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González-Martínez F, Gómez-Scarpetta R, Salcedo OB, Bermúdez-Reyes P, Castro-Villamizar P, Cerezo MDP, Martínez C, Tirado-Amador L, Salas-Zambrano A, Saldarriaga A, Sánchez-Molina M, Vila LA. Enamel fluorosis related with fluoride-containing water ingestion and urinary excretion in schoolchildren. J Clin Exp Dent 2024; 16:e51-e61. [PMID: 38314340 PMCID: PMC10837805 DOI: 10.4317/jced.61052] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 10/23/2023] [Indexed: 02/06/2024] Open
Abstract
Background Natural water sources are considered as the major environmental exposure of fluoride, resulting in increased prevalence of enamel fluorosis. This type of natural exposure should be permanently monitored to avoid the interactions with other non-natural fluoride sources. We evaluated the prevalence of enamel fluorosis in Colombian schoolchildren and its relationship with fluoride-containing water ingestion exposure dose and urinary fluoride excretion. Material and Methods We included 923 schoolchildren aged 7-12 years residing in eight municipalities in Colombia. Sampling of consumption water was performed in major aquifers used for daily supply. Samples were collected in 98 polyethylene containers and refrigerated until analysis. Water and urine fluoride concentrations were measured using the fluoride selective electrode method. Enamel fluorosis was evaluated using Thylstrup and Ferjerskov Index (TFI). Demographic and anthropometric characteristics were assessed. Besides, other exposures to non-natural fluoride were also evaluated. Logistic regression was applied for multiple analyses. Results The median fluoride concentration in water and urine samples was 10.5 mg/L and 0.63 mg/L respectively, with the highest value found in Algarrobo-Magdalena, and the lowest value found in Manzanares-Caldas. The overall prevalence of enamel fluorosis was 86.1%, being more frequent the mild codes with TFI-1 to TFI-2. The highest prevalence was found in Margarita-Bolívar and Manzanares-Caldas, and the most severe codes (TFI-5 to TFI-9) were detected in Manzanares-Caldas. The multiple analysis revealed water ingestion exposure dose, urinary excretion, involuntary intake of toothpaste, amount of table salt consumption and sex as significant factors (p< 0.001). Conclusions The fluoride ingestion exposure dose and its subsequent urinary excretion could be used as estimators of past fluoride exposure, explaining the current prevalence of enamel fluorosis in Colombian schoolchildren. Key words:Fluoride, groundwater ingestion, enamel fluorosis, prevalence, severity.
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Affiliation(s)
- Farith González-Martínez
- DDS, MSPH, PhD. Public Health Research Group Universidad de Cartagena-Cartagena de Indias, Colombia
- Asociación Colombiana de Facultades de Odontología-Bogotá-ACFO, Colombia
- Latin American Network of Research on Fluorides and Dental Fluorosis, Cartagena 130014, Colombia
| | - Ruth Gómez-Scarpetta
- Latin American Network of Research on Fluorides and Dental Fluorosis, Cartagena 130014, Colombia
- BAM, MSc. Universidad Cooperativa de Colombia-Villavicencio, Colombia
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Salas-Hernández A, Galleguillos M, Carrasco M, López-Cortés A, Redal MA, Fonseca-Mendoza D, Esperón P, González-Martínez F, Lares-Asseff I, Lazarowski A, Loera-Castañeda V, Remírez D, Martínez MF, Vargas R, Rios-Santos F, Macho A, Cayún JP, Perez GR, Gutierrez C, Cerpa LC, Leiva T, Calfunao S, Xajil L, Sandoval C, Suárez M, Gonzalez A, Echeverría-Garcés G, Sullón-Dextre L, Cordero-García E, Morales AR, Avendaño A, Sánchez E, Bastone LC, Lara C, Zuluaga-Arias P, Soler AM, Da Luz J, Burgueño-Rodríguez G, Vital M, Reyes-Reyes E, Huaccha A, Ariza YV, Tzul N, Rendón AL, Serrano R, Acosta L, Motta-Pardo A, Beltrán-Angarita L, Brand E, Jiménez MA, Hidalgo-Lozada GM, Romero-Prado MMJ, Escobar-Castro K, Umaña-Rivas M, Vivas JD, Lagos P, Martínez YB, Quesada S, Calfio C, Arias ML, Lavanderos MA, Cáceres DD, Salazar-Granara A, Varela NM, Quiñones LA. An updated examination of the perception of barriers for pharmacogenomics implementation and the usefulness of drug/gene pairs in Latin America and the Caribbean. Front Pharmacol 2023; 14:1175737. [PMID: 37251329 PMCID: PMC10213898 DOI: 10.3389/fphar.2023.1175737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
Pharmacogenomics (PGx) is considered an emergent field in developing countries. Research on PGx in the Latin American and the Caribbean (LAC) region remains scarce, with limited information in some populations. Thus, extrapolations are complicated, especially in mixed populations. In this paper, we reviewed and analyzed pharmacogenomic knowledge among the LAC scientific and clinical community and examined barriers to clinical application. We performed a search for publications and clinical trials in the field worldwide and evaluated the contribution of LAC. Next, we conducted a regional structured survey that evaluated a list of 14 potential barriers to the clinical implementation of biomarkers based on their importance. In addition, a paired list of 54 genes/drugs was analyzed to determine an association between biomarkers and response to genomic medicine. This survey was compared to a previous survey performed in 2014 to assess progress in the region. The search results indicated that Latin American and Caribbean countries have contributed 3.44% of the total publications and 2.45% of the PGx-related clinical trials worldwide thus far. A total of 106 professionals from 17 countries answered the survey. Six major groups of barriers were identified. Despite the region's continuous efforts in the last decade, the primary barrier to PGx implementation in LAC remains the same, the "need for guidelines, processes, and protocols for the clinical application of pharmacogenetics/pharmacogenomics". Cost-effectiveness issues are considered critical factors in the region. Items related to the reluctance of clinicians are currently less relevant. Based on the survey results, the highest ranked (96%-99%) gene/drug pairs perceived as important were CYP2D6/tamoxifen, CYP3A5/tacrolimus, CYP2D6/opioids, DPYD/fluoropyrimidines, TMPT/thiopurines, CYP2D6/tricyclic antidepressants, CYP2C19/tricyclic antidepressants, NUDT15/thiopurines, CYP2B6/efavirenz, and CYP2C19/clopidogrel. In conclusion, although the global contribution of LAC countries remains low in the PGx field, a relevant improvement has been observed in the region. The perception of the usefulness of PGx tests in biomedical community has drastically changed, raising awareness among physicians, which suggests a promising future in the clinical applications of PGx in LAC.
