease (systemic lupus erythematosus, antiphospholipid syndrome or rheumatoid arthritis) and thrombophilia. Mean uterine artery pulsatility index (mUtA-PI) at 11-13 and at 19-22 weeks' gestation was measured and analyzed according to quantitative and semi-quantitative models, to predict late PE (resulting in delivery ≥ 34 weeks) and early PE (delivery < 34 weeks). RESULTS Late PE developed in 21 (15.6%) pregnancies and early PE in six (4.4%). Using mUtA-PI, the detection rates of late and early PE for a false-positive rate of 10% were 14.3% and 33.3%, respectively, at 11-13 weeks, and 19.0% and 66.7%, respectively, at 19-22 weeks. Using a semi-quantitative approach, the group of pregnant women with mUtA-PI ≥ 90(th) percentile at both 11-13 and 19-22 weeks had a greater risk for early PE (odds ratio, 21.4 (95% CI, 2.5-184.7)) compared with the group with mUtA-PI < 90(th) percentile at both periods. Using a quantitative approach, there was relative worsening in the mUtA-PI (multiples of the median) from the first to the second trimester in all cases of early PE. CONCLUSION The application of semi-quantitative and especially quantitative models to evaluate sequential changes in uterine artery Doppler findings between the first and second trimesters could be of additional value in assessing high-risk women regarding their true risk of developing early PE.
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Affiliation(s)
- I Herraiz
- Fetal Medicine Unit-SAMID, Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
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Escribano D, Gutiérrez AM, Martínez Subiela S, Tecles F, Cerón JJ. Validation of three commercially available immunoassays for quantification of IgA, IgG, and IgM in porcine saliva samples. Res Vet Sci 2011; 93:682-7. [PMID: 22019471 DOI: 10.1016/j.rvsc.2011.09.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Revised: 09/23/2011] [Accepted: 09/26/2011] [Indexed: 11/24/2022]
Abstract
The objectives of this study were to perform the optimization and validation of three commercially available immunoassays for the measurement of IgA, IgG, and IgM (Igs) in porcine saliva samples and to determinate if their concentrations may be used to distinguish healthy from diseased animals. Intra and inter assay coefficients of variation were lower than 15% in all cases. All methods showed good linearity and recovery; and detection limits were low enough to detect Igs levels in healthy and diseased animals. The clinical validation showed an increase statistically significant (P<0.05) in the group of diseased animals versus healthy pigs. Therefore, these assays may be used in porcine saliva samples, in addition, the measurement of Igs in saliva could be a practical tool, simple and minimally invasive, to evaluate the humoral immune status of pigs.
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Affiliation(s)
- D Escribano
- Department of Animal Medicine and Surgery, University of Murcia, 30100 Espinardo, Murcia, Spain
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Escribano D, Herraiz I, Granados M, Arbues J, Mendoza A, Galindo A. Tetralogy of Fallot: prediction of outcome in the mid-second trimester of pregnancy. Prenat Diagn 2011; 31:1126-33. [PMID: 21928295 DOI: 10.1002/pd.2844] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 07/20/2011] [Accepted: 07/24/2011] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To evaluate the usefulness of fetal echocardiography in the mid-second trimester in predicting postnatal outcome of tetralogy of Fallot (ToF), focusing on the need for early intervention (EI) and surgery type: pulmonary valve-sparing surgery (PVSS) versus placement of transannular patch (TAP). METHODS Assessment of cardiac morphological and functional parameters in 23 live-born fetuses with isolated ToF was performed at 19 to 22 and 34 to 38 weeks. Comparisons were made between outcome groups (EI vs non-EI and PVSS vs TAP). EI was considered as requirement either of palliative procedure or corrective surgery before three months. RESULTS Overall survival was 96%. EI was required in 32% of cases and TAP in 50%. At 19 to 22 weeks, a pulmonary valve peak systolic velocity (PVPSV) ≥87.5 cm/s predicted EI with 100% sensitivity and 93.3% specificity (p < 0.01). At 34 to 38 weeks, the size of the pulmonary valve, pulmonary valve/aortic valve and main pulmonary artery/ascending aorta were significantly different, but the PVPSV again yielded the best performance: all cases undergoing EI and/or TAP were selected using cut-off of ≥144.5 cm/s. CONCLUSION The postnatal outcome of fetuses with ToF may be established using PVPSV from the mid-second trimester. This may be useful in providing the most appropriate perinatal management and accurate parental counselling.
