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Torrado I, Peña MI, Tsopana A, Mendoza I, Beitia JM, Mateo B, Chara LE, Vega A. IgE-mediated Allergy to Pembrolizumab and Successful Desensitization. J Investig Allergol Clin Immunol 2023; 33:304-306. [PMID: 36059234 DOI: 10.18176/jiaci.0858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Affiliation(s)
- I Torrado
- Allergy Department, University Hospital of Guadalajara, Spain
| | - M I Peña
- Allergy Department, University Hospital of Guadalajara, Spain
- ARADyAL Spanish Thematic Network and Co-operative Research Centre RD16/0006/0023, ISCIII, Madrid, Spain
| | - A Tsopana
- Allergy Department, University Hospital of Guadalajara, Spain
| | - I Mendoza
- Pharmacy Department, University Hospital of Guadalajara, Spain
| | - J M Beitia
- Allergy Department, University Hospital of Guadalajara, Spain
- ARADyAL Spanish Thematic Network and Co-operative Research Centre RD16/0006/0023, ISCIII, Madrid, Spain
| | - B Mateo
- Allergy Department, University Hospital of Guadalajara, Spain
- ARADyAL Spanish Thematic Network and Co-operative Research Centre RD16/0006/0023, ISCIII, Madrid, Spain
| | - L E Chara
- Oncology Department, University Hospital of Guadalajara, Spain
| | - A Vega
- Allergy Department, University Hospital of Guadalajara, Spain
- ARADyAL Spanish Thematic Network and Co-operative Research Centre RD16/0006/0023, ISCIII, Madrid, Spain
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Park SH, Hong SH, Kim K, Lee SW, Yon DK, Jung SJ, Abdeen Z, Ghayda RA, Ahmed MLCB, Serouri AA, Al‐Herz W, Al‐Shamsi HO, Ali S, Ali K, Baatarkhuu O, Nielsen HB, Bernini‐Carri E, Bondarenko A, Cassell A, Cham A, Chua MLK, Dadabhai S, Darre T, Davtyan H, Dragioti E, East B, Edwards RJ, Ferioli M, Georgiev T, Ghandour LA, Harapan H, Hsueh P, Mallah SI, Ikram A, Inoue S, Jacob L, Janković SM, Jayarajah U, Jesenak M, Kakodkar P, Kapata N, Kebede Y, Khader Y, Kifle M, Koh D, Maleš VK, Kotfis K, Koyanagi A, Kretchy J, Lakoh S, Lee J, Lee JY, Mendonça MDLL, Ling L, Llibre‐Guerra J, Machida M, Makurumidze R, Memish ZA, Mendoza I, Moiseev S, Nadasdy T, Nahshon C, Ñamendys‐Silva SA, Yongsi BN, Nicolasora AD, Nugmanova Z, Oh H, Oksanen A, Owopetu O, Ozguler ZO, Parperis K, Perez GE, Pongpirul K, Rademaker M, Radojevic N, Roca A, Rodriguez‐Morales AJ, Roshi E, Saeed KMI, Sah R, Sakakushev B, Sallam DE, Sathian B, Schober P, Ali PSS, Simonović Z, Singhal T, Skhvitaridze N, Solmi M, Subbaram K, Tizaoui K, Tlhakanelo JT, Torales J, Torres‐Roman JS, Tsartsalis D, Tsolmon J, Vieira DN, Rosa SGV, Wanghi G, Wollina U, Xu R, Yang L, Zia K, Zildzic M, Il Shin J, Smith L. Nonpharmaceutical interventions reduce the incidence and mortality of COVID‐19: A study based on the survey from the International COVID‐19 Research Network (ICRN). J Med Virol 2023; 95. [DOI: https:/doi.org/10.1002/jmv.28354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 09/02/2022] [Indexed: 09/03/2023]
Abstract
AbstractThe recently emerged novel coronavirus, “severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2),” caused a highly contagious disease called coronavirus disease 2019 (COVID‐19). It has severely damaged the world's most developed countries and has turned into a major threat for low‐ and middle‐income countries. Since its emergence in late 2019, medical interventions have been substantial, and most countries relied on public health measures collectively known as nonpharmaceutical interventions (NPIs). We aimed to centralize the accumulative knowledge of NPIs against COVID‐19 for each country under one worldwide consortium. International COVID‐19 Research Network collaborators developed a cross‐sectional online survey to assess the implications of NPIs and sanitary supply on the incidence and mortality of COVID‐19. The survey was conducted between January 1 and February 1, 2021, and participants from 92 countries/territories completed it. The association between NPIs, sanitation supplies, and incidence and mortality were examined by multivariate regression, with the log‐transformed value of population as an offset value. The majority of countries/territories applied several preventive strategies, including social distancing (100.0%), quarantine (100.0%), isolation (98.9%), and school closure (97.8%). Individual‐level preventive measures such as personal hygiene (100.0%) and wearing facial masks (94.6% at hospitals; 93.5% at mass transportation; 91.3% in mass gathering facilities) were also frequently applied. Quarantine at a designated place was negatively associated with incidence and mortality compared to home quarantine. Isolation at a designated place was also associated with reduced mortality compared to home isolation. Recommendations to use sanitizer for personal hygiene reduced incidence compared to the recommendation to use soap. Deprivation of masks was associated with increased incidence. Higher incidence and mortality were found in countries/territories with higher economic levels. Mask deprivation was pervasive regardless of economic level. NPIs against COVID‐19 such as using sanitizer, quarantine, and isolation can decrease the incidence and mortality of COVID‐19.
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Affiliation(s)
- Seung Hyun Park
- Yonsei University College of Medicine Seoul Republic of Korea
| | - Sung Hwi Hong
- Yonsei University College of Medicine Seoul Republic of Korea
| | - Kwanghyun Kim
- Department of Preventive Medicine Yonsei University College of Medicine Seoul Republic of Korea
- Department of Public Health Yonsei University Seoul Republic of Korea
| | - Seung Won Lee
- Department of Precision Medicine Sungkyunkwan University School of Medicine Suwon Republic of Korea
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine Seoul Republic of Korea
| | - Sun Jae Jung
- Department of Preventive Medicine Yonsei University College of Medicine Seoul Republic of Korea
- Department of Public Health Yonsei University Seoul Republic of Korea
| | - Ziad Abdeen
- Department of Community Health, Faculty of Medicine Al‐Quds University East Jerusalem Palestine
| | - Ramy Abou Ghayda
- Urology Institute, University Hospitals Case Western Reserve University, Cleveland Ohio United States of America
| | | | | | | | - Humaid O. Al‐Shamsi
- Burjeel Cancer Institute, Burjeel Medical City Abu Dhabi United Arab Emirates
| | - Sheeza Ali
- School of Medicine, The Maldives National University Male Maldives
| | - Kosar Ali
- University of Sulaimani College of Medicine Sulaymaniyah Iraq
| | - Oidov Baatarkhuu
- Department of Infectious Diseases Mongolian National University of Medical Sciences Ulaanbaatar Mongolia
| | - Henning Bay Nielsen
- Department of Anesthesia and Intensive Care Zealand University Hospital Roskilde Roskilde Denmark
- Department of Nutrition Exercise and Sports, University of Copenhagen Copenhagen Denmark
| | - Enrico Bernini‐Carri
- European Centre for Disaster Medicine, Council of Europe (CEMEC) Strasbourg France
| | - Anastasiia Bondarenko
- Department of Pediatrics, Immunology, Infectious and Rare Diseases International European University Kyiv Ukraine
| | - Ayun Cassell
- John F. Kennedy Medical Center, Edison New Jersey United States of America
| | - Akway Cham
- School of Medicine, University of Juba Juba South Sudan
| | - Melvin L. K. Chua
- Department of Head and Neck and Thoracic Cancers, Division of Radiation Oncology National Cancer Centre Singapore Singapore Singapore
- Oncology Academic Programme, Duke‐NUS Medical School Singapore Singapore
- Division of Medical Sciences National Cancer Centre Singapore Singapore Singapore
| | - Sufia Dadabhai
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore Maryland United States of America
| | - Tchin Darre
- Department of Pathology University of Lomé Lome Togo
| | - Hayk Davtyan
- Tuberculosis Research and Prevention Center Yerevan Armenia
| | - Elena Dragioti