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Affiliation(s)
- Aimeé Salas-Hernández
- Department of Pharmacology, Toxicology and Pharmaco-Dependence, Faculty of Pharmacy, University of Costa Rica, San Jose, Costa Rica
| | - Macarena Galleguillos
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile
| | - Matías Carrasco
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile
| | - Andrés López-Cortés
- Cancer Research Group (CRG), Faculty of Medicine, Universidad de Las Américas, Quito, Ecuador
| | - María Ana Redal
- Molecular Diagnostic Laboratory, Genetics Division, Faculty of Medicine, Hospital de Clínicas José de San Martín, University of Buenos Aires, Buenos Aires, Argentina
| | - Dora Fonseca-Mendoza
- Universidad del Rosario, School of Medicine and Health Sciences, Center for Research in Genetics and Genomics (CIGGUR), Institute of Translational Medicine (IMT), Bogotá, Colombia
| | - Patricia Esperón
- Molecular Genetic Unit, School of Chemistry, Universidad de la República, General Flores, CP 1800 2124, Montevideo, Uruguay
| | - Farith González-Martínez
- Toxicology and Public Health Research Laboratory, Department of Research, Faculty of Dentistry, University of Cartagena, Cartagena, Colombia
| | - Ismael Lares-Asseff
- Academy of Genomics and Laboratory of Pharmacogenomics and Molecular Biomedicine, Instituto Politécnico Nacional, CIIDIR-Unidad Durango, Durango, Mexico
| | - Alberto Lazarowski
- Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires- Argentina, Buenos Aires, Argentina
| | - Verónica Loera-Castañeda
- Academy of Genomics and Laboratory of Pharmacogenomics and Molecular Biomedicine, Instituto Politécnico Nacional, CIIDIR-Unidad Durango, Durango, Mexico
| | | | - Matías F. Martínez
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile
- Department of Pharmaceutical Sciences and Technology, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile
| | - Rodrigo Vargas
- Department of Molecular Biology, Galileo University, Guatemala City, Guatemala
| | - Fabricio Rios-Santos
- Department of Health. Faculty of Medicine, Federal University of Mato Grosso (UFMT), Cuibá, Brazil
| | - Antonio Macho
- Morphology and Applied Immunology Research Center (NuPMIA), University of Brasilia (UnB), Brasília, Brazil
| | - Juan P. Cayún
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile
| | - Germán R. Perez
- Department of Microbiology, Faculty of Biochemical and Pharmaceutical Sciences. National University of Rosario, Rosario, Argentina
| | - Carolina Gutierrez
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile
| | - Leslie C. Cerpa
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile
| | - Tamara Leiva
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile
| | - Susan Calfunao
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile
- Laboratory Pathological Anatomy, Hospital Luis Calvo Mackenna, Santiago, Chile
| | - Lesly Xajil
- Department of Research in Pharmacogenomics, Faculty of Chemical Sciences and Pharmacy, University of San Carlos de Guatemala, Guatemala, Guatemala
| | - Christopher Sandoval
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile
- Clinical Laboratory Blood Biochemistry and Immunoassay Section, Hospital Clínico Félix Bulnes Cerda, Santiago, Chile
| | - Marcelo Suárez
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile
- Pharmacy Service, Hospital UC-Christus, Santiago, Chile
| | | | | | | | - Eugenia Cordero-García
- Department of Pharmacology, Toxicology and Pharmaco-Dependence, Faculty of Pharmacy, University of Costa Rica, San Jose, Costa Rica
| | - Alexis R. Morales
- Department of Toxicology and Pharmacology, Faculty of Pharmacy and Bioanalisis, University of Los Andes, Merida, Venezuela
| | - Andrea Avendaño
- Department of Pediatrics, Medical Genetics Unity, Faculty of Medicine, University of Los Andes, Mérida, Venezuela
| | | | - Laura C. Bastone
- Laboratorio de Medicina Genómica, Gammalab, Grupo Gamma, Rosario, Argentina
| | - Cesar Lara
- Betesda La Alternativa Natural, San José, Costa Rica
| | | | - Ana María Soler
- Laboratorio de Genética Molecular Humana, Departamento de Ciencias Biológicas, Universidad de La República, Montevideo, Uruguay
| | - Julio Da Luz
- Laboratorio de Genética Molecular Humana, Departamento de Ciencias Biológicas, Universidad de La República, Montevideo, Uruguay
| | - Gabriela Burgueño-Rodríguez
- Laboratorio de Genética Molecular Humana, Departamento de Ciencias Biológicas, Universidad de La República, Montevideo, Uruguay
| | - Marcelo Vital
- Molecular Genetic Unit, School of Chemistry, Universidad de la República, General Flores 2124, Montevideo, Uruguay
| | - Elizabeth Reyes-Reyes
- Clinical Experimental Pharmacology Section, Teaching and Research Department, Institute of Oncology and Radiobiology, Havana, Cuba
| | | | - Yeimy V. Ariza
- Pharmaceutical Chemistry Program, El Bosque University, Bogotá, Colombia
| | - Naomi Tzul
- Drug Inspectorate Unit, Ministry of Health and Wellness, Belmopan, Belize
| | - Ana L. Rendón
- Department of Pharmaceutical Technology, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | | | - Larissa Acosta
- Faculty of Biology, Chemistry and Pharmacy, Galileo University, Guatemala, Guatemala
| | - Angelo Motta-Pardo
- GENOBIDC, Faculty of Pharmacy and Biochemistry, Universidad Nacional Mayor de San Marcos (UNMSM), CIGBM, Faculty of Medicine, Universidad de San Martin de Porres (USMP), Lima, Peru
| | - Leonardo Beltrán-Angarita
- Faculty of Heath Sciences, Central Unit of Valle del Cauca, Tuluá, Colombia
- Chemistry School, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Erika Brand
- Postgraduate Department, Master’s Degree in Immunology, Universidad Cayetano Heredia, Lima, Perú
| | | | | | - Marina M. J. Romero-Prado
- Department of Physiology, Health Sciences University Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Karla Escobar-Castro
- Laboratory of Histocompatibility and Immunogenetics, Department of Nephrology and Transplant, Hospital General San Juan de Dios, Guatemala, Guatemala
| | - Mariel Umaña-Rivas
- Department of Tropical Medicine, Faculty of Medicine, University of Brasília, Brasília, Brazil
| | - Juan D. Vivas
- Department of Clinical Pharmacology, Faculty of Medicine, University of La Sabana, Chía, Colombia
| | - Paola Lagos
- Recombinant Biopharmaceutical Laboratory, Department of Pharmacology, Faculty of Biological Sciences, University of Concepción, Concepción, Chile
| | - Yineth Ballén Martínez
- Medical Specialist in Epidemiology Clinical Pharmacology Teacher; Medical Scientific and Pharmacovigilance Advisor in the Pharmaceutical Industry, Bogotá, Colombia
| | - Sharleth Quesada
- Faculty of Pharmacy, University of Costa Rica, San Jose, Costa Rica
| | - Camila Calfio
- International Center for Biomedicine ICC, Santiago, Chile
| | - Maria L. Arias
- Tropical Diseases Research Center and Microbiology Faculty, University of Costa Rica, San José, Costa Rica
| | - María A. Lavanderos
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile
| | - Dante D. Cáceres
- Environmental Health Programme, School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Alberto Salazar-Granara
- Universidad de San Martín de Porres, Facultad de Medicina Humana, Centro de Investigación de Medicina Tradicional y Farmacología, Lima, Perú
| | - Nelson M. Varela
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile
| | - Luis A. Quiñones
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile
- Department of Pharmaceutical Sciences and Technology, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile
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Sir-Mendoza F, González-Martínez F, Madera M. Prevalence of KRAS, PIK3CA, BRAF and AXIN2 gene mutations in colorectal cancer and its relationship with dental agenesis: a systematic review. Rev Fac Med 2021. [DOI: 10.15446/revfacmed.v71n1.95595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: The study of allelic and genotypic frequencies contributes to determining the distribution of genetic variants in different populations and their possible association with biomarkers. This knowledge could improve the decision-making process regarding the management of some diseases such as colorectal cancer (CRC), in which the detection of clinical biomarkers such as dental agenesis could be crucial in clinical practice.
Objective: To evaluate the available scientific evidence on the prevalence of KRAS, PIK3CA, BRAF and AXIN2 mutations and their possible association with dental agenesis in people with CRC.
Materials and methods: A systematic search was conducted in PubMed, EMBASE and Cochrane Library databases using the following search strategy: type of studies: observational studies reporting the prevalence of KRAS, PIK3CA, BRAF and AXIN2 mutations in people diagnosed with CRC and their possible association with dental agenesis; publication language: English and Spanish; publication period: 2010-2020; search terms: “Genes”, “RAS”, “Kras”, “PIK3CA”, “BRAF”, “AXIN2”, “Mutation”, “Polymorphism”, “Colorectal Neoplasms”, “Colorectal Cancer”, used in different combinations (“AND” and “OR”).
Results: The initial search yielded 403 records, but only 30 studies met the eligibility criteria. Of these, 11, 5, 5 and 1 only reported the prevalence of PIK3CA, KRAS, BRAF and AXIN2 mutations, respectively; while 8 reported the prevalence of more than one of these mutations in patients with CRC. The prevalence of KRAS (p.Gly12Asp), PIK3CA (p.Glu545Lys), and BRAF (p.Val600Glu) mutations ranged from 20.5% to 54%, 3.5% to 20.2%, and 2.5% to 12.1%, respectively. There were no findings regarding the association between the occurrence of these mutations and dental agenesis.
