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Figueroa LM, Escobar G, Osorno J, Acuña M, Solarte J. Peritonealized urachal remnant and obstructive congenital peritoneal band. A case report. Cir Pediatr 2022; 35:46-49. [PMID: 35037441 DOI: 10.54847/cp.2022.01.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Intestinal obstruction as a result of congenital peritoneal bands is rare in surgical practice. It typically compromises the small bowel, and it also has been reported to involve the appendix or a Meckel's diverticulum. However, peritonealized urachal remnant as part of a congenital band is highly infrequent. CASE REPORT 5-year-old boy presenting with intestinal obstruction related to a peritoneal band from the mesentery to the appendix and a peritonealized urachal remnant, associated with an incidental finding of a Meckel's diverticulum. Diagnosis was achieved laparoscopically. The peritoneal band, the urachal remnant, and the Meckel's diverticulum were resected. DISCUSSION Kerkeni's congenital band classification consists of 4 independent groups. This case combines both a band stemming from an embryological remnant and an idiopathic band.
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Affiliation(s)
- L M Figueroa
- Pediatric Surgery Unit. Surgery Department. Del Valle University. Del Valle University Hospital. Cali, Valle del Cauca (Colombia)
| | - G Escobar
- Pediatric Surgery Unit. Surgery Department. Del Valle University. Del Valle University Hospital. Cali, Valle del Cauca (Colombia)
| | - J Osorno
- Pediatric Surgery Unit. Surgery Department. Del Valle University. Del Valle University Hospital. Cali, Valle del Cauca (Colombia)
| | - M Acuña
- Pediatric Surgery Unit. Surgery Department. Del Valle University. Del Valle University Hospital. Cali, Valle del Cauca (Colombia)
| | - J Solarte
- Pediatric Surgery Unit. Surgery Department. Del Valle University. Del Valle University Hospital. Cali, Valle del Cauca (Colombia)
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Barbé J, Poreaux C, Remen T, Schoeffler A, Cloché V, Schmutz JL, Escobar G, Busztejn AC. Prevalence of ocular disease during dupilumab treatment for atopic dermatitis: a bicentric retrospective comparative cohort study. Int J Dermatol 2021; 60:1520-1528. [PMID: 34037253 DOI: 10.1111/ijd.15584] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Received: 11/08/2020] [Revised: 02/10/2021] [Accepted: 03/19/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND Dupilumab is the first human monoclonal antibody approved for the treatment of atopic dermatitis (AD). Clinical trials have reported an increase of ocular side effects in patients who receive dupilumab, with a prevalence of 5-37%. OBJECTIVE To compare the prevalence of ocular disease between AD patients receiving dupilumab treatment and AD reference group and to study the profile of the patients who developed ocular disease secondary to dupilumab treatment. METHODS Efficacy outcomes were collected both at baseline and at month 4 (M4). Presence of ocular disease was recorded at M4. RESULTS Data from 100 patients were examined. At M4, ocular disease was significantly more frequent in the dupilumab group (36% vs. 10%, P = 0.002). Severe allergic conjunctivitis and blepharitis were significantly more frequent in the dupilumab group (30% vs. 4%, P < 0.001, and 22% vs. 2%, P = 0.004, respectively). Six of 18 patients permanently discontinued therapy. CONCLUSION This study observed a prevalence of 36% of ocular disease in AD patients treated with dupilumab. Additional studies are required to confirm the risk factors we found for dupilumab-associated ocular disease and to identify new ones. Consultation with an ophthalmologist before the introduction of dupilumab might limit the occurrence of complications.
