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Ruddy S, Bapna M, Karnik K, Yung L, Rodriguez G, Urban C, Yoon J, Prasad N, Segal-Maurer S, Turett G. Novel case of combination antibiotic therapy for treatment of a complicated polymicrobial urinary tract infection with one organism harboring a metallo-β-lactamase (MBL) in a pregnant patient. IDCases 2024; 36:e01946. [PMID: 38646598 PMCID: PMC11031789 DOI: 10.1016/j.idcr.2024.e01946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/23/2024] [Accepted: 04/14/2024] [Indexed: 04/23/2024] Open
Abstract
Carbapenem resistance due to metallo-beta-lactamases (MBLs) is a global phenomenon and an important challenge for antibiotic therapy (Boyd et al., 2020 [1]). While previous reports have demonstrated both in vitro and in vivo synergy using the combination of ceftazidime-avibactam and aztreonam against Stenotrophomonas maltophilia, an MBL-harboring organism, this treatment strategy has not been reported during pregnancy (Mojic et al., 2017 [2], [3], Mojica et al., 2016 [4], Alexander et al., 2020 [5]). We describe a 33-year-old pregnant female with polymicrobial, bilateral pyelonephritis caused by Stenotrophomonas maltophilia and other gram-negative bacteria. The organisms were eradicated with the combination of ceftazidime-avibactam and aztreonam followed by successful delivery with no observed adverse effects in either mother or child post-partum.
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Affiliation(s)
- S. Ruddy
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
| | - M. Bapna
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
| | - K. Karnik
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
| | - L. Yung
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Weill Cornell Medicine, Cornell University, New York, NY 10065, United States of America
| | - G. Rodriguez
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Columbia University School of Nursing, New York, NY, 10032, United States of America
| | - C. Urban
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Weill Cornell Medicine, Cornell University, New York, NY 10065, United States of America
| | - J. Yoon
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Weill Cornell Medicine, Cornell University, New York, NY 10065, United States of America
| | - N. Prasad
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Weill Cornell Medicine, Cornell University, New York, NY 10065, United States of America
| | - S. Segal-Maurer
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Weill Cornell Medicine, Cornell University, New York, NY 10065, United States of America
| | - G. Turett
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
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Rosende A, DiPette DJ, Martinez R, Brettler JW, Rodriguez G, Zuniga E, Ordunez P. HEARTS in the Americas clinical pathway. Strengthening the decision support system to improve hypertension and cardiovascular disease risk management in primary care settings. Front Cardiovasc Med 2023; 10:1102482. [PMID: 37180772 PMCID: PMC10169833 DOI: 10.3389/fcvm.2023.1102482] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/27/2023] [Indexed: 05/16/2023] Open
Abstract
Background HEARTS in the Americas is the regional adaptation of the WHO Global HEARTS Initiative. It is implemented in 24 countries and over 2,000 primary healthcare facilities. This paper describes the results of a multicomponent, stepwise, quality improvement intervention designed by the HEARTS in the Americas to support advances in hypertension treatment protocols and evolution towards the Clinical Pathway. Methods The quality improvement intervention comprised: 1) the use of the appraisal checklist to evaluate the current hypertension treatment protocols, 2) a peer-to-peer review and consensus process to resolve discrepancies, 3) a proposal of a clinical pathway to be considered by the countries, and 4) a process of review, adopt/adapt, consensus and approval of the clinical pathway by the national HEARTS protocol committee. A year later, 16 participants countries (10 and 6 from each cohort, respectively) were included in a second evaluation using the HEARTS appraisal checklist. We used the median and interquartile scores range and the percentages of the maximum possible total score for each domain as a performance measure to compare the results pre and post-intervention. Results Among the eleven protocols from the ten countries in the first cohort, the baseline assessment achieved a median overall score of 22 points (ICR 18 -23.5; 65% yield). After the intervention, the overall score reached a median of 31.5 (ICR 28.5 -31.5; 93% yield). The second cohort of countries developed seven new clinical pathways with a median score of 31.5 (ICR 31.5 -32.5; 93% yield). The intervention was effective in three domains: 1. implementation (clinical follow-up intervals, frequency of drug refills, routine repeat blood pressure measurement when the first reading is off-target, and a straightforward course of action). 2. treatment (grouping all medications in a single daily intake and using a combination of two antihypertensive medications for all patients in the first treatment step upon the initial diagnosis of hypertension) and 3. management of cardiovascular risk (lower BP thresholds and targets based on CVD risk level, and the use of aspirin and statins in high-risk patients). Conclusion This study confirms that this intervention was feasible, acceptable, and instrumental in achieving progress in all countries and all three domains of improvement: implementation, blood pressure treatment, and cardiovascular risk management. It also highlights the challenges that prevent a more rapid expansion of HEARTS in the Americas and confirms that the main barriers are in the organization of health services: drug titration by non-physician health workers, the lack of long-acting antihypertensive medications, lack of availability of fixed-doses combination in a single pill and cannot use high-intensity statins in patients with established cardiovascular diseases. Adopting and implementing the HEARTS Clinical Pathway can improve the efficiency and effectiveness of hypertension and cardiovascular disease risk management programs.
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Affiliation(s)
- Andres Rosende
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, United States
| | - Donald J. DiPette
- School of Medicine Columbia, University of South Carolina, Columbia, SC, United States
| | - Ramon Martinez
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, United States
| | - Jeffrey W. Brettler
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States
- Southern California Permanente Medical Group, Los Angeles, CA, United States
| | - Gonzalo Rodriguez
- Consultant for HEARTS in the Americas, PAHO/WHO Office in Argentina, Buenos Aires, Argentina
| | - Eric Zuniga
- Antofagasta Health Service, University of Antofagasta, Antofagasta, Chile
| | - Pedro Ordunez
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, United States
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Rodriguez G, Couto M, Fernandez M, Tassano M, Cabrera M, Cabral P, Melián MG, Cerecetto H. Exploring new strategies for technetium radiolabeled [1,2,4,5] tetrazines. Nucl Med Biol 2022. [DOI: 10.1016/s0969-8051(22)02211-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Sanmamed N, Alcantara P, Cerezo E, Gaztanaga M, Doval A, Corona J, Gomez S, Bustos A, Rodriguez G, Fuentes M, Sanz A, Vazquez G. Low Dose Radiotherapy in the Management of COVID-19 Pneumonia (LOWRAD-Cov19): Final Results. Int J Radiat Oncol Biol Phys 2022. [PMCID: PMC9595462 DOI: 10.1016/j.ijrobp.2022.07.1619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Purpose/Objective(s) To evaluate the results of LD-RT to lungs in the management of patients with COVID-19 pneumonia. Materials/Methods We conducted a prospective phase I-II trial enrolling COVID-19 patients ≥50 years-old, with bilateral lung involvement at imaging study and oxygen requirement. Patients received 1 Gy to whole lungs in a single fraction. Primary outcome was radiological response assessed as severity and extension scores at days +3 and +7. Secondary outcomes were toxicity (CTCAE v5.0), days of hospitalization, changes in inflammatory blood parameters (ferritin, lymphocytes, C-reactive protein, d-dimer and LDH) and SatO2/ FiO2 index (SAFI), at day +3 and +7. Descriptive analyses were summarized as means with standard deviation (SD) and/or medians with interquartile ranges (IQR). A Wilcoxon sign rank test for paired data was used to assess the CT scores and Chi Square was used to assess for comparison of categorical variables. Results Forty-one patients were included. Median age was 71 (IQR 60-84). Eighteen patients (47%) previously received any antiCOVID treatment (tocilizumab, lopinavir/ritonavir, remdesivir) and thirty-two patients (84%) received steroids during LD-RT. Extension score improved significantly (p=0.02) on day +7 and SAFI on day +3 and + 7 (p<0.01). Median SAFI on day 0 was 147 (IQR 118-264), 230 (IQR 120-343) on day +3 and 293 (IQR 121-353) on day +7. Significant decrease was found in C-reactive protein on day +7 (p=0.02) and in lymphocytes counts on day +3 and +7 (p=0.02). Median number of days in hospital after RT was 11 (range 4-78). With a median follow-up of 60 days after LD-RT, 26 (63%) patients were discharged, 11 (27%) died because of COVID respiratory failure and 4 (10%) died of other causes. Conclusion LD-RT is a feasible and well-tolerated treatment that may lead to rapid clinical improvement. Large randomized trials should be done to establish the efficacy of LD-RT to treat COVID-19 pneumonia.
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Affiliation(s)
- N.S. Sanmamed
- Hospital Clínico Universitario San Carlos, Madrid, ON, Spain,Corresponding author:
| | | | - E. Cerezo
- Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - M. Gaztanaga
- Departamento Oncología Radioterapia Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - A. Doval
- Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - J. Corona
- Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - S. Gomez
- Hospital Clinico San Carlos, Madrid, Spain
| | - A. Bustos
- Hospital Clinico San Carlos, Madrid, Spain
| | | | - M. Fuentes
- Fundacion Investigacion Biomedica Hospital Clinico San Carlos, Madrid, Spain
| | - A. Sanz
- Hospital Rio Hortega, Valladolid, Spain
| | - G. Vazquez
- Hospital Clínico Universitario San Carlos, Madrid, Spain
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Rodriguez G, Rosende A, Prado C, Cejas Mariño R, Irazola V, DiPette D, Orias M, Giraldo Arcila G, Laspiur S. [Implementation of the HEARTS Initiative in Argentina: initial resultsImplementação da Iniciativa HEARTS na Argentina: primeiros resultados]. Rev Panam Salud Publica 2022; 46:e181. [PMID: 36160765 PMCID: PMC9491484 DOI: 10.26633/rpsp.2022.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/29/2022] [Indexed: 11/24/2022] Open
Abstract
Las enfermedades cardiovasculares son la principal causa de morbimortalidad, y la hipertensión es su principal factor de riesgo. En 2018, Argentina comenzó a implementar la Iniciativa HEARTS en 5 centros de atención primaria de salud a través del Plan Nacional de Prevención y Control de la Hipertensión Arterial. En este estudio se presenta el impacto de su implementación en los indicadores de cobertura efectiva, tratamiento, tratamiento combinado y control. La Iniciativa HEARTS incluye múltiples componentes; entre ellos se destacan la capacitación de los equipos de salud, la reorganización de las tareas basada en la transferencia de competencias clínicas, la provisión de dispositivos de medición de la presión arterial automáticos y clínicamente validados, y la utilización de un único protocolo de tratamiento estandarizado. Se utilizó un modelo de datos longitudinales del tipo ecuación de estimación generalizada, y se agrupó la información de los 5 centros de salud mediante promedios ponderados según el tamaño de la población bajo cobertura. El análisis de los resultados fue estratificado en dos períodos de tiempo delimitados por la irrupción de las restricciones debidas al COVID-19. Durante el primer período de 18 meses se observó una mejoría significativa en el tratamiento (5,9%; p<0,01) y el tratamiento combinado (13,4%; p<0,01), sin cambios significativos en la cobertura (8,4%; p=0,87) y con un descenso paradojal en el control (−3,3%; p=0,02). Durante las restricciones y respecto del período previo, se constató una reducción generalizada en todos los indicadores, principalmente en la cobertura (−23,6%; p<0,01) y el control (−12,5%; p<0,01). Sin embargo, los niveles de tratamiento y tratamiento combinado persistieron por encima de los valores basales (1,7%; p<0,01 y 5,4%; p<0,01, respectivamente).