Conclusions: KRAS mutations were the most prevalent; however, there is no evidence on the association between dental agenesis and the occurrence of KRAS, PIK3CA and BRAF germline mutations in individuals with CRC.
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Fernández-Alonso C, González-Martínez F, Alonso-Avilés R, Liñán-López M, Benito-Lozano M. [On the treatment of epileptic seizures in patients with epilepsy in hospital emergency departments]. Rev Neurol 2021; 73:258-259. [PMID: 34569036 DOI: 10.33588/rn.7307.2021334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | | | | | - M Liñán-López
- Hospital Neurotraumatológico Virgen de las Nieves, Granada, España
| | - M Benito-Lozano
- Hospital Universitario de Canarias, Santa Cruz de Tenerife, España
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de la Mata-Navazo S, Toledo-Del Castillo B, Rodríguez-Jiménez C, Miranda-Herrero MC, Aguado-Del Hoyo A, González-Martínez F. [Sudden paralysis of upward gaze in a 9-year-old girl]. Rev Neurol 2020; 71:387-388. [PMID: 33145750 DOI: 10.33588/rn.7110.2020275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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González-Martínez F, Sánchez-Rodas D, Varela NM, Sandoval CA, Quiñones LA, Johnson-Restrepo B. As3MT and GST Polymorphisms Influencing Arsenic Metabolism in Human Exposure to Drinking Groundwater. Int J Mol Sci 2020; 21:ijms21144832. [PMID: 32650499 PMCID: PMC7402318 DOI: 10.3390/ijms21144832] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/24/2020] [Accepted: 06/24/2020] [Indexed: 01/28/2023] Open
Abstract
The urinary arsenic metabolites may vary among individuals and the genetic factors have been reported to explain part of the variation. We assessed the influence of polymorphic variants of Arsenic-3-methyl-transferase and Glutathione-S-transferase on urinary arsenic metabolites. Twenty-two groundwater wells for human consumption from municipalities of Colombia were analyzed for assessed the exposure by lifetime average daily dose (LADD) (µg/kg bw/day). Surveys on 151 participants aged between 18 and 81 years old were applied to collect demographic information and other factors. In addition, genetic polymorphisms (GSTO2-rs156697, GSTP1-rs1695, As3MT-rs3740400, GSTT1 and GSTM1) were evaluated by real time and/or conventional PCR. Arsenic metabolites: AsIII, AsV, monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA) were measured using HPLC-HG-AFS. The influence of polymorphic variants, LADD and other factors were tested using multivariate analyses. The median of total arsenic concentration in groundwater was of 33.3 μg/L and the median of LADD for the high exposure dose was 0.33 µg/kg bw/day. Univariate analyses among arsenic metabolites and genetic polymorphisms showed MMA concentrations higher in heterozygous and/or homozygous genotypes of As3MT compared to the wild-type genotype. Besides, DMA concentrations were lower in heterozygous and/or homozygous genotypes of GSTP1 compared to the wild-type genotype. Both DMA and MMA concentrations were higher in GSTM1-null genotypes compared to the active genotype. Multivariate analyses showed statistically significant association among interactions gene-gene and gene-covariates to modify the MMA and DMA excretion. Interactions between polymorphic variants As3MT*GSTM1 and GSTO2*GSTP1 could be potential modifiers of urinary excretion of arsenic and covariates as age, LADD, and alcohol consumption contribute to largely vary the arsenic individual metabolic capacity in exposed people.
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Affiliation(s)
- Farith González-Martínez
- Environmental Chemistry Research Group and Public Health Research Group, University of Cartagena, Cartagena 130015, Colombia;
- Latin American Network for Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), 28015 Madrid, Spain;
| | - Daniel Sánchez-Rodas
- Center for Research in Sustainable Chemistry, CIQSO, University of Huelva, 21071 Huelva, Spain;
| | - Nelson M. Varela
- Latin American Network for Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), 28015 Madrid, Spain;
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics (CQF), Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago 8320000, Chile;
| | - Christopher A. Sandoval
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics (CQF), Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago 8320000, Chile;
| | - Luis A. Quiñones
- Latin American Network for Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), 28015 Madrid, Spain;
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics (CQF), Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago 8320000, Chile;
- Correspondence: (L.A.Q.); (B.J.-R.); Tel.: +56-2-297-707-4144 (L.A.Q.); +57-301-363-5979 (B.J.-R.)
| | - Boris Johnson-Restrepo
- Environmental Chemistry Research Group and Public Health Research Group, University of Cartagena, Cartagena 130015, Colombia;
- Correspondence: (L.A.Q.); (B.J.-R.); Tel.: +56-2-297-707-4144 (L.A.Q.); +57-301-363-5979 (B.J.-R.)
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Perdomo-Lara SJ, Buenahora MR, Álvarez E, González-Martínez F, Rebolledo M, Aristizabal FA, Colegial CH, Horta A, Bustillo J, Díaz-Báez D, Ardila CM, Lafaurie GI. Human papilloma virus genotypes in dysplasia and epithelial hyperplasia of oral cavity using the luminex xmap technology. A multicenter study. Med Oral Patol Oral Cir Bucal 2020; 25:e61-e70. [PMID: 31880291 PMCID: PMC6982976 DOI: 10.4317/medoral.23188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 09/16/2019] [Indexed: 02/06/2023] Open
Abstract
Background Oral cancer associated with high risk (HPV-HR) human papilloma virus (HPV) has been increasing. HPV-HR has been associated with epithelial dysplasia, however, little information exists on its frequency in epithelial hyperplasia lesions. The aim of this study is to compare HPV genotypes in dysplastic and hyperplastic lesions of oral cavity.
Material and Methods Two hundred and fifty oral lesions: 131 dysplasia and 119 hyperplasia from two regions of Colombia were evaluated. One hundred seventy-four coming from urban area and 104 from a high risk population to oral cancer from a rural area. HPV was identified by qPCR and Twenty-four HPVs genotypes were evaluated by Luminex® technology. Logistic regressions were performed to establish the associations between HPV infections with oral dysplasia.
Results Twenty-eight percent (70/250) of the samples were positives for any HPV and HPV-HRs were more frequently than low risk HPVs. HPV-16 was the most detected genotype (16%) followed by HPV-31, 53, 18 and 45. HPV, HPV-HRs and HPV-16 were only associated with dysplasia in urban area; OR 3.28 (CI 95% 1.49-7.17), OR 7.94 (CI 95% 2.97-21.2) and OR 5.90 (CI 95% 2.05-17). Individuals in rural area showed more HPV and HPV-HRs infection in hyperplasic lesions than urban population. The majority of HPV+ lesions had multi-type of HPV (52/70) and the urban individuals showed more genotypes than rural population.
Conclusions HPV-.HRs are frequently found in hyperplastic and dysplastic epithelial lesions. HPV-HRs and HPV-16 were associated with dysplasia in urban population. Rural high risk population and urban population differ in the frequency and variety of HPV genotypes. Key words:Human papilloma virus, epithelial dysplasia, epithelial hyperplasia, HPV-genotypes.
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Affiliation(s)
- S-J Perdomo-Lara
- Universidad El Bosque Av. Carrera 9 No. 131 A - 02 Bogotá-Colombia
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González-Martínez F, Sánchez-Rodas D, Cáceres DD, Martínez MF, Quiñones LA, Johnson-Restrepo B. Arsenic exposure, profiles of urinary arsenic species, and polymorphism effects of glutathione-s-transferase and metallothioneins. Chemosphere 2018; 212:927-936. [PMID: 30286549 DOI: 10.1016/j.chemosphere.2018.08.139] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 05/02/2018] [Revised: 08/13/2018] [Accepted: 08/27/2018] [Indexed: 06/08/2023]
Abstract
This study assessed the effects of polymorphic variants of gutathione-S-transferase and metallothioneins on profiles of urinary arsenic species. Drinking groundwater from Margarita and San Fernando, Colombia were analyzed and the lifetime average daily dose (LADD) of arsenic was determined. Specific surveys were applied to collect demographic information and other exposure factors. In addition, GSTT1-null, GSTM1-null, GSTP1-rs1695 and MT-2A-rs28366003 genetic polymorphisms were evaluated, either by direct PCR or PCR-RFLP. Urinary speciated arsenic concentrations were determined by HPLC-HG-AFS for species such as AsIII, AsV, monomethylarsonic acid (MMA), dimethylarsinic acid (DMA), and total urinary As (TuAs). Primary methylation index (PMI) and secondary methylation index (SMI) were also calculated as indicators of the metabolic capacity. Polymorphisms effects were tested using multivariate analysis, adjusted by potential confounders. The As concentrations in groundwater were on average 34.6 ± 24.7 μg/L greater than the WHO guideline for As (10 μg/L). There was a correlation between As concentrations in groundwater and TuAs (r = 0.59; p = 0.000). Urinary inorganic arsenic (%InAs) was associated with GSTP1, LADD, GSTP1*Age, GSTP1*alcohol consumption (r2 = 0.43; likelihood-ratio test, p = 0.000). PMI was associated with sex (r2 = 0.20; likelihood-ratio test, p = 0.007). GSTP1 (AG + GG) homozygotes/heterozygotes could increase urinary %InAs and decrease the PMI ratio in people exposed to low and high As from drinking groundwater. Therefore, the explanatory models showed the participation of some covariates that could influence the effects of the polymorphisms on these exposure biomarkers to As.