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Affiliation(s)
- Jordane Barbé
- Dermatology Department, University Hospital of Nancy, Vandoeuvre les Nancy, France
| | - Claire Poreaux
- Dermatology Department, University Hospital of Nancy, Vandoeuvre les Nancy, France
| | - Thomas Remen
- Methodology, Promotion and Investigation Department, University Hospital of Nancy, Vandoeuvre les Nancy, France
| | - Amélie Schoeffler
- Dermatology Department, Hospital of Metz-Thionville, Thionville, France
| | - Véronique Cloché
- Ophthalmology Department, University Hospital of Nancy, Vandoeuvre les Nancy, France
| | - Jean-Luc Schmutz
- Dermatology Department, University Hospital of Nancy, Vandoeuvre les Nancy, France
| | - Gabriela Escobar
- Dermatology Department, Hospital de Clinicas de Porto Alegre, Rio Grande do Sul, Brazil
| | - Anne-Claire Busztejn
- Dermatology Department, University Hospital of Nancy, Vandoeuvre les Nancy, France
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DeAguero J, Howard T, Brearly A, Jett S, Watt J, Escobar G, Wagner B. Bioelemental Characterization of Electron‐dense Nanostructures in the Kidney Following Gadolinium‐based Contrast Agent Treatment. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.02815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Joshua DeAguero
- University of New Mexico‐Health Sciences CenterAlbuquerqueNM
| | - Tamara Howard
- University of New Mexico‐Health Sciences CenterAlbuquerqueNM
| | - Adrian Brearly
- Department of Earth and Planetary SciencesUniversity of New Mexico‐Health Sciences CenterAlbuquerqueNM
| | - Stephen Jett
- Center for Integrated Nanotechnologies Sandia National LaboratoriesAlbuquerqueNM
| | - John Watt
- Center for Integrated Nanotechnologies Los Alamos National LaboratoriesAlbuquerqueNM
| | - G. Escobar
- University of New Mexico‐Health Sciences CenterAlbuquerqueNM
| | - Brent Wagner
- University of New Mexico‐Health Sciences CenterAlbuquerqueNM
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Barbé J, Escobar G, Bursztejn AC. Bier anemic spots, cyanosis with urticaria-like eruption (BASCULE) syndrome: a simple benign pathology, but probably underdiagnosed. Int J Dermatol 2021; 60:1163-1164. [PMID: 33611787 DOI: 10.1111/ijd.15452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/09/2020] [Accepted: 01/14/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Jordane Barbé
- Dermatology Department, University Hospital of Nancy, Vandoeuvre les Nancy, France
| | - Gabriela Escobar
- Dermatology Department, Hospital de Clinicas de Porto Alegre, Rio Grande do Sul, Brazil
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Barbé J, Escobar G, Marzouki-Zerouali A, Lardenois E, Schmutz JL, Bursztejn AC. Disseminated indolent ALK-positive primary cutaneous anaplastic large cell lymphoma (C-ALCL) lasting for 10 years. Int J Dermatol 2020; 60:e146-e147. [PMID: 33249555 DOI: 10.1111/ijd.15324] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/08/2020] [Accepted: 11/03/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Jordane Barbé
- Dermatology Department, University Hospital of Nancy, Vandoeuvre les Nancy, France
| | - Gabriela Escobar
- Dermatology Department, University Hospital of Nancy, Vandoeuvre les Nancy, France
| | | | - Emilie Lardenois
- Pathologist Department, University Hospital of Nancy, Vandoeuvre les Nancy, France
| | - Jean-Luc Schmutz
- Dermatology Department, University Hospital of Nancy, Vandoeuvre les Nancy, France
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Torres-Loaiza JW, Velasco A, Villegas R, Salazar G, Escobar G. [Massive rotator cuff injury: arthroscopic treatment with upper capsular reconstruction]. Acta Ortop Mex 2020; 34:228-233. [PMID: 33535280] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Massive rotator cuff injuries (LMMRs) are those breaks of more than 5 cm either the anteroposterior plane, or lateromedial plane. Some authors consider them to be complete ruptures of at least two rotator cuff tendons. The clinical case of a 63-year-old man with this type of injury that was resolved by the superior capsule reconstruction technique is presented, technical details and some of the literature review to carry out the procedure are shown.
