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Parra V, Cifuentes S, Avendaño S, Ponce de León E, Florez C, Reyes G, Puentes F, Ballesteros M, Nuñez E, Gómez F, Márquez JR. Real-world experience of vedolizumab use in Colombian patients with inflammatory bowel disease-EXVEDOCOL. Gastroenterol Hepatol 2024:S0210-5705(24)00025-6. [PMID: 38311006 DOI: 10.1016/j.gastrohep.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/06/2024]
Abstract
BACKGROUND Real-world studies about the effectiveness and safety of vedolizumab (VDZ) in the treatment of inflammatory bowel disease (IBD) in Latin America are scarce. Our study describes the effectiveness and safety of VDZ in Colombian patients with IBD. METHODS EXVEDOCOL (EXperience of VEDOlizumab in COLombia) was a retrospective, multicenter, observational study. Adults with IBD receiving a first dose of VDZ between July 2016 and October 2018 were included. The co-primary outcomes clinical response, and remission, were determined at week 14 and last visit during the maintenance phase (LVMP). The secondary outcomes, deep remission and loss of response were recorded at LVMP. RESULTS Thirty-one patients (25 ulcerative colitis (UC), 6 Crohn's disease (CD)) were included. At week 14, clinical response was achieved by 87.1% (27/31) of the patients treated with VDZ, while loss of response was reported in 6.7% (2/30). The remission rate at week 14 was 65.5% (19/29) and 75.9% (22/29) at LVMP. Prior anti-TNF exposure was reported in 61.3% (19 patients) of whom 84.2% (16/19) achieved clinical response at week 14 and 89.5% (17/19) at LVMP. For anti-TNF naïve patients, clinical response was recorded in 91.7% (11/12) at week 14 and 100% (12/12) at LVMP. CONCLUSIONS High clinical remission rates and safety profile highlight VDZ as a valuable treatment option for IBD patients. Anti-TNF naïve patients may derive greater benefit from therapy. Studies with larger cohorts could confirm these findings.
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Affiliation(s)
- Viviana Parra
- Gastroadvanced, Bogotá, Hospital Internacional de Colombia, Bucaramanga, Colombia
| | | | | | | | - Cristian Florez
- Gastroadvanced, Bogotá, Hospital Internacional de Colombia, Bucaramanga, Colombia
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2
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Zinter MS, Dvorak CC, Mayday MY, Reyes G, Simon MR, Pearce EM, Kim H, Shaw PJ, Rowan CM, Auletta JJ, Martin PL, Godder K, Duncan CN, Lalefar NR, Kreml EM, Hume JR, Abdel-Azim H, Hurley C, Cuvelier GDE, Keating AK, Qayed M, Killinger JS, Fitzgerald JC, Hanna R, Mahadeo KM, Quigg TC, Satwani P, Castillo P, Gertz SJ, Moore TB, Hanisch B, Abdel-Mageed A, Phelan R, Davis DB, Hudspeth MP, Yanik GA, Pulsipher MA, Sulaiman I, Segal LN, Versluys BA, Lindemans CA, Boelens JJ, DeRisi JL. Pulmonary microbiome and transcriptome signatures reveal distinct pathobiologic states associated with mortality in two cohorts of pediatric stem cell transplant patients. medRxiv 2023:2023.11.29.23299130. [PMID: 38077035 PMCID: PMC10705623 DOI: 10.1101/2023.11.29.23299130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Lung injury is a major determinant of survival after pediatric hematopoietic cell transplantation (HCT). A deeper understanding of the relationship between pulmonary microbes, immunity, and the lung epithelium is needed to improve outcomes. In this multicenter study, we collected 278 bronchoalveolar lavage (BAL) samples from 229 patients treated at 32 children's hospitals between 2014-2022. Using paired metatranscriptomes and human gene expression data, we identified 4 patient clusters with varying BAL composition. Among those requiring respiratory support prior to sampling, in-hospital mortality varied from 22-60% depending on the cluster (p=0.007). The most common patient subtype, Cluster 1, showed a moderate quantity and high diversity of commensal microbes with robust metabolic activity, low rates of infection, gene expression indicating alveolar macrophage predominance, and low mortality. The second most common cluster showed a very high burden of airway microbes, gene expression enriched for neutrophil signaling, frequent bacterial infections, and moderate mortality. Cluster 3 showed significant depletion of commensal microbes, a loss of biodiversity, gene expression indicative of fibroproliferative pathways, increased viral and fungal pathogens, and high mortality. Finally, Cluster 4 showed profound microbiome depletion with enrichment of Staphylococci and viruses, gene expression driven by lymphocyte activation and cellular injury, and the highest mortality. BAL clusters were modeled with a random forest classifier and reproduced in a geographically distinct validation cohort of 57 patients from The Netherlands, recapitulating similar cluster-based mortality differences (p=0.022). Degree of antibiotic exposure was strongly associated with depletion of BAL microbes and enrichment of fungi. Potential pathogens were parsed from all detected microbes by analyzing each BAL microbe relative to the overall microbiome composition, which yielded increased sensitivity for numerous previously occult pathogens. These findings support personalized interpretation of the pulmonary microenvironment in pediatric HCT, which may facilitate biology-targeted interventions to improve outcomes.
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Affiliation(s)
- Matt S Zinter
- Division of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
- Division of Allergy, Immunology, and Bone Marrow Transplantation, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Christopher C Dvorak
- Division of Allergy, Immunology, and Bone Marrow Transplantation, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Madeline Y Mayday
- Division of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
- Departments of Laboratory Medicine and Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Gustavo Reyes
- Division of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Miriam R Simon
- Division of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Emma M Pearce
- Division of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Hanna Kim
- Division of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Peter J Shaw
- The Children`s Hospital at Westmead, Sydney, Australia
| | - Courtney M Rowan
- Indiana University, Department of Pediatrics, Division of Critical Care Medicine, Indianapolis, IN, USA
| | - Jeffrey J Auletta
- Hematology/Oncology/BMT and Infectious Diseases, Nationwide Children's Hospital, Columbus, OH, USA
- CIBMTR (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | - Paul L Martin
- Division of Pediatric and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Kamar Godder
- Cancer and Blood Disorders Center, Nicklaus Children's Hospital, Miami, FL, USA
| | - Christine N Duncan
- Harvard Medical School, Boston, Massachusetts; Division of Pediatric Oncology, Department of Pediatrics, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA, USA
| | - Nahal R Lalefar
- Division of Pediatric Hematology/Oncology, UCSF Benioff Children's Hospital Oakland, University of California San Francisco, Oakland, CA, USA
| | - Erin M Kreml
- Department of Child Health, Division of Critical Care Medicine, University of Arizona, Phoenix, AZ, USA
| | - Janet R Hume
- University of Minnesota, Department of Pediatrics, Division of Critical Care Medicine, Minneapolis, MN, USA
| | - Hisham Abdel-Azim
- Department of Pediatrics, Division of Hematology/Oncology and Transplant and Cell Therapy, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Loma Linda University School of Medicine, Cancer Center, Children Hospital and Medical Center, Loma Linda, CA, USA
| | - Caitlin Hurley
- Division of Critical Care, Department of Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Geoffrey D E Cuvelier
- CancerCare Manitoba, Manitoba Blood and Marrow Transplant Program, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amy K Keating
- Center for Cancer and Blood Disorders, Children's Hospital Colorado and University of Colorado, Aurora, CO, USA
- Harvard Medical School, Boston, Massachusetts; Division of Pediatric Oncology, Department of Pediatrics, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA, USA
| | - Muna Qayed
- Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta and Emory University, Atlanta, GA, USA
| | - James S Killinger
- Division of Pediatric Critical Care, Department of Pediatrics, Weill Cornell Medicine, New York, NY, USA
| | - Julie C Fitzgerald
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
| | - Rabi Hanna
- Department of Pediatric Hematology, Oncology and Blood and Marrow Transplantation, Pediatric Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Kris M Mahadeo
- Department of Pediatrics, Division of Hematology/Oncology, MD Anderson Cancer Center, Houston, TX, USA
- Division of Pediatric and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Troy C Quigg
- Pediatric Blood and Marrow Transplantation Program, Texas Transplant Institute, Methodist Children's Hospital, San Antonio, TX, USA
- Section of Pediatric BMT and Cellular Therapy, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
| | - Prakash Satwani
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, Columbia University, New York, NY, USA
| | - Paul Castillo
- University of Florida, Gainesville, UF Health Shands Children's Hospital, Gainesville, FL, USA
| | - Shira J Gertz
- Department of Pediatrics, Division of Critical Care Medicine, Joseph M Sanzari Children's Hospital at Hackensack University Medical Center, Hackensack, NJ, USA
- Department of Pediatrics, St. Barnabas Medical Center, Livingston, NJ, USA
| | - Theodore B Moore
- Department of Pediatric Hematology-Oncology, Mattel Children's Hospital, University of California, Los Angeles, CA, USA
| | - Benjamin Hanisch
- Children's National Hospital, Washington, District of Columbia, USA
| | - Aly Abdel-Mageed
- Section of Pediatric BMT and Cellular Therapy, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
| | - Rachel Phelan
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Dereck B Davis
- Department of Pediatrics, Hematology/Oncology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Michelle P Hudspeth
- Adult and Pediatric Blood & Marrow Transplantation, Pediatric Hematology/Oncology, Medical University of South Carolina Children's Hospital/Hollings Cancer Center, Charleston, SC, USA
| | - Greg A Yanik
- Pediatric Blood and Bone Marrow Transplantation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Michael A Pulsipher
- Division of Hematology, Oncology, Transplantation, and Immunology, Primary Children's Hospital, Huntsman Cancer Institute, Spense Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Imran Sulaiman
- Departments of Respiratory Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Laura and Isaac Perlmutter Cancer Center, New York University Grossman School of Medicine, New York University (NYU) Langone Health, New York, NY, USA
| | - Leopoldo N Segal
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Laura and Isaac Perlmutter Cancer Center, New York University Grossman School of Medicine, New York University (NYU) Langone Health, New York, NY, USA
| | - Birgitta A Versluys
- Department of Stem Cell Transplantation, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
- Division of Pediatrics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Caroline A Lindemans
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Laura and Isaac Perlmutter Cancer Center, New York University Grossman School of Medicine, New York University (NYU) Langone Health, New York, NY, USA
- Department of Stem Cell Transplantation, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Jaap J Boelens
- Department of Stem Cell Transplantation, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
- Division of Pediatrics, University Medical Center Utrecht, Utrecht, Netherlands
- Transplantation and Cellular Therapy, MSK Kids, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Joseph L DeRisi
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
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Parra-Izquierdo V, Frías-Ordoñez JS, Márquez JR, Puentes-Manosalva FE, Sarmiento F, García-Duperly R, Vargas M, Reyes G, Samper C, Barreiro-de-Acosta M. [Health-related quality of life by IBDQ-32 in colombian patients with inflammatory bowel disease in remission: A cross-sectional study]. Rev Gastroenterol Peru 2023; 43:95-103. [PMID: 37597222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/21/2023]
Abstract
In Colombia there are no data about perception of quality of life (QoL) in inflammatory bowel disease (IBD). The aim of this study was to determine the perception of QoL by means of the IBDQ-32 questionnaire in patients with IBD from a sample of patients from different referral centers. We carried out a cross-sectional study in adults with IBD in clinical remission, in outpatient follow-up, in 3 institutions in different cities, between June 2022 and November 2022, eligible subjects were identified, information was collected on different dates, about socio-demographic and clinical aspects, and the IBDQ-32 questionnaire was evaluated on one occasion. Descriptive and analytical analysis of the variables evaluated was performed. 80 patients, 70% women, mean age 38.5(range 18-72; SD 13.25) years. 67.5% ulcerative colitis (UC), 32.5% Crohn's disease (CD). Moderate QoL involvement (median 150 points, interquartile range118.3-181.5) was found in IBD, in UC median 151 (interquartile range120-174.75) points, while in CD 133 (interquartile range106.25-186.25) points. There was greater involvement in the systemic domain, with median 21 (interquartile range 15.8-27) points, and 18.5 (interquartile range 12.8-25.3) points, for UC and CD, respectively. The least affected corresponded to the digestive domain and social function, in median UC 48.5 (interquartile range 40-58.3), and 27(interquartile range 20.8-33); in median CD 43 (interquartile range 35.5-61.75) and 24.5(interquartile range 18-32.5), respectively. No statistically significant differences were found. This study provides unique information about QoL of patients with IBD in Colombia. It is necessary to continue reinforcing the accompaniment, support, and education of patients with IBD.