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Affiliation(s)
- Gonzalo Rodriguez
- Organización Panamericana de la Salud Buenos Aires Argentina Organización Panamericana de la Salud, Buenos Aires, Argentina
| | - Andrés Rosende
- Organización Panamericana de la Salud Washington, DC Estados Unidos de América Organización Panamericana de la Salud, Washington, DC, Estados Unidos de América
| | - Carolina Prado
- Instituto de Efectividad Clínica y Sanitaria Buenos Aires Argentina Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
| | - Rubén Cejas Mariño
- Ministerio de Salud La Rioja Argentina Ministerio de Salud, La Rioja, Argentina
| | - Vilma Irazola
- Instituto de Efectividad Clínica y Sanitaria Buenos Aires Argentina Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
| | - Donald DiPette
- Escuela de Medicina de la Universidad de Carolina del Sur Columbia Estados Unidos de América Escuela de Medicina de la Universidad de Carolina del Sur, Columbia, Estados Unidos de América
| | - Marcelo Orias
- Escuela de Medicina de la Universidad de Yale New Haven Estados Unidos de América Escuela de Medicina de la Universidad de Yale, New Haven, Estados Unidos de América
| | - Gloria Giraldo Arcila
- Organización Panamericana de la Salud Washington, DC Estados Unidos de América Organización Panamericana de la Salud, Washington, DC, Estados Unidos de América
| | - Sebastián Laspiur
- Organización Panamericana de la Salud Buenos Aires Argentina Organización Panamericana de la Salud, Buenos Aires, Argentina
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Quintana R, Garcia L, Alba P, Roverano S, Alvarez A, Graf C, Pisoni C, Spindler A, Gomez C, Figueredo HM, Papasidero S, Paniego RH, Delavega M, Civit De Garignani EE, Gonzalez Lucero L, Martire V, Águila Maldonado R, Gordon S, Gobbi C, Nieto R, Rausch G, Góngora V, D’amico MA, Dubinsky D, Orden AO, Zacariaz J, Romero J, Pera MA, Rillo O, Baez R, Arturi V, Gonzalez A, Vivero F, Schmid M, Caputo V, Larroude MS, Gomez G, Rodriguez G, Marin J, Collado MV, Jorfen M, Bedran Z, Sarano J, Zelaya D, Sacnun M, Finucci P, Rojas Tessel R, Sattler ME, Machado Escobar M, Astesana P, Paris UV, Allievi A, Vandale JM, Pons-Estel B, Pons-Estel G, García M. POS0707 POTENTIAL USE OF BELIMUMAB IN LUPUS PATIENTS FROM ARGENTINE COHORT ACCORDING DISEASE ACTIVITY STATE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.789] [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: 11/04/2022]
Abstract
BackgroundThe goal of targeted treatment in patients with Systemic Lupus Erythematosus (SLE) is to achieve clinical remission or low disease activity, with the best quality of life, low damage rates and better survival 1-4. RELESSAR is a multicenter, cross-sectional study registry of ≥18 years SLE (ACR 97) patients 5.ObjectivesTo describe demographic, clinical characteristics and treatments in SLE patients according to disease activity state. To evaluate the proportion of SLE and refractory SLE patients that are potentially candidates for Belimumab treatment (Active SLE despite standard treatment including increased acDNA autoantibodies and low complement).MethodsWe evaluated demographic and clinical data, treatments, score of damage (SLICC), activity (SLEDAI) and comorbidity (Charlson), hospital admissions and severe infections. The patients were compared according to disease activity: remission (SLEDAI = 0 and without corticosteroids), low disease activity (LDA, SLEDAI> 0 and ≤4 and without corticosteroids) and non-optimal control (SLEDAI> 4 and any dose of corticosteroids). Refractory SLE was defined according to Rituximab (RTX) use, non-response to cyclophosphamide or two or more immunosuppressant or splenectomized patients. Potential use of Belimumab according approved prescription in Argentina was analyzed.ResultsOverall, 1277 patients were analyzed: 299 (23.4%) were in remission, 162 (12.7%) in LDA and 816 (63.9%) with non-optimal control of the disease.Patients in non-optimal control group were younger, less frequently female and they showed less time of disease and lower socioeconomic status (p < 0.001). They were also more prevalent mestizos (p= 0.004), had higher SLEDAI and SLICC indexes (p <0.001) and higher use of immunosuppressant therapy (p <0.001). There was no difference regarding biologic treatment (RTX p= 0.547 and Belimumab p= 0.08). This group had higher proportion of hospital admissions and severe infections (p<0.001, respectively).Two hundred and one SLE patients fulfilled the use of Belimumab prescription criteria but only 45/201 patients (22,3%) received it in the last visit. Malar rash was the only clinical variable associated with the use of Belimumab (72.7% vs 29.8% p= 0.005).Seventy-six patients classified as refractory SLE (15.7%) and 56/76 (75.7%) never received Belimumab. Patients on Belimumab therapy were associated to treatment with lower doses of corticoids (p= 0.018) and lower rate of hospital admission caused by SLE flare (p= 0.027).ConclusionA high percentage of patients had uncontrolled disease upon entry into the registry and were potential candidates for treatment with Belimumab. The patients who received biologic treatment showed the benefit of requiring fewer doses of corticosteroids and having a lower rate of hospitalizations.References[1]Mok CC. Treat-to-target in systemic lupus erythematosus: Are we there yet? Expert Rev Clin Pharmacol. 2016;9(5).[2]Morand EF, Mosca M. Treat to target, remission and low disease activity in SLE. Vol. 31, Best Practice and Research: Clinical Rheumatology. 2017.[3]Golder V, Tsang-A-Sjoe MWP. Treatment targets in SLE: Remission and low disease activity state. Rheumatol (United Kingdom). 2020;59.[4]Ruiz-Irastorza G, Bertsias G. Treating systemic lupus erythematosus in the 21st century: new drugs and new perspectives on old drugs. Vol. 59, Rheumatology (United Kingdom). 2021.[5]Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum [Internet]. 1997;40(9):1725. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9324032Disclosure of InterestsRosana Quintana: None declared, Lucila Garcia: None declared, Paula Alba: None declared, Susana Roverano: None declared, Analia Alvarez: None declared, Cesar Graf: None declared, Cecilia Pisoni: None declared, Alberto Spindler: None declared, Catalina Gomez: None declared, Heber Matias Figueredo: None declared, Silvia Papasidero: None declared, Raul Horacio Paniego: None declared, Maria DeLaVega: None declared, Emma Estela Civit De Garignani: None declared, Luciana Gonzalez Lucero: None declared, Victoria Martire: None declared, Rodrigo Águila Maldonado: None declared, Sergio Gordon: None declared, Carla Gobbi: None declared, Romina Nieto: None declared, Gretel Rausch: None declared, Vanina Góngora: None declared, Maria Agustina D´Amico: None declared, Diana Dubinsky: None declared, Alberto Omar Orden: None declared, Johana Zacariaz: None declared, Julia Romero: None declared, Mariana Alejandra Pera: None declared, Oscar Rillo: None declared, Roberto Baez: None declared, Valeria Arturi: None declared, Andrea Gonzalez: None declared, Florencia Vivero: None declared, Marcela Schmid: None declared, Victor Caputo: None declared, Maria Silvia Larroude: None declared, Graciela Gomez: None declared, Graciela Rodriguez: None declared, Josefina Marin: None declared, Maria Victoria Collado: None declared, Marisa Jorfen: None declared, Zaida Bedran: None declared, Judith Sarano: None declared, David Zelaya: None declared, MONICA SACNUN: None declared, Pablo Finucci: None declared, Romina Rojas Tessel: None declared, Maria Emilia Sattler: None declared, MAXIMILIANO MACHADO ESCOBAR: None declared, Pablo Astesana: None declared, Ursula Vanesa Paris: None declared, Alberto Allievi: None declared, Juan Manuel Vandale: None declared, Bernardo Pons-Estel: None declared, Guillermo Pons-Estel: None declared, Mercedes García Grant/research support from: GSK grant
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DeLaVega M, Peon C, Rodriguez G, Benavidez F, Benitez A, Gamba MJ, Eleta M, Riopedre A. POS0673 ENDOTHELIAL INFLAMMATION IN RHEUMATOID ARTHRITIS PATIENTS TREATED WITH TOFACITINIB. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.737] [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: 11/03/2022]
Abstract
BackgroundSystemic inflammation in rheumatoid arthritis (RA) seems to accelerate atherosclerosis process and increased cardiovascular (CV) events. An adequate joint inflammation control is correlated with endothelial inflammation (EI) improvement. 18F-fluorodeoxyglucose positron emission tomography with computed tomography (FDG PET/CT) has been shown as a non-invasive, sensitive, and specific tool to show EI. Maximum standardized uptake value (SUV(max)) greater than 1,6 has been correlated with vascular and joint inflammation. Tofacitinib is a Jak inhibitor (JaKi) approved for RA that improves activity and function. The aim of this study is to evaluate the EI outcome by FDG-PET in RA patients treated with tofacitinib.ObjectivesTo assess the EI by FDG-PET/CT in RA patients at baseline and after 12 weeks of tofacitinib treatment initiation.To correlate the vascular findings with disease activity, lipid profile and carotid atherosclerosis by echo Doppler.MethodsProspective, observational study. Inclusion criteria: RA (ACR 2010) patients >18 years old, with high activity score (DAS 28 >3,2) and with biologics or synthetic Dmards requirement by Treat to Target strategy and who tofacitinib was prescribed. Exclusion Criteria: Biologics or Jaki previous use or major CV history known.A baseline Visit evaluating disease activity (DAS 28 and CDAI), functional status by Health Assessment Questionary (HAQ), CV and smoking history, treatments and lipid lab assessment was performed. EI was measured by PET-FDG/CT, showing the SUVmax and target-to-background ratio (TBR) in: right primitive carotid, left primitive carotid, ascendent aorta, descendent aorta and abdominal aorta. Carotid echo Doppler for showing plaque presence was done. During baseline visit tofacitinib was started. After 12 weeks the initial parameters were re-evaluated.ResultsConsecutively, 30 patients were included. Mean age 57 yo (21-79). Female 70%. Mean disease duration 8,3 years (1-40), mean Body mass index (BMI) 24,5. Clinical history: Hypertension 27%, smoking 6,6%, methotrexate treatment 46,6%, methotrexate plus leflunomide 50%, corticosteroids 7,6% (mean dosis 7,6 mg/day).Mean values of DAS 28, CDAI and HAQ were 5.21, 26,6 y 1,56 in baseline and 3,04, 8,80 y 1,09 in the final visit respectively (p:< 0,001 in all comparations) showing statistical significance activity improvement. Echo doppler showed Carotid plaque in 40% of patients without change between visits. Mean cholesterol levels were 188,5 y 207,53 mg/dl in baseline and final visit respectively (p: 0,0039), showing statistical significance. Endothelial uptake by PET-FDG in the 5 areas measured, considering baseline and final visit was: Right Primitive Carotid: SUV Max 2,03 and 1,93 (p: 0,32) and TRB Max 0,94 and 0,85 (p:1,0); Left Primitive Carotid Suv Max 2,07 and 1,94 (p:1,0) and TRB Max 0,92 and 0,90 (p:0,57); Ascendent Aorta SUV Max 2,63 and 2,57 (p:1,0) and TRB Max 1,18 and 1,15 (p:1,0); Descendent Aorta SUV Max 2,77 and 2,57 (p:0,26) and TRB Max 1,27 and 1,17 (p:0,26) and Abdominal Aorta SUV Max 2,59 and 2,43 (p:0,85) and TRB Max 1,15 y 1,11 (p:0,32). None of the endothelial uptake comparisons showed a significant difference between baseline and final visit after 12 weeks.ConclusionThis work shows that, despite the significant improvement in joint activity and function values, there was no modification in EI measured by FDG-PET during tofacitinib treatment along 12 weeks. It is noteworthy that all patients initially presented high inflammatory endothelial uptake values, which reinforces the hypothesis of vascular compromise associated with active joint disease. Studies with more observation time and evaluating the role of different treatments related to endothelium will be of clinical utility in the future.References[1]Rheumatology (Oxford). 2016 Oct;55(10):1777-85.[2]Metabolism. 2017 Feb;67:72-79.[3]Arthritis Res Ther. 2016 May 21;18(1):115.AcknowledgementsPfizer´s unrestricted grantDisclosure of InterestsNone declared
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Brettler JW, Giraldo Arcila GP, Aumala T, Best A, Campbell NR, Cyr S, Gamarra A, Jaffe MG, De la Rosa MJ, Maldonado J, Neira Ojeda C, Haughton M, Malcolm T, Perez V, Rodriguez G, Rosende A, Valdes Gonzalez Y, Wood PW, Zuniga E, Ordunez P. [Drivers and scorecards to improve hypertension control in primary care practice: Recommendations from the HEARTS in the Americas Innovation GroupFactores impulsores y métodos de puntuación para mejorar el control de la hipertensión en la práctica clínica de la atención primaria: recomendaciones del grupo de innovación de HEARTS en las Américas]. Rev Panam Salud Publica 2022; 46:e68. [PMID: 35573115 PMCID: PMC9097925 DOI: 10.26633/rpsp.2022.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Fundamentos. As doenças cardiovasculares (DCV) são as principais causas de morbimortalidade nas Américas, e a hipertensão arterial (HÁ) é o fator de risco modificável mais importante. Porém, as taxas de controle da HA continuam baixas, e a mortalidade por DCV está estagnada ou aumentando após décadas de redução contínua. Em 2016, a Organização Mundial da Saúde (OMS) lançou o pacote de medidas técnicas HEARTS para melhorar o controle da HA. A Organização Pan-Americana da Saúde (OPAS) criou a iniciativa HEARTS nas Américas para melhorar a gestão do risco cardiovascular (RCV), com ênfase no controle da HA. Até agora, essa iniciativa foi implementada em 21 países. Métodos. Para impulsionar a implementação, recrutou-se um grupo multidisciplinar de profissionais para selecionar impulsionadores-chave do controle da HA com base em evidências e elaborar um scorecard completo para monitorar sua implementação em unidades de atenção primária à saúde (APS). O grupo estudou sistemas de saúde com alto desempenho que haviam conseguido atingir um alto nível de controle da HA por meio de programas de melhoria da qualidade focados em medidas específicas de processo, com feedback regular para os profissionais das unidades de saúde. Resultados. Os oito fatores impulsionadores incluídos na seleção final foram categorizados em cinco domínios principais: (1) diagnóstico (exatidão da medição da pressão arterial e avaliação do RCV); (2) tratamento (protocolo padronizado de tratamento e intensificação do tratamento); (3) continuidade do cuidado e acompanhamento; (4) modelo de atenção (atendimento baseado em equipe, renovação da prescrição); e (5) sistema de avaliação do desempenho. Em seguida, os fatores impulsionadores e as recomendações foram transformados em medidas de processo, gerando dois scorecards inter-relacionados integrados ao sistema de monitoramento e avaliação da Iniciativa HEARTS nas Américas. Interpretação. O foco nesses impulsionadores-chave da HA e nos scorecards resultantes orientará o processo de melhoria da qualidade para atingir as metas de controle, a nível populacional, dos centros de saúde participantes nos países que estão implementando a iniciativa HEARTS.