- Department of Health, Medicine and Caring Sciences Pain and Rehabilitation Centre, Linköping University Linköping Sweden
| | - Barbora East
- 3rd Department of Surgery 1st Medical Faculty of Charles University, Motol University Hospital Prague Czech Republic
| | | | - Martina Ferioli
- Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna Bologna Italy
| | - Tsvetoslav Georgiev
- First Department of Internal Medicine Medical University—Varna Varna Bulgaria
| | | | - Harapan Harapan
- Department of Microbiology Universitas Syiah Kuala Banda Aceh Indonesia
| | - Po‐Ren Hsueh
- Departments of Laboratory Medicine and Internal Medicine China Medical University Hospital China Medical University Taichung Taiwan
| | - Saad I. Mallah
- Royal College of Surgeons in Ireland ‐ Bahrain Al Sayh Bahrain
| | - Aamer Ikram
- National Institute of Health, Islamabad Pakistan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health Tokyo Medical University Tokyo Japan
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas Barcelona Spain
- Faculty of Medicine University of Versailles Saint‐Quentin‐en‐Yvelines, Montigny‐le‐Bretonneux France
| | | | - Umesh Jayarajah
- Postgraduate Institute of Medicine, University of Colombo Colombo Sri Lanka
| | - Milos Jesenak
- Department of Pediatrics, Jessenius Faculty of Medicine in Martin University Teaching Hospital in Martin, Comenius University in Bratislava Bratislava Slovakia
| | | | - Nathan Kapata
- Zambia National Public Health Institute Lusaka Zambia
| | - Yohannes Kebede
- Department of Health, Behavior and Society Jimma University Jimma Ethiopia
| | - Yousef Khader
- Department of Public Health Jordan University of Science and Technology Irbid Jordan
| | - Meron Kifle
- Department of Clinical Medicine, Centre for Tropical Medicine and Global Health, Nuffield University of Oxford Oxford United Kingdom
| | - David Koh
- Saw Swee Hock School of Public Health National University of Singapore, Singapore Singapore
| | - Višnja Kokić Maleš
- Clinical Hospital Centre Split, University Department of Health Studies University of Split Croatia
| | - Katarzyna Kotfis
- Department of Anesthesiology, Intensive Therapy and Acute Intoxications Pomeranian Medical University in Szczecin Szczecin Poland
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Deu, ICREA, CIBERSAM, ISCIII Barcelona Spain
| | - James‐Paul Kretchy
- Public Health Unit, School of Medicine and Health Sciences Central University Accra Ghana
| | - Sulaiman Lakoh
- College of Medicine and Allied Health Sciences University of Sierra Leone Freetown Sierra Leone
| | - Jinhee Lee
- Department of Psychiatry Yonsei University Wonju College of Medicine, Wonju‐si Gangwon‐do Republic of Korea
| | - Jun Young Lee
- Department of Nephrology Yonsei University Wonju College of Medicine, Wonju‐si Gangwon‐do Republic of Korea
| | | | - Lowell Ling
- The Chinese University of Hong Kong, Hong Kong SAR China
| | | | - Masaki Machida
- Department of Preventive Medicine and Public Health Tokyo Medical University Tokyo Japan
| | - Richard Makurumidze
- Family Medicine, Global and Public Health Unit University of Zimbabwe Faculty of Medicine and Health Sciences Harare Zimbabwe
| | - Ziad A. Memish
- Director Research and Innovation Center, King Saud Medical City, Ministry of Health & College of Medicine Alfaisal University Riyadh Saudi Arabia
| | - Ivan Mendoza
- Tropical Cardiology Central University of Venezuela, Caracas Venezuela
| | - Sergey Moiseev
- Sechenov First Moscow State Medical University Moscow Russia
| | | | - Chen Nahshon
- Department of Gynecologic Surgery & Oncology Carmel Medical Center Haifa Israel
| | - Silvio A. Ñamendys‐Silva
- Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Instituto Nacional de Cancerologia Mexico City Mexico
| | | | | | | | - Hans Oh
- University of Southern California, Los Angeles California United States of America
| | - Atte Oksanen
- Faculty of Social Sciences Tampere University Tampere Finland
| | - Oluwatomi Owopetu
- Department of Community Medicine University College Hospital Ibadan Nigeria
| | - Zeynep Ozge Ozguler
- General Directorate of Public Health Ministry of Health of Turkey Adnan Saygun St, Çankaya Ankara Turkey
| | | | | | - Krit Pongpirul
- School of Global Health and Department of Preventive and Social Medicine, Faculty of Medicine Chulalongkorn University Bangkok Thailand
| | - Marius Rademaker
- Clinical Trials New Zealand, Waikato Hospital Campus Hamilton New Zealand
| | | | - Anna Roca
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara Gambia
| | - Alfonso J. Rodriguez‐Morales
- Grupo de Investigación Biomedicina Faculty of Medicine, Fundación Universitaria Autónoma de las Americas ‐ Institución Universitaria Visión de las Américas Pereira Colombia
- Master of Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur Lima Peru
- Gilbert and Rose‐Marie Chagoury School of Medicine, Lebanese American University Beirut Lebanon
| | - Enver Roshi
- Department of Public Health, Faculty of Medicine University of Medicine of Tirana Albania
| | | | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Institute of Medicine Kathmandu Nepal
| | - Boris Sakakushev
- RIMU/Research Institute of Medical University Plovdiv Bulgaria
- Chair of Propedeutics of Surgical Diseases
- University Hospital St. George, Plovdiv, Bulgaria
| | - Dina E. Sallam
- Pediatrics and Pediatric Nephrology Department Faculty of Medicine Ain Shams University Cairo Egypt
| | - Brijesh Sathian
- Geriatrics and Long Term Care Department Rumailah Hospital Doha Qatar
| | - Patrick Schober
- Department of Anesthesiology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam Netherlands
| | | | | | - Tanu Singhal
- Kokilaben Dhirubhai Ambani Hospital and Research Institute Mumbai India
| | | | - Marco Solmi
- Department of Psychiatry University of Ottawa Ontario Canada
- Department of Mental Health Ontario Canada
- Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ottawa Ontario Canada
- Department of Child and Adolescent Psychiatry Charité Universitätsmedizin Berlin Germany
| | - Kannan Subbaram
- School of Medicine, The Maldives National University Male Maldives
| | - Kalthoum Tizaoui
- Laboratory of Microorganisms and Actives Biomolecules, Faculty of Sciences of Tunis University Tunis El Manar Tunis Tunisia
| | - John Thato Tlhakanelo
- Department of Family Medicine and Public Health University of Botswana, Faculty of Medicine Gaborone Botswana
| | - Julio Torales
- National University of Asunción, School of Medical Sciences San Lorenzo Paraguay
| | | | | | - Jadamba Tsolmon
- Mongolian National University of Medical Sciences (MNUMS) Ulaanbaatar Mongolia
| | | | | | - Guy Wanghi
- Department of Basic Sciences, University of Kinshasa Faculty of Medicine, Laboratory of Physiology Kinshasa, Democratic Republic of the Congo
| | - Uwe Wollina
- Department of Dermatology and Allergology Städtisches Klinikum Dresden – Academic Teaching Hospital Dresden Germany
| | - Ren‐He Xu
- Faculty of Health Sciences University of Macau Macau China
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services School of Medicine, University of Calgary Calgary Canada
| | - Kashif Zia
- School of Health and Wellbeing, University of Glasgow Glasgow United Kingdom
| | - Muharem Zildzic
- Academy of Medical Science of Bosnia and Herzegovina Sarajevo Bosnia and Herzegovina
| | - Jae Il Shin
- Department of Pediatrics Yonsei University College of Medicine Seoul Republic of Korea
| | - Lee Smith
- Centre for Health Performance and Wellbeing Anglia Ruskin University Cambridge United Kingdom