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Affiliation(s)
- Farith González-Martínez
- Public Health Research Group, School of Dentistry, Campus of Zaragocilla, University of Cartagena, Cartagena 130015, Colombia; Environmental Chemistry Research Group, School of Exact and Natural Sciences, Campus of San Pablo, University of Cartagena, Cartagena 130015, Colombia
| | - Daniel Sánchez-Rodas
- Center for Research in Sustainable Chemistry, CIQSO, University of Huelva, Huelva 21071, Spain
| | - Dante D Cáceres
- Institute of Population Health, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Matías F Martínez
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics (CQF), Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile
| | - Luis A Quiñones
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics (CQF), Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile.
| | - Boris Johnson-Restrepo
- Environmental Chemistry Research Group, School of Exact and Natural Sciences, Campus of San Pablo, University of Cartagena, Cartagena 130015, Colombia.
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González-Martínez F, Tirado-Amador L, Bueno-Hernández J, Chica-Duque B, Díaz-Narváez VP. Changes in Empathy Levels on Dentistry’s Students of Public University in Cartagena City, Colombia. Pesqui bras odontopediatria clín integr 2018. [DOI: 10.4034/pboci.2018.181.44] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Orihuela S, Nin M, San Román S, Noboa O, Curi L, Silvariño R, González-Martínez F. Successful Pregnancies in Kidney Transplant Recipients: Experience of the National Kidney Transplant Program From Uruguay. Transplant Proc 2016; 48:643-5. [PMID: 27110021 DOI: 10.1016/j.transproceed.2016.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Renal transplantation increases the possibilities of pregnancy in women of reproductive age. The course of pregnancy was analyzed retrospectively in patients with kidney or kidney-pancreas transplant, surveying maternal-fetal or renal graft complications and the relation with pre-pregnancy renal function. METHODS A cohort that includes all the kidney transplant recipients who went through pregnancy in Uruguay in a period of 28 years is described. Forty pregnancies in 32 patients were registered; the average time between the kidney transplant and the beginning of the gestation period was 47 months. From the total gestations, 10 abortions, 1 neonatal death, and 1 fetal demise were registered. From the remaining pregnancies, we highlight prematurity (18/29) and low birth weight (14/21). Twenty-nine in 30 pregnancies ended in cesarean section; in 8 of 30, pre-eclampsia diagnosis was performed. Acute rejection was diagnosed in 2 of 30 pregnancies, both undergoing their first post-transplant year. RESULTS Two patients required dialysis throughout the pregnancy because of progress into severe renal insufficiency. Higher obstetric perinatal morbidity and renal function deterioration was related to lower pre-pregnancy glomerular filtration rate (GFR). CONCLUSIONS A successful pregnancy is possible in transplant recipients, yet there are risks of prematurity, low birth weight, and abortion. A lower GFR before pregnancy was associated with poorer maternal and perinatal results as shown in the different series.
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Affiliation(s)
- S Orihuela
- Nephrology and Urology Institute, Montevideo, Uruguay
| | - M Nin
- Nephrology and Urology Institute, Montevideo, Uruguay; Department of Nephrology, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay.
| | - S San Román
- Department of Nephrology, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - O Noboa
- Department of Nephrology, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - L Curi
- Nephrology and Urology Institute, Montevideo, Uruguay
| | - R Silvariño
- Department of Nephrology, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - F González-Martínez
- Nephrology and Urology Institute, Montevideo, Uruguay; Department of Nephrology, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
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Madera-Anaya M, Tirado-Amador L, González-Martínez F. [Empathy-related factors in Nursing students of the Cartagena University]. Enferm Clin 2016; 26:282-9. [PMID: 27453491 DOI: 10.1016/j.enfcli.2016.06.004] [Citation(s) in RCA: 14] [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: 01/17/2016] [Revised: 06/04/2016] [Accepted: 06/06/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine empathy levels and its relationship with sociodemographic, academic and family factors in nursing students. METHOD Cross-sectional study, 196 nursing students were randomly selected at the University of Cartagena, Colombia. A questionnaire that asked about sociodemographic, family and academic factors and the Scale of Physician Empathy Jefferson-version S were applied. Shapiro-Wilk test was used to assess the normality assumption. t Student, ANOVA, Pearson test and simple linear regression were used to establish the relationship (p<0.05). RESULTS The global empathy score was 108.6±14.6; statistically significant associations between global empathy with the training year (p=0.004) and grade point average (R(2)=0.058; p=0.001; r=0.240) were found. Moreover, the "perspective taking" dimension with provenance (rural/urban) (p=0.010) and family functioning (p=0.003); the "compassionate care" dimension with the training year (p=0.002) and the "putting themselves in the place of the patient" dimension with academic performance (p=0.034). CONCLUSION The empathy levels in nursing students may vary depending on various personal and academic factors,these characteristics should be taken into account for implementing teaching strategies to promote higher empathy levels since the early training years.
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Affiliation(s)
- Meisser Madera-Anaya
- Centro de Excelencia CIGES, Universidad de La Frontera, Temuco, Chile; Grupo de Salud Pública (GISPOUC), Universidad de Cartagena, Cartagena, Colombia.
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Nin M, Coitiño R, Kurdian M, Orihuela L, Astesiano R, Garau M, López D, Rievas G, Rodriguez I, González-Martínez F, Noboa O. Acute Antibody-Mediated Rejection in Kidney Transplant Based on the 2013 Banff Criteria: Single-Center Experience in Uruguay. Transplant Proc 2016; 48:612-5. [PMID: 27110014 DOI: 10.1016/j.transproceed.2016.03.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Acute antibody-mediated rejection (AMR) diagnosis criteria have changed in recent consensus of Banff, with current evidence of C4d-negative AMR. Our objective was to evaluate incidence of AMR in renal transplantation according to Banff 2013 criteria and to examine the histological features and outcome. METHODS This retrospective study involved all kidney transplants with histological diagnosis of acute rejection (AR) at our center between 2000 and 2014. All the biopsies with AR were re-assessed by a nephro-pathologist and classified by use of the Banff 2013 criteria. RESULTS Of 205 kidney transplants, biopsy-proven AR was diagnosed in 25 cases (12%). Re-assessing them according to Banff 2013 criteria, AMR was diagnosed in 17 (8.3%) and represented 68% of the confirmed rejections. AMR diagnosis was performed on day 23 ± 26, with median of 11 days. From the 17 cases, 7 had concomitant T-cell-mediated rejection. All cases presented endothelial edema and acute tubular necrosis. Glomerulitis was found in 12 cases and capillaritis in 14. In 3, associated thrombotic micro-angiopathy (TMA) was found. Intimal and transmural arteritis was evidenced in 5 and 1 patient. In 2, transplant glomerulopathy was present. Seven of the 10 biopsies with C4d staining in the peri-tubular capillaries were positive. Twelve cases received plasmapheresis, 6 received gamma-globulin, and 6 received rituximab. After administration of anti-AMR therapy, 16 cases recovered renal function, reaching a serum creatinine level of 1.5 ± 0.6 mg %. Graft survival at 1 year was lower in the AMR group versus patients without AMR (81.9% vs 98.9%, log-rank test, P < .001). Risk factors for AMR were re-transplant (30% vs 7%, P = .02), HLA-DR mismatch (1.06 ± 0.65 vs 0.7 ± 0.6, P = .03), panel-reactive antibody (28% ± 33 vs 6.2 ± 13, P = .00), and delayed graft function (82% vs 30%, P = .00). CONCLUSIONS Adapting the new Banff 2013 criteria increased the sensitivity of the diagnosis of ARM. Regarding our data, despite an adequate response to the therapy, it resulted in a worse graft survival by the first year of renal transplant.