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Affiliation(s)
- Viviana Parra-Izquierdo
- Gastroenterología y Reumatología, Hospital Internacional de Colombia, Bucaramanga, Colombia; Fundación Colombiana de Enfermedad Inflamatoria Intestinal, Bucaramanga, Colombia
| | | | - Juan Ricardo Márquez
- Fundación Colombiana de Enfermedad Inflamatoria Intestinal, Bucaramanga, Colombia; Coloproctología. Instituto de Coloproctología, Clínica Las Américas, Medellín, Colombia
| | - Fabián Eduardo Puentes-Manosalva
- Fundación Colombiana de Enfermedad Inflamatoria Intestinal, Bucaramanga, Colombia; Gastroenterología y Endoscopía Digestiva, Universidad de Caldas, Manizales, Caldas, Colombia
| | - Fernando Sarmiento
- Fundación Colombiana de Enfermedad Inflamatoria Intestinal, Bucaramanga, Colombia; Gastroenterología Pediátrica, Hospital de la Misericordia, Bogotá, Colombia
| | - Rafael García-Duperly
- Fundación Colombiana de Enfermedad Inflamatoria Intestinal, Bucaramanga, Colombia; Coloproctología, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Melquisedec Vargas
- Fundación Colombiana de Enfermedad Inflamatoria Intestinal, Bucaramanga, Colombia; Gastroenterología Pediátrica, Gastrokids SAS, Pereira, Colombia
| | - Gustavo Reyes
- Fundación Colombiana de Enfermedad Inflamatoria Intestinal, Bucaramanga, Colombia; Gastroenterología y Endoscopia Digestiva, Clínica Universitaria de Colombia, Bogotá
| | - Carolina Samper
- Fundación Colombiana de Enfermedad Inflamatoria Intestinal, Bucaramanga, Colombia
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4
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Armeno M, Caballero E, Verini A, Reyes G, Galarza N, Cresta A, Caraballo RH. Telemedicine- versus outpatient-based initiation and management of ketogenic diet therapy in children with drug-resistant epilepsy during the COVID-19 pandemic. Seizure 2022; 98:37-43. [DOI: 10.1016/j.seizure.2022.03.023] [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] [Received: 02/24/2022] [Revised: 03/19/2022] [Accepted: 03/31/2022] [Indexed: 10/18/2022] Open
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5
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Zinter MS, Versluys AB, Lindemans CA, Mayday MY, Reyes G, Sunshine S, Chan M, Fiorino EK, Cancio M, Prevaes S, Sirota M, Matthay MA, Kharbanda S, Dvorak CC, Boelens JJ, DeRisi JL. Pulmonary microbiome and gene expression signatures differentiate lung function in pediatric hematopoietic cell transplant candidates. Sci Transl Med 2022; 14:eabm8646. [PMID: 35263147 PMCID: PMC9487170 DOI: 10.1126/scitranslmed.abm8646] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Impaired baseline lung function is associated with mortality after pediatric allogeneic hematopoietic cell transplantation (HCT), yet limited knowledge of the molecular pathways that characterize pretransplant lung function has hindered the development of lung-targeted interventions. In this study, we quantified the association between bronchoalveolar lavage (BAL) metatranscriptomes and paired pulmonary function tests performed a median of 1 to 2 weeks before allogeneic HCT in 104 children in The Netherlands. Abnormal pulmonary function was recorded in more than half the cohort, consisted most commonly of restriction and impaired diffusion, and was associated with both all-cause and lung injury-related mortality after HCT. Depletion of commensal supraglottic taxa, such as Haemophilus, and enrichment of nasal and skin taxa, such as Staphylococcus, in the BAL microbiome were associated with worse measures of lung capacity and gas diffusion. In addition, BAL gene expression signatures of alveolar epithelial activation, epithelial-mesenchymal transition, and down-regulated immunity were associated with impaired lung capacity and diffusion, suggesting a postinjury profibrotic response. Detection of microbial depletion and abnormal epithelial gene expression in BAL enhanced the prognostic utility of pre-HCT pulmonary function tests for the outcome of post-HCT mortality. These findings suggest a potentially actionable connection between microbiome depletion, alveolar injury, and pulmonary fibrosis in the pathogenesis of pre-HCT lung dysfunction.
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Affiliation(s)
- Matt S Zinter
- School of Medicine, Department of Pediatrics, Division of Critical Care Medicine, University of California, San Francisco, San Francisco, CA 94143, USA.,School of Medicine, Department of Pediatrics, Division of Allergy, Immunology, and Bone Marrow Transplantation, University of California, San Francisco, San Francisco, CA 94143, USA
| | - A Birgitta Versluys
- University Medical Center Utrecht, Department of Pediatric Stem Cell Transplantation, Utrecht, 3584 CX, Netherlands.,Princess Maxima Center for Pediatric Oncology, Department of Hematopoietic Cell Transplantation, Utrecht 3584 CX, Netherlands
| | - Caroline A Lindemans
- University Medical Center Utrecht, Department of Pediatric Stem Cell Transplantation, Utrecht, 3584 CX, Netherlands.,Princess Maxima Center for Pediatric Oncology, Department of Hematopoietic Cell Transplantation, Utrecht 3584 CX, Netherlands
| | - Madeline Y Mayday
- Department of Pathology, Graduate Program in Experimental Pathology, and Yale Stem Cell Center, Yale University, New Haven, CT 06510, USA
| | - Gustavo Reyes
- School of Medicine, Department of Pediatrics, Division of Critical Care Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Sara Sunshine
- School of Medicine, Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Marilynn Chan
- School of Medicine, Department of Pediatrics, Division of Pulmonology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Elizabeth K Fiorino
- WC Medical College, Department of Pediatrics, Division of Pulmonology, Allergy and Immunology, Cornell University, New York City, NY 10065, USA
| | - Maria Cancio
- WC Medical College, Department of Pediatrics, Cornell University, New York City, NY 10065, USA.,Department of Pediatric Stem Cell Transplantation and Cellular Therapies, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Sabine Prevaes
- Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht University, Utrecht, 3584 CX, Netherlands
| | - Marina Sirota
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA 94143, USA.,School of Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Michael A Matthay
- School of Medicine, Cardiovascular Research Institute, Departments of Medicine and Anesthesiology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Sandhya Kharbanda
- School of Medicine, Department of Pediatrics, Division of Allergy, Immunology, and Bone Marrow Transplantation, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Christopher C Dvorak
- School of Medicine, Department of Pediatrics, Division of Allergy, Immunology, and Bone Marrow Transplantation, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Jaap J Boelens
- WC Medical College, Department of Pediatrics, Cornell University, New York City, NY 10065, USA.,Department of Pediatric Stem Cell Transplantation and Cellular Therapies, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Joseph L DeRisi
- School of Medicine, Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA 94143, USA.,Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
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Salamanca J, Díez-Villanueva P, Canabal A, Reyes G, Ramasco F, Alfonso F. Outcomes of a multidisciplinary mechanical circulatory support network in cardiogenic shock in a centre without heart transplant program: A successful interprofessional coordination model. Rev Esp Anestesiol Reanim (Engl Ed) 2022; 69:129-133. [PMID: 35279416 DOI: 10.1016/j.redare.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/09/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Cardiogenic shock (CS) mortality remains very high and mechanical circulatory support (MCS) may provide an effective alternative of treatment in selected patients. The aim of this study is to analyse the results of a multidisciplinary team care program (including anaesthesiologists, cardiologists, cardiothoracic surgeons, and intensivists) in CS patients who required MCS, in a tertiary centre without a heart transplant (HT) program. METHODS Prospective observational study that sought to analyse the characteristics and survival to discharge predictors in a consecutive CS patients cohort treated with MCS. RESULTS A total of 48 patients were included. Mean age was 61 ± 14 years. Before MCS, 45.8% of the patients presented with cardiac arrest. A 54.2% 30-day survival and 45.8% overall survival to discharge, was found. Age and vasoactive-inotropic score were independent predictors of mortality. CONCLUSIONS A multidisciplinary team-care based MCS program in CS patients is feasible and may achieve favourable results in a centre without HT program.
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Affiliation(s)
- J Salamanca
- Servicio de Cardiología, Hospital Universitario de La Princesa, IIS-IP, CIBER-CV, Madrid, Spain
| | - P Díez-Villanueva
- Servicio de Cardiología, Hospital Universitario de La Princesa, IIS-IP, CIBER-CV, Madrid, Spain
| | - A Canabal
- Servicio de Medicina Intensiva, Hospital Universitario de La Princesa, IIS-IP, Madrid, Spain
| | - G Reyes
- Servicio de Cirugía Cardiaca, Hospital Universitario de La Princesa, IIS-IP, Madrid, Spain
| | - F Ramasco
- Servicio de Anestesiología y Reanimación, Hospital Universitario de La Princesa, IIS-IP, Madrid, Spain
| | - F Alfonso
- Servicio de Cardiología, Hospital Universitario de La Princesa, IIS-IP, CIBER-CV, Madrid, Spain.
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7
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Montes A, Cecconi A, Monguio E, Martinez Vives P, Rojas AM, Lopez Melgar B, Diego G, Benedicto A, Dominguez L, Olviera MJ, Caballero P, Hernandez Muniz S, Reyes G, Jimenez Borreguero LJ, Alfonso F. Exploring the feasibility of the aorta to pulmonary artery ratio as novel risk marker of acute aortic syndromes in dilated aorta without conventional criteria for surgery. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Based on current guidelines, surgery indication of thoracic ascending aortic aneurysm (TAAA) is mainly driven by the aortic diameter. However, most cases of TAAA acute complications occur in patients who did not previously meet the 55 mm criteria for preventive surgical replacement (1). Both aorta indexed to height and to body surface area have been proposed as possible solution but indexed diameters of healthy aortas widely vary (2). Accordingly, new individualized biomarkers to improve the risk stratification of dilated aorta without a conventional criteria for surgery remain an unmet clinical need. Since aorta and pulmonary artery have an established ratio in general population (upper normal ratio of 1.2) (3), the aorta-to-pulmonary-artery ratio (A:PA) may better define the wall stress in a dilated aorta, overcoming the individual limitations of conventional size criteria.