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Schwamm LH, Kamel H, Granger CB, Piccini JP, Katz JM, Sethi PP, Sidorov EV, Kasner SE, Silverman SB, Merriam TT, Franco N, Ziegler PD, Bernstein RA, Abi-Samra F, Acosta I, Al Balushi A, Al-Awwad A, Alimohammad R, Alkahalifah M, Allred J, Alsorogi M, Arias V, Aroor S, Arora R, Asdaghi N, Asi K, Assar M, Badhwar N, Banchs J, Bansal S, Barrett C, Beaver B, Beldner S, Belt G, Bernabei M, Bernard M, Bhatt N, Black J, Bledsoe D, Bonaguidi H, Bonyak K, Boyd C, Cajavilca C, Caprio F, Carter J, Chancellor B, Chang C, Chaudhary G, Chaudhary S, Cheung P, Ching M, Chinitz L, Chiu D, Chokhawala H, Choudhuri I, Choudry S, Clayton S, Cross J, Cucchiara B, Culpepper A, Daniels J, Dash S, Del Brutto V, Deline C, Delpirou Nouh C, Deo R, Dhamoon M, Dillon G, Donsky A, Doshi A, Downey A, Dukkipati S, Epstein L, Etherton M, Fara M, Fayad PB, Felberg R, Flaster M, Frankel D, Furer S, Gadhia R, Gadient P, Garabelli P, Gibson D, Glotzer T, Goltz D, Gordon D, Graner S, Graybeal D, Grimes MR, Guerrero W, Hanna J, Hao Q, Hasabnis S, Hasan R, Heist EK, Horowitz D, Hourihane JM, Hussein H, Ishida K, Ismail H, Jadonath R, Jamal S, Jamnadas P, Jia J, Johnson M, Jung R, Kalafut M, Kalia J, Kandel A, Kasner S, Katz L, Katz J, Kaur G, Kearney M, Khatib S, Kim S, Kim C, Kipta J, Koch S, Koruth J, Kreger H, Krueger K, Kurian C, LaFranchise E, Lambrakos L, Langan MN, Lee R, Libman R, Lillemoe K, Logan W, Lord A, Lubitz S, Luciano J, Lynch J, Maccaro PC, Magadan A, Magun R, Malik M, Malik A, Manda S, Marulanda-Londono E, Matos Diaz I, Mattera B, McCall-Brown A, Mcclelland N, Meisel K, Memon Z, Mendelson S, Mendoza I, Merriam T, Messe S, Miles WM, Miller M, Mir O, Mitrani R, Morin D, Morris K, Moussavi M, Mowla A, Moye S, Mullen M, Mullins S, Neisen K, Nguyen C, Niazi I, Olson N, Olsovsky G, Ortiz G, Ostrander M, Pakala A, Parker B, Parker M, Passman R, Patel A, Patel A, Pickett RA(D, Polin G, Radoslovich G, Ramano J, Rami T, Ramirez D, Rasmussen J, Ray B, Reddy V, Reddy R, Reeves R, Regenhardt R, Rempe D, Rogers P, Rogers J, Rowe S, Rowley C, Ruff I, Sackett M, Sajjad R, Salem R, Saltzman M, Santangeli P, Saucedo S, Sawyer R, Schaller R, Seeger S, Sethi P, Shang T, Sharma J, Sharma R, Sheinart K, Shukla G, Shultz J, Sidorov E, Silverman S, Simonson J, Singh D, Skalabrin E, Sloane K, Smith M, Smith W, Soik D, Stavrakis S, Stein L, Steinberg JS, Sur N, Switzer D, Talpur N, Tansy A, Tempro K, Thavapalan V, Thomas A, Thomas K, Torres J, Torres L, Tuhrim S, Uddin P, Vidal G, Viswanathan A, Volpi J, Ward K, Weinberger J, Whang W, Wilder M, Willner J, Wright P, Yuan Q, Zhang C, Zhu D, Zide K, Zimmerman J, Zweifler R. Predictors of Atrial Fibrillation in Patients With Stroke Attributed to Large- or Small-Vessel Disease: A Prespecified Secondary Analysis of the STROKE AF Randomized Clinical Trial. JAMA Neurol 2023; 80:99-103. [PMID: 36374508 PMCID: PMC9664367 DOI: 10.1001/jamaneurol.2022.4038] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Importance The Stroke of Known Cause and Underlying Atrial Fibrillation (STROKE AF) trial found that approximately 1 in 8 patients with recent ischemic stroke attributed to large- or small-vessel disease had poststroke atrial fibrillation (AF) detected by an insertable cardiac monitor (ICM) at 12 months. Identifying predictors of AF could be useful when considering an ICM in routine poststroke clinical care. Objective To determine the association between commonly assessed risk factors and poststroke detection of new AF in the STROKE AF cohort monitored by ICM. Design, Setting, and Participants This was a prespecified analysis of a randomized (1:1) clinical trial that enrolled patients between April 1, 2016, and July 12, 2019, with primary follow-up through 2020 and mean (SD) duration of 11.0 (3.0) months. Eligible patients were selected from 33 clinical research sites in the US. Patients had an index stroke attributed to large- or small-vessel disease and were 60 years or older or aged 50 to 59 years with at least 1 additional stroke risk factor. A total of 496 patients were enrolled, and 492 were randomly assigned to study groups (3 did not meet inclusion criteria, and 1 withdrew consent). Patients in the ICM group had the index stroke within 10 days before insertion. Data were analyzed from October 8, 2021, to January 28, 2022. Interventions ICM monitoring vs site-specific usual care (short-duration external cardiac monitoring). Main Outcomes and Measures The ICM device automatically detects AF episodes 2 or more minutes in length; episodes were adjudicated by an expert committee. Cox regression multivariable modeling included all parameters identified in the univariate analysis having P values <.10. AF detection rates were calculated using Kaplan-Meier survival estimates. Results The analysis included the 242 participants randomly assigned to the ICM group in the STROKE AF study. Among 242 patients monitored with ICM, 27 developed AF (mean [SD] age, 66.6 [9.3] years; 144 men [60.0%]; 96 [40.0%] women). Two patients had missing baseline data and exited the study early. Univariate predictors of AF detection included age (per 1-year increments: hazard ratio [HR], 1.05; 95% CI, 1.01-1.09; P = .02), CHA2DS2-VASc score (per point: HR, 1.54; 95% CI, 1.15-2.06; P = .004), chronic obstructive pulmonary disease (HR, 2.49; 95% CI, 0.86-7.20; P = .09), congestive heart failure (CHF; with preserved or reduced ejection fraction: HR, 6.64; 95% CI, 2.29-19.24; P < .001), left atrial enlargement (LAE; HR, 3.63; 95% CI, 1.55-8.47; P = .003), QRS duration (HR, 1.02; 95% CI, 1.00-1.04; P = .04), and kidney dysfunction (HR, 3.58; 95% CI, 1.35-9.46; P = .01). In multivariable modeling (n = 197), only CHF (HR, 5.06; 95% CI, 1.45-17.64; P = .05) and LAE (HR, 3.32; 1.34-8.19; P = .009) remained significant predictors of AF. At 12 months, patients with CHF and/or LAE (40 of 142 patients) had an AF detection rate of 23.4% vs 5.0% for patients with neither (HR, 5.1; 95% CI, 2.0-12.8; P < .001). Conclusions and Relevance Among patients with ischemic stroke attributed to large- or small-vessel disease, CHF and LAE were associated with a significantly increased risk of poststroke AF detection. These patients may benefit most from the use of ICMs as part of a secondary stroke prevention strategy. However, the study was not powered for clinical predictors of AF, and therefore, other clinical characteristics may not have reached statistical significance. Trial Registration ClinicalTrials.gov Identifier: NCT02700945.
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Affiliation(s)
- Lee H. Schwamm
- Department of Neurology, Massachusetts General Hospital, Boston
| | - Hooman Kamel
- Department of Neurology, Weill Cornell Medicine, New York, New York,Deputy Editor, JAMA Neurology
| | - Christopher B. Granger
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Jonathan P. Piccini
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Jeffrey M. Katz
- Department of Neurology and Radiology, North Shore University Hospital, Manhasset, New York
| | - Pramod P. Sethi
- Guilford Neurology Associates, Moses H. Cone Hospital, Greensboro, North Carolina
| | - Evgeny V. Sidorov
- Department of Neurology, The University of Oklahoma Health Sciences Center, Oklahoma City
| | - Scott E. Kasner
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | | | | | - Noreli Franco
- Clinical Department, Medtronic, Minneapolis, Minnesota
| | | | - Richard A. Bernstein
- Davee Department of Neurology, Feinberg School of Medicine of Northwestern University, Chicago, Illinois
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Olarte N, Vincent L, Ebner B, Grant J, Maning J, Hernandez R, Rivera-Rodriguez B, Giraldo M, Mendoza I. Atrioventricular nodal ablation with pacemaker implant is associated with improved safety outcomes compared to pulmonary vein isolation of atrial fibrillation with heart failure. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Pulmonary vein isolation (PVI) and atrioventricular nodal ablation (AVNA) with pacemaker implant have both been advocated for patients with atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF). Direct comparisons between the two are limited.
Purpose
We sought to compare outcomes and complications following PVI versus AVNA with implant of a cardiac implantable electronic device (CIED) among patients with AF and HFrEF.