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Affiliation(s)
- J W Torres-Loaiza
- Traumatología Artroscopía. Hospital General «Pablo Arturo Suárez», Quito, Ecuador
| | - A Velasco
- Traumatología Artroscopía. Hospital General «Pablo Arturo Suárez», Quito, Ecuador
| | - R Villegas
- Hospital General «Pablo Arturo Suárez», Quito, Ecuador
| | - G Salazar
- Traumatología Artroscopía. Hospital General «Pablo Arturo Suárez», Quito, Ecuador
| | - G Escobar
- Traumatología Artroscopía. Hospital General «Pablo Arturo Suárez», Quito, Ecuador
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Castillo H, Schoderbek D, Dulal S, Escobar G, Wood J, Nelson R, Smith G. Response to Dr Katz. Int J Radiat Biol 2016; 92:169-170. [PMID: 27340716] [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: 06/06/2023]
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Castillo H, Schoderbek D, Dulal S, Escobar G, Wood J, Nelson R, Smith G. Stress induction in the bacteria Shewanella oneidensis and Deinococcus radiodurans in response to below-background ionizing radiation. Int J Radiat Biol 2015; 91:749-56. [PMID: 26073528 DOI: 10.3109/09553002.2015.1062571] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The 'Linear no-threshold' (LNT) model predicts that any amount of radiation increases the risk of organisms to accumulate negative effects. Several studies at below background radiation levels (4.5-11.4 nGy h(-1)) show decreased growth rates and an increased susceptibility to oxidative stress. The purpose of our study is to obtain molecular evidence of a stress response in Shewanella oneidensis and Deinococcus radiodurans grown at a gamma dose rate of 0.16 nGy h(-1), about 400 times less than normal background radiation. MATERIALS AND METHODS Bacteria cultures were grown at a dose rate of 0.16 or 71.3 nGy h(-1) gamma irradiation. Total RNA was extracted from samples at early-exponential and stationary phases for the rt-PCR relative quantification (radiation-deprived treatment/background radiation control) of the stress-related genes katB (catalase), recA (recombinase), oxyR (oxidative stress transcriptional regulator), lexA (SOS regulon transcriptional repressor), dnaK (heat shock protein 70) and SOA0154 (putative heavy metal efflux pump). RESULTS Deprivation of normal levels of radiation caused a reduction in growth of both bacterial species, accompanied by the upregulation of katB, recA, SOA0154 genes in S. oneidensis and the upregulation of dnaK in D. radiodurans. When cells were returned to background radiation levels, growth rates recovered and the stress response dissipated. CONCLUSIONS Our results indicate that below-background levels of radiation inhibited growth and elicited a stress response in two species of bacteria, contrary to the LNT model prediction.
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Affiliation(s)
- Hugo Castillo
- a Department of Biology , New Mexico State University , Las Cruces , NM , USA
| | - Donald Schoderbek
- b Department of Agriculture , Food, and Nutritional Science, University of Alberta , Edmonton , Alberta, Canada
| | - Santosh Dulal
- c School of Medicine, University of North Carolina , Chapel Hill NC
| | - Gabriela Escobar
- a Department of Biology , New Mexico State University , Las Cruces , NM , USA
| | - Jeffrey Wood
- d Department of Energy-Carlsbad Field Office , Carlsbad , NM , USA
| | - Roger Nelson
- d Department of Energy-Carlsbad Field Office , Carlsbad , NM , USA
| | - Geoffrey Smith
- a Department of Biology , New Mexico State University , Las Cruces , NM , USA
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Fejerskov O, Escobar G, Jøssing M, Baelum V. A functional natural dentition for all - and for life? The oral healthcare system needs revision. J Oral Rehabil 2013; 40:707-22. [DOI: 10.1111/joor.12082] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2013] [Indexed: 11/30/2022]
Affiliation(s)
- O. Fejerskov
- Department of Biomedicine; University of Aarhus; Aarhus Denmark
| | - G. Escobar
- Faculty of Dentistry; Universidad de Antioquia; Medellin Colombia
| | | | - V. Baelum
- Department of Dentistry; University of Aarhus; Aarhus Denmark
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Holguín Á, Yebra G, Martín L, de Pineda AT, Ruiz LE, Quezada AY, Nieto AI, Escobar G. Transmitted drug-resistance in human immunodeficiency virus-infected adult population in El Salvador, Central America. Clin Microbiol Infect 2013; 19:E523-32. [PMID: 23782115 DOI: 10.1111/1469-0691.12264] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 02/06/2013] [Revised: 04/22/2013] [Accepted: 05/09/2013] [Indexed: 11/26/2022]
Abstract
El Salvador harbours one of the largest Central American human immunodeficiency virus (HIV) epidemics, but few studies have analysed it in depth. Here, we describe the presence of transmitted drug resistance (TDR) and HIV variants in the HIV-infected adult population in El Salvador. Dried blood spots from 119 HIV-infected antiretroviral-naive adults attended in El Salvador were collected in 2011. The TDR was assessed according to the list recommended by the WHO. HIV-1 variants were described using phylogeny. Pol sequences could be amplified in 88 patients (50.6% men), with a mean age of 35 years. Almost all (96.7%) were infected with HIV through sexual practice and 58.7% were recently diagnosed. The mean CD4(+) count was 474 cells/mm(3) and 43.1% and 15.5% of patients showed moderate (<500 CD4 cells) or severe (<200) immune suppression, respectively. HIV-1 viral load was >100 000 copies/mL in 24.7% of patients and <2000 copies/mL in 9.1%. Five samples (5.7%) harboured any TDR mutation: 2.3% for nucleoside reverse transcriptase inhibitor (NRTI) and non-nucleoside reverse transcriptase inhibitor (NNRTI), and 1.4% for protease inhibitor (PI). All showed only one TDR single-class resistance mutation: M184I (two cases) for NRTI, K101E and K103N for NNRTI and L23I for PI. All viruses excepting one (URF_BG) belonged to subtype B. No phylogenetic TDR networks were found. In conclusion, we report a TDR prevalence of 5.7% in El Salvador, lower than in other Central American studies. Periodical studies are essential to monitor and prevent TDR emergence in low-income and middle-income regions. Also, more efforts are needed to promote early diagnosis and prevention of infection in El Salvador.