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Affiliation(s)
- M Nin
- Department of Nephrology, Hospital de Clinicas, Universidad de la República, Montevideo, Uruguay.
| | - R Coitiño
- Department of Nephrology, Hospital de Clinicas, Universidad de la República, Montevideo, Uruguay
| | - M Kurdian
- Department of Nephrology, Hospital de Clinicas, Universidad de la República, Montevideo, Uruguay
| | - L Orihuela
- Department of Nephrology, Hospital de Clinicas, Universidad de la República, Montevideo, Uruguay
| | - R Astesiano
- Department of Nephrology, Hospital de Clinicas, Universidad de la República, Montevideo, Uruguay
| | - M Garau
- Department of Nephrology, Hospital de Clinicas, Universidad de la República, Montevideo, Uruguay
| | - D López
- Department of Nephrology, Hospital de Clinicas, Universidad de la República, Montevideo, Uruguay
| | - G Rievas
- Department of Hemoterapia, Hospital de Clinicas, Universidad de la República, Montevideo, Uruguay
| | - I Rodriguez
- Department of Hemoterapia, Hospital de Clinicas, Universidad de la República, Montevideo, Uruguay
| | - F González-Martínez
- Department of Nephrology, Hospital de Clinicas, Universidad de la República, Montevideo, Uruguay
| | - O Noboa
- Department of Nephrology, Hospital de Clinicas, Universidad de la República, Montevideo, Uruguay
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Orihuela S, Curi L, Nin M, Manzo L, Gonzalez G, Nuñez N, Kurdian M, Cuñeti L, Larre Borges P, González-Martínez F. First 1500 Kidney Transplants at the Institute of Nephrology and Urology in Uruguay: Analysis of the Results. Transplant Proc 2016; 48:616-9. [PMID: 27110015 DOI: 10.1016/j.transproceed.2016.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The Institute of Nephrology and Urology (INU) has performed 75% of kidney transplantations (KT) in Uruguay during its 35 years of activity, with 90.6% from cadaveric donors. We investigated the risk factors (RF) for delayed graft function (DGF) and patient and graft survival (SV). METHODS We analyzed retrospectively the characteristics and evolution of 1500 KT performed by INU until December 2014. The incidence of DGF and RF for patient and graft SV were analyzed in 4 eras, according to the year that KT was performed. RESULTS The number of KT per year has progressively increased until reaching 40 KT per million population in 2006, with a decrease of the living donor KT (LDKT) rate. The age of the donors (D) and recipients (R) as well as the time on dialysis (TOD) have progressively increased over the different eras. Five hundred twenty-five R (35%) presented with DGF. The RF for DGF were the age of the R and the D, the TOD, the DDKT, and the warm ischemia time (WIT). In the DDKT group, the cold ischemia time and "died of stroke" were added factors. The death-censored graft SV at 1, 5, 10, and 15 years were 90%, 76%, 62%, and 49%, respectively. They improved as from era I, the patient SV being 92%, 83%, and 75% at 1, 5, and 10 years, in era I; 98%, 93%, and 86% in era II; 98%, 92%, and 83% in era III; and 95% and 90% at 1 and 5 years in era IV (P < .001). The graft SV over the same periods was 76%, 58%, and 40% in era I; 88%, 68%, and 52% in era II; 93%, 81%, and 70% in era III; and 93% and 85% at 1 and 5 years in era IV (P < .0001). The RF for patient SV were diabetes mellitus, era I, lower albuminemia, older age or TOD, and DGF. For kidney SV, the era, the age of the R, TOD, DGF, and D older than 60 years were RF associated with a worse evolution. In DDKT, the RF for the graft SV were the era, younger age of the R, and DGF. The group with the worst graft SV was the one made up of children and adolescents. CONCLUSIONS Our results relating to patient and graft SV are acceptable and comparable to those mentioned on large records such as the OPNT/SRTR and the Collaborative Transplant Study. This has been the case, even though we have transplanted increasingly aged patients, with increasingly aged donors, or donors with associated pathology. The risk factors that we found both for DGF and SV have also been pointed out by other authors. The validity of some findings has the limitation of being from a retrospective analysis; hence, they should be corroborated by a prospective study.
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Affiliation(s)
- S Orihuela
- Nephrology and Urology Institute, Montevideo, Uruguay.
| | - L Curi
- Nephrology and Urology Institute, Montevideo, Uruguay
| | - M Nin
- Nephrology and Urology Institute, Montevideo, Uruguay
| | - L Manzo
- Nephrology and Urology Institute, Montevideo, Uruguay
| | - G Gonzalez
- Nephrology and Urology Institute, Montevideo, Uruguay
| | - N Nuñez
- Nephrology and Urology Institute, Montevideo, Uruguay
| | - M Kurdian
- Nephrology and Urology Institute, Montevideo, Uruguay
| | - L Cuñeti
- Nephrology and Urology Institute, Montevideo, Uruguay
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González-Martínez F, Orihuela S, Alvarez I, Dibello N, Curi L, Nin M, Wimber E, Mizraji R, Bengochea M, González G, Manzo L, Toledo R, Silva W, Chopitea Á, Lopez D, Balboa O, Porto D, Noboa O. Development of the National Kidney Transplantation Program in Uruguay. Transplant Proc 2015; 47:2336-9. [PMID: 26518920 DOI: 10.1016/j.transproceed.2015.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The first kidney transplantation (KT) in Uruguay was performed in 1969. We report the rates of KT and survival of patients and grafts up to December 2014. The country has a surface of 176,215 km(2) and a population of 3,286,314 inhabitants (18.6 inhabitants per km(2)). Till December 31, 2014, 1,940 KT have been performed in Uruguay (41.8 pmp that year); 90.4% of them were from cadaveric donors (CD). Median age of recipients (R) was 44 ± 14 years; R older than 55 years increased from 0 to 27% during the period. Our pre-emptive KT program started in 2007. Optimal donors (D) decreased from 65.2% to 35.5%, and D older than 45 years old increased from 9% to 37%. Trauma as cause of death decreased from 49% to 32% and stroke as cause of death increased from 25% to 39%. Patient survival rates at 1, 5, and 8 years were 93%, 87%, and 78%, respectively for KT performed between 1980 and 1989; they were 98%, 93%, and 89%, respectively, for KT performed between 1990 and1999; they were 97%, 91%, and 90%, respectively, for KT performed between 2000 and 2010. In December 2013, there were 1098 patients pmp in renal replacement therapy, 758 pmp in dialysis, and 340 pmp (30.9%) with a functioning graft. Our national KT program is mainly based (90.6%) on cadaveric donation. Epidemiological changes in the characteristics of R and D followed the changes in aging that occurred in the general population and the dialysis population. The survival rates from patients and kidneys are similar to those reported by the European and the American registries.