Purpose
The aim of our study is to find a novel aortic indexed diameter with better prognostic performance. Therefore, we aimed to explore the feasibility of using the A:PA as risk predictor in TAAA with aortic diameter < 55 mm.
Methods
All consecutive patients with an acute aortic syndrome (AAS), diagnosed by CT scan in our tertiary hospital between January 2010 and June 2021 undergoing surgical repair, were retrospectively analyzed. Patients with pulmonary hypertension were excluded to prevent distortions in the pulmonary artery diameter. Basic clinical characteristics regarding indications of surgery were collected along with measurements of the aortic maximum diameter and pulmonary artery maximum diameter, obtained by multiplane reconstruction (Figure, Panels A, B). Patients were categorized into three groups based on aortic diameter terciles: group A included patients with < 47 mm, group B ≥ 47 mm but < 55 mm and group C ≥ 55 mm. Considering a high risk of concomitant confounding factors the lower tercile was subsequently excluded of the analysis.
Results
A total 48 patients were included. 69% of the patients had an aortic diameter that would have not fulfilled a preventive surgery indication. Two patients had bicuspid aortic valve, both of them with aortic aneurysms > 55 mm. None had high risk connective tissue disorders. There were no significant differences in baseline characteristics between the groups (Table 1).
A
PA ratio was similar in group B and C [1.91 (0.41) versus 2.11(0.45); p = 0.251], suggesting a similar aortic wall stress between aortas despite the difference in aortic diameters [49.5 mm (5.0) versus 58 mm (4.7); p < 0.001] (Figure 1, Panels C, D).
Conclusions: Our findings suggest that the A
PA ratio may be a promising risk stratification biomarker for TAAA without a conventional criteria for preventive surgery. This novel parameter should be prospectively tested in cohorts of TAAA. To the best of our knowledge, this is the first attempt to describe the usefulness of this parameter. Abstract FIGURE 1 Abstract TABLE 1
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Affiliation(s)
- A Montes
- University Hospital De La Princesa, Madrid, Spain
| | - A Cecconi
- University Hospital De La Princesa, Madrid, Spain
| | - E Monguio
- University Hospital De La Princesa, Madrid, Spain
| | | | - AM Rojas
- University Hospital De La Princesa, Madrid, Spain
| | | | - G Diego
- University Hospital De La Princesa, Madrid, Spain
| | - A Benedicto
- University Hospital De La Princesa, Madrid, Spain
| | - L Dominguez
- University Hospital De La Princesa, Madrid, Spain
| | - MJ Olviera
- University Hospital De La Princesa, Madrid, Spain
| | - P Caballero
- University Hospital De La Princesa, Madrid, Spain
| | | | - G Reyes
- University Hospital De La Princesa, Madrid, Spain
| | | | - F Alfonso
- University Hospital De La Princesa, Madrid, Spain
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Fontes S, Marín-Jiménez A, Berry M, Sánchez-García J, Reyes G, Krygier G, Cuello M. P-177 Early onset colorectal cancer outcomes in a public Uruguayan cancer centre. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.232] [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: 11/24/2022] Open
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9
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Rey Rubiano AM, Reyes G, Delgado A. Management of distal intestinal obstruction syndrome by enteroscopy in a post-lung transplant patient. Rev Esp Enferm Dig 2021; 112:330-331. [PMID: 32188255 DOI: 10.17235/reed.2020.6908/2020] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This is a case of a male patient who had a post-lung transplant complication given to distal intestinal obstruction by meconium. He was managed with laxative irrigation though enteroscope directly in the ileum with immediate resolution, without complications, avoiding surgical management. No similar cases have been reported.
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Affiliation(s)
| | - Gustavo Reyes
- Gastroenterología, Hospital Universitario Fundación Santa fe de Bogotá, Colombia
| | - Andrés Delgado
- Medicina Interna, Hospital Universitario Fundación Santa fe de Bogotá, colombia
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Alpizar-Rodriguez D, Irazoque-Palazuelos F, Rodriguez-Reyne TS, Zamora E, Xibille Friedmann DX, Castillo Ortiz A, Martínez-Martínez MU, Zazueta BE, Duran Barragan S, Rull-Gabayet M, Vázquez-Del Mercado Espinosa M, Moctezuma-Ríos JF, Barragán-Garfías A, Martin-Nares E, Cervantes-Rosete D, Vega-Morales D, Aguiar Castellanos M, Reyes G, Macias M, Maya-Piña LV, Cobos-Villanueva F, Navarro-Zarza JE, Sanchez-Rodriguez A, Cruz-Domínguez MDP, Jimenez Jimenez X, Marquez O, Martínez A, Vargas Guerrero A, Andrade L, Pacheco Tena CF. POS1242 FACTORS ASSOCIATED WITH MORTALITY IN PATIENTS WITH RHEUMATIC DISEASES AND COVID-19 IN MEXICO. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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:As of the 25th of January 2021, more than 150 thousand deaths as consequence of COVID-19 have been reported in Mexico [1]. Advanced age, male gender and comorbidities have been described as risk factors for severe disease and mortality in general population [2]. COVID-19 mortality in Mexican patients with rheumatic and musculoskeletal diseases (RMDs) is unknown.Objectives:To describe characteristics of Mexican patients with RMDs and COVID-19, and to analyse factors associated with mortality.Methods:The Global Rheumatology Alliance COVID-19 (GRA) physician reported registry, is an international effort to collect information on COVID19 in adult patients with RMDs. GRA is an observational registry. The first patient from Mexico was registered on April 17, 2020. All Mexican patients registered in GRA until October 30, 2020 were included in this analysis. The association of mortality with demographic and clinical variables was estimated using logistic regression analysis.Results:A total of 323 patients were registered, with a median age of 52 (IQR 41-61) years old, 166 (51.4%) patients lived in Mexico City. The most frequent RMDs were rheumatoid arthritis, 149 (46.1%) and systemic lupus erythematosus, 24 (19.8%). Over a third of patients with RMDs and COVID-19 (119 (36.8%)) were hospitalized, and 43 (13.3%) died. Table 1 shows clinical and demographic characteristics. In the univariable analysis, the absence of comorbidities was a protective factor, OR 0.3 (95% CI 0.1-0.6). Factors associated with mortality at COVID-19 diagnosis were age over 65 years old, having type 2 diabetes, chronic renal insufficiency, treatment at COVID-19 diagnosis with corticosteroids or with CD20 inhibitors. In the multivariable adjusted analysis, these factors remained independently associated with mortality. No associations with other treatments or comorbidities at COVID-19 diagnosis were found.Conclusion:Mexican patients with RMDs and COVID-19 in the GRA physician reported registry had a mortality of 13.3%. Factors associated with mortality were those described in the general population, such as older age and being on corticosteroids and CD20 inhibitors treatment at COVID-19 diagnosis.References:[1]WHO. Coronavirus disease (COVID-19) pandemic. https://www.who.int/emergencies/diseases/novel-coronavirus-2019. (accessed 26 January, 2021).[2]Zhou F, et al. Lancet 2020;395(10229):1054-62.Table 1.Clinical and demographic characteristics of patients with rheumatic diseases and COVID-19 in Mexico and mortality.Characteristics at COVID-19 diagnosisTotalN=323Death43 (13.3)Survivors280 (86.7)UnivariableOR (95% CI)MultivariableOR (95% CI)Women, n(%)268 (82.9)33 (76.7)235 (83.9)0.6 (0.3-1.4)0.5 (0.2-1.3)Age >65 years old, n(%)62 (19.2)18 (41.9)44 (15.7)3.9 (1.9-7.7)3.9 (1.9-8.3)RMDs* n(%)-Rheumatoid arthritis149 (46.1)23 (53.5)126 (45.0)1.6 (0.7-3.7)-Systemic Lupus Erythemathosus64 (19.8)10 (23.3)54 (19.3)1.6 (0.6-4.3)-Spondyloarthritis (axial and others)33 (10.2)2 (4.7)31 (11.1)0.1 (0.1-2.8)-Others77 (23.8)8 (18.6)69 (24.6)1-Moderate/High disease activity1, n(%)57 (18.6)7 (17.9)50 (18.7)1.0 (0.4-2.5)-None comorbidities, n(%)136 (42.1)8 (18.6)128 (45.7)0.3 (0.1-0.6)-Hypertension*, n(%)88 (27.2)12 (27.9)76 (27.1)1.0 (0.5-2.1)-Type 2 Diabetes*, n(%)49 (15.2)13 (30.2)36 (12.9)2.9 (1.4-6.1)2.4 (1.1-5.4)Obesity*, n(%)21 (6.5)3 (6.9)18 (6.4)1.1 (0.3-3.9)-Chronic obstructive pulmonary disease*, n(%)15 (4.6)1 (2.3)14 (5.0)0.5 (0.1-3.5)-Chronic renal insufficiency*, n(%)17 (5.2)6 (13.9)11 (3.9)3.9 (1.4-11.4)3.4 (1.1-10.4)Cardiovascular diseases*, n(%)14 (4.3)2 (4.7)12 (4.3)1.1 (0.2-5.0)-Corticosteroids*, n(%)171 (52.9)30 (69.7)141 (50.3)2.3 (1.1-4.5)3.0 (1.4-6.5)CsDMARD*, n(%)247 (76.5)33 (16.3)214 (76.4)1.0 (0.5- 2.2)-CD20 inhibitor*, n(%)21 (6.5)7 (16.3)14 (5.0)3.7 (1.4-9.9)4.9 (1.7-14.5)*Overlapped, 1 307 patients.Disclosure of Interests:None declared
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Juliao-Baños F, Puentes F, López R, Saffon M, Reyes G, Parra V, Galiano M, Barraza M, Molano J, Álvarez E, Corrales R, Vargas L, Gil F, Álvarez P, Limas L, Prieto R, Yance P, Díaz F, Bareño J, Juliao-Baños F, Arrubla M, Camargo J, Puentes F, Arango L, López R, García R, Mendoza B, Saffon MA, Roldan LF, Zuleta J, Reyes G, Parra V, Flórez C, Nuñez E, Galiano MT, Barraza M, Sanchez IC, Molano JL, Lizarazo JI, Cuellar I, Álvarez E, Corrales R, Gil F, Vargas LE, Álvarez P, Limas LM, Prieto R, Ballén H, Delgado L, Yance P, Díaz F. Characterization of inflammatory bowel disease in Colombia: Results of a national register. Revista de Gastroenterología de México (English Edition) 2021. [DOI: 10.1016/j.rgmxen.2020.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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Zinter MS, Lindemans CA, Versluys BA, Mayday MY, Sunshine S, Reyes G, Sirota M, Sapru A, Matthay MA, Kharbanda S, Dvorak CC, Boelens JJ, DeRisi JL. The pulmonary metatranscriptome prior to pediatric HCT identifies post-HCT lung injury. Blood 2021; 137:1679-1689. [PMID: 33512420 PMCID: PMC7995292 DOI: 10.1182/blood.2020009246] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/15/2020] [Indexed: 02/07/2023] Open
Abstract
Lung injury after pediatric allogeneic hematopoietic cell transplantation (HCT) is a common and disastrous complication that threatens long-term survival. To develop strategies to prevent lung injury, novel tools are needed to comprehensively assess lung health in HCT candidates. Therefore, this study analyzed biospecimens from 181 pediatric HCT candidates who underwent routine pre-HCT bronchoalveolar lavage (BAL) at the University Medical Center Utrecht between 2005 and 2016. BAL fluid underwent metatranscriptomic sequencing of microbial and human RNA, and unsupervised clustering and generalized linear models were used to associate microbiome gene expression data with the development of post-HCT lung injury. Microbe-gene correlations were validated using a geographically distinct cohort of 18 pediatric HCT candidates. The cumulative incidence of post-HCT lung injury varied significantly according to 4 pre-HCT pulmonary metatranscriptome clusters, with the highest incidence observed in children with pre-HCT viral enrichment and innate immune activation, as well as in children with profound microbial depletion and concomitant natural killer/T-cell activation (P < .001). In contrast, children with pre-HCT pulmonary metatranscriptomes containing diverse oropharyngeal taxa and lacking inflammation rarely developed post-HCT lung injury. In addition, activation of epithelial-epidermal differentiation, mucus production, and cellular adhesion were associated with fatal post-HCT lung injury. In a separate validation cohort, associations among pulmonary respiratory viral load, oropharyngeal taxa, and pulmonary gene expression were recapitulated; the association with post-HCT lung injury needs to be validated in an independent cohort. This analysis suggests that assessment of the pre-HCT BAL fluid may identify high-risk pediatric HCT candidates who may benefit from pathobiology-targeted interventions.