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Affiliation(s)
- Á Holguín
- HIV-1 Molecular Epidemiology Laboratory, Microbiology Department, Hospital Ramón y Cajal-IRYCIS, Madrid, Spain
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Lin Z, Pandolfino JE, Carlson D, Bidari K, Escobar G, Xiao Y, Kahrilas PJ. Localizing the contractile deceleration point (CDP) in patients with abnormal esophageal pressure topography. Neurogastroenterol Motil 2012; 24:972-5. [PMID: 22726890 PMCID: PMC3602322 DOI: 10.1111/j.1365-2982.2012.01959.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The contractile deceleration point (CDP) is an important landmark for interpreting esophageal pressure topography (EPT) plots. Previous analysis in normal subjects confirmed that the CDP could be localized using an algorithm that found the time during peristalsis at which a maximal length of the distal esophagus was contracting concurrently (tML method). This study aimed to test the tML method for localizing CDP in patients with abnormal motility. METHODS High-resolution manometry studies of 75 patients with normal and disordered peristalsis were analyzed. Two experts, JEP and YX, used the original tangent-intersection method to score CDP coordinates for the first two swallows of each study. Alternative computerized algorithms tested against the expert were: (i) the tML method, (ii & iii) the intercept between the leading edge of the 30-mmHg isobaric contour and a line 2.0 cm (or 10% of esophageal length) proximal to the esophagogastric junction (EGJ) at rest, or (iv) the 'tML-3 cm' method, which added the stipulation that the CDP be within 3 cm of the EGJ. KEY RESULTS All tested algorithms were highly correlated with the expert. However, the tMl-3 cm method was better in the sense that it eliminated outliers (>1 s discrepancy with the expert) that occurred with the other methods usually attributable to weak distal peristalsis. CONCLUSIONS & INFERENCES Optimal automated CDP localization was achieved in both normal and a spectrum of abnormal motility using the tML method with the added stipulation that the CDP be restricted to within the distal 3 cm of the EGJ at rest.
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Affiliation(s)
- Zhiyue Lin
- Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611 USA
| | - John E. Pandolfino
- Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611 USA
| | - Dustin Carlson
- Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611 USA
| | - Kiran Bidari
- Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611 USA
| | - Gabriela Escobar
- Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611 USA
| | - Yinglian Xiao
- Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611 USA
,Department of Gastroenterology and Hepatology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China, 510080
| | - Peter J. Kahrilas
- Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611 USA
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Nicodème F, Pandolfino JE, Lin Z, Xiao Y, Escobar G, Kahrilas PJ. Adding a radial dimension to the assessment of esophagogastric junction relaxation: validation studies of the 3D-eSleeve. Am J Physiol Gastrointest Liver Physiol 2012; 303:G275-80. [PMID: 22628033 PMCID: PMC3423108 DOI: 10.1152/ajpgi.00063.2012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
High-resolution manometry (HRM) with esophageal pressure topography (EPT) allowed for the establishment of an objective quantitative measurement of esophagogastric junction (EGJ) relaxation, the integrated relaxation pressure (IRP). This study assessed whether or not a novel 3D-HRM assembly could improve on this measurement. Twenty-five normal subjects were studied with both a standard HRM assembly and a novel hybrid assembly (3D-HRM), including a 9.0 cm 3D-HRM segment composed of 96 radially dispersed independent pressure sensors. The standard IRP was computed using each assembly and compared with a novel paradigm, the 3D-IRP, an analysis premised on finding the axial maximum and radial minimum pressure at each sensor ring along the sleeve segment. Fourteen additional subjects underwent barium swallows with 3D-HRM and concurrent videofluoroscopy to compare the electronic sleeve (eSleeve) paradigm (circumferential average) to the 3D eSleeve paradigm (radial minimum) as a predictor of transphincteric flow. The 3D-IRP was significantly less than all other calculations of IRP with the upper limit of normal being 12 mmHg vs. 17 mmHg for the standard IRP. The sensitivity (0.78) and the specificity (0.88) of the 3D-eSleeve were also better than the standard eSleeve (0.55 and 0.85, respectively) for predicting flow permissive time verified fluoroscopically. The 3D-IRP and 3D-eSleeve calculated using the radial pressure minimum lowered the normative range of EGJ relaxation (upper limit of normal 12 mmHg) and yielded intraluminal pressure gradients that better correlated with bolus flow than did analysis paradigms based on circumferentially averaged pressure.