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Affiliation(s)
- Jeffrey W Brettler
- Southern California Permanente Medical Group Los Angeles EUA Southern California Permanente Medical Group, Los Angeles, EUA.,Departamento de Ciências de Sistemas de Saúde Kaiser Permanente Bernard J. Tyson School of Medicine Pasadena EUA Departamento de Ciências de Sistemas de Saúde, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, EUA
| | - Gloria P Giraldo Arcila
- Departamento de Doenças Não Transmissíveis e Saúde Mental Organização Pan-Americana da Saúde Washington, DC EUA Departamento de Doenças Não Transmissíveis e Saúde Mental, Organização Pan-Americana da Saúde, Washington, DC, EUA
| | - Teresa Aumala
- Centro de Atenção Primária à Saúde Ministério da Saúde, Centro de Salud Conocoto Quito Equador Centro de Atenção Primária à Saúde, Ministério da Saúde, Centro de Salud Conocoto, Quito, Equador
| | - Allana Best
- Ministério da Saúde Porto de Espanha Trinidad e Tobago Ministério da Saúde, Porto de Espanha, Trinidad e Tobago
| | - Norm Rc Campbell
- Departamento de Medicina Fisiologia e Farmacologia e Ciências da Saúde Comunitária Libin Cardiovascular Institute of Alberta Calgary Canadá Departamento de Medicina, Fisiologia e Farmacologia e Ciências da Saúde Comunitária, Libin Cardiovascular Institute of Alberta, Calgary, Canadá
| | - Shana Cyr
- Ministério da Saúde Bem-Estar e Idosos Castries Santa Lúcia Ministério da Saúde, Bem-Estar e Idosos, Castries, Santa Lúcia
| | - Angelo Gamarra
- Departamento de Doenças Não Transmissíveis e Saúde Mental Organização Pan-Americana da Saúde Washington, DC EUA Departamento de Doenças Não Transmissíveis e Saúde Mental, Organização Pan-Americana da Saúde, Washington, DC, EUA
| | - Marc G Jaffe
- Departamento de Endocrinologia The Permanente Medical Group Kaiser San Francisco Medical Center San Francisco EUA Departamento de Endocrinologia, The Permanente Medical Group, Kaiser San Francisco Medical Center, San Francisco, EUA
| | - Mirna Jimenez De la Rosa
- Escola de Saúde Pública Faculdade de Ciências da Saúde Universidad Autónoma de Santo Domingo República Dominicana Escola de Saúde Pública, Faculdade de Ciências da Saúde, Universidad Autónoma de Santo Domingo, República Dominicana.,Oficina Escuela de Salud Publica Ciudad Universitaria Universidad Autónoma de Santo Domingo Distrito Nacional República Dominicana Oficina Escuela de Salud Publica, Ciudad Universitaria, Universidad Autónoma de Santo Domingo, Distrito Nacional, República Dominicana
| | - Javier Maldonado
- Organização Pan-Americana da Saúde Bogotá Colômbia Organização Pan-Americana da Saúde, Bogotá, Colômbia
| | - Carolina Neira Ojeda
- Departamento de Doenças Não Transmissíveis Ministério da Saúde Santiago do Chile Chile Departamento de Doenças Não Transmissíveis, Ministério da Saúde, Santiago do Chile, Chile
| | - Modesta Haughton
- Organização Pan-Americana da Saúde Ancón Panamá Organização Pan-Americana da Saúde, Ancón, Panamá
| | - Taraleen Malcolm
- Organização Pan-Americana da Saúde Porto de Espanha Trinidad e Tobago Organização Pan-Americana da Saúde, Porto de Espanha, Trinidad e Tobago
| | - Vivian Perez
- Organização Pan-Americana da Saúde Lima Peru Organização Pan-Americana da Saúde, Lima, Peru
| | - Gonzalo Rodriguez
- Organização Pan-Americana da Saúde Ciudad Autónoma de Buenos Aires Buenos Aires Argentina Organização Pan-Americana da Saúde, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Andres Rosende
- Departamento de Doenças Não Transmissíveis e Saúde Mental Organização Pan-Americana da Saúde Washington, DC EUA Departamento de Doenças Não Transmissíveis e Saúde Mental, Organização Pan-Americana da Saúde, Washington, DC, EUA
| | - Yamile Valdes Gonzalez
- Comitê Técnico Consultivo Nacional de Hipertensão Arterial Hospital Universitário "General Calixto García" Havana Cuba Comitê Técnico Consultivo Nacional de Hipertensão Arterial, Hospital Universitário "General Calixto García", Havana, Cuba
| | - Peter W Wood
- Departamento de Medicina Divisão de Medicina Interna Geral University of Alberta Edmonton Canadá Departamento de Medicina, Divisão de Medicina Interna Geral, University of Alberta, Edmonton, Canadá
| | - Eric Zuniga
- Servicio de Salud Antofagasta Universidad de Antofagasta Antofagasta Chile Servicio de Salud Antofagasta, Universidad de Antofagasta, Antofagasta, Chile
| | - Pedro Ordunez
- Departamento de Doenças Não Transmissíveis e Saúde Mental Organização Pan-Americana da Saúde Washington, DC EUA Departamento de Doenças Não Transmissíveis e Saúde Mental, Organização Pan-Americana da Saúde, Washington, DC, EUA
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Brettler JW, Giraldo Arcila GP, Aumala T, Best A, Campbell NR, Cyr S, Gamarra A, Jaffe MG, De la Rosa MJ, Maldonado J, Neira Ojeda C, Haughton M, Malcolm T, Perez V, Rodriguez G, Rosende A, Valdes Gonzalez Y, Wood PW, Zuñiga E, Ordunez P. [Drivers and scorecards to improve hypertension control in primary care practice: Recommendations from the HEARTS in the Americas Innovation GroupFatores impulsionadores e scorecards para melhorar o controle da hipertensão arterial na atenção primária: recomendações do Grupo de Inovação da Iniciativa HEARTS nas Américas]. Rev Panam Salud Publica 2022; 46:e56. [PMID: 35573117 PMCID: PMC9097922 DOI: 10.26633/rpsp.2022.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Antecedentes. Las enfermedades cardiovasculares (ECV) son la principal causa de morbilidad y mortalidad en la Región de las Américas y la hipertensión es el factor de riesgo modificable asociado más importante. Sin embargo, las tasas de control de la hipertensión siguen siendo bajas y la mortalidad por ECV está estancada o en aumento después de décadas de reducción continua. En el 2016, la Organización Mundial de la Salud (OMS) presentó el paquete técnico HEARTS para mejorar el control de la hipertensión. La Organización Panamericana de la Salud (OPS) diseñó la iniciativa HEARTS en las Américas para mejorar el control del riesgo de ECV, que hace hincapié en el control de la hipertensión y que, hasta la fecha, se ha implementado en 21 países. Métodos. Para avanzar en la implementación, se creó un grupo interdisciplinario de profesionales de la salud con el objetivo de seleccionar los factores impulsores claves del control de la hipertensión basados en la evidencia y diseñar un método de puntuación integral para dar seguimiento a su implementación en los centros de atención de salud primaria (APS). El grupo estudió los sistemas de salud de alto desempeño que logran un control elevado de la hipertensión mediante programas de mejora de la calidad que se centran en medidas específicas con respecto a los procesos, con retroalimentación regular a los prestadores en los centros de salud. Resultados. Los ocho factores impulsores finales seleccionados se clasificaron en cinco dominios principales: 1) diagnóstico (exactitud de la medición de la presión arterial y evaluación del riesgo de ECV); 2) tratamiento (protocolo de tratamiento e intensificación del tratamiento estandarizados); 3) continuidad de la atención y seguimiento; 4) sistema de prestación del tratamiento (atención basada en un trabajo en equipo, reposición de la medicación) y 5) sistema para la evaluación del desempeño. Los factores impulsores y las recomendaciones se tradujeron en medidas con respecto a los procesos, lo que llevó a dos métodos de puntuación integrados e interconectados en el sistema de seguimiento y evaluación del programa HEARTS en las Américas. Conclusiones. El enfoque que se centra en estos factores impulsores clave de la hipertensión y los métodos de puntuación resultantes servirá de guía para el proceso de mejora de la calidad con objeto de alcanzar los objetivos de control a nivel poblacional en los centros de salud participantes de los países que implementan el programa HEARTS.