Methods
We queried the National Inpatient Sample from 2011 to 2019, using relevant ICD-9 and -10 diagnostic and procedural codes for AF, HFrEF, ablation, and CIED implant to identify our study cohort. Exclusion criteria included presence of a pre-existing CIED, ventricular arrhythmias, non-AF supraventricular arrhythmias, and surgical AF ablation. Baseline characteristics included age, sex, race, and comorbidities related to AF and cardiovascular disease. Severity of comorbidities was assessed via Deyo-Charlson Comorbidity Index (Deyo-CCI). Outcomes investigated include all-cause mortality, major adverse cardiovascular events (MACE), extra-cardiac procedural complications, length of stay, and total hospital charges. Outcomes associations were analyzed using multivariate logistic regression adjusted for baseline characteristics that were significantly different (P<0.05) between cohorts expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI). SPSS v28.0 (IBM, Armonk, NY) was used to carry out all calculations.
Results
We identified 3,565 encounters for PVI and 1,355 for AVNA with CIED implant among hospitalized patients with AF and HFrEF. Patients who underwent AVNA were more often older (73.8 vs 66.2 years), with more severe comorbidities (mean Deyo-CCI score 2.9 vs 2.6) and were more likely to have an emergent procedure performed (81.3% vs 69.7%; p<0.001 for all). However, the AVNA cohort had less mortality (0.5% vs 1.2%, p=0.03), MACE (6.1% vs 7.8%, p=0.04), and total complications (12.7% vs 16.3%, p=0.002), but longer hospital stay (8.0 vs 6.5 days) and higher total charges ($201,100 vs $159,382; p<0.001 for both). After adjusting for confounders, AVNA remained independently associated with decreased odds of mortality (aOR: 0.370; 95% CI [0.159–0.862], p=0.02), MACE (aOR: 0.552; 95% CI [0.420–0.726], p<0.001), and total complications (aOR: 0.708; 95% CI [0.589–0.852], p<0.001).
Conclusion
Despite older age with more severe comorbidities and less elective procedures, hospitalized patients with AF and HFrEF who underwent AVNA with CIED implant had improved safety outcomes compared to PVI. Further studies comparing the intermediate and long-term outcomes and efficacy between therapies are needed to better delineate which would best serve this population.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Olarte
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - L Vincent
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - B Ebner
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - J Grant
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - J Maning
- Northwestern University, Cardiology , Chicago , United States of America
| | - R Hernandez
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - B Rivera-Rodriguez
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - M Giraldo
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - I Mendoza
- Jackson Memorial Hospital, Cardiology , Miami , United States of America
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Mendoza I, Carta KG, Rodriguez HA, Morr I, Lourdes Rojas Gimon ED, meza-mendez Y, Urbaez E, Blanco S, Mendoza I. CE-541-01 OUTCOMES IN PATIENTS WITH COVID-19 COMPLICATED BY HIGH GRADE ATRIOVENTRICULAR BLOCK. Heart Rhythm 2022. [PMCID: PMC9049656 DOI: 10.1016/j.hrthm.2022.03.687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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6
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García-Martínez CE, Scatularo CE, Farina JM, Saldarriaga C, Pérez GE, Wyss F, Spina S, Mendoza I, Santi RL, Martínez-Sellés M, Baranchuk A. CYSTICERCOSIS & HEART: A systematic review. Curr Probl Cardiol 2022:101195. [PMID: 35395330 DOI: 10.1016/j.cpcardiol.2022.101195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/02/2022] [Indexed: 11/03/2022]
Abstract
Cysticercosis is a parasitic tissue infection caused by larval cysts of the tapeworm Taenia solium. These larval cysts infect brain, muscle, or other tissue, and are a major cause of adult-onset seizures in most low-income countries with tropical climate. Prevalence it's around 50 million people. Although cardiovascular system is not the most affected, this disease can also be associated with multiple and randomly distributed cysts in the subpericardium, subendocardium and myocardium in up to 25% of infected patients. Most cardiac cysticercosis' cases are asymptomatic, but it can manifest with ventricular arrhythmias and conduction disorders. Area Covered: The "Neglected Tropical Diseases and other Infectious Diseases affecting the Heart" (NET-Heart project) is an initiative by the Emerging Leaders group of the Interamerican Society of Cardiology to systematically review all these endemic conditions affecting the heart. A systematic review was conducted following PRISMA guidelines and including articles published in MEDLINE, ScienceDirect, PubMed and LILACS databases. A total of 41 papers were included in this review. Expert Opinion: In the areas of greatest prevalence, unhealthiness and poverty favor the development of this disease, which highlights the need to establish global health policies that reduce morbidity and mortality, economic losses of the affected population, and health costs related to hospitalizations for cardiovascular involvement. Authors provide an algorithm to evaluate the possibility of Cysticercosis' cardiovascular complications.
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Affiliation(s)
| | | | - Juan María Farina
- Department of Cardiothoracic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Clara Saldarriaga
- Department of Cardiology and Heart Failure Clinic, Cardiovascular Clinic Santa Maria, University of Antioquia, Medellín, Colombia
| | | | - Fernando Wyss
- Technology and Cardiovascular Service - Cardiosolutions, Guatemala City, Guatemala
| | - Salvador Spina
- Head of Echocardiography and Advisor of the Cardiology Service Central Aeronautical Hospital, Buenos Aires, Argentina
| | - Ivan Mendoza
- Tropical Cardiology, Tropical Medicine Institute. Central University of Venezuela, Caracas, Venezuela
| | - Ricardo Lopez Santi
- Head of promotion and prevention at the Hospital Italiano de La Plata, La Plata, Argentina
| | - Manuel Martínez-Sellés
- Cardiology Department, Hospital General Universitario Gregorio Marañon, CIBERCV. Universidad Europea, Universidad Complutense. Madrid, Spain
| | - Adrian Baranchuk
- Division of Cardiology, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canad.
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7
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Mendoza I, Luis Paz J, González-Paz LA, Márquez EA, Vera-Villalobos J, Mora JR, Alvarado YJ, Cordova-Sintjago T, Loroño G. MA. Reaction mechanism of the gas-phase pyrolysis of N – acetylthiourea and N, N’–diacetylthiourea: a theoretical study based in density functional theory. COMPUT THEOR CHEM 2022. [DOI: 10.1016/j.comptc.2022.113702] [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: 11/27/2022]
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8
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Tran DB, Mendoza I. OUTCOMES OF LEADLESS PACEMAKER IMPLANTATION: RESULTS FROM THE FIRST 200 PATIENTS FROM A SINGLE CENTER. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01117-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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9
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Farina JM, García-Martínez CE, Saldarriaga C, Pérez GE, Melo MBD, Wyss F, Sosa-Liprandi A, Ortiz-Lopez HI, Gupta S, López-Santi R, Mendoza I, Baranchuk A. Leishmaniasis and Heart. Arch Cardiol Mex 2022; 92:85-93. [PMID: 34987235 PMCID: PMC8771027 DOI: 10.24875/acm.20000508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
As one of the neglected tropical diseases, leishmaniasis is defined as a parasitic communicable disease that is most prevalent in tropical and subtropical regions, affecting especially populations living in poverty. It has a profound negative impact on developing economies. It represents a group of heterogeneous syndromes with a wide spectrum of severity ranging from self-resolving cutaneous injuries to disseminated visceral compromise. Visceral leishmaniasis represents its most severe form, can affect almost all organs, and can have fatal consequences, especially in immunosuppressed patients. Cardiac involvement seems to be rare but has not been deeply studied. Consequently, there are no clear recommendations for the screening of cardiac manifestations in these patients. However, cardiovascular complications could be potentially lethal. In addition, there are valuable reports on the potential cardiotoxicity caused by drugs used in the treatment of this condition, so knowledge of its side effects could have important implications. This article is a part of the “Neglected Tropical Diseases and other Infectious Diseases affecting the Heart” project (the NET-Heart Project); its purpose is to review all the information available regarding cardiac implications of this disease and its treatment and to add knowledge to this field of study, focusing on the barriers for diagnosis and treatment, and how to adopt strategies to overcome them.