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Affiliation(s)
- Matt S Zinter
- Division of Critical Care Medicine and
- Division of Allergy, Immunology, and Bone Marrow Transplantation, Department of Pediatrics, School of Medicine, University of California, San Francisco, CA
| | - Caroline A Lindemans
- Department of Pediatric Stem Cell Transplantation, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Hematopoietic Cell Transplantation, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Birgitta A Versluys
- Department of Pediatric Stem Cell Transplantation, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Hematopoietic Cell Transplantation, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Madeline Y Mayday
- Graduate Program in Experimental Pathology, and Yale Stem Cell Center, Department of Pathology, Yale University, New Haven, CT
| | - Sara Sunshine
- Department of Biochemistry and Biophysics, School of Medicine
| | | | - Marina Sirota
- Bakar Computational Health Sciences Institute, and
- Department of Pediatrics, School of Medicine, University of California, San Francisco, CA
| | - Anil Sapru
- Division of Critical Care Medicine, Department of Pediatrics, School of Medicine, University of California, Los Angeles, CA
| | - Michael A Matthay
- Department of Medicine and
- Department of Anesthesiology, Cardiovascular Research Institute, School of Medicine, University of California, San Francisco, CA
| | - Sandhya Kharbanda
- Division of Allergy, Immunology, and Bone Marrow Transplantation, Department of Pediatrics, School of Medicine, University of California, San Francisco, CA
| | - Christopher C Dvorak
- Division of Allergy, Immunology, and Bone Marrow Transplantation, Department of Pediatrics, School of Medicine, University of California, San Francisco, CA
| | - Jaap J Boelens
- Department of Pediatric Stem Cell Transplantation and Cellular Therapies, Memorial Sloan Kettering Cancer Center, New York, NY; and
| | - Joseph L DeRisi
- Department of Biochemistry and Biophysics, School of Medicine
- Chan Zuckerberg Biohub, San Francisco, CA
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Juliao-Baños F, Puentes F, López R, Saffon MA, Reyes G, Parra V, Galiano MT, Barraza M, Molano J, Álvarez E, Corrales R, Vargas LE, Gil F, Álvarez P, Limas L, Prieto R, Yance P, Díaz F, Bareño J. Characterization of inflammatory bowel disease in Colombia: Results of a national register. Rev Gastroenterol Mex (Engl Ed) 2020; 86:153-162. [PMID: 32723624 DOI: 10.1016/j.rgmx.2020.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 04/29/2020] [Accepted: 05/14/2020] [Indexed: 02/07/2023]
Abstract
AIM To determine the clinical, sociodemographic, and treatment characteristics of inflammatory bowel disease (IBD) in a Colombian population register. METHODS A descriptive, analytic, observational, cross-sectional, multicenter study on patients with IBD from 17 hospital centers in 9 Colombian cities was conducted. RESULTS A total of 2,291 patients with IBD were documented, 1,813 (79.1%) of whom presented with ulcerative colitis (UC), 456 (19.9%) with Crohn's disease (CD), and 22 with IBD unclassified (0.9%). The UC/CD ratio was 3.9:1. A total of 18.5% of the patients with UC and 47.3% with CD received biologic therapy. Patients with extensive UC had greater biologic therapy use (OR = 2.78, 95% CI: 2.10-3.65, p = 0.000), a higher surgery rate (OR = 5.4, 95% CI: 3.5-8.3, p = 0.000), and greater frequency of hospitalization (OR = 4.34, 95% CI: 3.47-5.44, p = 0.000). Patients with severe UC had greater biologic therapy use (OR = 5.04, 95% CI: 3.75-6.78, p = 0.000), a higher surgery rate (OR = 8.64, 95% CI: 5.4-13.78, p = 0.000), and greater frequency of hospitalization (OR = 28.45, 95% CI: 19.9-40.7, p = 0.000). CD patients with inflammatory disease behavior (B1) presented with a lower frequency of hospitalization (OR = 0.12, 95% CI: 0.07-0.19, p = 0.000), a lower surgery rate (OR = 0.08, 95% CI: 0.043-0.15, p = 0.000), and less biologic therapy use (OR = 0.26, 95% CI: 0.17-0.41, p = 0.000). CONCLUSION In Colombia, there is a predominance of UC over CD (3.9:1), as occurs in other Latin American countries. Patients with extensive UC, severe UC, or CD with noninflammatory disease behavior (B2, B3) have a worse prognosis.
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Affiliation(s)
- F Juliao-Baños
- Clínica de Enfermedad Inflamatoria Intestinal, Hospital Pablo Tobón Uribe, Medellín, Colombia.
| | - F Puentes
- Unidad de Cirugía Gastrointestinal, Cirujanos Unidos, Manizales, Colombia
| | - R López
- Unidad de Gastroenterología y Patología, Fundación Santa Fe, Bogotá, Colombia
| | - M A Saffon
- Unidad de Gastroenterología, Instituto Gastroclínico, Medellín, Colombia
| | - G Reyes
- Unidad de Gastroenterología, Clínica Colombia, Bogotá, Colombia
| | - V Parra
- Unidad de Gastroenterología, Gastroadvanced, Bogotá-Medellín, Colombia
| | - M T Galiano
- Unidad de Gastroenterología, MTG Servimed SAS, Bogotá, Colombia
| | - M Barraza
- Unidad de Gastroenterología, Endodigestivos, Pereira, Colombia
| | - J Molano
- Unidad de Gastroenterología, Emdiagnóstica SAS, Bogotá, Colombia
| | - E Álvarez
- Unidad de Gastroenterología, IMAT, Montería, Colombia
| | - R Corrales
- Unidad de Gastroenterología, Clínica Intermedios, Montería, Colombia
| | - L E Vargas
- Unidad de Gastroenterología, Clínica La Misericordia, Barranquilla, Colombia
| | - F Gil
- Unidad de Gastroenterología, Clínica Colombia, Bogotá, Colombia
| | - P Álvarez
- Unidad de Gastroenterología, Clínica La Carolina, Bogotá, Colombia
| | - L Limas
- Unidad de Cirugía Gastrointestinal, LIMEQ, Tunja, Colombia
| | - R Prieto
- Unidad de Gastroenterología, Hospital Central de la Policía, Bogotá, Colombia
| | - P Yance
- Unidad de Gastroenterología, Gastrosalud, Santa Marta, Colombia
| | - F Díaz
- Unidad de Gastroenterología, Hospital Universitario del Caribe, Cartagena, Colombia
| | - J Bareño
- Centro de Epidemiología, Universidad CES, Medellín, Colombia
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Chavez JD, Tang X, Campbell MD, Reyes G, Kramer PA, Stuppard R, Keller A, Zhang H, Rabinovitch PS, Marcinek DJ, Bruce JE. Mitochondrial protein interaction landscape of SS-31. Proc Natl Acad Sci U S A 2020; 117:15363-15373. [PMID: 32554501 PMCID: PMC7334473 DOI: 10.1073/pnas.2002250117] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Mitochondrial dysfunction underlies the etiology of a broad spectrum of diseases including heart disease, cancer, neurodegenerative diseases, and the general aging process. Therapeutics that restore healthy mitochondrial function hold promise for treatment of these conditions. The synthetic tetrapeptide, elamipretide (SS-31), improves mitochondrial function, but mechanistic details of its pharmacological effects are unknown. Reportedly, SS-31 primarily interacts with the phospholipid cardiolipin in the inner mitochondrial membrane. Here we utilize chemical cross-linking with mass spectrometry to identify protein interactors of SS-31 in mitochondria. The SS-31-interacting proteins, all known cardiolipin binders, fall into two groups, those involved in ATP production through the oxidative phosphorylation pathway and those involved in 2-oxoglutarate metabolic processes. Residues cross-linked with SS-31 reveal binding regions that in many cases, are proximal to cardiolipin-protein interacting regions. These results offer a glimpse of the protein interaction landscape of SS-31 and provide mechanistic insight relevant to SS-31 mitochondrial therapy.