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Affiliation(s)
- Frédéric Nicodème
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
| | - John E. Pandolfino
- 1Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;
| | - Zhiyue Lin
- 1Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;
| | - Yinglian Xiao
- 1Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; ,3Department of Gastroenterology and Hepatology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Gabriela Escobar
- 1Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;
| | - Peter J. Kahrilas
- 1Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;
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Upchurch GR, Eliason JL, Rectenwald JE, Escobar G, Kabbani L, Criado E. Endovascular Abdominal Aortic Aneurysm Repair Versus Open Repair: Why and Why Not? ACTA ACUST UNITED AC 2009; 21:48-53. [DOI: 10.1177/1531003509333363] [Citation(s) in RCA: 7] [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: 11/16/2022]
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de Araujo A, de Barros Lopes A, Trucollo Michalczuk M, Stifft J, Nardelli E, Escobar G, Rossi G, Alvares-da-Silva MR. Is there yet any place for reagent strips in diagnosing spontaneous bacterial peritonitis in cirrhotic patients? An accuracy and cost-effectiveness study in Brazil. J Gastroenterol Hepatol 2008; 23:1895-900. [PMID: 19120878 DOI: 10.1111/j.1440-1746.2008.05571.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 12/12/2022]
Abstract
BACKGROUND Diagnosis of spontaneous bacterial peritonitis (SBP) is currently based on ascitic cell counting, but there is a need for a more simple and rapid diagnostic tool. The objectives of this study are to evaluate the accuracy of reagent strips in diagnosing SBP and compare their costs with total and differential cell counts. PATIENTS AND METHODS 71 cirrhotic in- and outpatients were consecutively included (159 samples). Spontaneous bacterial peritonitis was defined as neutrophil cells >or= 250/microL. The cutoff values for each reagent strip were defined by a receiver operating characteristic (ROC) curve. Sensitivity (S), Specificity (Sp), Positive and Negative Predictive Values (PPV and NPV), Accuracy (Ac) and cost-effectiveness (US$) in comparison to cell count exam were calculated. RESULTS Spontaneous bacterial peritonitis was diagnosed in 17 patients (23.9%), 11 of them with positive culture (64.7%). The best cutoff points found in ROC curves were 1+ for Multistix 10 SG and ca. 75 for Choiceline 10 (Multistix 10 SG S = 80%, Sp = 98.5%, PPV = 90.9%, NPV = 96.2%, Ac = 95%; Choiceline 10 S = 76.9%, Sp = 97.7%, PPV = 87%, NPV = 95.6%, Ac = 94%). In terms of cost-effectiveness by cost/accuracy, cell count was 41.5, Multistix 10 SG 0.57, and Choiceline 10, 0.19 (P < 0.001). CONCLUSION Reagent strips are a useful tool for diagnosing SBP in cirrhotic patients, but they have some limitations. Strips are especially indicated when total and differential cell counts are not quickly available or sometimes unavailable. They are also indicated as screening test in emergency rooms to anticipate the diagnosis of SBP and allow its early treatment. It's an interesting option in developing countries.
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Affiliation(s)
- Alexandre de Araujo
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul Gastroenterology, Porto Alegre, Brazil.