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Affiliation(s)
- D Escribano
- Department of Obstetrics and Gynaecology, Hospital Universitario '12 de Octubre', Madrid, Spain
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Galindo A, Nieto O, Nieto MT, Rodríguez-Martín MO, Herraiz I, Escribano D, Granados MA. Prenatal diagnosis of right aortic arch: associated findings, pregnancy outcome, and clinical significance of vascular rings. Prenat Diagn 2009; 29:975-81. [PMID: 19603384 DOI: 10.1002/pd.2327] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To analyze the characteristics and clinical implications of right aortic arch (RAA) detected in fetal life. METHODS Retrospective study of all cases of RAA diagnosed prenatally in high-risk patients who underwent fetal echocardiography between 2000 and 2007. RESULTS There were 48 RAA; 18 had vascular ring (Group 1), including 15 RAA with aberrant left subclavian artery and 3 double aortic arch, and 30 had not vascular ring (Group 2), all RAA with mirror-image branching. The prenatal diagnosis was confirmed in 94%. In Group 1 most fetuses had normal heart (89%), and none had 22q11 deletion. There were 16 live births and all infants but one are asymptomatic (mean follow-up of 31 months). In Group 2 almost all fetuses had congenital heart defects (CHDs) (97%), and five were chromosomally abnormal (17%), including four 22q11 deleted. The 1-year survival rate was 69%, which was significantly higher in Group 1 (89% vs 57%, p < 0.05). CONCLUSIONS RAA can be accurately diagnosed by fetal echocardiography. The outlook for these patients largely depends on the presence of associated defects, mainly CHDs, and their severity. If isolated, aortic arch anomalies are asymptomatic vascular variants in most cases. This information is important to assist parental counseling in pregnancy.
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Affiliation(s)
- A Galindo
- Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Madrid, Spain.
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Galindo A, Mendoza A, Arbues J, Grañeras A, Escribano D, Nieto O. Conotruncal anomalies in fetal life: accuracy of diagnosis, associated defects and outcome. Eur J Obstet Gynecol Reprod Biol 2009; 146:55-60. [PMID: 19481856 DOI: 10.1016/j.ejogrb.2009.04.032] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2008] [Revised: 04/14/2009] [Accepted: 04/27/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To assess the accuracy of prenatal echocardiography, associated anomalies, and outcome of fetuses with conotruncal anomalies (CTA). STUDY DESIGN We searched our database for CTA prenatally diagnosed between 1990 and 2005. We included tetralogy of Fallot (TOF), transposition of the great arteries (TGA), double-outlet right ventricle (DORV), truncus arteriosus (TA), pulmonary atresia with ventricular septal defect (PA-VSD) and posterior malalignment type VSD with aortic arch obstruction (pmtVSD-AAO). Data of 144 fetuses with complete follow-up were retrieved and analyzed. RESULTS The main reason for referral was suspected heart defect on a routine obstetric scan (72%). Most cases were detected < or =22 weeks (55%). The presence of a CTA was confirmed postnatally in 143 cases (99%), and the diagnosis of the first fetal echocardiography was correct in 126 (87.5%). Most diagnosis of TOF (33/36, 91.7%), TGA (34/38, 89.5%) and DORV (34/38, 89.5%) were proved correct. Inadequate assessment of the interventricular septum, the distal aortic arch and/or the severity of the right outflow tract obstruction accounted for most errors. The accuracy rate was lower in TA (11/14, 78.6%) and PA-VSD (4/7, 57.1%), with evaluation of the branch pulmonary arteries as the main source of discrepancies. In 7/18 incorrect cases subsequent scans allowed to obtain a correct diagnosis. Most fetuses (64%) had an isolated CTA. Thirty-seven had chromosomal anomalies (26%) but none were found in TGA. 22q11 deletion affected 8.7% of the tested patients. Nuchal translucency (NT) was above 95th centile in 19/104 cases (18%) in which NT were measured. Fifty cases were interrupted. The overall one-year survival rate was 71%, with differences between cases with and without associated defects (9/25, 36% vs. 57/68, 83.8%; p<0.01). The uncomplicated forms of TGA and TOF had the best survival rates (100%). CONCLUSIONS Most CTA can be diagnosed by fetal echocardiography with a high degree of accuracy. Chromosomal defects should always be ruled out, except for simple TGA. Current survival figures in many isolated CTA, especially simple TGA and TOF, support a change in the "classical" concept that congenital heart defects detected prenatally often have the worst outlook. CONDENSATION Most CTA can be diagnosed by fetal echocardiography with a high degree of accuracy. Isolated CTA are more common and most of these may have a favourable outcome.
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Affiliation(s)
- A Galindo
- Fetal Medicine Unit. Department of Obstetrics and Gynaecology. Hospital Universitario 12 de Octubre Avenida de Córdoba s/n. 28041 Madrid, Spain.