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Affiliation(s)
- Juan D Chavez
- Department of Genome Sciences, University of Washington, Seattle, WA 98105
| | - Xiaoting Tang
- Department of Genome Sciences, University of Washington, Seattle, WA 98105
| | | | - Gustavo Reyes
- Department of Radiology, University of Washington, Seattle, WA 98105
| | - Philip A Kramer
- Department of Radiology, University of Washington, Seattle, WA 98105
| | - Rudy Stuppard
- Department of Radiology, University of Washington, Seattle, WA 98105
| | - Andrew Keller
- Department of Genome Sciences, University of Washington, Seattle, WA 98105
| | - Huiliang Zhang
- Department of Pathology, University of Washington, Seattle, WA 98195
| | | | - David J Marcinek
- Department of Radiology, University of Washington, Seattle, WA 98105
| | - James E Bruce
- Department of Genome Sciences, University of Washington, Seattle, WA 98105;
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Fortuna B, García-Rodríguez F, Rubio N, Villlarreal AV, Faugier E, Reyes G, Mendieta S, Peláez-Ballestas I, Jimenez S, Rosiles S, Guadarrama J. AB0981 VALIDATION OF THE CAREGIVERS QUESTIONNAIRE (IMPACT OF PEDIATRIC RHEUMATIC DISEASES ON CAREGIVERS MULTIASSESSMENT QUESTIONNAIRE) IN PEDIATRIC RHEUMATIC DISEASES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6543] [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:The CAREGIVERS questionnaire is used as a multidimension screening instrument for burden of caregivers, it allows to examine the impact of juvenile idiopathic arthritis (JIA) on several areas of the caregiver’s life, looking for specific concerns and needs in which treatment could be required. This instrument has shown a good understanding among participants, reliability and consistency to measure the psychosocial and economic impact on primary caregivers of patients with JIA.Objectives:The aim of this study is to validate CAREGIVERS questionnaire with the most common pediatric rheumatic diseases, such as JIA, systemic lupus erythematosus (SLE) and juvenile dermatomyositis (JDM).Methods:The external validation phase of the constructed questionnaire will be carried out following Feinstein’s clinimetric and psychometrics methodology, to measure the impact of the disease on the caregiver and create a risk profile for treatment detachment.Results:A total of 200 questionnaires are applied to caregivers of pediatric patients with rheumatic diseases: 109 caregivers of patients with JIA, 28 caregivers of patients with DMJ and 63 caregivers of patients with SLE. When analyzing all the questions together, a general Cronbach’s alpha of 0.6751 was obtained (Table 1).Table 1.External validation of the QuestionnaireDimensionNumero de ÍtemsAlfa de CronbachI. Impacto Emocional60.5669II. Impacto Social30.47IIIA. Impacto Financiero40.6736IIIB. Impacto Laboral30.3151IV. Impacto Familiar50.4948V. Impacto en la Relación entre Cuidador-paciente1NAVI. Impacto en la relación de pareja1NAVII. Impacto en la Religión/Creencias/Espiritualidad1NAVIII. Impacto de las Redes Sociales40.6642Total280.6751Conclusion:The CAREGIVERS questionnaire showed to be validated to assess the impact of pediatric rheumatic diseases.References:[1]Keppeke, L.d., Molina, J., Miotto e Silva, V.B.et al.Psychological characteristics of caregivers of pediatric patients with chronic rheumatic disease in relation to treatment adherence.Pediatr Rheumatol16,63 (2018).https://doi.org/10.1186/s12969-018-0280-7[2]Cohen EM, Morley-Fletcher A, Mehta DH, Lee YC. A systematic review of psychosocial therapies for children with rheumatic diseases. Pediatr Rheumatol [Internet]. Pediatric Rheumatology; 2017;15(1):6. Available from:http://ped-rheum.biomedcentral.com/articles/10.1186/s12969-016-0133-1.[3]Torres-Made, M.D., Peláez-Ballestas, I., García-Rodríguez, F.et al.Development and validation of the CAREGIVERS questionnaire: multi-assessing the impact of juvenile idiopathic arthritis on caregivers.Pediatr Rheumatol18,3 (2020).https://doi.org/10.1186/s12969-020-0400-z[4]Feinstein AR. Clinimetrics. New Haven: Yale University Press, 1987.Disclosure of Interests:None declared
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Fernández-Ávila DG, Patino-Hernandez D, Kowalski S, Vargas-Caselles A, Sapag Durán AM, Cachafeiro Vilar A, Meléndez B, Pastelín CS, Graf C, Rossetto C, Palleiro D, Trincado D, Fernández-Ávila D, Arrieta D, Reyes G, Then J, Ugarte-Gil MF, Cardiel M, Colman N, Chávez N, Burgos P, Montufar R, Sandino S, Fuentes-Silva Y, Soriano E. AB1270 RHEUMATOLOGY WORKFORCE IN LATIN AMERICA: TRAINING AND CURRENT STATUS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2353] [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:The demand for rheumatology care has been steadily increasing over the last few years. However, supply seems to be insufficient, according to previous research1. This situation may be at least partly explained by less physicians beginning a rheumatology residency program2.Objectives:We aim to identify baseline data, room for change, and to strengthen functional processes associated with the rheumatology workforce in order to improve care offered to patients living with rheumatic diseases.Methods:Descriptive cross-sectional study. We obtained data on each country through local PANLAR rheumatologists. They completed an online survey using the RedCap® platform, used for capture and storage of data. The sample was described according to the type of variable.Results:19 Latin American countries were included in this study, globally 1 rheumatologist was available per 106,838 inhabitants. The highest rates were found in Uruguay (1 per 23.695 inhabitants) and Argentina (1 per 40.384 inhabitants). The lowest rates were found in Nicaragua (1 per 640.648 inhabitants) and Guatemala (1 per 559.902 inhabitants). The ratio between women and men rheumatologists was 0,99 women per each man. The lowest proportions were found in Peru (0,26:1), and the highest in the Dominican Republic (2.5:1). The average age for rheumatologists was 51,6 (SD12,75). Lowest average ages were found in Paraguay (43,1 SD10,77) and the highest age averages were found in Peru (56,23 SD12.93). The average monthly compensation was USD $2.382,6 (SD$1.462,5). Venezuela had the lowest salary ($197), the highest salary was found in Costa Rica ($4.500). The proportion of rheumatologists trained abroad was 26,7%, ranging between 0% in Uruguay and 90% in Bolivia.The countries with more rheumatology training programs were Brazil n = 50 and Mexico n = 20, while Ecuador, Honduras and Nicaragua don’t have any. The countries with the greatest amount of active residents were Brazil (n = 252) and Argentina (n = 100). The educational level required to enter the program was postgraduate studies in internal medicine in 42.11% of the programs. Currently, 108 residency programs in Latin America are active. Duration of residency programs is variable: 2 years (79.63% of cases), 3 years (16.67%), 4 years (1.85%), 5 years (0.96%) or 6 years (0.96%). The median monthly compensation for residents was $ 528 USD (IQR $ 774), the country with the highest payment was Costa Rica ($ 2637). Contrarily, in Cuba, Chile and Colombia there is no payment to residents. Finally, in 8 countries (42.11%) residents must not pay for their postgraduate studies, the average annual tuition expense in the rest of countries is $ 1248 (SD $ 2749).Conclusion:The rate of rheumatologists per inhabitant is low. The demographic characteristics and the current status of the rheumatology workforce, as well as rheumatology training in Latin-America varies widely among countries. For instance, relevant differences can be found regarding payment to rheumatologists and residents, and tuition fees. The collected information will be useful when planning regional-based strategies, as well as for future research projects in each country and within PANLAR.References:[1]Battafarano DF, Ditmyer M, Bolster MB, et al. 2015 American College of Rheumatology Workforce Study: Supply and Demand Projections of Adult Rheumatology Workforce, 2015-2030. Arthritis Care Res.2018;70(4):617-26[2]Zborovski S, Rohekar G, Rohekar S. Strategies to improve recruitment into rheumatology: results of the Workforce in Rheumatology Issues Study. J Rheumatol. 2010;37:1749-55Disclosure of Interests:Daniel G. Fernández-Ávila: None declared, Daniela Patino-Hernandez: None declared, Sergio Kowalski: None declared, Alfredo Vargas-Caselles: None declared, Ana María Sapag Durán: None declared, Antonio Cachafeiro Vilar: None declared, Belia Meléndez: None declared, Carlos Santiago Pastelín: None declared, Cesar Graf: None declared, Chayanne Rossetto: None declared, Daniel Palleiro: None declared, Daniela Trincado: None declared, Diana Fernández-Ávila: None declared, Dina Arrieta: None declared, Gil Reyes: None declared, Jossiell Then: None declared, Manuel F. Ugarte-Gil Grant/research support from: Jannsen, Pfizer, Mario Cardiel: None declared, Nelly Colman: None declared, Nilmo Chávez: None declared, Paula Burgos: None declared, Ruben Montufar: None declared, Sayonara Sandino: None declared, Yurilis Fuentes-Silva: None declared, Enrique Soriano Grant/research support from: AbbVie, Eli Lilly, GlaxoSmithKline, Novartis, Pfizer Inc, Sandoz, Consultant of: AbbVie, Eli Lilly, GlaxoSmithKline, Novartis, Pfizer Inc, Sandoz, Speakers bureau: AbbVie, Amber, Bristol-Myers Squibb, Eli Lilly, Novartis, Pfizer Inc, Roche
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Salazar-Martín AG, García-Granada AA, Reyes G, Gomez-Gras G, Puigoriol-Forcada JM. Time-Dependent Mechanical Properties in Polyetherimide 3D-Printed Parts Are Dictated by Isotropic Performance Being Accurately Predicted by the Generalized Time Hardening Model. Polymers (Basel) 2020; 12:E678. [PMID: 32204307 PMCID: PMC7182950 DOI: 10.3390/polym12030678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/06/2020] [Accepted: 03/15/2020] [Indexed: 11/16/2022] Open
Abstract
The Fused-Deposition Modelling (FDM) technique has transformed the manufacturing discipline by simplifying operational processes and costs associated with conventional technologies, with polymeric materials being indispensable for the development of this technology. A lack of quantification of viscoelastic/plastic behavior has been noted when addressing FDM parts with Polyetherimide (PEI), which is currently being investigated as a potential material to produce functional end-products for the aerospace and health industry. Primary and secondary creep along with stress relaxation tests have been conducted on FDM PEI specimens by applying stresses from 10 to 40 MPa for 100 to 1000 min. Specimens were 3D printed by varying the part build orientation, namely XY, YZ, and XZ. Creep results were fitted to the Generalized Time Hardening equation (GTH), and then this model was used to predict stress relaxation behavior. FDM PEI parts presented an isotropic creep and stress relaxation performance. The GTH model was proven to have a significant capacity to fit viscoelastic/plastic performances for each single build orientation (r > 0.907, p < 0.001), as well as a tight prediction of the stress relaxation behavior (r > 0.998, p < 0.001). Averaged-orientation coefficients for GTH were also closely correlated with experimental creep data (r > 0.958, p < 0.001) and relaxation results data (r > 0.999, p < 0.001). FDM PEI parts showed an isotropic time-dependent behavior, which contrasts with previous publications arguing the significant effect of part build orientation on the mechanical properties of FDM parts. These findings are strengthened by the high correlation obtained between the experimental data and the averaged-coefficient GTH model, which has been proven to be a reliable tool to predict time-dependent performance in FDM parts.
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Affiliation(s)
| | - A. A. García-Granada
- Grup d’Enginyeria en Producte Industrial, (GEPI), Institut Químic de Sarrià, Universitat Ramon Llull, Via Augusta 390, 08017 Barcelona, Spain; (A.G.S.-M.); (G.R.); (G.G.-G.); (J.M.P.-F.)
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Escobar Juárez Y, Soto Molina H, Juarez Vasquez K, Reyes G, Guzmán-Vázquez S, Fernández del Valle C. PDB1 CALIDAD DE VIDA ASOCIADA CON OBESIDAD EN PACIENTES MEXICANOS. Value Health Reg Issues 2019. [DOI: 10.1016/j.vhri.2019.08.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bianchi E, Stermer A, Boekelheide K, Sigman M, Hall SJ, Reyes G, Dere E, Hwang K. High-quality human and rat spermatozoal RNA isolation for functional genomic studies. Andrology 2018; 6:374-383. [PMID: 29470852 DOI: 10.1111/andr.12471] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 12/11/2017] [Accepted: 01/04/2018] [Indexed: 12/30/2022]
Abstract
Sperm RNA is a sensitive monitoring endpoint for male reproductive toxicants, and a potential biomarker to assess male infertility and sperm quality. However, isolation of sperm RNA is a challenging procedure due to the heterogeneous population of cells present in the ejaculate, the low yield of RNA per spermatozoon, and the absence of 18S and 28S ribosomal RNA subunits. The unique biology of spermatozoa has created some uncertainty in the field about RNA isolation methods, indicating the need for rigorous quality control checks to ensure reproducibility of data generated from sperm RNA. Therefore, we developed a reliable and effective protocol for RNA isolation from rat and human spermatozoa that delivers highly purified and intact RNA, verified using RNA-specific electrophoretic chips and molecular biology approaches such as RT-PCR and Western blot analysis. The sperm RNA isolation technique was optimized using rat spermatozoa and then adapted to human spermatozoa. Three steps in the sperm isolation procedure, epididymal fluid collection, sperm purification, and spermatozoon RNA extraction, were evaluated and assessed. The sperm RNA extraction methodology consists of collection of rat epididymal fluid with repeated needle punctures of the epididymis, somatic cell elimination using detergent-based somatic cell lysis buffer (SCLB) and the use of RNA isolation Kit. Rat sperm heads are more resistant to disruption than human spermatozoa, necessitating the addition of mechanical lysis with microbeads and heat in the rat protocol, whereas the human sperm protocol only required lysis buffer. In conclusion, this methodology results in reliable and consistent isolation of high-quality sperm RNA. Using this technique will aid in translation of data collected from animal models, and reproducibility of clinical assessment of male factor fertility using RNA molecular biomarkers.