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Affiliation(s)
- Juan Ma Farina
- Division of Cardiology, Clínica Olivos, Buenos Aires, Argentina
| | | | - Clara Saldarriaga
- Department of Cardiology and Heart Failure Clinic, Cardiovascular Clinic Santa Maria, Universidad de Antioquia, Medellín, Colombia
| | - Gonzalo E Pérez
- Division of Cardiology, Clínica Olivos, Buenos Aires, Argentina
| | | | - Fernando Wyss
- Technology and Cardiovascular Service of Guatemala - Cardiosolutions, Guatemala City, Guatemala
| | | | | | - Shyla Gupta
- Division of Cardiology, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canada
| | - Ricardo López-Santi
- Division of Cardiology, Hospital Italiano de La Plata, Buenos Aires, Argentina
| | - Ivan Mendoza
- Department of Cardiology, Tropical Medicine Institute, Universidad Central de Venezuela, Caracas, Venezuela
| | - Adrian Baranchuk
- Division of Cardiology, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canada
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10
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Dangl M, Ebner B, Grant JK, Vincent LT, Maning J, Olorunfemi O, Olarte NI, Sancassani R, Rosario C, Mendoza I. B-PO05-111 SAFETY OF CATHETER ABLATION FOR ATRIAL FIBRILLATION IN ABDOMINAL SOLID ORGAN TRANSPLANT RECIPIENTS. Heart Rhythm 2021. [DOI: 10.1016/j.hrthm.2021.06.1030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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11
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Araiza-Garaygordobil D, García-Martínez CE, Burgos LM, Saldarriaga C, Liblik K, Mendoza I, Martinez-Selles M, Scatularo CE, Farina JM, Baranchuk A. Dengue and the heart. Cardiovasc J Afr 2021; 32:276-283. [PMID: 34292294 DOI: 10.5830/cvja-2021-033] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/24/2021] [Indexed: 11/06/2022] Open
Abstract
Dengue is a neglected viral arthropod-borne tropical disease transmitted by the bite of infected Aedes spp. mosquitoes. It is responsible for a significant global burden of disease and corresponding socio-economic implications. There are four different virus serotypes, all of which are found predominantly in countries with tropical climates. Patients with dengue may present with cardiovascular (CV) manifestations, contributing to associated death and disability. A systematic review was conducted to identify CV manifestations of dengue, wherein 30 relevant studies were identified in the MEDLINE and PubMed databases. CV complications of dengue include rhythm abnormalities, hypotension, myocarditis, pericarditis and deterioration in myocardial function. Prompt recognition and treatment of CV complications of dengue are essential to reduce morbidity and mortality in these patients, who are at risk of progressing to cardiogenic shock and heart failure.
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Affiliation(s)
| | | | - Lucrecia María Burgos
- Department of Heart Failure, Pulmonary Hypertension and Heart Transplant, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - Clara Saldarriaga
- Department of Cardiology and Heart Failure Clinic, Cardiovascular Clinic Santa Maria, University of Antioquia, Medellín, Colombia
| | - Kiera Liblik
- Division of Cardiology, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canada
| | - Ivan Mendoza
- Tropical Cardiology, Tropical Medicine Institute, Central University of Venezuela, Caracas, Venezuela
| | - Manuel Martinez-Selles
- Hospital General Universitario Gregorio Marañón, CIBERCV, Universidad Europea, Universidad Complutense, Madrid, Spain
| | | | | | - Adrian Baranchuk
- Division of Cardiology, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canada. Adrian.
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13
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Ebner BF, Vincent L, Grant J, Maning J, Olarte N, Olorunfemi O, Colombo R, Mendoza I. EVALUATING THE IMPACT OF ATRIAL FIBRILLATION ON PATIENT UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT WITH AND WITHOUT PRIOR CATHETER ABLATION. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02472-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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14
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Liblik K, Byun J, Saldarriaga C, Perez GE, Lopez-Santi R, Wyss FQ, Liprandi AS, Martinez-Sellés M, Farina JM, Mendoza I, Burgos LM, Baranchuk A. Snakebite Envenomation and Heart: Systematic Review. Curr Probl Cardiol 2021; 47:100861. [PMID: 33992425 DOI: 10.1016/j.cpcardiol.2021.100861] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/27/2021] [Indexed: 12/15/2022]
Abstract
Snakebite envenomation is a neglected tropical disease which can result in morbidity and mortality. Cardiac implications are poorly understood due to the low frequency of cardiotoxicity combined with a lack of robust information, as snakebites commonly occur in remote and rural areas. This review aims to assess cardiovascular implications of snakebite envenoming and proposes an algorithm for screening of cardiovascular manifestations. A systematic review was performed and 29 articles relating to cardiovascular involvement in snakebite envenomation were selected. Cardiovascular involvement seems to be rare and includes a wide spectrum of outcomes, such as myocardial infarction, ventricular dysfunction, hypotension, cardiac arrest, and myocarditis. In a significant proportion of the cases analyzed (24.39%), the cardiovascular manifestations had major consequences (cardiac arrest, myocardial infarction, malignant ventricular arrhythmias, or death). Clinical monitoring, physical examination, and early electrocardiogram should be considered as key measures to detect cardiovascular involvement in patients with evidence of systemic illness.
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Affiliation(s)
- Kiera Liblik
- Department of Medicine, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canada
| | - Jin Byun
- Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Clara Saldarriaga
- Department of Cardiology and Heart Failure Clinic, Cardiovascular Clinic Santa Maria, University of Antioquia, Medellín, Colombia
| | - Gonzalo E Perez
- Division of Cardiology, Clínica Olivos, Buenos Aires, Argentina
| | - Ricardo Lopez-Santi
- Division of Cardiology, Hospital Italiano de la Plata, Buenos Aires, Argentina
| | - Fernando Q Wyss
- Division of Cardiology, Clínica Olivos, Buenos Aires, Argentina
| | - Alvaro S Liprandi
- Guatemala Cardiovascular Services and Technology, Cardiosolutions, Guatemala City
| | | | - Juan M Farina
- Hospital General Universitario Gregorio Marañón, CIBERCV, Universidad Europea, Universidad Complutense, Madrid, Spain
| | - Ivan Mendoza
- Tropical Cardiology, Tropical Medicine Institute, Central University of Venezuela, Caracas, Venezuela
| | - Lucrecia M Burgos
- Department of Heart Failure, Pulmonary Hypertension and Heart Transplant, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - Adrian Baranchuk
- Division of Cardiology, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canada.
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15
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Cotella JI, Sauce AL, Saldarriaga CI, Perez GE, Farina JM, Wyss F, Sosa Liprandi A, Mendoza I, Múnera AG, Alexander B, Baranchuk A. Chikungunya and the Heart. Cardiology 2021; 146:324-334. [PMID: 33789296 DOI: 10.1159/000514206] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 12/29/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Neglected tropical diseases are a group of communicable diseases that occur in tropical and subtropical conditions and are closely related to poverty and inadequate sanitation conditions. Among these entities, chikungunya remains one of the most widely spread diseases. Although the main symptoms are related to a febrile syndrome, cardiovascular (CV) involvement has been reported, with short- and long-term implications. As part of the "Neglected Tropical Diseases and other Infectious Diseases involving the Heart" (NET-Heart) Project, the aim of this review is to compile all the information available regarding CV involvement of this disease, to help healthcare providers gain knowledge in this field, and contribute to improving early diagnosis, treatment, and prevention strategies. METHODS We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement in conducting and reporting this systematic review. The search was conducted using MEDLINE/PubMed, SciELO, and LILACS databases to identify any relevant studies or reviews detailing an association between chikungunya and cardiac involvement published from January 1972 to May 31, 2020. RESULTS Despite its mechanism not being fully understood, CV involvement has been described as the most frequent atypical presentation of chikungunya (54.2%). Myocarditis is the most prevalent CV complication. Different rhythm disturbances have been reported in 52% of cases, whereas heart failure was reported in 15% of cases, pericarditis in 5%, and acute myocardial infarction in 2%. Overall estimated CV mortality is 10%, although in patients with other comorbidities, it may increase up to 20%. In the proper clinical setting, the presence of fever, polyarthralgia, and new-onset arrhythmia suggests chikungunya virus-related myocarditis. CONCLUSION Although most cases are rarely fatal, CV involvement in chikungunya infection remains the most frequent atypical presentation of this disease and may have severe manifestations. Timely diagnosis and appropriate management are necessary to improve patient outcomes.