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Affiliation(s)
- Jeffrey W Brettler
- Kaiser Permanente del Sur de California Los Ángeles Estados Unidos de América Kaiser Permanente del Sur de California, Los Ángeles, Estados Unidos de América.,Departamento de Ciencias de Sistemas de Salud Facultad de Medicina Bernard J. Tyson de Kaiser Permanente Pasadena Estados Unidos de América Departamento de Ciencias de Sistemas de Salud, Facultad de Medicina Bernard J. Tyson de Kaiser Permanente, Pasadena, Estados Unidos de América
| | - Gloria P Giraldo Arcila
- Departamento de Enfermedades no Transmisibles y Salud Mental Organización Panamericana de Salud Washington Estados Unidos de América Departamento de Enfermedades no Transmisibles y Salud Mental, Organización Panamericana de Salud, Washington, Estados Unidos de América
| | - Teresa Aumala
- Centro de Atención Primaria de Salud Ministerio de Salud Centro de Salud Conocoto Quito Ecuador Centro de Atención Primaria de Salud, Ministerio de Salud, Centro de Salud Conocoto, Quito, Ecuador
| | - Allana Best
- Ministerio de Salud Puerto España Trinidad y Tabago Ministerio de Salud, Puerto España, Trinidad y Tabago
| | - Norm Rc Campbell
- Departamento de Medicina Fisiología y Farmacología y Ciencias de Salud Comunitaria Instituto Cardiovascular Libin de Alberta Calgary Canadá Departamento de Medicina, Fisiología y Farmacología y Ciencias de Salud Comunitaria, Instituto Cardiovascular Libin de Alberta, Calgary, Canadá
| | - Shana Cyr
- Ministerio de Salud Bienestar y Asuntos de la Tercera Edad Castries Santa Lucía Ministerio de Salud, Bienestar y Asuntos de la Tercera Edad, Castries, Santa Lucía
| | - Angelo Gamarra
- Departamento de Enfermedades no Transmisibles y Salud Mental Organización Panamericana de Salud Washington Estados Unidos de América Departamento de Enfermedades no Transmisibles y Salud Mental, Organización Panamericana de Salud, Washington, Estados Unidos de América
| | - Marc G Jaffe
- Departamento de Endocrinología Grupo Médico Permanente Centro Médico de San Francisco Kaiser San Francisco Estados Unidos de América Departamento de Endocrinología, Grupo Médico Permanente, Centro Médico de San Francisco Kaiser, San Francisco, Estados Unidos de América
| | - Mirna Jimenez De la Rosa
- Escuela de Salud Pública Facultad de Ciencias de la Salud Universidad Autónoma de Santo Domingo Santo Domingo Dominican Republic Escuela de Salud Pública, Facultad de Ciencias de la Salud, Universidad Autónoma de Santo Domingo, Santo Domingo, República Dominicana.,Oficina Escuela de Salud Pública Ciudad Universitaria Universidad Autónoma de Santo Domingo Santo Domingo República Dominicana Oficina Escuela de Salud Pública, Ciudad Universitaria, Universidad Autónoma de Santo Domingo, Santo Domingo, República Dominicana
| | - Javier Maldonado
- Organización Panamericana de Salud Bogotá Colombia Organización Panamericana de Salud, Bogotá, Colombia
| | - Carolina Neira Ojeda
- Departamento de Enfermedades no Transmisibles Ministerio de Salud Santiago de Chile Chile Departamento de Enfermedades no Transmisibles, Ministerio de Salud, Santiago de Chile, Chile
| | - Modesta Haughton
- Organización Panamericana de Salud Ancon Panamá Organización Panamericana de Salud, Ancon, Panamá
| | - Taraleen Malcolm
- Organización Panamericana de la Salud Puerto España Trinidad y Tabago Organización Panamericana de la Salud, Puerto España, Trinidad y Tabago
| | - Vivian Perez
- Organización Panamericana de Salud Lima Perú Organización Panamericana de Salud, Lima, Perú
| | - Gonzalo Rodriguez
- Organización Panamericana de la Salud Ciudad Autónoma de Buenos Aires Argentina Organización Panamericana de la Salud, Ciudad Autónoma de Buenos Aires, Argentina
| | - Andres Rosende
- Departamento de Enfermedades no Transmisibles y Salud Mental Organización Panamericana de Salud Washington Estados Unidos de América Departamento de Enfermedades no Transmisibles y Salud Mental, Organización Panamericana de Salud, Washington, Estados Unidos de América
| | - Yamile Valdes Gonzalez
- Comité Técnico Asesor Nacional sobre Hipertensión Hospital Universitario "General Calixto García" La Habana Cuba Comité Técnico Asesor Nacional sobre Hipertensión, Hospital Universitario "General Calixto García", La Habana, Cuba
| | - Peter W Wood
- Departamento de Medicina División de Medicina Interna General Universidad de Alberta Edmonton Canadá Departamento de Medicina, División de Medicina Interna General, Universidad de Alberta, Edmonton, Canadá
| | - Eric Zuñiga
- Servicios de Salud Antofagasta Universidad de Antofagasta Antofagasta Chile Servicios de Salud Antofagasta, Universidad de Antofagasta, Antofagasta, Chile
| | - Pedro Ordunez
- Departamento de Enfermedades no Transmisibles y Salud Mental Organización Panamericana de Salud Washington Estados Unidos de América Departamento de Enfermedades no Transmisibles y Salud Mental, Organización Panamericana de Salud, Washington, Estados Unidos de América
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Brettler JW, Arcila GPG, Aumala T, Best A, Campbell NR, Cyr S, Gamarra A, Jaffe MG, la Rosa MJD, Maldonado J, Ojeda CN, Haughton M, Malcolm T, Perez V, Rodriguez G, Rosende A, González YV, Wood PW, Zúñiga E, Ordunez P. Drivers and scorecards to improve hypertension control in primary care practice: Recommendations from the HEARTS in the Americas Innovation Group. Lancet Reg Health Am 2022; 9:None. [PMID: 35711685 PMCID: PMC9121401 DOI: 10.1016/j.lana.2022.100223] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the Americas, and hypertension is the most significant modifiable risk factor. However, hypertension control rates remain low, and CVD mortality is stagnant or rising after decades of continuing reduction. In 2016, the World Health Organization (WHO) launched the HEARTS technical package to improve hypertension control. The Pan American Health Organization (PAHO) designed the HEARTS in the Americas Initiative to improve CVD risk management, emphasizing hypertension control, to date implemented in 21 countries. Methods To advance implementation, an interdisciplinary group of practitioners was engaged to select the key evidence-based drivers of hypertension control and to design a comprehensive scorecard to monitor their implementation at primary care health facilities (PHC). The group studied high-performing health systems that achieve high hypertension control through quality improvement programs focusing on specific process measures, with regular feedback to providers at health facilities. Findings The final selected eight drivers were categorized into five main domains: (1) diagnosis (blood pressure measurement accuracy and CVD risk evaluation); (2) treatment (standardized treatment protocol and treatment intensification); (3) continuity of care and follow-up; (4) delivery system (team-based care, medication refill), and (5) system for performance evaluation. The drivers and recommendations were then translated into process measures, resulting in two interconnected scorecards integrated into the HEARTS in the Americas monitoring and evaluation system. Interpretation Focus on these key hypertension drivers and resulting scorecards, will guide the quality improvement process to achieve population control goals at the participating health centers in HEARTS implementing countries. Funding No funding to declare.
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Affiliation(s)
- Jeffrey W Brettler
- Southern California Permanente Medical Group, Los Angeles, CA, USA.,Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Gloria P Giraldo Arcila
- Department of Non-Communicable Diseases and Mental Health. Pan American Health Organization (PAHO), Washington, DC, USA
| | - Teresa Aumala
- Primary Health Care Center, Ministry of Health, Centro de Salud Conocoto, Quito, Ecuador
| | - Allana Best
- Ministry of Health, Park Street, Port of Spain, Trinidad and Tobago
| | - Norm Rc Campbell
- Department of Medicine, Physiology and Pharmacology and Community Health Sciences, Libin Cardiovascular Institute of Alberta, Calgary, AB, Canada
| | - Shana Cyr
- Ministry of Health, Wellness & Elderly Affairs, Sir Stanislaus James Building, Waterfront, Castries, Saint Lucia
| | - Angelo Gamarra
- Department of Non-Communicable Diseases and Mental Health. Pan American Health Organization (PAHO), Washington, DC, USA
| | - Marc G Jaffe
- Department of Endocrinology, The Permanente Medical Group, Kaiser San Francisco Medical Center, San Francisco, CA, USA
| | - Mirna Jimenez De la Rosa
- School of Public Health, Faculty of Health Sciences, Universidad Autónoma de Santo Domingo, Dominican Republic.,Oficina Escuela de Salud Pública, Ciudad Universitaria, Universidad Autónoma de Santo Domingo, Distrito Nacional, Dominican Republic
| | | | - Carolina Neira Ojeda
- Department of Noncommunicable Diseases, Ministry of Health, Santiago de Chile, Chile
| | | | - Taraleen Malcolm
- Pan American Health Organization (PAHO), Port of Spain, Trinidad and Tobago
| | - Vivian Perez
- Pan American Health Organization,(PAHO), Lima, Peru
| | - Gonzalo Rodriguez
- Pan American Health Organization, (PAHO), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Andres Rosende
- Department of Non-Communicable Diseases and Mental Health. Pan American Health Organization (PAHO), Washington, DC, USA
| | - Yamilé Valdés González
- National Technical Advisory Committee on Hypertension, University Hospital "General Calixto García", Havana, Cuba
| | - Peter W Wood
- Department of Medicine, Division of General Internal Medicine, University of Alberta, Edmonton, AB, Canada
| | - Eric Zúñiga
- Health Services Antofagasta, Servicio de Salud Antofagasta, Universidad de Antofagasta, Antofagasta, Chile
| | - Pedro Ordunez
- Department of Non-Communicable Diseases and Mental Health. Pan American Health Organization (PAHO), Washington, DC, USA
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Sakai T, Ko JS, Crouch CE, Kumar S, Little MB, Chae MS, Ganoza A, Gómez-Salinas L, Humar A, Kim SH, Koo BN, Rodriguez G, Sirianni J, Smith NK, Song JG, Ullah A, Hendrickse A. Perioperative management of adult living donor liver transplantation: Part 1 - recipients. Clin Transplant 2022; 36:e14667. [PMID: 35435293 DOI: 10.1111/ctr.14667] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/06/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022]
Abstract
Living donor liver transplantation was first developed to mitigate the limited access to deceased donor organs in Asia in the 1990s. This alternative liver transplantation option has become an established and widely practiced transplantation method for adult patients suffering from end-stage liver disease. It has successfully addressed the shortage of deceased donors. The Society for the Advancement of Transplant Anesthesia and the Korean Society of Transplant Anesthesia jointly reviewed published studies on the perioperative management of live donor liver transplant recipients. The review aims to offer transplant anesthesiologists and critical care physicians a comprehensive overview of the perioperative management of adult live liver transplantation recipients. We feature the status, outcomes, surgical procedure, portal venous decompression, anesthetic management, prevention of acute kidney injury, avoidance of blood transfusion, monitoring and therapeutic strategies of hemodynamic derangements, and Enhanced Recovery After Surgery protocols for liver transplant recipients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Tetsuro Sakai
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.,Clinical and Translational Science Institute, University of Pittsburgh, PA, USA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, PA, USA
| | - Justin Sangwook Ko
- Department of Anesthesiology & Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Cara E Crouch
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sathish Kumar
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Michael B Little
- Department of Anesthesiology, UT Health San Antonio, San Antonio, TX, USA
| | - Min Suk Chae
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Armando Ganoza
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Luis Gómez-Salinas
- Department of Anesthesiology and Pain Medicine, Hospital General Universitario de Alicante, Alicante, Spain
| | - Abhi Humar
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Sang Hyun Kim
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Gyeonggi-do, Republic of Korea
| | - Bon-Nyeo Koo
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Gonzalo Rodriguez
- Department of Surgery, Hospital General Universitario de Alicante, Alicante, Spain
| | - Joel Sirianni
- Department of Anesthesia & Perioperative Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Natalie K Smith
- Department of Anesthesiology, Perioperative & Pain Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Jun-Gol Song
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Aisha Ullah
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Adrian Hendrickse
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Huamán L, Huincho S, Aguirre E, Rodriguez G, Brandolini A, Hidalgo A. Physico-chemical characteristics and oxidative stability of oils from different Peruvian castor bean ecotypes. grasasaceites 2022. [DOI: 10.3989/gya.1016202] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of this research was to assess the physico-chemical properties and shelf-life of oils press-extracted at two temperatures (60 °C and 80 °C) from five Peruvian castor bean ecotypes. A wide variation for all traits was observed. Low acidity index, low peroxide index and absence of p-anisidine were recorded. The total tocopherol contents ranged from 798 to 1040 mg/kg. A higher antioxidant capacity was detected in methanolic extracts than in hexane extract. From the Rancimat performed at 150-170 °C, the predicted shelf-life at 25 °C ranged from 0.15 to 8.93 years; the higher extraction temperature led to a longer shelf-life, probably because of enzyme inactivation.
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Chinelli J, Medina A, Martinez M, Ramirez V, Rodriguez G. Laparoscopic mesh rectopexy in recurrent rectal prolapse - a video vignette. Colorectal Dis 2021; 23:2491. [PMID: 34157203 DOI: 10.1111/codi.15775] [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] [Indexed: 02/08/2023]
Affiliation(s)
- J Chinelli
- Clínica Quirúrgica 2 (Surgical Clinic 2), Hospital Maciel, Montevideo, Uruguay
| | - A Medina
- Clínica Quirúrgica 2 (Surgical Clinic 2), Hospital Maciel, Montevideo, Uruguay
| | - M Martinez
- Clínica Quirúrgica 2 (Surgical Clinic 2), Hospital Maciel, Montevideo, Uruguay
| | - V Ramirez
- Clínica Quirúrgica 2 (Surgical Clinic 2), Hospital Maciel, Montevideo, Uruguay
| | - G Rodriguez
- Clínica Quirúrgica 2 (Surgical Clinic 2), Hospital Maciel, Montevideo, Uruguay
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Gutierrez A, Bento L, Novelli S, Gutierrez G, Salas Q, Bastos‐Oreiro M, Perez A, Hernani R, Viguria MC, Lopez‐Godino O, Montoro J, Piñana JL, Ferra C, Parody R, Martin C, Gomez‐Espuch J, Yañez L, Rodriguez G, Zanabilli J, Herrera P, Varela MR, Sampol A, Caballero MD. CURRENT ROLE OF ALLOGENEIC STEM CELL TRANSPLANTATION IN MANTLE CELL LYMPHOMA IN THE ERA OF NEW IMMUNOTHERAPEUTIC AND TARGETED THERAPIES. THE GETH/GELTAMO EXPERIENCE. Hematol Oncol 2021. [DOI: 10.1002/hon.56_2880] [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)
- A. Gutierrez
- Hospital Universitario Son Espases Hematology 07120 Spain
| | - L. Bento
- Hospital Universitario Son Espases Hematology 07120 Spain
| | - S. Novelli
- Hospital Sant Pau Hematology Barcelona Spain
| | | | - Q. Salas
- Hospital Clinic Hematology Barcelona Spain
| | | | - A. Perez
- Hospital Clinico Universitario de Valencia Hematology Valencia Spain
| | - R. Hernani
- Hospital Clinico Universitario de Valencia Hematology Valencia Spain
| | | | | | - J. Montoro
- Hospital La Fe Hematology Valencia Spain
| | | | - C. Ferra
- Hospital de Can Ruti Hematology Badalona Spain
| | - R. Parody
- Hospital de Bellvitge Hematologyi Barcelona Spain
| | - C. Martin
- Hospital Reina Sofia Hematology Cordoba Spain
| | | | - L. Yañez
- Hospital de Valldecilla Hematology Santander Spain
| | - G. Rodriguez
- Hospital Virgen del Rocio Hematology Sevilla Spain
| | - J. Zanabilli
- Hospital Universitario Central de Asturias Hematology Oviedo Spain
| | - P. Herrera
- Hospital Ramon y Cajal Hematology Madrid Spain
| | - M. R. Varela
- Hospital Juan Canelejo Hematology La Coruña Spain
| | - A. Sampol
- Hospital Universitario Son Espases Hematology 07120 Spain
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Belli LS, Fondevila C, Cortesi PA, Conti S, Karam V, Adam R, Coilly A, Ericzon BG, Loinaz C, Cuervas-Mons V, Zambelli M, Llado L, Diaz-Fontenla F, Invernizzi F, Patrono D, Faitot F, Bhooori S, Pirenne J, Perricone G, Magini G, Castells L, Detry O, Cruchaga PM, Colmenero J, Berrevoet F, Rodriguez G, Ysebaert D, Radenne S, Metselaar H, Morelli C, De Carlis LG, Polak WG, Duvoux C. Protective Role of Tacrolimus, Deleterious Role of Age and Comorbidities in Liver Transplant Recipients With Covid-19: Results From the ELITA/ELTR Multi-center European Study. Gastroenterology 2021; 160:1151-1163.e3. [PMID: 33307029 PMCID: PMC7724463 DOI: 10.1053/j.gastro.2020.11.045] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Despite concerns that liver transplant (LT) recipients may be at increased risk of unfavorable outcomes from COVID-19 due the high prevalence of co-morbidities, immunosuppression and ageing, a detailed analysis of their effects in large studies is lacking. METHODS Data from adult LT recipients with laboratory confirmed SARS-CoV2 infection were collected across Europe. All consecutive patients with symptoms were included in the analysis. RESULTS Between March 1 and June 27, 2020, data from 243 adult symptomatic cases from 36 centers and 9 countries were collected. Thirty-nine (16%) were managed as outpatients while 204 (84%) required hospitalization including admission to the ICU (39 of 204, 19.1%). Forty-nine (20.2%) patients died after a median of 13.5 (10-23) days, respiratory failure was the major cause. After multivariable Cox regression analysis, age >70 (HR, 4.16; 95% CI, 1.78-9.73) had a negative effect and tacrolimus (TAC) use (HR, 0.55; 95% CI, 0.31-0.99) had a positive independent effect on survival. The role of co-morbidities was strongly influenced by the dominant effect of age where comorbidities increased with the increasing age of the recipients. In a second model excluding age, both diabetes (HR, 1.95; 95% CI, 1.06-3.58) and chronic kidney disease (HR, 1.97; 95% CI, 1.05-3.67) emerged as associated with death CONCLUSIONS: Twenty-five percent of patients requiring hospitalization for COVID-19 died, the risk being higher in patients older than 70 and with medical co-morbidities, such as impaired renal function and diabetes. Conversely, the use of TAC was associated with a better survival thus encouraging clinicians to keep TAC at the usual dose.