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Affiliation(s)
- E Bianchi
- Division of Urology, Rhode Island Hospital, Providence, RI, USA.,Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - A Stermer
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - K Boekelheide
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - M Sigman
- Division of Urology, Rhode Island Hospital, Providence, RI, USA.,Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - S J Hall
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - G Reyes
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - E Dere
- Division of Urology, Rhode Island Hospital, Providence, RI, USA.,Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - K Hwang
- Division of Urology, Rhode Island Hospital, Providence, RI, USA.,Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
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Koprich J, Johnston T, Howson P, Reyes G, Omana V, Brotchie J. Characterization and reproducibility of a macaque model of Parkinson’s disease alpha-synucleinopathy. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Menacho J, Rotllant L, Molins JJ, Reyes G, García-Granada AA, Balcells M, Martorell J. Arterial pulse attenuation prediction using the decaying rate of a pressure wave in a viscoelastic material model. Biomech Model Mechanobiol 2017; 17:589-603. [PMID: 29168070 PMCID: PMC5845065 DOI: 10.1007/s10237-017-0980-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 10/31/2017] [Indexed: 11/30/2022]
Abstract
The present study examines the possibility of attenuating blood pulses by means of introducing prosthetic viscoelastic materials able to absorb energy and damp such pulses. Vascular prostheses made of polymeric materials modify the mechanical properties of blood vessels. The effect of these materials on the blood pulse propagation remains to be fully understood. Several materials for medical applications, such as medical polydimethylsiloxane or polytetrafluoroethylene, show viscoelastic behavior, modifying the original vessel stiffness and affecting the propagation of blood pulses. This study focuses on the propagation of pressure waves along a pipe with viscoelastic materials using the Maxwell and the Zener models. An expression of exponential decay has been obtained for the Maxwell material model and also for low viscous coefficient values in the Zener model. For relatively high values of the viscous term in the Zener model, the steepest part of the pulse can be damped quickly, leaving a smooth, slowly decaying wave. These mathematical models are critical to tailor those materials used in cardiovascular implants to the mechanical environment they are confronted with to repair or improve blood vessel function.
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Affiliation(s)
- J Menacho
- IQS School of Engineering, Universitat Ramon Llull, Via Augusta 390, 08017, Barcelona, Spain
| | - L Rotllant
- IQS School of Engineering, Universitat Ramon Llull, Via Augusta 390, 08017, Barcelona, Spain.,Department of Applied Sciences, CBSET, 500 Shire Way, Lexington, MA, USA
| | - J J Molins
- IQS School of Engineering, Universitat Ramon Llull, Via Augusta 390, 08017, Barcelona, Spain
| | - G Reyes
- IQS School of Engineering, Universitat Ramon Llull, Via Augusta 390, 08017, Barcelona, Spain
| | - A A García-Granada
- IQS School of Engineering, Universitat Ramon Llull, Via Augusta 390, 08017, Barcelona, Spain
| | - M Balcells
- IQS School of Engineering, Universitat Ramon Llull, Via Augusta 390, 08017, Barcelona, Spain. .,IMES - MIT, 77 Massachusetts Av., E25-229, Cambridge, MA, 02139, USA.
| | - J Martorell
- IQS School of Engineering, Universitat Ramon Llull, Via Augusta 390, 08017, Barcelona, Spain
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Flesler S, Reyes G, Fortini S, Ramos B, Cersosimo R, Bartuluchi M, Caraballo R. [Vagus nerve stimulation: treatment of 158 pediatric patients with a long-term follow-up]. Rev Neurol 2017; 64:496-501. [PMID: 28555455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIM To describe a series of patients with drug resistant epilepsy treated with vagus nerve stimulation in a national pediatric hospital, evaluating efficacy, safety and tolerability. PATIENTS AND METHODS A retrospective analysis of 158 pediatric patients with epilepsy resistant to pharmacological and non pharmacological treatment including surgery that were treated with vagus nerve stimulation between 2001-2015. Patients with progressive encephalopathies, and congenital heart disease were excluded. RESULTS 158 patients (80 male) were included, with a mean age at implantation of 11.4 years and a mean age at evolution of epilepsy of 9.5 years. Time of follow-up: 1-15 years (median: 6.9 years). Patient's age at this time: 2-31 years (median: 14.1 years). Effectiveness: 66.5% of patients showed more or equal at 50% of seizure control at 24 months of implant. Just three patients showed severe side effects (1.8%). Minor side effects were seen in 26 patients (16.4%). Without side effects: 129 (81.8%). CONCLUSION Vagus nerve stimulation is an effective, tolerable and safe therapy in our pediatric series with refractory epilepsy.
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Affiliation(s)
- S Flesler
- Hospital Nacional de Pediatria J. P. Garrahan, 1818 Buenos Aires, Argentina
| | - G Reyes
- Hospital Nacional de Pediatria J. P. Garrahan, 1818 Buenos Aires, Argentina
| | - S Fortini
- Hospital Nacional de Pediatria J. P. Garrahan, 1818 Buenos Aires, Argentina
| | - B Ramos
- Hospital Nacional de Pediatria J. P. Garrahan, 1818 Buenos Aires, Argentina
| | - R Cersosimo
- Hospital Nacional de Pediatria J. P. Garrahan, 1818 Buenos Aires, Argentina
| | - M Bartuluchi
- Hospital Nacional de Pediatria J. P. Garrahan, 1818 Buenos Aires, Argentina
| | - R Caraballo
- Hospital Nacional de Pediatria J. P. Garrahan, 1818 Buenos Aires, Argentina
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Vigueras RM, Reyes G, Rojas-Castañeda J, Rojas P, Hernández R. Testicular torsion and its effects on the spermatogenic cycle in the contralateral testis of the rat. Lab Anim 2016; 38:313-20. [PMID: 15207043 DOI: 10.1258/002367704323133709] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of the present study was to evaluate the effects of unilateral testicular torsion on the contralateral testis with respect to the stages of the cycle of the seminiferous epithelium (CSE). Fifty-five male Wistar rats, 60 days old, were used. The animals were divided into 11 groups. Groups 1-5 were subjected to unilateral testicular torsion from 3 to 48 h, followed by detorsion. Groups 6-10 had unilateral orchiectomies after unilateral testicular torsion for 3 to 48 h. Animals constituting group 11 served as the control sham-operated group. All animals were killed after 2 months. The percentage of affected tubules (tubules showing pathological changes) in the contralateral testis was estimated based on the CSE stages. In the torsion/detorsion group, the percentage of affected tubules was significantly greater (58.6%) than in torsion/orchiectomy group (48.0%). Stages VI-XI of the spermatogenic cycle were the most affected when compared with the rest of the stages in each experimental group ( P <0.05). These results show that stages VI-XI of the spermatogenic cycle, the stages associated with low antioxidant capacities, are the most sensitive to the effects of testicular torsion on the contralateral testis.
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Affiliation(s)
- R M Vigueras
- Laboratorio de Histomorfología, Torre de Investigación 'Dr Joaquin Cravioto', Instituto Nacional de Pediatría, SS, México, DF, México.
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García J, Llinares E, Reyes G, Jaramillo A, Bassa P, Soler M. Cervical lymph nodes from unknown primary tumour. Squamous cell carcinoma of tonsils related to human papilloma virus detected by 18 F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol 2016. [DOI: 10.1016/j.remnie.2016.01.004] [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]
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Reyes G, Rodriguez-Serrano D, Chicot-Llano M, Leal O, Figueroa C, Mingo A. Leiomiosarcoma de arteria pulmonar: una enfermedad infrecuente y de difícil diagnóstico. Med Intensiva 2016; 40:64-5. [DOI: 10.1016/j.medin.2015.03.007] [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] [Received: 03/13/2015] [Revised: 03/24/2015] [Accepted: 03/24/2015] [Indexed: 11/28/2022]
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García JR, Llinares E, Reyes G, Jaramillo A, Bassa P, Soler M. Cervical lymph nodes from unknown primary tumour. Squamous cell carcinoma of tonsils related to papilloma human virus detected by (18)F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol 2015; 35:137-8. [PMID: 26337464 DOI: 10.1016/j.remn.2015.07.008] [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] [Received: 06/01/2015] [Revised: 07/20/2015] [Accepted: 07/22/2015] [Indexed: 11/15/2022]
Affiliation(s)
- J R García
- Centro PET. CETIR-ERESA, Esplugues de Llobregat, Barcelona, España.
| | - E Llinares
- Centro PET. CETIR-ERESA, Esplugues de Llobregat, Barcelona, España
| | - G Reyes
- Centro PET. CETIR-ERESA, Esplugues de Llobregat, Barcelona, España
| | - A Jaramillo
- Centro PET. CETIR-ERESA, Esplugues de Llobregat, Barcelona, España
| | - P Bassa
- Centro PET. CETIR-ERESA, Esplugues de Llobregat, Barcelona, España
| | - M Soler
- Centro PET. CETIR-ERESA, Esplugues de Llobregat, Barcelona, España
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Martín E, Hornero F, Rodríguez R, Castellà M, Porras C, Romero B, Maroto L, Pérez de la Sota E, Echevarría M, Dalmau M, Díez L, Buendía J, Enríquez F, Castaño M, Reyes G, Ginel A, Pérez M, García R, Barquero J, Heredero A, Jiménez A, Castedo E, Lugo J, Pradas G, Gómez M, Rieta J. Estudio multicéntrico español para la predicción del riesgo perioperatorio de accidente cerebrovascular tras cirugía de bypass coronario aislada: el modelo PACK2. Cirugía Cardiovascular 2014. [DOI: 10.1016/j.circv.2014.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Hornero F, Martín E, Mena-Durán AV, Rodríguez R, Castellà M, Porras C, Romero B, Maroto L, de la Sota E P, Echevarría M, Dalmau MJ, Díez L, Buendía J, Enríquez F, Castaño M, Reyes G, Ginel A, Pérez M, Barquero J, Jiménez A, Castedo E, Pradas G, Gómez M. Atrial Fibrillation and Stroke Risk After Coronary Artery Bypass Grafting Surgery. J Atr Fibrillation 2013; 6:909. [PMID: 28496894 DOI: 10.4022/jafib.909] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 09/11/2013] [Accepted: 09/13/2013] [Indexed: 11/10/2022]
Abstract
Background: The present multicentre study was aimed at determining the effect of preoperative atrial fibrillation (preop-AF) as stroke risk factor in coronary artery bypass graft surgery (CABG) during the perioperative period. Methods: Patients undergoing isolated CABG surgery were enrolled from 21 Spanish centers. Baseline variables related with perioperative stroke risk were recorded and analysed. The Northern New England Cardiovascular Disease Study Group (NNECVDSG) stroke risk schema was used to stratify stroke risk and compare predicted vs observed neurologic outcomes in this study. Results: 26347 patients were enrolled in the study. Prevalence of preop-AF was 4.2%, and was associated significantly with major cardiovascular comorbidities. The stroke rate was 1.38% (365 strokes), and it was slightly higher for patients with preop-AF vs non preop-AF, 1.82% vs 1.36%, p = 0.2. NNECVDSG schema showed good predictive ability calculating the area under the receiver operating characteristic curve (c-statistic 0.696; 95% CI 0.668 to 0.723). To investigate the associations of baseline preoperative variables with perioperative CABG-stroke a logistic regression model was performed. Preop-AF impact on perioperative stroke was lower that other variables. Preop-AF did not show an adverse impact in the quartiles groups according to NNECVDSG Stroke Risk Index. Conclusion: Risk of perioperative stroke in isolated CABG surgery patients is not significantly increased by preop-AF.