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Nydam T, McIntyre R, Escobar G, Hamiel C, Banerjee A. IkB degradation and NF-kB nuclear translocation are dependent on intact microtubules. J Surg Res 2006. [DOI: 10.1016/j.jss.2005.11.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Prats M, Escobar G, Galvan E, Carrasco J, Portillo R. A switching control strategy based on output regulation subspaces for the control of induction motors using a three-level inverter. ACTA ACUST UNITED AC 2003. [DOI: 10.1109/lpel.2003.819159] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Malpica A, Calzadilla M, Baumrucker J, Jimenez J, Lopez L, Escobar G, Montes C. Kinetics and Mechanism for Oxime Formation from Pyridine-2-, -3-, and -4-carboxaldehydes. J Org Chem 2002. [DOI: 10.1021/jo00091a031] [Citation(s) in RCA: 9] [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] [Indexed: 11/30/2022]
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Abstract
To evaluate morbidity, quality of life, and oncological outcomes of patients with advanced breast cancer, recurrence, or sequelae secondary to radiotherapy, the authors present their experience with 21 patients at the Instituto Nacional de Cancerología in Mexico City, who underwent resection of the lesion and reconstruction using thoracoepigastric fasciocutaneous, rectus abdominis, or latissimus dorsi musculocutaneous flaps. Complications included partial flap necrosis and bronchopleural fistulae in 2 of 7 patients with whole-thickness chest wall resection. The remaining patients progressed nicely, with a short recovery period. The patients and the surgical team evaluated results in terms of aesthetics and function using questionnaires. The results were from fair to good according to Sneeuw's scale. Pedicled musculocutaneous and fasciocutaneous flaps are an excellent reconstructive option in patients with advanced, recurrent breast cancer and in those with radionecrotic complications, which sometimes require resection of the whole-thickness chest wall.
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Affiliation(s)
- B Rivas
- Plastic and Reconstructive Section, Instituto Nacional de Cancerología, Mexico City, México
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Echeverri F, Arango V, Quiñones W, Torres F, Escobar G, Rosero Y, Archbold R. Passifloricins, polyketides alpha-pyrones from Passiflora foetida resin. Phytochemistry 2001; 56:881-885. [PMID: 11324922 DOI: 10.1016/s0031-9422(00)00478-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Three polyketides alpha-pyrones, named passifloricins, were isolated from Passiflora foetida resin; their structures and relative configurations were assigned through 2D NMR spectroscopic analyses. These types of compounds were not detected in other passion flowers.
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Affiliation(s)
- F Echeverri
- Universidad de Antioquia, Departamento de Química, Medellin, Colombia.
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Mohle-Boetani JC, Lieu TA, Ray GT, Escobar G. Preventing neonatal group B streptococcal disease: cost-effectiveness in a health maintenance organization and the impact of delayed hospital discharge for newborns who received intrapartum antibiotics. Pediatrics 1999; 103:703-10. [PMID: 10103290 DOI: 10.1542/peds.103.4.703] [Citation(s) in RCA: 32] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To estimate the cost and health benefits of implementing a risk factor-based prevention strategy for early-onset neonatal group B streptococcal (GBS) disease, using baseline assumptions and costs from a health maintenance organization. With the risk factor-based strategy, intrapartum antibiotics (IPAs) would be provided to women with fever, prolonged rupture of membranes, or preterm labor. A second objective was to determine the impact of an increased length of stay for well term infants with mothers who received IPAs. METHODS We used decision analysis to compare the costs and benefits of the prevention strategy with usual obstetric practice for a cohort of 100 000 women and their newborn infants. We derived baseline values from a previous study based on chart review and automated cost data from a health maintenance organization in Northern California. In sensitivity analyses, we varied baseline assumptions, including additional costs for observing well term infants who received IPAs. RESULTS If adherence to guidelines were 100%, 17% of mothers would receive IPAs at a cost of $490,000; $1.6 million would be saved by preventing 66 GBS cases (64% reduction). The net savings would be $1.1 million and 61 life-years. The net cost is sensitive to the cost of caring for well infants who received IPAs. If each term infant of a mother who received IPAs had 1 more day of observation than other term infants, there would be a net cost of $8.1 million; the cost per GBS case prevented would be $120,000 and the cost per life-year saved would be $130,000. CONCLUSIONS Implementation in a health maintenance organization of a risk factor-based strategy to prevent neonatal GBS disease can prevent substantial disease and be cost saving. However, if the length of hospital stay were extended among well term infants whose mothers received IPAs, the strategy would be relatively costly compared with other medical interventions.
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