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Affiliation(s)
- Juan I Cotella
- Division of Cardiology, Centro Privado de Cardiología San Miguel de Tucumán, Tucumán, Argentina
| | - Ana L Sauce
- Division of Cardiology, Centro Médico Nacional Siglo XXI, Mexico, Mexico
| | - Clara I Saldarriaga
- Department of Cardiology and Heart Failure Clinic, Clínica Cardiovascular, University of Antioquia, Medellin, Colombia
| | - Gonzalo E Perez
- Division of Cardiology, Clínica Olivos, Buenos Aires, Argentina
| | - Juan M Farina
- Division of Cardiology, Clínica Olivos, Buenos Aires, Argentina
| | - Fernando Wyss
- Servicios y Tecnología Cardiovascular de Guatemala - Cardiosolutions, Guatemala, Guatemala
| | | | - Ivan Mendoza
- Division of Cardiology, Tropical Medicine Institute, Central University of Venezuela, Caracas, Venezuela
| | - Ana G Múnera
- Division of Cardiology, Hospital General de Medellín, Medellín, Colombia
| | - Bryce Alexander
- Division of Cardiology, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canada
| | - Adrian Baranchuk
- Division of Cardiology, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canada
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16
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Ebner B, Grant J, Vincent L, Maning J, Olorunfemi O, Olarte N, Colombo R, Lambrakos L, Mendoza I. Comparison of in-hospital outcomes of patients undergoing catheter ablation for typical versus atypical atrial flutter. J Interv Card Electrophysiol 2021; 63:295-302. [PMID: 33770337 DOI: 10.1007/s10840-021-00982-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Catheter ablation (CA) is indicated as definitive therapy for patients with either typical or atypical atrial flutter (TAFlutter and AAFlutter, respectively) which is unresponsive to medical therapy. There is a paucity of data regarding in-hospital outcomes of patients undergoing CA. METHODS Retrospective study using the NIS to identify patients ≥18 years who underwent CA between 2015 and 2017. Individuals were identified using ICD-10-CM/PCS for TAFlutter, AAFlutter, and CA. RESULTS A total of 17,390 patients underwent CA for Aflutter (33% AAFlutter and 67% TAFlutter). The TAFlutter group was younger (mean 65.9 years vs. 67.2 years), with less females (30% vs. 43%, p ≤ 0.001 for both) compared to the AAFlutter group. The TAFlutter group had a higher rate of diabetes, tobacco use, obesity, and chronic obstructive pulmonary disease (p ≤ 0.001 for all). The AAFlutter cohort had increased prior strokes and atrial fibrillation (p ≤ 0.001 for both). The mean CHA2DS2-VASc score was found to be 2.3 in AAFlutter compared to 2.1 in TAFlutter (p ≤ 0.001). There were significantly higher proportions of thromboembolic events, transfusions, and longer length of stay in the TAFlutter group (p ≤ 0.001 for all) with the AAFlutter group having significantly higher rates of cardioversion, implantation of cardiac devices, and increased hospital charges (p ≤ 0.001 for all); no significant difference was found in mortality after controlling for comorbidities. CONCLUSIONS We found higher complication rates in CA for patients with TAFlutter, but no difference in in-hospital all-cause mortality. Variation in CA depending upon the mechanism of AFlutter may underlie these differences, and warrant further study.
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Affiliation(s)
- Bertrand Ebner
- Department of Internal Medicine, University of Miami Hospital Miller School of Medicine/Jackson Memorial Hospital, 1611 NW 12th Avenue, Miami, FL, 33136, USA.
| | - Jelani Grant
- Department of Internal Medicine, University of Miami Hospital Miller School of Medicine/Jackson Memorial Hospital, 1611 NW 12th Avenue, Miami, FL, 33136, USA
| | - Louis Vincent
- Department of Internal Medicine, University of Miami Hospital Miller School of Medicine/Jackson Memorial Hospital, 1611 NW 12th Avenue, Miami, FL, 33136, USA
| | - Jennifer Maning
- Department of Internal Medicine, University of Miami Hospital Miller School of Medicine/Jackson Memorial Hospital, 1611 NW 12th Avenue, Miami, FL, 33136, USA
| | - Odunayo Olorunfemi
- Cardiovascular Division, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Neal Olarte
- Cardiovascular Division, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Rosario Colombo
- Cardiovascular Division, Jackson Memorial Hospital, Miami, FL, USA
| | - Litsa Lambrakos
- Cardiovascular Division, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ivan Mendoza
- Cardiovascular Division, Jackson Memorial Hospital, Miami, FL, USA
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17
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Scatularo CE, Ballesteros OA, Saldarriaga C, Mendoza I, Wyss F, Liprandi AS, Munera A, Liendro MC, Baranchuk A. Zika & heart: A systematic review. Trends Cardiovasc Med 2020; 32:52-58. [PMID: 33220438 DOI: 10.1016/j.tcm.2020.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/08/2020] [Accepted: 11/13/2020] [Indexed: 12/22/2022]
Abstract
Zika virus infection affects more than 80 countries in the world, mainly those with a tropical climate. Although the most frequent clinical presentation is characterized by rash, conjunctivitis, myalgia, arthralgia and fever, in some cases it is associated with cardiovascular manifestations, such as myocarditis, pericarditis, heart failure and arrhythmias. Furthermore, maternal transmission of the virus generates congenital Zika syndrome, which is associated with cardiac septal defects. Early recognition and treatment of Zika's cardiovascular complications are essential to reduce morbidity and mortality in these patients. There is no specific antiviral treatment or vaccine in humans, so the development of public health strategies to prevent its transmission is of paramount importance. The "Neglected Tropical Diseases and other Infectious Diseases" (NET-Heart project) is an initiative to systematically review all these devastating endemic conditions affecting the heart to spread knowledge and propose algorithms for early diagnosis and treatment.
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Affiliation(s)
| | | | - Clara Saldarriaga
- Department of Cardiology and Heart Failure Clinic, Cardiovascular Clinic Santa Maria, University of Antioquia, Medellín, Colombia
| | - Ivan Mendoza
- Tropical Cardiology, Tropical Medicine Institute, Central University of Venezuela, Caracas, Venezuela
| | - Fernando Wyss
- Cardiovascular Services and Technology of Guatemala - Cardiosolutions, Guatemala City, Guatemala
| | | | - Ana Munera
- Division of Cardiology, Hospital General de Medellín, Medellín, Colombia
| | | | - Adrian Baranchuk
- Division of Cardiology, Kingston Health Science Center, Queen's University, Kingston K7L 2V7, Ontario, Canada.
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Abstract
INTRODUCTION Human African Trypanosomiasis is a neglected tropical disease resulting from the infection with the parasite Trypanosoma brucei. Neurological compromise often dominates, and the impact of cardiovascular involvement has not been fully investigated. Recently, publications indicate that cardiovascular compromise is more frequent than previously thought. Early detection of cardiac complications may be of utmost importance for healthcare teams. AREA COVERED As a part of the 'Neglected Tropical Diseases and other Infectious Diseases involving the Heart' (the NET-Heart Project), the purpose of this article is to review all the information available regarding cardiovascular implications of this disease, focusing on diagnosis and treatment, and proposing strategies for early detection of cardiac manifestations. An electronic systematic literature review of articles published in MEDLINE, PubMed and EMBASE was performed. From 50 initial studies, 18 were selected according to inclusion criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was used for conducting and reporting this review. EXPERT OPINION Cardiovascular compromise through infiltrative and inflammatory mechanisms seems to be frequent, and includes a wide spectrum of severity. Conventional 12-lead electrocardiogram could be a useful test for screening cardiovascular manifestations and used as a guide for considering specific treatments or more sophisticated diagnostic tools.