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Affiliation(s)
- F Hornero
- Instituto Cardiovascular. Heart Surgery Dept. Hospital General Universitario. Avda. Tres Cruces, s/n Valencia (Spain)
| | - E Martín
- Instituto Cardiovascular. Heart Surgery Dept. Hospital General Universitario. Avda. Tres Cruces, s/n Valencia (Spain)
| | - A V Mena-Durán
- Instituto Cardiovascular. Heart Surgery Dept. Hospital General Universitario. Avda. Tres Cruces, s/n Valencia (Spain)
| | - R Rodríguez
- Heart Surgery Dept. Hospital Vall d'Hebrón. Barcelona. Passeig de la Vall d'Hebron, 119. Barcelona (Spain)
| | - M Castellà
- Heart Surgery Dept. Hospital Clinic I Provincial. Carrer Villarroel, 170. Barcelona (Spain)
| | - C Porras
- Heart Surgery Dept. Hospital Clínico Universitario Virgen de la Victoria. Avda. Cervantes,2. Málaga (Spain)
| | - B Romero
- Heart Surgery Dept. Hospital Germans Trias i Pujol. Ctra. Canyet, S/N. Badalona (Spain)
| | - L Maroto
- Heart Surgery Dept. Hospital Clínico San Carlos. Calle Profesor Martín Lagos, s/n. Madrid (Spain)
| | - Pérez de la Sota E
- Heart Surgery Dept. Hospital Doce de Octubre. Avda. de Córdoba, s/n. Madrid (Spain)
| | - Mª Echevarría
- Heart Surgery Dept. Hospital Clínico Universitario. Avda. Ramón y Cajal s/n. Valladolid (Spain)
| | - M J Dalmau
- Heart Surgery Dept. Hospital Universitario. Calle San Vicente, 58. Salamanca (Spain)
| | - L Díez
- Heart Surgery Dept. Hospital Marqués de Valdecilla. Avenida Valdecilla, s/n Santander (Spain)
| | - J Buendía
- Heart Surgery Dept. Complejo Hospitalario. Av. de Barber, 30. Toledo (Spain)
| | - F Enríquez
- Heart Surgery Dept. Hospital Son Espases. Carretera de Valldemossa, 79. Palma de Mallorca (Spain)
| | - M Castaño
- Heart Surgery Dept. Complejo Asistencial Hospital of León. Altos de Nava s/n. León (Spain)
| | - G Reyes
- Heart Surgery Dept. Hospital de La Princesa. C/ Diego de León, 62. Madrid (Spain
| | - A Ginel
- Heart Surgery Dept. Hospital de la Santa Creu i Sant Pau. C/ Sant Quintí, 89. Barcelona (Spain)
| | - M Pérez
- Heart Surgery Dept. Hospital Universitari i Politècnic La Fe. Bulevar Sur, s/n. Valencia (Spain)
| | - J Barquero
- Heart Surgery Dept. Hospital Universitario Virgen Macarena. Av. Dr. Fedriani, 3. Sevilla (Spain)
| | - A Jiménez
- Heart Surgery Dept. Hospital Fundación Jiménez Díaz. Avda. Reyes Católicos, 2 Madrid (Spain)
| | - E Castedo
- Heart Surgery Dept. Hospital Universitario Puerta de Hierro. Calle Joaquin Rodrigo, 2 Majadahonda (Spain)
| | - G Pradas
- Heart Surgery Dept. Hospital Xeral. C/ Pizarro, 22.Vigo (Spain)
| | - M Gómez
- Heart Surgery Dept. Hospital Universitario Puerta del Mar. Avda. Ana de Viya, 21. Cádiz (Spain)
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Ghannoum MA, Hossain MA, Long L, Mohamed S, Reyes G, Mukherjee PK. Evaluation of Antifungal Efficacy in an Optimized Animal Model ofTrichophytonmentagrophytes-Dermatophytosis. J Chemother 2013; 16:139-44. [PMID: 15216947 DOI: 10.1179/joc.2004.16.2.139] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Dermatophytoses are known to cause considerable discomfort, cosmetic problems and financial loss that have been recognized as a significant health concern worldwide. Since currently available antifungal agents have limitations in their efficacy, new agents are being developed. This study was undertaken to optimize an in vivo model of experimental dermatophytosis for evaluation of the efficacy of antifungal compounds. Guinea pigs were infected with different inocula of T. mentagrophytes to establish dermatophytosis. The optimal conditions for dermatophytosis in guinea pigs were found to be an inoculum size of 1 x 10(7) fungal cells applied on abraded skin. After optimization, animals were treated with oral or topical formulations of terbinafine. The optimized guinea pig model was found to be highly reproducible, and useful in the primary screening and evaluation of the anti-dermatophytic efficacy of topical and oral formulations of antifungal agents.
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Affiliation(s)
- M A Ghannoum
- Center for Medical Mycology, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, Ohio 44106-5028, USA.
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Gutiérrez-Pérez O, Rojas-Castañeda JC, Chavez-Saldaña M, Reyes G, Vigueras-Villaseñor RM. Infertility in rats subjected to genitofemoral nerve section is not associated with testicular damage. Andrologia 2013; 46:151-7. [PMID: 23356484 DOI: 10.1111/and.12063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2012] [Indexed: 11/26/2022] Open
Abstract
This work was aimed at assessing the relationship between testicular ascent and infertility induced by genitofemoral nerve (GFN) section in rats. Eighteen male rats were assigned to three experimental groups as follows: (i) Group SGFN was subjected to surgical section of genitofemoral nerve; (ii) Group Sham; (iii) Control group. The GFN was cut at puberty (28D), and the contralateral testis removed at 90D, with fertility tests at 120D. At 150D, maturity index, epithelial area and histopathological index of seminiferous tubules of all rats were determined and statistically compared between superior and inferior testicle poles, and between groups. There were no differences in testicular parameters, sperm morphology or sperm concentrations (P > 0.05). Section of NGF interfered with fertility (58.3 ± 15.4 in SGFN versus 83.3 ± 10.5 in Sham) and litter size (6.2 ± 1.1 in SGFN versus 10.7 ± 1.4 in Sham). Cremaster of SGFN group showed early neuropathy. The GFN section induced partial testicular ascent and diminished fertility without damage on testicular morphology or spermatic parameters, because, cremaster could affect the contractibility and ejaculation mechanisms in which it participates. The study of the damage on cremaster induced by an injury on GFN could have an overview of the mechanisms inherent in the testicular ascent induced by this iatrogenic alteration and their potential risks on fertility.
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Affiliation(s)
- O Gutiérrez-Pérez
- Laboratorio de Biología de la Reproducción, Instituto Nacional de Pediatría, México D.F, México
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Llivina L, Colominas S, Reyes G, Abella J. Progress on the development of H-concentration probes in eutectic lead–lithium: Synthesis and characterization of electrochemical sensor materials. Fusion Engineering and Design 2012. [DOI: 10.1016/j.fusengdes.2012.02.061] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cacho Diaz B, Flores-Gavilan P, Herrera A, Reyes G, Granados M. Reasons To Visit the Neurologist in Patients with Systemic Cancer (P07.107). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.107] [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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Leal O, Bustamante J, Álvarez P, Badia S, Aguilar E, Domínguez L, Guijarro M, Reyes G, Sarraj A, Nuche J. 237. Malformación hamartomatosa de la aurícula izquierda como causa infrecuente de ataque isquémico transitorio de repetición. Cirugía Cardiovascular 2012. [DOI: 10.1016/s1134-0096(12)70450-3] [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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Álvarez Navarro P, Bustamante J, Loeches B, Leal O, Sarria C, Badia S, Aguilar E, Sarraj A, Reyes G, Nuche J. 326. Tratamiento quirúrgico de la endocarditis infecciosa izquierda activa. Cirugía Cardiovascular 2012. [DOI: 10.1016/s1134-0096(12)70626-5] [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: 10/26/2022] Open
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Reyes G, Álvarez P, Badia S, Leal O, Aguilar E, Sarraj A, Bustamante J, Nuche J. 134. Factores predictivos de transfusión sanguínea en cirugía cardíaca. Cirugía Cardiovascular 2012. [DOI: 10.1016/s1134-0096(12)70605-8] [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: 10/26/2022] Open
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Reyes G, Badia S, Álvarez P, Leal O, Aguilar E, Sarraj A, Bustamante J, Nuche J. 189. Comparación de los resultados clínicos y ecocardiográficos de dos sistemas de ablación de la fibrilación auricular. Cirugía Cardiovascular 2012. [DOI: 10.1016/s1134-0096(12)70552-1] [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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Reyes G. Revista Colombiana de Anestesiología: aún en su volumen 40 sigue en busca de la excelencia como medio de la difusión de nuestra producción científica. Revista Colombiana de Anestesiología 2012. [DOI: 10.1016/s0120-3347(12)70002-3] [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: 10/27/2022] Open
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Serret P, Colominas S, Reyes G, Abellà J. Characterization of ceramic materials for electrochemical hydrogen sensors. Fusion Engineering and Design 2011. [DOI: 10.1016/j.fusengdes.2011.01.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Reyes G, Prieto M, Alvarez P, Orts M, Bustamante J, Santos G, Sarraj A, Planas A. Cell saving systems do not reduce the need of transfusion in low-risk patients undergoing cardiac surgery. Interact Cardiovasc Thorac Surg 2011; 12:189-93. [DOI: 10.1510/icvts.2010.251538] [Citation(s) in RCA: 13] [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: 11/06/2022] Open
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Badia S, Reyes G, Benedicto A, Álvarez P, Bustamante J, Sarraj A, Nuche J. 104. Resultados a medio plazo de la crioablación quirúrgica de la fibrilación auricular. Cirugía Cardiovascular 2010. [DOI: 10.1016/s1134-0096(10)70720-8] [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: 10/26/2022] Open
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Onik G, Zemel R, Atkinson D, Weaver ML, Reyes G. Use of a biplane transrectal ultrasound probe in hepatic cryosurgery: Technical note. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/13645709309152976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ramírez LJ, Moreno MA, Gartdner L, Gómez LM, Calderón M, Sáenz X, Reyes G, Jaramillo J. Modelo de enseñanza de las habilidades psicomotoras básicas en anestesia para estudiantes de ciencias de la salud: sistematización de una experiencia. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s0120-3347(08)62008-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Castillo S, Mozas P, Reyes G, Andrés E, Mallén M, Cenarro A, Pueyo M, Tejedor D, Argimón J, Panisello J, Plana N, Martínez A, Alonso R, Pocoví M, Mata P. W14.348 Cardiovascular risk factors in a Spanish heterozygous FH cohort. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90347-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Budu CE, Luengpailin J, Reyes G, Doyle RJ, Cowan MM. Virulence factors of Porphyromonas gingivalis are modified by polyphenol oxidase and asparaginase. Oral Microbiol Immunol 2003; 18:313-7. [PMID: 12930524 DOI: 10.1034/j.1399-302x.2003.00092.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Porphyromonas gingivalis is a well-adapted pathogen of the periodontal pocket distinguished by its wide array of proteolytic activities and its ability to adhere to multiple substrata in the oral cavity. Microbial proteins with binding functions (such as adhesins and enzymes) very often contain critical tyrosine residues, supported by one or more asparagines in the binding cleft. This study investigates the reduction in adhesiveness and in proteolytic activity after treating P. gingivalis with the tyrosine- and asparagine-targeting enzymes polyphenol oxidase (PPO) and asparaginase (ASG). Cysteine protease activity was reduced by pretreatment with both enzymes, while the trypsin-like activity was affected only by PPO. Adhesion to buccal epithelial cells, laminin and fibronectin as well as hemagglutination was reduced by one or both of the enzymes. PPO, but not ASG, reduced the coaggregation of P. gingivalis with Actinomyces naeslundii. Treatment with these enzymes might provide an alternative to traditional antimicrobial strategies.