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Affiliation(s)
- F González-Martínez
- Department of Nephrology, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Nephrology and Urology Institute, Montevideo, Uruguay.
| | - S Orihuela
- Nephrology and Urology Institute, Montevideo, Uruguay
| | - I Alvarez
- National Institute of Donation and Transplantation, Universidad de la República and Ministerio de Salud Pública, Montevideo, Uruguay
| | - N Dibello
- Evangelical Hospital, Montevideo, Uruguay
| | - L Curi
- Nephrology and Urology Institute, Montevideo, Uruguay
| | - M Nin
- Department of Nephrology, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Nephrology and Urology Institute, Montevideo, Uruguay; Ablation Team, Montevideo, Uruguay
| | - E Wimber
- Evangelical Hospital, Montevideo, Uruguay
| | - R Mizraji
- National Institute of Donation and Transplantation, Universidad de la República and Ministerio de Salud Pública, Montevideo, Uruguay
| | - M Bengochea
- National Institute of Donation and Transplantation, Universidad de la República and Ministerio de Salud Pública, Montevideo, Uruguay
| | - G González
- Nephrology and Urology Institute, Montevideo, Uruguay; Ablation Team, Montevideo, Uruguay
| | - L Manzo
- Nephrology and Urology Institute, Montevideo, Uruguay; Ablation Team, Montevideo, Uruguay
| | - R Toledo
- National Institute of Donation and Transplantation, Universidad de la República and Ministerio de Salud Pública, Montevideo, Uruguay
| | - W Silva
- Department of Nephrology, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Nephrology and Urology Institute, Montevideo, Uruguay; Evangelical Hospital, Montevideo, Uruguay
| | - Á Chopitea
- Nephrology and Urology Institute, Montevideo, Uruguay; Ablation Team, Montevideo, Uruguay
| | - D Lopez
- Department of Nephrology, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Evangelical Hospital, Montevideo, Uruguay
| | - O Balboa
- Nephrology and Urology Institute, Montevideo, Uruguay
| | - D Porto
- Nephrology and Urology Institute, Montevideo, Uruguay
| | - O Noboa
- Department of Nephrology, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
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González-Martínez F, Curi L, González-Carballido G, Núñez N, Manzo L, Kurdián M, Larre Borges P, Nin M, Orihuela S. Preemptive kidney transplantation--a team experience in Uruguay. Transplant Proc 2014; 46:2984-6. [PMID: 25420806 DOI: 10.1016/j.transproceed.2014.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Kidney transplantation is the best treatment for end-stage chronic renal disease. In Uruguay, the prevalence of patients on dialysis is 757 patients per millon inhabitants, plus 316 alive with a functioning renal graft. We install a preemptive renal transplantation program. Twenty-five patients received grafts without dialysis from 2004 to 2013, 5 receiving their 2nd transplantation and 17 from cadaveric donors, with 7.4 ± 7.7 months in the waiting list. At 24 months, patients' survival rate was 100% and the grafts' 97%, with a serum creatinine of 1.4 ± 0.6 mg%. The developed programs of dialysis and renal health care contributed install our preemptive kidney transplantation. Kidney transplantation should be proposed to selected patients with chronic renal failure as primary therapy of substitution of renal function.
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Affiliation(s)
- F González-Martínez
- Institute of Nephrology and Urology, School of Medicine, Universidad de la República, Montevideo, Uruguay.
| | - L Curi
- Institute of Nephrology and Urology, School of Medicine, Universidad de la República, Montevideo, Uruguay
| | - G González-Carballido
- Institute of Nephrology and Urology, School of Medicine, Universidad de la República, Montevideo, Uruguay
| | - N Núñez
- Institute of Nephrology and Urology, School of Medicine, Universidad de la República, Montevideo, Uruguay
| | - L Manzo
- Institute of Nephrology and Urology, School of Medicine, Universidad de la República, Montevideo, Uruguay
| | - M Kurdián
- Institute of Nephrology and Urology, School of Medicine, Universidad de la República, Montevideo, Uruguay
| | - P Larre Borges
- Institute of Nephrology and Urology, School of Medicine, Universidad de la República, Montevideo, Uruguay
| | - M Nin
- Institute of Nephrology and Urology, School of Medicine, Universidad de la República, Montevideo, Uruguay
| | - S Orihuela
- Institute of Nephrology and Urology, School of Medicine, Universidad de la República, Montevideo, Uruguay
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Divaris K, Polychronopoulou A, Villa-Torres L, Mafla AC, Moya GA, González-Martínez F, Vila-Sierra LA, Fortich-Mesa N, Gómez-Scarpetta RÁ, Duque-Restrepo LM. Extracurricular Factors Influence Perceived Stress in a Large Cohort of Colombian Dental Students. J Dent Educ 2014. [DOI: 10.1002/j.0022-0337.2014.78.2.tb05672.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Kimon Divaris
- Department of Pediatric Dentistry; School of Dentistry, University of North Carolina at Chapel Hill; United States
| | - Argy Polychronopoulou
- Department of Preventive and Community Dentistry; University of Athens School of Dentistry; Athens Greece
| | - Laura Villa-Torres
- Department of Health Behavior; Gillings School of Global Public Health, University of North Carolina at Chapel Hill; United States
| | - Ana Cristina Mafla
- Universidad Cooperativa de Colombia-Pasto School of Dentistry; Pasto Colombia
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Divaris K, Polychronopoulou A, Villa-Torres L, Mafla AC, Moya GA, González-Martínez F, Vila-Sierra LA, Fortich-Mesa N, Gómez-Scarpetta RÁ, Duque-Restrepo LM. Extracurricular factors influence perceived stress in a large cohort of Colombian dental students. J Dent Educ 2014; 78:213-225. [PMID: 24489029] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The aim of this study was to investigate the association of extracurricular factors including socioeconomic status and career choice with perceived stress in dental school in a large cohort of Colombian dental students. Participants in the study were 5,700 students enrolled in seventeen Colombian dental schools. The study employed a Spanish adaptation of the Dental Environment Stressors (DES30-Sp) questionnaire and recorded an array of demographic, socioeconomic, career choice, and dental studies-related information. Data analyses relied on descriptive, bivariate, and multivariate methods based on multi-level mixed-effects linear regression and post hoc estimation of predictive margins. "Fear of failing a course or year" emerged as the highest ranked item. Male students consistently reported less perceived stress than females, and stress scores were higher among seniors. Independent of gender, age, and study year, having dentistry as one's first career choice, relying on financial support, and belonging to higher socioeconomic strata were associated with lower stress levels. Academic environment interventions aimed to improve students' educational well-being will need to account for the individual heterogeneity among them. These data from a robust cohort of predoctoral dental students underscore the importance of considering students' educational experiences in a broader social and economic context.
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Affiliation(s)
- Kimon Divaris
- 228 Brauer Hall, Department of Pediatric Dentistry, School of Dentistry, CB#7450, University of North Carolina, Chapel Hill, NC 27599-7450;.
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Arrieta-Vergara KM, González-Martínez F, Luna-Ricardo L. Exploración del riesgo para fluorosis dental en niños de las clínicas odontológicas universidad de Cartagena. Rev Salud Publica (Bogota) 2011. [DOI: 10.1590/s0124-00642011000400012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Ramos-Martinez K, González-Martínez F, Luna-Ricardo L. [Oral and nutritional health status in children attending a school in Cartagena, 2009]. Rev Salud Publica (Bogota) 2010; 12:950-960. [PMID: 22030682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/19/2010] [Accepted: 12/01/2010] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Describing the association between the nutritional and oral health status of children attending a school in Cartagena, Colombia. METHOD This was a descriptive, cross-sectional study. The sample consisted of 180 children between aged 5 to 12. Malnutrition was assessed by anthropometric and biochemical tests, a questionnaire was used for ascertaining theirdiets andgingival disease, changes in soft tissues, dental caries, enamel abnormalities and oral hygiene status were measured clinically. Descriptive statistics involved frequency distributions. Disease prevalence was estimated for inferring the results; odds ratios(OR)were used for assessing the strength of association between variables (95 % confidence interval)and the X² test was used determining statistical significance. RESULTS 2 % (0.0-4.4 95 % CI)chronic malnutrition was found. The most prevalent oral diseases were dental caries (82 %;77-88 95 % CI), periodontal disease (66 %;59-73 95 % CI), fluorosis (30 %; 23-37 95 % CI), hypocalcification (11 %; 6-15 95 % CI) and hypoplasia (6 %;3-10 95 % CI). Malnutrition and hypoplasia and the risk of malnutrition andfluorosis had the highest estimates of association (OR=18.5; 2.33-147.2 95 % CI; p=0.000 and OR=2.63;1.02-6.76 95 % CI;p=0.04, respectively). CONCLUSIONS A direct association between malnutrition and oral pathologies could not be determined;alterationssuch as fluorosis and hypoplasia could be influenced by malnutrition.