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Affiliation(s)
- Luca S. Belli
- Department of Hepatology and Gastroenterology, Niguarda Hospital, Milan, Italy,Correspondence Address correspondence to: Luca S. Belli, Department of Hepatology and Gastroenterology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
| | - Constantino Fondevila
- Department of General and Digestive Surgery, Hospital Clínic, Institut d’Investigacion Biomediques August Pi-Sunyer (IDIBAPS) Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), University of Barcelona, Barcelona, Spain
| | - Paolo A. Cortesi
- Research Centre on Public Health (CESP), University of Milan-Bicocca, Monza, Italy
| | - Sara Conti
- Research Centre on Public Health (CESP), University of Milan-Bicocca, Monza, Italy
| | - Vincent Karam
- European Liver Transplant Registry, Centre Hépatobiliaire, Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Paul-Brousse, Paris-Saclay University, Villejuif, France
| | - Rene Adam
- European Liver Transplant Registry, Centre Hépatobiliaire, Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Paul-Brousse, Paris-Saclay University, Villejuif, France
| | - Audrey Coilly
- Centre Hepato-Biliaire, Assistance Publique-Hôpitaux de Paris, Hôpital Paul-Brousse, Paris-Sud Saclay University, Villejuif, France
| | - Bo Goran Ericzon
- Division of Transplantation Surgery, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Carmelo Loinaz
- Chirugía General, Doce de Octubre Universidad Complutense de Madrid, Madrid, Spain
| | - Valentin Cuervas-Mons
- Departimento de Medicina, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Madrid, Spain
| | - Marco Zambelli
- Department of Surgery, “Papa Giovanni XXIII” Hospital, Bergamo, Lombardia, Italy
| | - Laura Llado
- Liver Transplant Unit, Hospital Uniersitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - Fernando Diaz-Fontenla
- Unidad de Trasplante Hepático, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Federica Invernizzi
- Division of Gastroenterology and Hepatology, University of Milan, Milan, Italy
| | - Damiano Patrono
- Liver Transplantation Center, Molinette Hospital, Turin, Italy
| | - Francois Faitot
- Service de Chirurgie Hépatobiliaire et Transplantation, Hôpital de Hautepierre, Strasbourg, France
| | - Sherrie Bhooori
- Department of Surgery and Oncology, Istituto Nazionale Tumori, Milan, Italy
| | - Jacques Pirenne
- Department of Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Giovanni Perricone
- Department of Hepatology and Gastroenterology, Niguarda Hospital, Milan, Italy
| | - Giulia Magini
- Service de Transplantation, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Lluis Castells
- Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain
| | - Oliver Detry
- Department of Abdominal Surgery and Transplantation, Centre Hospitalier Universitaire Liege, University of Liege, Liege, Belgium
| | - Pablo Mart Cruchaga
- Cirugía General y Digestiva, Clínica Universidad de Navarra, Pamplona, Spain
| | - Jordi Colmenero
- Department of General and Digestive Surgery, Hospital Clínic, Institut d’Investigacion Biomediques August Pi-Sunyer (IDIBAPS) Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), University of Barcelona, Barcelona, Spain
| | - Frederick Berrevoet
- Department of General and Hepatobiliary Surgery, Ghent University, Ghent, Belgium
| | - Gonzalo Rodriguez
- Department of General & Digestive Surgery, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General Universitario de Alicante, Alicante, Spain
| | - Dirk Ysebaert
- Department of Surgery, Antwerp University Hospital, Antwerp University, Edegem, Belgium
| | - Sylvie Radenne
- Service d’Hépato-Gastroentérologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Herold Metselaar
- Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Cristina Morelli
- Liver and Multi-organ Transplantation, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Luciano G. De Carlis
- General Surgery and Abdominal Transplantation Unit, Niguarda-Cà Granda Hospital, and School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Wojciech G. Polak
- Department of Surgery, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Christophe Duvoux
- Department of Hepatology and Medical Liver Transplant Unit, Henri Mondor Hospital Assistance Publique-Hôpitaux de Paris, Paris-Est University, Creteil, France
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Rodriguez G, Moore SJ, Neff RC, Glass ED, Stevenson TK, Stinnett GS, Seasholtz AF, Murphy GG, Cazares VA. Deficits across multiple behavioral domains align with susceptibility to stress in 129S1/SvImJ mice. Neurobiol Stress 2020; 13:100262. [PMID: 33344715 PMCID: PMC7739066 DOI: 10.1016/j.ynstr.2020.100262] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/07/2020] [Accepted: 10/16/2020] [Indexed: 01/08/2023] Open
Abstract
Acute physical or psychological stress can elicit adaptive behaviors that allow an organism maintain homeostasis. However, intense and/or prolonged stressors often have the opposite effect, resulting in maladaptive behaviors and curbing goal-directed action; in the extreme, this may contribute to the development of psychiatric conditions like generalized anxiety disorder, major depressive disorder, or post-traumatic stress disorder. While treatment of these disorders generally focuses on reducing reactivity to potentially threatening stimuli, there are in fact impairments across multiple domains including valence, arousal, and cognition. Here, we use the genetically stress-susceptible 129S1 mouse strain to explore the effects of stress across multiple domains. We find that 129S1 mice exhibit a potentiated neuroendocrine response across many environments and paradigms, and that this is associated with reduced exploration, neophobia, decreased novelty- and reward-seeking, and spatial learning and memory impairments. Taken together, our results suggest that the 129S1 strain may provide a useful model for elucidating mechanisms underlying myriad aspects of stress-linked psychiatric disorders as well as potential treatments that may ameliorate symptoms.
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Affiliation(s)
- G Rodriguez
- Michigan Neuroscience Institute, USA.,Neuroscience Graduate Program, USA
| | - S J Moore
- Department of Molecular and Integrative Physiology, USA.,Michigan Neuroscience Institute, USA
| | - R C Neff
- Department of Molecular and Integrative Physiology, USA
| | - E D Glass
- Department of Molecular and Integrative Physiology, USA.,Michigan Neuroscience Institute, USA
| | | | | | - A F Seasholtz
- Michigan Neuroscience Institute, USA.,Neuroscience Graduate Program, USA.,Department of Biological Chemistry University of Michigan, Ann Arbor, MI, USA
| | - G G Murphy
- Department of Molecular and Integrative Physiology, USA.,Michigan Neuroscience Institute, USA.,Neuroscience Graduate Program, USA
| | - V A Cazares
- Department of Molecular and Integrative Physiology, USA.,Michigan Neuroscience Institute, USA.,Department of Psychology, Williams College, MA, USA
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Mahal J, Seu R, Deccy S, Rodriguez G. 202 Linking Emergency Department Patients at Risk for Human Immunodeficiency Virus to Pre-Exposure Prophylaxis. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Salama M, Ataman-Millhouse L, Braham M, Berjeb K, Khrouf M, Rodrigues JK, Reis FM, Silva TC, Sánchez F, Romero S, Smitz J, Vásquez L, Vega M, Sobral F, Terrado G, Lombardi MG, Scarella A, Bourlon MT, Verduzco-Aguirre H, Sánchez AM, Adiga SK, Tholeti P, Udupa KS, Mahajan N, Patil M, Dalvi R, Venter C, Demetriou G, Geel J, Quintana R, Rodriguez G, Quintana T, Viale L, Fraguglia M, Coirini M, Remolina-Bonilla YA, Noguera JAR, Velásquez JC, Suarez A, Arango GD, Pineda JID, Aldecoa MDC, Javed M, Al Sufyan H, Daniels N, Oranye BC, Ogunmokun AA, Onwuzurigbo KI, Okereke CJ, Whesu TC, Woodruff TK. Installing oncofertility programs for common cancers in limited resource settings (Repro-Can-OPEN Study): An extrapolation during the global crisis of Coronavirus (COVID-19) pandemic. J Assist Reprod Genet 2020; 37:1567-1577. [PMID: 32594284 PMCID: PMC7320246 DOI: 10.1007/s10815-020-01821-7] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/10/2020] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The state of limited resource settings that Coronavirus (COVID-19) pandemic has created globally should be taken seriously into account especially in healthcare sector. In oncofertility, patients should receive their fertility preservation treatments urgently even in limited resource settings before initiation of anticancer therapy. Therefore, it is very crucial to learn more about oncofertility practice in limited resource settings such as in developing countries that suffer often from shortage of healthcare services provided to young patients with cancer. METHODS As an extrapolation during the global crisis of COVID-19 pandemic, we surveyed oncofertility centers from 14 developing countries (Egypt, Tunisia, Brazil, Peru, Panama, Mexico, Colombia, Guatemala, Argentina, Chile, Nigeria, South Africa, Saudi Arabia, and India). Survey questionnaire included questions on the availability and degree of utilization of fertility preservation options in case of childhood cancer, breast cancer, and blood cancer. RESULTS All surveyed centers responded to all questions. Responses and their calculated oncofertility scores showed different domestic standards for oncofertility practice in case of childhood cancer, breast cancer, and blood cancer in the developing countries under limited resource settings. CONCLUSIONS Medical practice in limited resource settings has become a critical topic especially after the global crisis of COVID-19 pandemic. Understanding the resources necessary to provide oncofertility treatments is important until the current COVID-19 pandemic resolves. Lessons learned will be valuable to future potential worldwide disruptions due to infectious diseases or other global crises.