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Affiliation(s)
- C E Budu
- Department of Microbiology and Immunology, Health Sciences Center, University of Louisville, Louisville, KY, USA
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Mozas P, Castillo S, Reyes G, Tejedor D, Civeira F, García-Alvarez I, Puzo J, Cenarro A, Alonso R, Mata P, Pocoví M. Apolipoprotein E genotype is not associated with cardiovascular disease in heterozygous subjects with familial hypercholesterolemia. Am Heart J 2003; 145:999-1005. [PMID: 12796755 DOI: 10.1016/s0002-8703(02)94788-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Familial hypercholesterolemia (FH) is a genetic disorder characterized by high low-density lipoprotein cholesterol levels and premature cardiovascular disease (CVD). There are important differences in the presence of CVD among heterozygous subjects with FH. Some of this variability can be explained by genetic factors, and the apolipoprotein (apo) E genotype has been proposed as a useful marker. METHODS We analyzed the apo E genotype in 706 non-related subjects who were heterozygous for FH from Spain. CVD was present in 198 subjects (28%), 132 men (41%) and 66 women (17%). RESULTS Apo E allele frequencies for the epsilon 3, epsilon 4, and epsilon 2 alleles were 0.89, 0.09, and 0.02 respectively. Age, body mass index, smoking status, high blood pressure, diabetes mellitus, presence of tendon xanthomas, total cholesterol level, triglyceride levels, high-density lipoprotein cholesterol level, low-density lipoprotein cholesterol level, and Lp(a) did not differ among genotypes. The incidence of CVD and the age of onset of CVD did not differ among genotypes either. In the multivariant analysis, apo E genotype did not contribute significantly to CVD. CONCLUSIONS Heterozygous men with FH have a very high risk of coronary disease in a Mediterranean country, and the apo E genotype in this large group of adults with FH is not associated either with CVD or lipid values, in contrast with the established effect in the general population.
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Affiliation(s)
- P Mozas
- Departamento Bioquímica, Biología Molecular-Celular, Universidad de Zaragoza, Zaragoza, Spain
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Cenarro A, Artieda M, Castillo S, Mozas P, Reyes G, Tejedor D, Alonso R, Mata P, Pocoví M, Civeira F. A common variant in the ABCA1 gene is associated with a lower risk for premature coronary heart disease in familial hypercholesterolaemia. J Med Genet 2003; 40:163-8. [PMID: 12624133 PMCID: PMC1735389 DOI: 10.1136/jmg.40.3.163] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Familial hypercholesterolaemia (FH) is a common autosomal codominant hereditary disease caused by defects in the LDL receptor (LDLR) gene, and one of the most common characteristics of affected subjects is premature coronary heart disease (CHD). In heterozygous FH patients, the clinical expression of FH is highly variable in terms of the severity of hypercholesterolaemia and the age of onset and severity of CHD. Identification of mutations in the ATP binding cassette transporter 1 (ABCA1) gene in patients with Tangier disease, who exhibit reduced HDL cholesterol and apolipoprotein A1 concentrations and premature coronary atherosclerosis, has led us to hypothesise that ABCA1 could play a key role in the onset of premature CHD in FH. In order to know if the presence of the R219K variant in the ABCA1 gene could be a protective factor for premature CHD in FH, we have determined the presence of this genetic variant by amplification by PCR and restriction analysis in a group of 374 FH subjects, with and without premature CHD. The K allele of the R219K variant was significantly more frequent in FH subjects without premature CHD (0.32, 95% CI 0.27 to 0.37) than in FH subjects with premature CHD (0.25, 95% CI 0.21 to 0.29) (p<0.05), suggesting that the genetic variant R219K in ABCA1 could influence the development and progression of atherosclerosis in FH subjects. Moreover, the K allele of the R219K polymorphism seems to modify CHD risk without important modification of plasma HDL-C levels, and it appears to be more protective for smokers than non-smokers.
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Affiliation(s)
- A Cenarro
- Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Zaragoza, Spain.
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Castillo S, Reyes G, Tejedor D, Mozas P, Suarez Y, Lasuncion MA, Cenarro A, Civeira F, Alonso R, Mata P, Pocovi M. A double mutant [N543H+2393del9] allele in the LDL receptor gene in familial hypercholesterolemia: effect on plasma cholesterol levels and cardiovascular disease. Hum Mutat 2002; 20:477. [PMID: 12442279 DOI: 10.1002/humu.9087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Familial hypercholesterolemia is a genetic disorder caused by mutations in the LDL receptor gene. During a survey of mutations of LDL receptor gene in Spanish FH patients we found two mutations in the same allele: a missense N543H mutation in exon 11 and a 9bp inframe deletion (2393del9) located in exon 17. This double mutant allele was founded in 10 out of 458 unrelated patients: one homozygous FH [N543H+2393del9] + [N543H+2393del9], one compound heterozygote [N543H+2393del9] + [W-18X+E256K] and 8 heterozygotes. Flow cytometric analysis showed a defective LDL binding (20% of normal value) and internalization (23%) in lymphocytes from the homozygous patient; furthermore, studies of mitogen-stimulated lymphocytes demonstrated that the ability of LDL to support cell proliferation was impaired. Unexpectedly, not all carriers of the double mutant allele develop hypercholesterolemia and, furthermore, cholesterol-lowering treatment of the homozygous patient resulted in a 58% LDL cholesterol reduction. In conclusion, the phenotypic expression in the homozygous and heterozygous patients presented here, as well as the LDL-receptor residual activity, allowed the classification of this mutation as mild extending the group of mild mutations found at homozygosity.
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Affiliation(s)
- S Castillo
- Departamento de Bioquimica y Biologia Molecular y Celular, Universidad de Zaragoza, Zaragoza
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Hossain MA, Mukherjee PK, Reyes G, Long L, Ghannoum MA. Effects of fluconazole singly and in combination with 5-fluorocytosine or amphotericin B in the treatment of cryptococcal meningoencephalitis in an intracranial murine model. J Chemother 2002; 14:351-60. [PMID: 12420852 DOI: 10.1179/joc.2002.14.4.351] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
In this study we developed a highly reproducible intracranial murine model of cryptococcosis. Mice (Balb/c, 5-7 weeks old) were challenged intracranially and treated with intermediate (30 mg/kg) or high (90 mg/kg) dose fluconazole, and amphotericin B (0.75 mg/kg), administered singly or in combination with flucytosine (100 mg/kg). Survival and brain CFU analyses were performed. Effect of fluconazole prophylaxis was also determined. Our data show that the developed model mimics clinical signs of cryptococcal meningitis. In single treatment, fluconazole (30 mg/kg) was more efficacious than amphotericin B or flucytosine (P < 0.0001). Combination treatment led to significantly increased anticryptococcal activity, which was highest for high dose fluconazole + flucytosine (P < 0.0001). However, no significant difference was observed between high dose fluconazole treatment with and without flucytosine (P >0.05). Fluconazole prophylaxis led to a significant decrease in brain CFU. In conclusion, high dose fluconazole administered post-infection, or as prophylaxis, may be highly efficacious in the treatment and prevention of meningoencephalitis.
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Affiliation(s)
- M A Hossain
- Center for Medical Mycology, Department of Dermatology, University Hospitals of Cleveland, Case Western Reserve University, OH 44106-5028, USA
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López Rodríguez FJ, Voces R, Lima P, Reyes G, Silva J, Ruiz M, Rico M, González De Diego F, Fortuny R, Garrido G, González Santos JM, Albertos J, Fernández Calella D, Vallejo JL. [Clinical results of double versus single mammary artery myocardiac revascularization: 15 years of follow-up]. Rev Esp Cardiol 2001; 54:868-79. [PMID: 11446963 DOI: 10.1016/s0300-8932(01)76413-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Use of the left internal mammary artery to bypass the left anterior descending coronary artery reduces cardiac events and increases survival. However, there is some controversy as to the benefits of using both mammary arteries. OBJECTIVES To assess the long-term outcome of the use of both mammary arteries in comparison with the use of only one. PATIENTS AND METHOD A retrospective cohort study with a mean follow-up of 9.0 +/- 4.2 years was performed including 108 patients consecutively revascularized using both mammary arteries (II) and 108 patients randomly chosen in whom one mammary artery (I) was used for this purpose. RESULTS Both groups were similar. There were no differences between the groups in operative morbidity or mortality. The survival at 10 years was similar (II: 84.61 +/- 4%; I: 85.18 +/- 3.8%), whereas recurrence of angina (II: 29.63 +/- 5.3%; I: 47.55 +/- 5.6%) (p = 0.012), the requirement for percutaneous angioplasty (II: 3.98 +/- 2%; I: 12.99 +/- 4.1%) (p = 0.009) and cardiologic events (II: 33.48 +/- 5.5%; I: 48.48 +/- 5.5%)(p = 0.022) were all lower in the group in which both mammary arteries were used. In the multivariate analysis, the use of both mammary arteries was an independent protective factor against angina recurrence (RR = 0.55), angioplasty (RR = 0.18) and cardiologic event (RR = 0.60). CONCLUSIONS The use of both mammary arteries for revascularization does not increase operative morbidity. Since this procedure acts as an independent factor against angina recurrence, angioplasty and cardiologic event
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Affiliation(s)
- F J López Rodríguez
- Servicios de Cirugía Cardiovascular. Hospital General Universitario Gregorio Marañón, Madrid.
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