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Herraiz I, López-Jiménez EA, García-Burguillo A, Nieto O, Villar OP, Escribano D, Galindo A. Role of uterine artery Doppler in interpreting low PAPP-A values in first-trimester screening for Down syndrome in pregnancies at high risk of impaired placentation. Ultrasound Obstet Gynecol 2009; 33:518-523. [PMID: 19402101 DOI: 10.1002/uog.6366] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES Low maternal serum levels of pregnancy-associated plasma protein-A (PAPP-A) are associated with both increased risk of aneuploidies and impaired trophoblastic invasion, while high uterine artery (UtA) resistance is associated with impaired trophoblastic invasion but not with an increased risk of aneuploidies. The aim of this study was to determine whether high UtA resistance plays a role in explaining low PAPP-A levels in the absence of aneuploidies. METHODS This was a prospective study of 116 singleton pregnancies at high risk for impaired placentation (having at least one major risk factor: prior history of pre-eclampsia, pregestational diabetes mellitus, chronic hypertension, chronic kidney disease, body mass index >30, autoimmune disorder, thrombophilia or recurrent pregnancy loss), booked for routine assessment of risk for aneuploidies by means of the first-trimester combined screening test (nuchal translucency thickness (NT) + PAPP-A + beta-human chorionic gonadotropin (beta-hCG)). Measurement of NT and the mean UtA pulsatility index (PI) were carried out at the 11 to 13 + 6-week scan. All values were calculated in multiples of the median (MoM) adjusted for gestational age. A cut-off risk of 1/270 at time of sampling was adopted to differentiate high- from low-risk groups for trisomy 21. RESULTS There were 108 patients deemed to be at low risk for trisomy 21 and eight at high risk. None had chromosomal defects, giving a false-positive rate for trisomy 21 of 6.9%. The greatest differences between patients at low risk and those at high risk for trisomy 21 were found in their PAPP-A (0.98 vs. 0.38 MoM, P < 0.01) and beta-hCG (1.09 vs. 1.77 MoM, P = 0.04) values. Greater NT thickness (1.02 vs. 0.90 MoM) and higher mean UtA-PI (1.05 vs. 0.96 MoM) were recorded in the high-risk group, although the differences did not reach statistical significance (P = 0.19 and 0.40, respectively). After log-transformation there were no significant correlations between mean UtA-PI and NT and between mean UtA-PI and beta-hCG. There was a significant negative linear correlation between mean UtA-PI and PAPP-A (r = -0.331; P < 0.01). After adjusting the PAPP-A values by UtA-PI, the false-positive rate for trisomy 21 decreased to 2.6%. CONCLUSION Mean UtA-PI at the 11 to 13 + 6-week scan may be an effect-modifier variable for PAPP-A that should be taken into account in the first-trimester combined screening for aneuploidies, at least in pregnancies at high risk for impaired placentation.
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Affiliation(s)
- I Herraiz
- Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Hospital Universitario 12 de Octubre, Madrid, Spain
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Galindo A, Gutiérrez-Larraya F, Escribano D, Arbues J, Velasco JM. Clinical significance of persistent left superior vena cava diagnosed in fetal life. Ultrasound Obstet Gynecol 2007; 30:152-61. [PMID: 17616965 DOI: 10.1002/uog.4045] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVES To determine the prevalence and clinical significance of persistent left superior vena cava (PLSVC) in fetuses with and without cardiac and extracardiac anomalies. METHODS Charts and recorded images were reviewed from high-risk patients who underwent fetal echocardiography between January 2000 and December 2005. This retrospective study included 54 fetuses with confirmed PLSVC who were diagnosed based on the presence of an additional vessel identified to the left of the pulmonary artery in the three-vessel view of the heart. Associated congenital heart defects (CHDs), extracardiac abnormalities, including first trimester nuchal translucency (NT) thickness, and fetal/postnatal outcome were analyzed. RESULTS Of 5,737 referrals, 5,233 had a normal heart, and PLSVC was observed in 10 of these fetuses (0.2%; Group 1). CHDs were present in 504 and PLSVC was observed in 44 of these cases (9%). In the latter group, 18/44 (41%) fetuses had heterotaxy syndrome (Group 2) where the most common structural heart defects were atrioventricular septal defect and double-outlet right ventricle. Fetuses without heterotaxy syndrome (Group 3) accounted for 26/44 (59%) cases of CHDs associated with PLSVC. In this group of fetuses the most common CHDs were left outflow tract obstructive defects and conotruncal anomalies. Increased NT was observed in 29%, without differences among the three groups. The survival rates among fetuses in Groups 1, 2 and 3 were 100%, 44% and 50%, respectively. After excluding patients who underwent pregnancy termination, there were no significant differences in the survival rates among the groups, probably due to the small size of the samples. CONCLUSIONS PLSVC is associated with CHDs. The identification of PLSVC should prompt a thorough examination of the fetus to identify additional cardiac and extracardiac anomalies. The prognosis of affected fetuses largely depends on whether or not the PLSVC is associated with a CHD.