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Affiliation(s)
- M. Salama
- Oncofertility Consortium, Feinberg School of Medicine, Northwestern University, Chicago, Illinois USA
| | - L. Ataman-Millhouse
- Oncofertility Consortium, Feinberg School of Medicine, Northwestern University, Chicago, Illinois USA
| | - M. Braham
- Aziza Othmana Hospital of Tunis, Tunis, Tunisia
| | - K. Berjeb
- Aziza Othmana Hospital of Tunis, Tunis, Tunisia
| | - M. Khrouf
- FERTILLA, Clinique la Rose, Tunis, Tunisia
| | - J. K. Rodrigues
- Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - F. M. Reis
- Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - T. Cury- Silva
- Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - F. Sánchez
- Laboratorio de Biología Reproductiva y Preservación de la Fertilidad, Laboratorios de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - S. Romero
- Laboratorio de Biología Reproductiva y Preservación de la Fertilidad, Laboratorios de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - J. Smitz
- Laboratorio de Biología Reproductiva y Preservación de la Fertilidad, Laboratorios de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - L. Vásquez
- Unidad de Oncología Pediátrica, Hospital Edgardo Rebagliati Martins, Lima, Peru
| | - M. Vega
- Panama Fertility, Sistema Nacional de Investigadores, Panama City, Panama
| | - F. Sobral
- Pregna Medicina Reproductiva, Buenos Aires, Argentina
| | - G. Terrado
- Pregna Medicina Reproductiva, Buenos Aires, Argentina
| | | | - A. Scarella
- Centro de Reproduccion Humana, Facultad de Medicina, Universidad de Valparaiso, Valparaiso, Chile
| | - M. T. Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - H. Verduzco-Aguirre
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - A. M. Sánchez
- Instituto Nacional de Perinatología Isidro Espinoza de los Reyes, Mexico City, Mexico
| | - S. K. Adiga
- Fertility Preservation Centre, Department of Clinical Embryology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - P. Tholeti
- Fertility Preservation Centre, Department of Clinical Embryology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - K. S. Udupa
- Department of Medical Oncology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - N. Mahajan
- Mother and Child Hospital, New Delhi, India
| | - M. Patil
- Dr. Patil’s Fertility and Endoscopy Clinic, Bangalore, India
| | - R. Dalvi
- Hospital Institute of Medical Sciences & SRCC children’s Hospital, Mumbai, India
| | - C. Venter
- Vitalab Fertility Centre, Johannesburg, South Africa
| | - G. Demetriou
- Department Medical Oncology, University of Witwatersrand, Johannesburg, South Africa
| | - J. Geel
- Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | | | | | | | - L. Viale
- Procrearte, Buenos Aires, Argentina
| | | | - M. Coirini
- Hospital de Niños Victor J. Vilela. Rosario, Santa Fe, Argentina
| | | | | | | | - A. Suarez
- Instituto Nacional de Cancerología, Bogota, Colombia
| | | | - J. I. D. Pineda
- Instituto Guatemalteco de Seguridad Social (IGSS), Guatemala City, Guatemala
| | - M. D. C. Aldecoa
- Instituto Guatemalteco de Seguridad Social (IGSS), Guatemala City, Guatemala
| | - M. Javed
- Thuriah Medical Center, Riyadh, Kingdom of Saudi Arabia
| | - H. Al Sufyan
- Thuriah Medical Center, Riyadh, Kingdom of Saudi Arabia
| | - N. Daniels
- The Oncology and Fertility Centres of Ekocorp Plc, Eko Hospitals, Lagos, Nigeria
| | - B. C. Oranye
- The Oncology and Fertility Centres of Ekocorp Plc, Eko Hospitals, Lagos, Nigeria
| | - A. A. Ogunmokun
- The Oncology and Fertility Centres of Ekocorp Plc, Eko Hospitals, Lagos, Nigeria
| | | | | | - T. C. Whesu
- Kingswill Specialist Hospital, Lagos, Nigeria
| | - T. K. Woodruff
- Oncofertility Consortium, Feinberg School of Medicine, Northwestern University, Chicago, Illinois USA
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Viola M, Benitez A, Garbarino C, Rodriguez G, Benavidez F, Peon C, Blanco ES, Molina H, Gómez G, Redondo G, Delavega M, Mata D, Riopedre A, Messina O. FRI0607-HPR FREQUENCY AND PATIENTS BELIEFS ON VACCINATION IN RHEUMATIC DISEASES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4986] [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: 11/04/2022]
Abstract
Background:Infectious diseases are increased in patients with rheumatic disorders; vaccination improves morbidity and mortalityObjectives:The aim of this study was to describe the frequency of vaccination in patients with rheumatic disorders and to compare the results with those obtained in 2009 and 2013 in a similar population. We also identified factors leading to lack of vaccination and patients beliefs on vaccines.Methods:Multicentric cross sectional study in patients with autoinmune diseases from external rheumatology offices. Evaluation of vaccination status and patients´ knowledge about vaccines were studied. A comparative analysis was carried out with the series registered in 2009 and 2013 in a similar population.Results:179 patients (158 female, 88.3% and 21 male, 11.7%) were evaluated. Median age was 52 years. Main pathologies were: Rheumatoid Arthritis 65.9% (n:118), Systemic Lupus Erythematosus 11.7% (n:21), Systemic Sclerosis 3.9% (7), Sjogren Syndrome n = 3.4% (n:6), other diseases 15% (n: 27). Median disease duration: 8.87 years. Ninety three percent of patients (n:167) were taking inmunomodulators and 36.8% (n: 66) were using oral corticosteroids (20mg/day or less); 26,8% patients (n: 48) were receiving biological therapies. Vaccination frequency in the population was: Influenza 82% (147); 13-valent conjugate pneumococcal 69.3% (124), 23-valent pneumococcal 64.2% (115) and hepatitis B 62% (111). Comparative with 2009 and 2013 series there was an increase in the rate of vaccinated patients: influenza (82% vs. 39,1% and 74,2% respectively), antineumococcal (64% vs. 17% and 29%) and hepatitis B (62% vs. 6,7% and 26,7%).Reasons for non-vaccination were absence of medical indication (41% of patients for hepatitis B; 32% for 23-valent pneumococcal; 38% for 13-valent pneumococcal and 34% for influenza).139 patients (77, 7%) knew the benefits of vaccines, 164 (91, 6%) thought vaccines are useful; 134 (74,9%) reported that vaccines may decrease dying probability, 155 (86,5%) thought that vaccines are effective to prevent diseases and 149 patients (83,2%) believed that they prevent serious infections. 71 patients (39%) believed that vaccines can lead to serious consequences and 99 (55,3%) that they are more likely to acquire infections than the rest of the population.Conclusion:Frequency of vaccination has increased since 2009 but there is still misinformation regarding vaccines risks and benefits. Promotion and information is essential to improve adherence.References:[1]2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. Furer V, et al. Ann Rheum Dis 2020;79:39–52[2] Vaccines and Disease-Modifying Antirheumatic Drugs: Practical Implications for the Rheumatologist. Friedman MA et al. Rheum Dis Clin North Am. 2017 Feb; 43 (1):1-13.[3] Recommendations and barriers to vaccination in systemic lupus erythematosus. Garg M et al. Autoimmun Rev. 2018 Oct; 17 (10):990-1001.[4] Comparison of national clinical practice guidelines and recommendations on vaccination of adult patients with autoimmune rheumatic diseases. Papadopoulou D. et al. Rheumatol Int. 2014 Feb;34 (2):151-63.[5] Guías de recomendaciones de prevención de infecciones en pacientes que reciben modificadores de la respuesta biológica. Jordán R. Et al. Rev Arg Reumatol. 2014; 25 (2): 08-26.Disclosure of Interests:Malena Viola: None declared, Alejandro Benitez: None declared, Cecilia Garbarino: None declared, Gonzalo Rodriguez: None declared, Federico Benavidez: None declared, Claudia Peon: None declared, Eliana Soledad Blanco: None declared, Hernan Molina: None declared, Gimena Gómez: None declared, griselda redondo: None declared, Maria DeLaVega: None declared, Dario Mata: None declared, Augusto Riopedre: None declared, Osvaldo Messina Speakers bureau: Amgen; Americas Health Foundation; Pfizer
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Benavidez F, Rodriguez G, Riopedre A, Mata D, Benitez A, Peon C, Viola M, Blanco ES, Molina H, Garbarino C, Secco A, Caceres A, Sasaki P, Carballo G, Ingenito F, Fernandez M, Alberti L, Caro F, Paulin F, Delavega M. FRI0056 LUNG COMPROMISE SCREENING IN PATIENTS WITH EARLY RA. A MULTICENTRIC CROSS SECTIONAL STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1003] [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: 11/03/2022]
Abstract
Background:Rheumatoid arthritis (RA) affects 0.4-1.3% of general population (1). It can affect lungs in different ways, with interstitial lung disease (ILD) as the most severe. Clinically evident ILD has been reported in 10-42% of patients, with a great impact in prognosis (2).Objectives:Toidentify the prevalence of lung involvement in early rheumatoid arthritis patients (ERA) without previous known lung disease and describe the association between high resolution computed tomography (HRCT), lung functional tests (LFT) and clinical findings.Methods:Cross sectional multicentric study. We included ERA patients (1 year or less since diagnose) consecutively. Patients with previous RA related lung disease or biologic/targeted synthetic Dmard treatment were excluded. HRCT, immunological tests (rheumatoid factor, anti-CCP, ANA), LFT and clinical evaluation were performed.Results:We included 74 patients, 63 (85,1%) woman, mean (SD) of 47 (17,7) years. Thirty-seven patients (50%) were current or former smokers. Abnormal findings in HRCT were found in 62 patients (88,6%): ILD in 6 (8,6%), airway involvement in 40 (70%) and emphysema in 7 (10%). Ten patients (13,5%) had abnormal auscultation (2 sibilances, 2 roncus, and 6 crackles). Six patients (8,1%) had digital clubbing. Regarding immunological tests, 54/61 (88,5%) patients were positive for Anti CCP, and 53/61 (86,9%) were positive for FR. We compared features of patients with findings related to RA in HRCT (interstitial and/or airway) with those without them. We found no differences in the mean (SD) of DAS-28 [4,74 (1,38) vs 4,32 (1,39); p= 0,27]. The prevalence of anti- CCP was not higher in patients with abnormal HRCT [38/44 (86,3%) vs 16/17 (94,1%); p=0,39]. Patients with abnormal HRCT were older [median (IQR) 50,5 years (44,5-59,5) vs 43 years (32-51); p=0,008) and showed higher VSG values [mean (SD) 39,09 (24,03) vs 27,38 (17,6); p= 0,043]. Abnormal physical examination or dyspnea (class 2 mMRC or higher) was significantly associated with HRCT abnormalities [26 (50%) vs 3 (13,6%); p=0.003) and the presence of ILD on HRCT was significantly associated with crackles on the auscultation [4/68(6,25%) vs 2/6 (33,33%); p 0,023].Conclusion:This study shows a high prevalence of lung involvement in ERA patients of less 1 year from diagnosis. Also, we showed a significant association between HRCT and physical examination findings. This data highlights the importance of the clinical examination in Rheumatoid Arthritis patients. More studies with bigger samples and longitudinal follow up are needed to confirm and complete our results.References:[1]Rooney BK, Silman AJ. Epidemiology of the rheumatic diseases. Curr Opin Rheumatol [Internet]. 1999 Mar [cited 2016 Jul 19];11(2):91–7. Available from:http://www.ncbi.nlm.nih.gov/pubmed/10319210.[2]Antin-Ozerkis D, Evans J, Rubinowitz A, Homer RJ, Matthay RA. Pulmonary Manifestations of Rheumatoid Arthritis. Clin Chest Med [Internet]. 2010;31(3):451–78. Available from:http://dx.doi.org/10.1016/j.ccm.2010.04.003.Disclosure of Interests:None declared
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Cedres S, Hernando-Calvo A, Iranzo P, Callejo A, Aranda NP, Navarro A, Martinez-Marti A, Assaf J, Miquel J, Rodriguez G, Monton V, Pedrola A, Viaplana C, Carbonell C, Sanso M, Dienstmann R, Amat R, Vivancos A, Felip E. P1.16-05 Incidence and Outcome of Multiple Primary Cancers (MPC) in a Series of Lung Cancer (LC) Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cedres S, Assaf J, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Rodriguez G, Monton V, Gonzalo J, Miquel J, Pedrola A, Dienstmann R, Felip E. Real-world use of systemic therapy in elderly patients with malignant pleural mesothelioma (MPM). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz266.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
Orofacial clefting is the most common congenital craniofacial malformation, appearing in approximately 1 in 700 live births. Orofacial clefting includes several distinct anatomic malformations affecting the upper lip and hard and soft palate. The etiology of orofacial clefting is multifactorial, including genetic or environmental factors or their combination. A large body of work has focused on the molecular etiology of cleft lip and clefts of the hard palate, but study of the underlying etiology of soft palate clefts is an emerging field. Recent advances in the understanding of soft palate development suggest that it may be regulated by distinct pathways from those implicated in hard palate development. Soft palate clefting leads to muscle misorientation and oropharyngeal deficiency and adversely affects speech, swallowing, breathing, and hearing. Hence, there is an important need to investigate the regulatory mechanisms of soft palate development. Significantly, the anatomy, function, and development of soft palatal muscles are similar in humans and mice, rendering the mouse an excellent model for investigating molecular and cellular mechanisms of soft palate clefts. Cranial neural crest-derived cells provide important regulatory cues to guide myogenic progenitors to differentiate into muscles in the soft palate. Signals from the palatal epithelium also play key roles via tissue-tissue interactions mediated by Tgf-β, Wnt, Fgf, and Hh signaling molecules. Additionally, mutations in transcription factors, such as Dlx5, Tbx1, and Tbx22, have been associated with soft palate clefting in humans and mice, suggesting that they play important regulatory roles during soft palate development. Finally, we highlight the importance of distinguishing specific types of soft palate defects in patients and developing relevant animal models for each of these types to improve our understanding of the regulatory mechanism of soft palate development. This knowledge will provide a foundation for improving treatment for patients in the future.