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Affiliation(s)
| | | | - Clara Saldarriaga
- Department of Cardiology and Heart Failure, Cardiovascular Clinic Santa Maria, University of Antioquia , Medellín, Colombia
| | - Ivan Mendoza
- Department of Medicine, Instituto de Medicina Tropical , Caracas, Venezuela
| | - Alvaro Sosa Liprandi
- Department of Cardiology, Sanatorio Güemes, Francisco Acuña de Figueroa , Buenos Aires, Argentina
| | - Fernando Wyss
- Department of Cardiology, Technology and Cardiovascular Service of Guatemala - Cardiosolutions , Guatemala City, Guatemala
| | - Lucrecia Maria Burgos
- Department of Heart Failure, Pulmonary Hypertension and Heart Transplant, Instituto Cardiovascular De Buenos Aires , Buenos Aires, Argentina
| | - Bryce Alexander
- Division of Cardiology, Kingston Health Science Center, Queen's University , Kingston, Ontario, Canada
| | - Adrian Baranchuk
- Division of Cardiology, Kingston Health Science Center, Queen's University , Kingston, Ontario, Canada
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Belnavis G, Rivner H, Colombo R, Rego A, Mendoza I, Mendoza C, Braghiroli J. Percutaneous solution for a frequent complication after transcatheter aortic valve replacement: A case of atrioventricular leadless pacemaker implantation after transcatheter aortic valve replacement. HeartRhythm Case Rep 2020; 7:8-11. [PMID: 33505846 PMCID: PMC7813783 DOI: 10.1016/j.hrcr.2020.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Gillian Belnavis
- Department of Cardiology, Jackson Memorial Hospital, 1611 NW 12th Ave, Miami, Florida
| | - Harold Rivner
- Department of Cardiology, Jackson Memorial Hospital, 1611 NW 12th Ave, Miami, Florida
| | - Rosario Colombo
- Department of Cardiology, Jackson Memorial Hospital, 1611 NW 12th Ave, Miami, Florida
| | - Alfredo Rego
- Department of Cardiology, Jackson Memorial Hospital, 1611 NW 12th Ave, Miami, Florida
| | - Ivan Mendoza
- Department of Cardiology, Jackson Memorial Hospital, 1611 NW 12th Ave, Miami, Florida
| | - Cesar Mendoza
- Department of Cardiology, Jackson Memorial Hospital, 1611 NW 12th Ave, Miami, Florida
| | - Joao Braghiroli
- Department of Cardiology, Jackson Memorial Hospital, 1611 NW 12th Ave, Miami, Florida
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Yeung C, Mendoza I, Echeverria LE, Baranchuk A. Chagas' cardiomyopathy and Lyme carditis: Lessons learned from two infectious diseases affecting the heart. Trends Cardiovasc Med 2020; 31:233-239. [PMID: 32376493 DOI: 10.1016/j.tcm.2020.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/04/2020] [Accepted: 04/05/2020] [Indexed: 12/26/2022]
Abstract
Chagas' disease and Lyme disease are two endemic, vector-borne zoonotic infectious diseases that impact multiple organ systems, including the heart. Chagas' cardiomyopathy is a progressive process that can evolve into a dilated cardiomyopathy and heart failure several decades after the acute infection; in contrast, although early-disseminated Lyme carditis has been relatively well characterized, the sequelae of Lyme disease on the heart are less well-defined. A century of research on Chagas' cardiomyopathy has generated compelling data for pathophysiological models, evaluated the efficacy of therapy in large randomized controlled trials, and explored the social determinants of health impacting preventative measures. Recognizing the commonalities between Chagas' disease and Lyme disease, we speculate on whether some of the lessons learned from Chagas' cardiomyopathy may be applicable to Lyme carditis.
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Affiliation(s)
- Cynthia Yeung
- Department of Medicine, Clinical Electrophysiology and Pacing, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, Ontario K7L 2V7, Canada
| | - Ivan Mendoza
- Department of Experimental Cardiology, Institute of Tropical Medicine, Central University of Venezuela Section of Cardiology, Caracas, Venezuela
| | - Luis Eduardo Echeverria
- Clínica de Falla Cardíaca y Trasplante, Fundación Cardiovascular de Colombia, Floridablanca, Colombia
| | - Adrian Baranchuk
- Department of Medicine, Clinical Electrophysiology and Pacing, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, Ontario K7L 2V7, Canada.
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Stewart C, Solomons N, Mendoza I, May S, Maberly G. Salt Iodine Variation within an Extended Guatemalan Community: The Failure of Intuitive Assumptions. Food Nutr Bull 2018. [DOI: 10.1177/156482659601700308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Guatemalan law mandates an iodine concentration from 30 to 700 parts per million (ppm) in all table salt offered in local commerce. Forty-four specimens of salt were collected in urban and rural sectors of a county on the outskirts of the capital of Guatemala and analysed for their iodine content by an iodate titration method. The concentrations ranged from 1 to 117 ppm, (mean ± SD 26.6 ± 21.7 ppm, median 24 ppm). Salt samples with iodine in both the adequate and the inadequate ranges were found in each of five subjurisdictions (township and four hamlets), and the median concentration was equivalent at all sites, without an urban-to-rural gradient. Similarly, the mandated iodine concentration was no more likely to be found in salt packaged under a brand name with a commercial label than in salt in a plain, unlabelled package. The findings place in relief the continuing difficulties in Guatemala in the effort to provide a universally protective level of iodine in table salt.
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Romero-Abal ME, Bulux J, Mendoza I, Grazioso C, Solomons NW. Haematological Status of Preschool and School-Age Children in Urban and Rural Areas of Guatemala. Food Nutr Bull 2018. [DOI: 10.1177/156482659501600110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We studied the prevalence of low haematocrit values (defined as <38%) in 1,253 children from urban and rural areas of Guatemala, to examine any urban-rural or age-related trends. Though the crude prevalences of low haematocrit for all the children showed a significant difference between urban and rural residents, the significance disappeared when these values were adjusted for differences in the age profiles of the two groups. As expected, preschool children had significantly more low haematocrits (32.0%) than school-age children (6.0%) (p < .05). Ferritin levels were available for 35.9% of the preschool children (one urban and one rural location); of these, 51.8% had levels below 12 mg/l, indicating iron deficiency. These values were used to determine the predictive value of haematocrit compared with ferritin values, and the cut-off at which haematocrit reaches optimum sensitivity and specificity to diagnose iron depletion. A cut-off of 39% had a sensitivity of 61% and a specificity of 45% in urban preschoolers, and a cut-off of 38% had a sensitivity of 75% and specificity of 42% in rural preschoolers.
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Solomons NW, Mendoza I, Gutierrez L, Monteiro C. Analysis of the Reconnaissance Project. Phase 2: The Individual. Food Nutr Bull 2018. [DOI: 10.1177/156482659701800318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The essential units for testing hypotheses about the influences of ageing and urbanization in the CRONOS (Cross-Cultural Research on the Nutrition of Older Subjects) process are the responses to the questions on the questionnaire and the physical measurements of individuals, aggregated into distributions by age, sex, geography, and their combinations. In the Reconnaissance experience, the number of subjects per country (about 24) was insufficient to provide meaningful group or subgroup averages. However, the process allowed the investigators to get a sense of which measurements were consistent across countries and which were aberrant in some sites. In general, despite the lack of inter-site standardization, most of the items in the protocol seem to have been measured with acceptable consistency and accuracy across geographic areas. Problem areas identified were in the measurement of arm span, the determination of arterial blood pressure, and the accuracy of 24-hour recall methods for total energy and nutrient intakes.
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Affiliation(s)
- Noel W. Solomons
- Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM) in Guatemala City, Guatemala
| | - Ivan Mendoza
- Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM) in Guatemala City, Guatemala
| | | | - Carlos Monteiro
- Department of Nutrition in the School of Public Health in the University of Sao Paulo in São Paulo, Brazil
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Rodríguez-Angulo H, Marques J, Mendoza I, Villegas M, Mijares A, Gironès N, Fresno M. Differential cytokine profiling in Chagasic patients according to their arrhythmogenic-status. BMC Infect Dis 2017; 17:221. [PMID: 28327099 PMCID: PMC5361844 DOI: 10.1186/s12879-017-2324-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 03/14/2017] [Indexed: 01/08/2023] Open
Abstract
Background Chagas disease is caused by the protozoan Trypanosoma cruzi and is characterized by heart failure and sudden death. Identifying which factors are involved in evolution and treatment response is actually challenging. Thus, the aim of this work was to determine the Th1/Th17 (IL-6, IL-2, TNF, IL-17 and IFN-γ) and Th2 (IL-4 and IL-10) serum profile in Venezuelan Chagasic patients stratified according amiodarone treatment, hypertension and arrhythmias. Methods Sera from 38 chagasic patients were analyzed to determine the level of cytokines by Multiplexed Bead-Based Immunoassays. ANOVA test was applied to determine differences for each group. Additionally, a Linear Discriminant Analysis (LDA) was applied to observe the accuracy of different cytokines to discriminate between the groups. Results The levels of several cytokines were significantly higher in the high-risk of sudden death and untreated group. LDA showed that IL-2, IFN-γ and IL-10 were the best cytokines for discriminating between high-risk of sudden death and untreated patients versus low-risk of sudden death, treated and control groups. Conclusions High IL-2 levels seem to identify patients with high-risk of sudden death and seems adequate as treatment efficacy marker. To our knowledge, this is the first report about the anti-inflammatory role of the amiodarone in Chagas disease, suggesting an inmunomodulatory effect that may be exploited as coadjutant therapy in chronic Chagas disease. Electronic supplementary material The online version of this article (doi:10.1186/s12879-017-2324-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Juan Marques
- Instituto de Medicina Tropical, Caracas, Venezuela
| | - Ivan Mendoza
- Instituto de Medicina Tropical, Caracas, Venezuela
| | | | - Alfredo Mijares
- Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela
| | - Núria Gironès
- Centro de Biología Molecular Severo Ochoa, CSIC-UAM, Cantoblanco, 28049, Madrid, Spain
| | - Manuel Fresno
- Centro de Biología Molecular Severo Ochoa, CSIC-UAM, Cantoblanco, 28049, Madrid, Spain
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Carta KAG, Mendoza I, Morr I, Mendoza I, Misticchio F, Meza Y, Finizola V, Chazzin G, Marques J. MYOCARDITIS, HEART FAILURE AND ARRHYTHMIAS IN PATIENTS WITH ZIKA. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34295-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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26
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Hernandez M, Neninger E, Santiesteban E, Ortiz R, Amador R, Bello L, Acosta S, Flores Y, Cala M, Martínez O, Calana A, Pichs G, Robaina M, Sánchez L, Viada C, Valdez A, Mendoza I, Guerra P, Crombet T. 536 RANIDO trial: Racotumomab-alum vaccine, Nimotuzumab or Docetaxel as switch maintenance therapy for advanced NSCLC. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30337-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lamarre GPA, Mendoza I, Rougerie R, Decaëns T, Hérault B, Bénéluz F. Stay out (almost) all night: contrasting responses in flight activity among tropical moth assemblages. Neotrop Entomol 2015; 44:109-115. [PMID: 26013127 DOI: 10.1007/s13744-014-0264-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 12/09/2014] [Indexed: 06/04/2023]
Abstract
Variations in diel activity among hyperdiverse tropical communities of moths, despite representing a key component of niche partitioning between species, have barely been studied so far. Using light trapping from dawn to sunset over a 1-year period in French Guiana, we investigated these variations within and between two families of moths (Sphingidae and Saturniidae). Our results revealed contrasting patterns in flight activity at night between Sphingidae and Saturniidae. Sphingidae reached their peak in species richness and abundance between 7:00 and 8:00 p.m., followed by a decrease around 11:00 p.m. to midnight, whereas Saturniidae were continuously present throughout the night, with a peak around midnight. In addition, we found changes in diel activity among some of the most common genera in each family, highlighting distinct behavioral, physiological, and functional traits among taxa. Given differences in flight activity at different taxonomic levels, it is strongly recommended to monitor by light trapping throughout the night to effectively sample saturniid and sphingid assemblages, even though the activity of Sphingidae sharply declines after midnight. These results improve the general natural history information of tropical moths and reinforce the need of further research on the ecological and taxonomic consequences of differences in diel activity.