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Affiliation(s)
- Ketty Ramos-Martinez
- Departamento de Odontología Preventiva y Social, Facultad de Odontología, Universidad de Cartagena, Colombia.
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Díaz-Cárdenas S, González-Martínez F. Prevalencia de caries dental y factores familiares en niños escolares de Cartagena de Indias, Colombia. Rev Salud Publica (Bogota) 2010; 12:843-51. [DOI: 10.1590/s0124-00642010000500014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2010] [Accepted: 12/10/2010] [Indexed: 11/21/2022] Open
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González-Martínez F, Sánchez-Pedraza R, Carmona-Arango L. [Risk indicators for dental caries in preschool children from La Boquilla, Cartagena]. Rev Salud Publica (Bogota) 2010; 11:620-30. [PMID: 20169218 DOI: 10.1590/s0124-00642009000400013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2008] [Accepted: 07/12/2009] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Describing the occurrence of dental caries in preschool children from the Boquilla neighbourhood in Cartagena and relating it to risk factors reported in the medical literature. METHODS The sample consisted of 238 preschool children aged 3 to 5. Average age was 4.1. Regarding gender, there were 116 boys and 122 girls. The children were individually selected in a probabilistic way, bearing in mind the size of the population from the chosen educational institution; a questionnaire and clinical instrument were used. The data was analysed according to outcome using Odd ratios for bivariate analysis and logistical regression for multivariable analysis. RESULTS Caries prevalence was 60 %, mainly occurring amongst 5 year old children. The major risk factors observed were parents having not progressed to more than secondary level studies and a background of caries. A 26.6 OR was obtained at the moment of adjusting the logistical regression estimators for having a background of caries, 3.37 OR for daily candy consumption and 2.17 OR for non-exposure to fluorides. CONCLUSIONS The presence of caries in this population could be explained by means of the three associated risk factors mentioned above. This evidence may become changed when other circumstances, moments and places are involved in children having the same characteristics.
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Furuya MEY, González-Martínez F, Vargas MH, Miranda-Novales MG, Bernáldez-Ríos R, Zúñiga-Vázquez G. Guidelines for diagnosing and treating pulmonary infiltrates in children with acute leukaemia: impact of timely decisions. Acta Paediatr 2008; 97:928-34. [PMID: 18430068 DOI: 10.1111/j.1651-2227.2008.00808.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Children with leukaemia are at increased risk of pulmonary complications, often with unspecific clinical data, delayed diagnosis and a high mortality rate. We evaluated the usefulness of diagnostic-therapeutic guidelines (DTG) in which specific times for decision making were incorporated. METHODS Clinical charts of children with acute leukaemia and suspicion of pulmonary involvement were reviewed. Patients were allocated to group I if their diagnostic and therapeutic decisions were in accordance with the DTG, and to group II if not. RESULTS Children from group I (n=32) and group II (n=28) did not differ with respect to age (9.3+/-0.5 years old, mean+/-SEM), gender, type, risk and stage of leukaemia, anaemia and neutropenia. Total length of hospital stay and hospitalization due to the pulmonary disease were shorter in group I than in group II (14.8+/-2.1 vs. 28.5+/-3.7 days, p=0.0016; and 10.8+/-1.0 vs. 18.4+/-1.8 days, p=0.0003, respectively). Two patients (6.3%) died due to the pulmonary pathology in group I, and nine (32.1%, p=0.016) in group II. CONCLUSIONS Diagnostic-therapeutic guidelines that incorporate timely decisions constitute a useful algorithm to reduce the length of hospital stay and mortality in children with acute leukaemia and pulmonary infiltrates. A prospective study is needed to validate these results.
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Affiliation(s)
- M E Y Furuya
- Unidad de Investigación Médica en Enfermedades Respiratorias, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México DF, México.
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González-Martínez F, de León-Belmar J, Navarro-Gutierrez S, Herráiz-de Castro C, Montero-López L, Liaño-Martínez H. [Lowered incidence of post-lumbar puncture headache following the application of the second edition of the International Headache Society classification]. Rev Neurol 2005; 41:582-6. [PMID: 16288419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
INTRODUCTION In 1988 the International Headache Society (IHS) published the 1st edition of its headache classification and the 2nd edition was completed in 2003. AIM. To determine whether there exist changes in the incidence of post-lumbar puncture headache depending on the edition of the IHS classification. PATIENTS AND METHODS Between 2002 and 2003 data was gathered prospectively for 78 patients who were submitted to a diagnostic lumbar puncture, 40 obstetric spinal anaesthesias and 516 non-obstetric spinal anaesthesias. The 1st edition was used and, after the appearance of the 2nd edition, the cases were recoded. RESULTS With the 1st edition, there were 31 out of 78 cases (39.7%) of post-puncture headache in diagnostic punctures, and when the 2nd edition was used, the number dropped to 10 cases (12.8%). The incidence of headache among patients who had undergone obstetric spinal anaesthesia was six cases out of a total of 40 (15%) using the 1st edition, and four cases with the 2nd edition (10%). The incidence of headache among patients after non-obstetric spinal anaesthesia was 80 cases out of a total of 516 (15.5%) when the 1st edition was utilised and 25 cases with the 2nd edition (4.85%). CONCLUSIONS To compare the incidences of post-lumbar puncture headaches obtained by diverse observers we need to know which edition was used, since there are considerable differences between the results obtained using one edition or the other. The main reason accounting for the discrepancy between the two editions is the compulsory association of some accompanying sign, since this was not a necessary criterion in the 1st edition but it is included in the 2nd.
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González-Martínez F, Curi L, Núñez H, González AC, Orihuela N, González G, Orihuela S. Counting of lymphocyte subpopulations using standard versus low-dose antiCD3 monoclonal antibody treatment. Transplant Proc 2004; 36:1659-60. [PMID: 15350443 DOI: 10.1016/j.transproceed.2004.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The monoclonal anti-CD3 antibody is used as part of prophylaxis and also in treatment of rejection. In the present article we analyzed changes in different lymphocyte subpopulations after anti-CD3 treatment. T lymphocytes were decreased under anti-CD3 antibody administration, with a simultaneous increase in B lymphocytes but no changes in natural killer (NK)cells. No differences were found between patients administered anti-CD3 antibody (Ab) at 5 versus 2.5 mg/d. It is uncertain whether these changes may be implicated in the lack of response or in the prophylactic effects of anti-CD3 Ab.
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Affiliation(s)
- F González-Martínez
- Instituto de Nefrologia y Urologia, and Centro de Nefrologia, Facultad de Medicina, Montevideo, Uruguay.
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González-Martínez F, Curi L, Orihuela S, González G, Núñez N, Nin M. Cardiovascular disease and/or elderly donors in renal transplantation: The outcome of grafts and patients. Transplant Proc 2004; 36:1687-8. [PMID: 15350453 DOI: 10.1016/j.transproceed.2004.07.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Kidney transplant programs nowadays increasingly use elderly, hypertensive and cardiac disease donors (expanded criteria donors). The impact of these donors on patient and graft outcome was investigated in our transplant population. Among 257 consecutive cadaveric kidney transplants, 56 were from expanded criteria donors. The frequency of anuria, delayed graft function, and the days of renal failure were higher using organs from the expanded criteria donor group. Serum creatinine was higher in this group, although the statistical significance disappeared at 36 months. There were no significant differences in graft or patient survival during the first 3 years. The use of expanded criteria donors should not be discouraged, but recipient selection and immunosuppression use should be adapted and cold ischemia minimized.