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Affiliation(s)
- J Li
- 1 Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - G Rodriguez
- 1 Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - X Han
- 1 Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - E Janečková
- 1 Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - S Kahng
- 1 Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - B Song
- 1 Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Y Chai
- 1 Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
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Garcia-Sanz R, Sureda A, de la Cruz F, Canales M, Gonzalez AP, Pinana JL, Rodriguez A, Gutierrez A, Domingo-Domenech E, Sanchez-Gonzalez B, Rodriguez G, Lopez J, Moreno M, Rodriguez-Salazar MJ, Jimenez-Cabrera S, Caballero MD, Martinez C. Brentuximab vedotin and ESHAP is highly effective as second-line therapy for Hodgkin lymphoma patients (long-term results of a trial by the Spanish GELTAMO Group). Ann Oncol 2019; 30:612-620. [PMID: 30657848 DOI: 10.1093/annonc/mdz009] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [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] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In this work, we assessed the efficacy and safety of brentuximab vedotin (BV) plus ESHAP (BRESHAP) as second-line therapy for Relapsed/Refractory Hodgkin lymphoma (RRHL) to improve the results before autologous stem-cell transplantation (ASCT). PATIENTS AND METHODS This was a multicenter, open-label, phase I-II trial of patients with RRHL after first-line chemotherapy. Treatment had three 21-day cycles of etoposide, solumedrol, high-dose AraC, and cisplatin. BV was administered at three dose levels (0.9, 1.2, and 1.8 mg/kg) intravenous on day ‒1 to 3 + 3 cohorts of patients. Final BV dose was 1.8 mg/kg. Responding patients proceeded to ASCT, followed by three BV courses (1.8 mg/kg, every 21 days). Main end points for evaluation were maximum tolerable dose and overall and complete response (CR) before ASCT. RESULTS A total of 66 patients were recruited (median age 36 years; range 18-66): 40 were primary refractory, 16 early relapse and 10 late relapse. There were 39 severe adverse events were reported in 22 patients, most frequently fever (n = 25, 35% neutropenic), including 3 deaths. Grade 3-4 hematological toxicity presented in 28 cases: neutropenia (n = 21), thrombocytopenia (n = 14), and anemia (n = 7). Grade ≥3-4 extrahematological adverse events (≥5%) were non-neutropenic fever (n = 13) and hypomagnesaemia (n = 3). Sixty-four patients underwent stem-cell mobilization; all collected >2×10e6/kg CD34+ cells (median 5.75; range 2.12-33.4). Overall response before transplant was 91% (CI 84% to 98%), including 70% (CRs 95% CI 59% to 81%). 60 patients were transplanted with no failure engraftments. Post-transplant response was CR in 49 patients (82% CI 73% to 91%) and partial responses in six (10% CI 5% to 15%). After a mean follow-up of 27 months, the 30-month time to treatment to failure was 74% (95% CI 68% to 80%), progression-free survival 71% (95% CI 65% to 77%), and overall survival 91% (CI 84% to 98%). CONCLUSION BRESHAP looks a safe and effective pre-transplant induction regimen, does not jeopardize transplant and allows long-term remissions and survival.
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Affiliation(s)
- R Garcia-Sanz
- Servicio de Hematología, Hospital Universitario de Salamanca; Instituto de Investigación Biomédica de Salamanca (IBSAL); Centro de Investigación del Cáncer de Salamanca, Salamanca; Servicio de Hematología, Hospital Duran i Reynals, Instituto Catalá d'Oncologia, L'Hospitalet de Llobregat, Barcelona.
| | - A Sureda
- Servicio de Hematología, Hospital Virgen del Rocio de Sevilla, Seville
| | - F de la Cruz
- Servicio de Hematología, Hospital La Paz de Madrid, Madrid
| | - M Canales
- Servicio de Hematología, Hospital Central de Asturias, Oviedo, Asturias
| | - A P Gonzalez
- Servicio de Hematología, Hospital Clínico de Valencia, Valencia
| | - J L Pinana
- Servicio de Hematología, Hospital 12 de Octubre de Madrid, Madrid
| | - A Rodriguez
- Servicio de Hematología, Hospital Son Espases de Palma de Mallorca, Palma de Mallorca
| | - A Gutierrez
- Servicio de Hematología, Hospital del Mar de Barcelona, Barcelona
| | | | | | - G Rodriguez
- Servicio de Hematología, Hospital Ramón y Cajal, Madrid
| | - J Lopez
- Servicio de Hematología, Hospital Germans Trias y Pujol de Badalona, Barcelona
| | - M Moreno
- Servicio de Hematología, Hospital Universitario de Canarias, Tenerife
| | | | | | - M D Caballero
- Servicio de Hematología, Hospital Universitario de Salamanca; Instituto de Investigación Biomédica de Salamanca (IBSAL); Centro de Investigación del Cáncer de Salamanca, Salamanca; Servicio de Hematología, Hospital Duran i Reynals, Instituto Catalá d'Oncologia, L'Hospitalet de Llobregat, Barcelona
| | - C Martinez
- Hospital Clinic de Barcelona, Barcelona, Spain
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Rodriguez G, Morselli A. Instruments optimizations for low energy Gamma-ray detection. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201920901044] [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: 11/14/2022] Open
Abstract
There is an experimental gap in the study of the non-thermal universe in the photon energy range from 0.3 to 100 MeV. We have analyzed the performance of a detector with unprecedented sensitivity, angular and energy resolution and combined with polarimetric capability to study of the most powerful Galactic and extragalactic sources and with a line sensitivity in the MeV energy range two orders of magnitude better than previous generation of instruments that can determine the origin of key isotopes fundamental for the understanding of supernova explosion and the chemical evolution of our Galaxy.
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Cedres Perez S, Sanso M, Hernando-Calvo A, Callejo A, Pardo Aranda N, Navarro Mendivil A, Martinez A, Remon J, Miquel J, Rodriguez G, Monton V, Villacampa G, Dienstmann R, Vivancos A, Felip Font E. Multiple primary cancers (MPC) in a series of lung cancer (LC) patient: Incidence and outcome. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Boaga J, Ghinassi M, D'Alpaos A, Deidda GP, Rodriguez G, Cassiani G. Geophysical investigations unravel the vestiges of ancient meandering channels and their dynamics in tidal landscapes. Sci Rep 2018; 8:1708. [PMID: 29374215 PMCID: PMC5786030 DOI: 10.1038/s41598-018-20061-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 04/10/2017] [Accepted: 01/10/2018] [Indexed: 11/09/2022] Open
Abstract
Whether or not one can detect relict signatures of the past imprinted in current landscapes is a question of the utmost theoretical and practical relevance for meandering tidal channels, owing to their influence on the morphodynamic evolution of tidal landscapes, a critically fragile environment, especially in face of expected climatic changes. Unravelling the sedimentary patterns of ancient channels is an expensive process that usually requires high resolution sediment coring. Here we use a novel inversion process of multi-frequency electromagnetic measurements to reveal the signature and characterize the dynamics of a salt-marsh paleo-meander in the Venice Lagoon. We show that the ancient meander migrated laterally while vertically aggrading, developing a peculiar bar geometry which is less common in analogous fluvial meanders. The observed point-bar dynamics and the associated architectural geometry are consistent with remote sensing and borehole data and contrast with current assessments of tidal meander morphodynamics mediated from classical fluvial theories. In addition, the proposed technique, rapid and non-invasive, bears important consequences for detecting buried stratal geometries and reconstructing the spatial distribution of ancient sedimentary bodies, providing quantitative data for the description of landscape evolution in time.
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Affiliation(s)
- Jacopo Boaga
- Dipartimento di Geoscienze, Università di Padova, Padua, Italy
| | | | - Andrea D'Alpaos
- Dipartimento di Geoscienze, Università di Padova, Padua, Italy
| | - G P Deidda
- Dipartimento di Ingegneria Civile, Ambientale e Architettura, Università di Cagliari, Cagliari, Italy
| | - G Rodriguez
- Dipartimento di Matematica e Informatica, Università di Cagliari, Cagliari, Italy
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Ding G, Fondevila N, Palacio MA, Merke J, Martinez A, Camacho B, Aignasse A, Figini E, Rodriguez G, Lv L, Liu Z, Shi W. Prevalence of honeybee viruses in different regions of China and Argentina. REV SCI TECH OIE 2017; 35:825-833. [PMID: 28332647 DOI: 10.20506/rst.35.3.2572] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Honeybees are threatened by various pathogens and parasites. More than 18 viruses have been described in honeybees and many of them have been detected in China and Argentina. In China, both Apis cerana and Apis mellifera are raised. In Argentina, beekeepers raise different ecotypes of A. mellifera: European honeybees (in both temperate and subtropical regions) and Africanised honeybees (in subtropical areas only). A thorough study was carried out in both China and Argentina to analyse the current virus presence and distribution in different climatic zones and gather information on different bee species/subspecies. Adult honeybees were collected from apiaries in temperate and subtropical regions of China (including areas with exclusive populations of A. mellifera, areas where A. mellifera and A. cerana co-exist, and areas with exclusive populations of A. cerana) and Argentina. Six viruses, namely, deformed wing virus (DWV), black queen cell virus (BQCV), sacbrood virus (SBV), chronic bee paralysis virus (CBPV), acute bee paralysis virus (ABPV) and Israeli acute paralysis virus (IAPV) were detected in China, both in A. cerana and in A. mellifera, while four viruses (DWV, BQCV, CBPV and ABPV) were present in Argentina. Interestingly, multiple infections were commonly found in China, with up to five different viruses co-circulating in some colonies without apparent abnormalities. In this study, no Chinese samples were positive for slow bee paralysis virus. The most prevalent viruses were BQCV (China) and DWV (Argentina). Kashmir bee virus was absent from samples analysed for both countries.