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Affiliation(s)
- A Galindo
- Ultrasound and Fetal Physiopathology Unit, Department of Obstetrics and Gynaecology, Hospital Universitario '12 de Octubre', Madrid, Spain.
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Escribano D, Galindo A, Arbués J, Puente JM, De la Fuente P. Prenatal management of placental chorioangioma: value of the middle cerebral artery peak systolic velocity. Fetal Diagn Ther 2006; 21:489-93. [PMID: 16969001 DOI: 10.1159/000095659] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2005] [Accepted: 11/16/2005] [Indexed: 11/19/2022]
Abstract
Placental chorioangiomas are benign tumors of the placenta. Large chorioangiomas may cause severe complications such as fetal anemia, hydrops and fetal death. We report the use of sonographic findings and peak systolic velocity in the middle cerebral artery in the diagnosis and management of fetal anemia without the occurrence of hydrops fetalis in a pregnant woman with a large placental chorioangioma. Successful intrauterine blood transfusion was performed at 26 weeks. Spontaneous thrombosis of the main supplying blood vessel of the chorioangioma was detected at 33 weeks. The child was delivered at 39 weeks of pregnancy in normal clinical condition.
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Affiliation(s)
- D Escribano
- Fetal Pathophysiology and Ultrasound Unit, Department of Obstetrics and Gynecology, Hospital Universitario '12 de Octubre', Madrid, Spain
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Noguero M, Sancho B, Escribano D, Campos E, Viana P, Muñoz J, Jiménez J, de La Fuente P. Enfermedad de Mondor. Descripción de un caso clínico. Clínica e Investigación en Ginecología y Obstetricia 2005. [DOI: 10.1016/s0210-573x(05)73471-7] [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: 11/16/2022]
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41
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Castro-Gago M, Eirís J, Fernández-Bustillo J, Escribano D, Pintos E, Monasterio L, Peña J. Severe myoclonic epilepsy associated with mitochondrial cytopathy. Childs Nerv Syst 1995; 11:630-3. [PMID: 8608578 DOI: 10.1007/bf00300719] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We describe a case in which severe myoclonic epilepsy of infancy is associated with a disturbance in mitochondrial function. EEG traces showed diffuse spike-wave patterns inducible by intermittent photic stimulation. Laboratory analyses revealed high lactic acid levels in cerebrospinal fluid and urine, without metabolic acidosis or high lacticacidaemia. Muscle biopsy showed a slight increase in the number of mitochondria, which had a tendency towards subsarcolemmal locations, and clefts in the myofibrillar membrane that contained granular material staining positive for oxidative enzymes and red with modified Gomori stain. Quantification of the enzymatic activities of homogenized muscle showed partial deficiency of the mitochondrial respiratory chain complexes III and IV. Severe myoclonic epilepsy associated with mitochondrial cytopathy was diagnosed, but the possibility cannot be ruled out that the myoclonic epilepsy (or perhaps simply nonspecific epileptic encephalopathy) was secondary to the mitochondrial cytopathy. Thorough diagnostic analysis in severe myoclonic epilepsy cases is called for with a view to elucidation of a possible metabolic aetiology.
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Affiliation(s)
- M Castro-Gago
- Department of Paediatrics, Hospital General de Galicia, Clínico Universitario, Santiago de Compostela, Spain
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42
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Hidalgo E, Solano A, Escribano D. [Hematuria in a traveling doctor]. Enferm Infecc Microbiol Clin 1992; 10:623-4. [PMID: 1292606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- E Hidalgo
- Servicio de Microbiología, Hospital de Jove, Gijón, Asturias
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43
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Palenciano L, de Vega A, Escribano D. [Fenoterol, ipratropium bromide and their combination in bronchial asthma]. Med Clin (Barc) 1984; 82:617-20. [PMID: 6234440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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44
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Molins JL, del Busto B, Losada CM, Macho M, Ibrahim A, Redondo C, Escribano D. [Hemorrhagic ascites: an unusual presentation of hypernephroma]. Med Clin (Barc) 1983; 81:879-80. [PMID: 6656469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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45
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Alcoba M, Martínez Concejo R, López López C, López Nicolas S, Roman A, Escribano D, Peral V. [Lactate dehydrogenase in pleural fluid. Diagnostic value]. Rev Clin Esp 1976; 140:445-8. [PMID: 935570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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