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Mazzuchi N, González C, González-Martínez F, Schwedt E, Correa A, Correa F, Fernández-Cean J. [Significance of comorbidity in the control of the quality of treatment of dialysis patients]. Nefrologia 2001; 21:471-5. [PMID: 11795016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
The Uruguayan Dialysis Registry (UDR) is an obligatory registry and includes all the patients on dialysis treatment in the country. The dialysis prevalence rate at 12-31-1997 was 604 pmp and the mortality rate in 1997 was 132 deaths per 1,000 patient years at risk. Adjusted mortality of each dialysis center in the country (n = 35) is calculated every year. In this paper, mortality in the different centers was compared applying the usual methodology in order to identify centers with higher mortality and the importance of comorbidity m the mortality comparison among centers was analyzed. 1. The prevalent and incident population of the 1992-1996 period was considered (n 2989). The mortality rate of each dialysis center, adjusted for age and nephropathy by indirect standardization, was calculated. The prevalent and incident population (1985-1991) of the UDR was used as standard. Standardized mortality rate (SMR) for each center and for the total population was obtained dividing observed deaths by expected deaths. 2. The prevalent population at january 1, 1994 was considered (n 1131) and the observation period was extended from january 1, 1994 to december 31, 1997. Demographic and co-morbidity data were collected at the start of the observation period. Multivariate analysis of survival was applied to identify significant risk factors (Cox hazard regression model). The mortality rate of each dialysis center was adjusted for the significant risk factors. Seven centers had significant higher mortality rate adjusted for age and nephropathy than the average of the standard population. Four year survival in the 7 centers (51.6%) was lower than in the other 28 centers (63.6%) (p = 0.0001). In the multivariate analysis, 5 variables (age, diabetes, arteriosclerotic heart disease, cerebrovascular disease and peripheral vascular disease) were significantly related with mortality. The relative risk of death, adjusted for the five significant risk factors showed higher significant mortality only in four centers. Three centers did not show mortality differences with the other centers when mortality was analyzed in the multivariate analysis with the significant risk factors. We concluded that adjusting the mortality rate to the significant risk factors allow to discriminate if the differences observed among centers are related or not to an unequal distribution of the risk factors.
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Affiliation(s)
- N Mazzuchi
- Instituto de Nefrología y Urología Ramón y Cajal 2550 Montevideo 11600 C.C. 16217 Uruguay.
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González C, Fernández-Cean J, González-Martínez F, Schwedt E, Mazzuchi N. [Chronic dialysis in Uruguay: mortality trends from 1981 to 1998]]. Nefrologia 2001; 21:342-8. [PMID: 11816509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Uruguay is a developing country with 3.16 million inhabitants. Chronic dialysis treatment (CDT) expanded after the creation of a National Fund of Resources in 1980 who receives contribution from all inhabitants to finance, among others, the CDT and renal transplantation. During the 1981-1998 period, about 4,819 patients were treatment, 2,365 patients had died, 454 were transplanted and 51 patients were lost to follow-up due to change in residence. At the start of the treatment, mean age was 57.0 +/- 17.7 years, 37% were 65 or older than 65 year old, 61.3% were male and 98% of patients were white persons. The most common diseases responsible for End Stage Renal Disease were: hypertension (22%), chronic glomerulonephritis (19%) and diabetic nephropathy (15%). In 1998, there were 44 dialysis units in the country (13.6 units per million population--pmp), 100% of them had water treatment (reverse osmosis 96.8%) and reuse dialyzer. The most frequent causes of death were: cardiovascular and infection. In this paper, eighteen years of the mortality time course of CDT are analyzed. Annual mortality rate was expressed as deaths per 1,000 patients years at risk (M/1,000). The indirect standardization method was applied to adjust the mortality rate. Two populations were used as standard: the 1996 population of USRDS to adjust for age, sex, race and nephropathy and the 1996 Uruguayan general population to adjust for age. Standardized mortality rate (SMR) for each year was obtained dividing observed deaths by expected deaths. From 1981 to 1998, the incident population increased from 32 to 133 patients per million populations and the prevalent population from 28 to 639 pmp. There was a simultaneously increase in the prevalence of diabetic patients and of patients older than 65 years. The annual mortality rate decreased from 249 to 138 deaths per 1,000 patient years (M/1,000). The standardized mortality (SM) with the USRDS population as standard decreased from 452 in 1981 to 132 in 1998 and the SMR from 2.07 to 0.60. The SMR with the Uruguayan general population decreased from 17 to 4. In conclusion, these results are similar with those observed in developed countries. There has been a decrease both in the gross and the standardized mortality ratio in the period of observation.
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Affiliation(s)
- C González
- Instituto de Nefrología y Urología Ramón y Cajal 2546 Montevideo 11600, C. C. 16217 Uruguay.
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Mazzuchi N, González-Martínez F, Carbonell E, Curi L, Fernández-Cean J, Orihuela S. Comparison of survival for haemodialysis patients vs renal transplant recipients treated in Uruguay. Nephrol Dial Transplant 1999; 14:2849-54. [PMID: 10570086 DOI: 10.1093/ndt/14.12.2849] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Our aim was to compare survival among renal transplant recipients and haemodialysis patients treated in Uruguay. METHODS All the patients transplanted in Uruguay (n=460) and all the patients who started haemodialysis (HD) in three centres in Uruguay (n=695) from 01 January 1981 to 31 December 1998 were included. Overall survival, adjusted survival and survival of the patients in the low-risk group were compared for HD patients and renal transplant recipients. Diabetic and non-diabetic patients were considered independently. The low-risk group was defined by the absence of any significant risk factor related to mortality on the Cox proportional hazard regression model (age more than 55 years at start of HD, previous history of diabetes, heart disease, cancer, and smoking habit). The significant variables were also used to adjust the survival curve. RESULTS Overall survival was significantly greater in renal transplant recipients (P<0.0001). One-, five- and ten-year survival rates were 95.2, 88.0 and 78.8% for renal transplant recipients and 90.6, 62.7 and 39.8% for HD patients. In non-diabetic patients, adjusted survival rates (for age, heart disease, cancer, and smoking habit) were similar in renal transplant recipients and HD patients (P=0.8713). In the low-risk group as well, significant differences in survival between renal transplant recipients (n=289) and HD patients (n=134) were not observed (P=0.2312). Ten-year survival rates were 82.6 and 87.9% respectively. In diabetic patients 5-year survival rates adjusted for heart disease, smoking habit, and chronic pulmonary disease were 89.2% for renal transplant recipients and 40.9% for HD patients (P=0. 0168) The relative risk of haemodialysis patients related to renal graft recipients was 2.85 (1.21-6.75). CONCLUSIONS We conclude that when the outcome is adjusted to co-morbid factors there is no difference between renal transplant recipients and haemodialysis patients survival in non-diabetic patients, while renal transplantation gives better survival rates than haemodialysis in diabetic patients.
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Affiliation(s)
- N Mazzuchi
- Instituto de Nefrología y Urología, Servicio de Asistencia Renal Integral, Montevideo, Uruguay
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Rodríguez-Cuartero A, González-Martínez F. [Neutropenic enterocolitis]. Rev Esp Enferm Dig 1999; 91:597-8. [PMID: 10491495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Rodríguez-Cuartero A, González-Martínez F. [Non-hodgkin's lymphoma and cytomegalovirus gastric infection]. Rev Esp Enferm Dig 1998; 90:598. [PMID: 9780796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Rodríguez-Cuartero A, González-Martínez F. Sjögren's syndrome, renal tubular acidosis and nephrocalcinosis. Clin Nephrol 1998; 49:204. [PMID: 9543606] [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: 02/07/2023] Open
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Rodríguez-Cuartero A, González-Martínez F. [Heat syndrome: the first 7 cases in Granada]. An Med Interna 1997; 14:341-344. [PMID: 9410119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
We present the seven first cases with heatstroke in Granada provinces. Six patients were elderly man with passive heatstroke, the other was a young adult with active heatstroke. The clinic picture was evident: fever, hiperpnea, anhidrosis and mental impairment; there was not peculiar biochemic sign though the prognosis depended of the development of tubular kidney failure. We expose the main phisiopathologic therapeutic measure.
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González-Martínez F, Agost-Carreño C, Silva-Ancao M, Elgueta S, Cerdas-Calderón M, Almaguer M, Garcés G, Saldaña-Arévalo M, Castellano P, Perez-Guardia E, Centurión C, Castillo H, Santiago-Delpín S, Lafontaine H, Rodríguez-Juanicó L, Milanés C, Mazzuchi N. 1993 Renal Transplantation Annual Data Report: Dialysis and Renal Transplantation Register of the Latin American Society of Nephrology and Hypertension. Transplant Proc 1997; 29:257-60. [PMID: 9122987 DOI: 10.1016/s0041-1345(96)00086-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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