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Rodriguez G, Mendoza Ruvalcaba N. SUBJECTIVE MEMORY COMPLAINTS, LEARNING POTENTIAL, AND OBJECTIVE COGNITIVE FUNCTIONING IN OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1209] [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: 11/14/2022] Open
Affiliation(s)
- G. Rodriguez
- Gerontology, University of Guadalajara, Guadalajara, Jalisco, Mexico
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Magnano L, Alonso-Alvarez S, Alcoceba M, Rivas-Delgado A, Muntañola A, Andrade-Campos M, Rodriguez G, Sancho J, Mercadal S, Salar A, Arranz R, Terol M, Jiménez-Ubieto A, González de Villambrosía S, Bello J, López L, Novelli S, De Cabo E, Infante M, Pardal E, Canals M, González M, Martín A, Caballero M, López-Guillermo A. PATIENTS WITH FOLLICULAR LYMPHOMA (FL) IN MAINTAINED COMPLETE RESPONSE (CR) AT 30 MONTHS SHOW A SURVIVAL SIMILAR TO A SEX- AND AGE-MATCHED SPANISH GENERAL POPULATION. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_90] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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)
- L. Magnano
- Hematology; Hospital Clinico de Barcelona; Barcelona Spain
| | | | - M. Alcoceba
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | | | - A. Muntañola
- Hematology; Hospital Universitario Mútua de Terrassa, Terrassa; Barcelona Spain
| | | | - G. Rodriguez
- Hematology; Hospital Universitario Virgen del Rocío; Sevilla Spain
| | - J. Sancho
- Hematology; Hospital H. Germans Trias i Pujol (ICO-IJC); Badalona Spain
| | - S. Mercadal
- Hematology; Hospital Duran i Reynals (ICO), Hospitalet de Llobregat; Barcelona Spain
| | - A. Salar
- Hematology; Hospital del Mar; Barcelona Spain
| | - R. Arranz
- Hematology; Hospital de la Princesa; Madrid Spain
| | - M. Terol
- Hematology; Hospital Clínico de Valencia; Valencia Spain
| | | | | | - J. Bello
- Hematology; Hospital de Nuestra Señora de la Esperanza; Santiago de Compostela Spain
| | - L. López
- Hematology; Hospital MD Anderson; Madrid Spain
| | - S. Novelli
- Hematology; Hospital de la Santa Creu i Sant Pau; Barcelona Spain
| | - E. De Cabo
- Hematology; Hospital del Bierzo, Ponferrada; León Spain
| | - M. Infante
- Hematology; Hospital Infanta Leonor; Madrid Spain
| | - E. Pardal
- Hematology; Hospital Virgen del Puerto, Plasencia; Cáceres Spain
| | - M. Canals
- Hematology; Hospital Universitario La Paz; Madrid Spain
| | - M. González
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - A. Martín
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - M. Caballero
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
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Affiliation(s)
- G. Rodriguez
- Commissariat à l’Energie Atomique, Cadarache – CEA/DEN/CAD/DER/STR Building 201, 13108 St Paul lez Durance, France
| | - F. Baque
- Commissariat à l’Energie Atomique, Cadarache – CEA/DEN/CAD/DER/STR Building 201, 13108 St Paul lez Durance, France
| | - J. C. Astegiano
- Commissariat à l’Energie Atomique, Cadarache – CEA/DEN/CAD/DER/STR Building 201, 13108 St Paul lez Durance, France
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Chang D, Kittleson M, Patel J, Aintablian T, Rodriguez G, Levine R, Geft D, Kransdorf E, Czer L, Esmailian F, Kobashigawa J. Coronary Vasospasm After Heart Transplantation: Does It Portend Poor Outcome? J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ithurrart LS, Busso CA, Torres YA, Montenegro OA, Giorgetti H, Rodriguez G, Cardillo DS, Ambrosino ML. Total soil available nitrogen under perennial grasses after burning and defoliation. RUSS J ECOL+ 2017. [DOI: 10.1134/s1067413617220015] [Citation(s) in RCA: 4] [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: 11/23/2022]
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Vidal C, Werlinger F, Duarte V, Osben R, Rodriguez G, Cortés J. Maxillofacial trauma: preliminary results of a multicentre study at emergency units in Chile (FONIS SA1520196 Project). Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Vitali P, Mavilio N, Capello D, Rosa M, Ferrari A, Levrero F, Pilot A, Nobili F, Rodriguez G. Studio RMf della dominanza emisferica in destrimani e non destrimani. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/197140090001300124] [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: 11/15/2022]
Abstract
La valutazione non invasiva della dominanza emisferica per il linguaggio è una delle più promettenti applicazioni cliniche della risonanza magnetica funzionale, specie nei pazienti destinati alla neurochirurgia. In questo studio sono state eseguite due prove linguistiche in un gruppo di giovani volontari sani (8 destrimani, 12 non destrimani): una di fluenza fonemica ed una di associazione semantica. Tra i voxels statisticamente attivati nei due emisferi sono stati calcolati tre indici di asimmetria (emisferico, frontale e temporoparietale) in ogni soggetto e per ogni prova. Nel complesso, la prova di fluenza fonemica attivava fortemente il lobo frontale, mentre la prova di associazione semantica determinava un pattern di attivazione piu distribuito, che comprendeva anche il giro temporale medio ed il giro angolare. Per quanto riguarda gli indici di asimmetria, nei destrimani quello emisferico e quello frontale indicavano sempre l'attivazione prevalente dell'emisfero sinistro. Un solo soggetto ambidestro ha presentato nella prova di fluenza fonemica indici di asimmetria emisferico e frontale espressivi di lateralizzazione destra. D'altra parte, l'indice di asimmetria temporoparietale deponeva per una lieve revalenza dell'emisfero destro in un destrimane ed per una chiara lateralizzazione destra in un non destrimane. La risonanza magnetica funzionale appare dunque metodica sensibile ed appropriata nella valutazione della dominanza emisferica per il linguaggio. L'impiego di indici di asimmetria lobari può meglio evidenziare il differente contributo alla dominanza emisferica delle aree frontali rispetto a quelle temporoparietali. Infine, l'individuazione delle aree corticali correlate con la funzione linguistica è uno strumento potenzialmente utile per il neurochirurgo nel programmare resezioni di aree limitrofe.
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Affiliation(s)
| | | | | | | | - A. Ferrari
- Servizio di Fisica Sanitaria, Ospedale S. Martino; Genova
| | - F. Levrero
- Servizio di Fisica Sanitaria, Ospedale S. Martino; Genova
| | - A. Pilot
- Servizio di Fisica Sanitaria, Ospedale S. Martino; Genova
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Mikkelsen A, Galli C, Eiben G, Ahrens W, Iacoviello L, Molnár D, Pala V, Risé P, Rodriguez G, Russo P, Tornaritis M, Veidebaum T, Vyncke K, Wolters M, Mehlig K. Blood fatty acid composition in relation to allergy in children aged 2-9 years: results from the European IDEFICS study. Eur J Clin Nutr 2016; 71:39-44. [PMID: 27650873 DOI: 10.1038/ejcn.2016.158] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 07/11/2016] [Accepted: 07/12/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Blood polyunsaturated fatty acids (PUFA) are involved in allergy development, but the etiological role of n-6 and n-3 PUFA is still controversial. A European multicenter study of children (IDEFICS) provided the opportunity to explore the cross-sectional association between fatty acids (FA) and allergy. SUBJECTS/METHODS Blood FA levels were measured in 2600 children aged 2-9 years and were recorded as the percentage of weight of all FA detected. Logistic regression of allergy status on FA components was adjusted for age, sex, country, body mass index, family history of allergic disease, breast-feeding, and number of siblings. The results were given as odds ratios (OR) for current vs no allergy ever and an increase in FA by 1 s.d. RESULTS Overall, higher proportions of n-6 PUFA were associated with higher odds of allergy (OR=1.21 (1.05, 1.40)). Monounsaturated FA (MUFA) were associated with reduced risk for allergy (OR=0.75 (0.65, 0.87)), whereas saturated FA did not differ by allergy status. The strongest associations were observed in children <4 years old, with ORs of allergy given as 1.62 (1.15, 2.29) for n-3 PUFA and 0.63 (0.42, 0.95) for MUFA. With regard to individual FA, these associations were independently observed for docosapentaenoic acid (22:5 n-3) and oleic acid (18:1 n-9). CONCLUSIONS Both PUFA subtypes were positively associated with allergy in an age-dependent manner, whereas MUFA was associated with less allergy. The observation of high proportions of n-3 PUFA in allergic children younger than 4 years might help to understand the nature of early onset of atopic disease.
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Affiliation(s)
- A Mikkelsen
- Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Närhälsan, Research and Development Primary Health Care, Region Västra Götaland, Sweden
| | - C Galli
- Department of Pharmacological and Biomolecular Sciences, DiSFeB, University of Milan, Milan, Italy
| | - G Eiben
- Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - W Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - L Iacoviello
- Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy
| | - D Molnár
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - V Pala
- Epidemiology Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - P Risé
- Department of Pharmacological and Biomolecular Sciences, DiSFeB, University of Milan, Milan, Italy
| | - G Rodriguez
- GENUD (Growth, Exercise, Nutrition, and Development) Research Group, University of Zaragoza, Zaragoza, Spain.,Instituto de Investigación Sanitaria, Aragón, Spain
| | - P Russo
- Institute of Food Sciences, CNR, Avellino, Italy
| | - M Tornaritis
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - T Veidebaum
- National Institute for Health Development, Tallinn, Estonia
| | - K Vyncke
- Department of Public Health, University of Ghent, Ghent, Belgium
| | - M Wolters
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - K Mehlig
- Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Morales A, Carvajal P, Silva N, Hernandez M, Godoy C, Rodriguez G, Cabello R, Garcia-Sesnich J, Hoare A, Diaz PI, Gamonal J. Clinical Effects of Lactobacillus rhamnosus in Non-Surgical Treatment of Chronic Periodontitis: A Randomized Placebo-Controlled Trial With 1-Year Follow-Up. J Periodontol 2016; 87:944-52. [DOI: 10.1902/jop.2016.150665] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Nobili F, Rodriguez G, Malfatto L, Celestino MA, Hassan K, Francione S, Marenco S, Rosadini G. Correlates of contralateral hypoperfusion in chronic stroke patients. Neurol Res 2016; 14:125-6. [PMID: 1355866 DOI: 10.1080/01616412.1992.11740029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- F Nobili
- Department of Motor Science-Neurophysiopathology, University and Center for Cerebral Neurophysiology (CNR), Genova, Italy
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Abstract
A recently developed spatial operator algebra approach to modeling and analysis of multibody robotic systems is used to develop O(n) recursive algorithms that compute the op erational space mass matrix and the operational space coriolis/centrifugal and gravity terms of an n-link serial manipulator. These algorithms enable an O(n) recursive im plementation of operational space control.
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Affiliation(s)
- K. Kreutz-Delgado
- Electrical and Computer Engineering Department University of California, San Diego La Jolla, California 92093-0407
| | - A. Jain
- Jet Propulsion Laboratory California Institute of Technology Pasadena, California 91109
| | - G. Rodriguez
- Jet Propulsion Laboratory California Institute of Technology Pasadena, California 91109
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Abstract
A recently developed spatial operator algebra for manipu lator modeling, control, and trajectory design is dis cussed. The elements of this algebra are linear operators whose domain and range spaces consist of forces, moments, velocities, and accelerations. The effect of these operators is equivalent to a spatial recursion along the span of a manipulator. Inversion of operators can be efficiently obtained via techniques of recursive filtering and smoothing. The operator algebra provides a high- level framework for describing the dynamic and kinematic behavior of a manipulator and for control and trajectory design algorithms. The interpretation of expressions within the algebraic framework leads to enhanced concep tual and physical understanding of manipulator dynamics and kinematics. Furthermore, implementable recursive algorithms can be immediately derived from the abstract operator expressions by inspection. Thus the transition from an abstract problem formulation and solution to the detailed mechanization of specific algorithms is greatly simplified.
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Affiliation(s)
- G. Rodriguez
- Jet Propulsion Laboratory California Institute of Technology Pasadena, California
| | - A. Jain
- Jet Propulsion Laboratory California Institute of Technology Pasadena, California
| | - K. Kreutz-Delgado
- AMES Department University of California, San Diego La Jolla, California
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Aparicio M, Jitianu A, Rodriguez G, Degnah A, Al-Marzoki K, Mosa J, Klein L. Corrosion Protection of AISI 304 Stainless Steel with Melting Gel Coatings. Electrochim Acta 2016. [DOI: 10.1016/j.electacta.2015.12.142] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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42
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Longo Muñoz F, Earl J, Martinez Avila J, Rodriguez Garrote M, Guerrero C, Galindo J, Priego P, Rodriguez G, García-Moreno F, Lopez F, Hervás A, Caminoa A, García I, Soteras C, Vázquez-Sequeiros E, Botella J, Pachón Olmos V, Ferreiro Monteagudo R, Vaz M, Gómez A, Guillén-Ponce C, Carrato A. P-016 Circulating mRNA expression of CD133, SNAIL, ZEB1 and ZHX as biomarkers in gastric and esophageal cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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43
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Esaki H, Brunner P, Czarnowicki T, Rodriguez G, Immaneni S, Renert-Yuval Y, Suarez-Farinas M, Krueger J, Paller A, Guttman-Yassky E. 039 Early onset pediatric atopic dermatitis skin phenotype is Th2, but also Th17-polarized. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.064] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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44
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Patel J, Kittleson M, Czer L, Aintablian T, Stimpson E, Daun T, Manayan T, Rodriguez G, Chang D, Ramzy D, Kobashigawa J. Chronic Lung Disease Fev1/Fvc <70% and Primary Graft Dysfunction; a Marker for Prolonged Intubation Immediately Post-Transplantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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45
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Rodriguez G, Pieralisi I, Anderlei T, Ducci A, Micheletti M. Appraisal of fluid flow in a shaken bioreactor with conical bottom at different operating conditions. Chem Eng Res Des 2016. [DOI: 10.1016/j.cherd.2015.12.012] [Citation(s) in RCA: 4] [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: 02/06/2023]
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46
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Kittleson M, Patel J, Czer L, Aintablian T, Rodriguez G, Velleca A, Kearney B, Chang D, Hamilton M, Esmailian F, Zhang X, Reinsmoen N, Kobashigawa J. Proliferation Signal Inhibitors Prevent Donor-Specific Antibody Production in Sensitized Patients after Heart Transplantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.798] [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: 10/22/2022] Open
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47
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Pieralisi I, Rodriguez G, Micheletti M, Paglianti A, Ducci A. Microcarriers’ suspension and flow dynamics in orbitally shaken bioreactors. Chem Eng Res Des 2016. [DOI: 10.1016/j.cherd.2015.11.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Patel J, Kittleson M, Czer L, Aintablian T, Sharoff R, Rodriguez G, Kearney B, Perry N, Hage A, Esmailian F, Kobashigawa J. Severity of Hypertension After Heart Transplant: Does It Impact Outcome? J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Araneda J, Lobos L, Oliva P, Bastias J, Rodriguez G. MON-PP193: Intake of Sugar-Sweetened Beverages by Overweight and Obese School Children in the Province of Ñuble, Chile. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30625-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lépori AJ, Mishima RS, Rodriguez G, Moreyra EA, Serra JL, Tibaldi MA, Martellotto A, Moreyra Jr E. Relationship between electrocardiographic characteristics of left bundle branch block and echocardiographic findings. Cardiol J 2015; 22:397-403. [DOI: 10.5603/cj.a2015.0005] [Citation(s) in RCA: 4] [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: 10/07/2014] [Revised: 12/24/2014] [Accepted: 01/01/2015] [Indexed: 11/25/2022] Open
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