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Affiliation(s)
- G P A Lamarre
- Univ Antilles Guyane, UMR Ecologie des Forêts de Guyane, Kourou, French Guiana,
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Lambiris I, Mendoza I, Helguera M, Escudero JB, Bonilla C. Thirty years of blackouts: a case report of swallow syncope. J Community Hosp Intern Med Perspect 2013; 3:20323. [PMID: 23882389 PMCID: PMC3716027 DOI: 10.3402/jchimp.v3i1.20323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 12/21/2012] [Revised: 02/13/2013] [Accepted: 02/22/2013] [Indexed: 11/14/2022] Open
Abstract
Deglutition syncope has been demonstrated in isolated case reports, the first being described over 50 years ago. It is thought to be caused by a hypersensitive vagotonic reflex in response to esophageal dilation after swallowing. It can cause syncope due to complete atrioventricular (AV) block and acute reduction of cardiac output. Although rare, its lethality is worthy of discussion, as early recognition can offer complete treatment with placement of a pacemaker. A 54-year-old man presented with 30 years of lightheadedness and syncope, followed by disorientation and tremors, after eating sandwiches or drinking carbonated beverages. He initially was evaluated by a neurologist. Work-up included cardiac 2D transthoracic echocardiogram, electroencephalogram, swallow stud, pulmonary function tests, electrocardiogram, and cardiac stress testing. All tests were within normal limits, and it was determined that he was suffering from convulsive syncope and deglutition syncope. Referral to the cardiac electrophysiology department with tilt-table testing accompanied by swallow evaluation was then recommended. The tests demonstrated marked vagal response resulting in sinus bradycardia with second-degree AV block and pauses up to 3.5 seconds. Patient experienced near syncope. A rate-responsive, dual-chamber Boston Scientific pacemaker with DDDR programming was implanted. Patient has remained asymptomatic at follow-up.
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Macías A, Alfonso S, Santiesteban E, Viada C, Mendoza I, Guerra P, Gómez R, Ardigo M, Vázquez A, Pérez R. Active Specific Immunotherapy with Racotumomab in the Treatment of Advanced. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33820-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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31
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Mendoza I, Novaro GM. Repeat recurrence of takotsubo cardiomyopathy related to inhaled beta-2-adrenoceptor agonists. World J Cardiol 2012; 4:211-3. [PMID: 22761975 PMCID: PMC3386312 DOI: 10.4330/wjc.v4.i6.211] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 05/29/2012] [Accepted: 06/05/2012] [Indexed: 02/06/2023] Open
Abstract
Takotsubo cardiomyopathy (also referred to as transient apical ballooning syndrome, broken heart syndrome or stress cardiomyopathy) is an increasingly recognized entity in the western world typically characterized by reversible left ventricular dysfunction that develops in the setting of acute severe emotional or physical stress. Increased catecholamine levels have been proposed to play a central role in the pathogenesis of the disease, although the specific pathophysiology of this condition remains elusive at the present moment. In recent times, there have been reports of takotsubo cardiomyopathy (TC) following medical interventions such as invasive or surgical procedures or specific medical regimens. In the current report, we present a patient with multiple recurrences of TC triggered by the same medical therapeutic intervention; in our particular case, repetitive exposure to inhaled beta-2-adrenoceptor agonist.
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Affiliation(s)
- Ivan Mendoza
- Ivan Mendoza, Gian M Novaro, Department of Cardiology, Cleveland Clinic Florida, Weston, FL 33331, United States
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Mendoza I, Marques J, Ivan MM, Alarcon B, Misticchio F, Moleiro F, Matheus A, Torres J, Noya O. ATRIAL TACHYARRHYTHMIAS AS A MANIFESTATION OF ORALLY ACQUIRED ACUTE CHAGAS DISEASE. J Am Coll Cardiol 2011. [DOI: 10.1016/s0735-1097(11)60035-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mendoza I, Novaro GM. Takotsubo cardiomyopathy: New disease or unrecognized diagnosis. Maturitas 2010; 67:3-4. [DOI: 10.1016/j.maturitas.2010.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 06/08/2010] [Accepted: 06/08/2010] [Indexed: 10/19/2022]
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Mendoza I, Lago R, Cardona R, Morris L. Stress Cardiomyopathy Induced by Common Surgical and Medical Interventions. When Patients Get More Than They Asked for. J Card Fail 2010. [DOI: 10.1016/j.cardfail.2010.06.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Morrison B, Mendoza I, Delgado D, Reyes Jaimes O, Aranzazu N, Paniz Mondolfi AE. Diffuse (anergic) cutaneous leishmaniasis responding to amphotericin B. Clin Exp Dermatol 2009; 35:e116-9. [PMID: 19886959 DOI: 10.1111/j.1365-2230.2009.03737.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
American cutaneous leishmaniasis is an important endemic zoonotic disease in the New World that comprises a spectrum of clinical manifestations. Diffuse cutaneous leishmaniasis (DCL) is a rare form of the disease characterized by antigen-specific immunodeficiency that often presents with multiple disfiguring non-ulcerated confluent nodules or plaques that involve large areas of the skin, resembling lepromatous leprosy. Relapse is invariable in advanced stages, despite aggressive chemotherapy, and a plethora of drugs has been tested with unchanging results. We report on a severe an exceptional case that resolved after treatment with amphotericin B, a drug considered only mildly effective, and discuss the therapeutic approach to this disease.
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Affiliation(s)
- B Morrison
- New York University School of Medicine, New York, NY, USA
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Noya BAD, Ruiz R, Diaz Z, Colmenares C, Zavala R, Mauriello L, Surez J, Torres J, Naranjo L, Castro J, Marques J, Mendoza I, Ossenkopp J, Noya O. Large Outbreak of Orally-Acquired Acute Chagas’ Disease, in a Publlc School of Caracas, Venezuela. Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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37
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Gómez-Aparicio L, Pérez-Ramos IM, Mendoza I, Matías L, Quero JL, Castro J, Zamora R, Marañón T. Oak seedling survival and growth along resource gradients in Mediterranean forests: implications for regeneration in current and future environmental scenarios. OIKOS 2008. [DOI: 10.1111/j.1600-0706.2008.16814.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.9] [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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Gómez-Aparicio L, Pérez-Ramos IM, Mendoza I, Matías L, Quero JL, Castro J, Zamora R, Marañón T. Oak seedling survival and growth along resource gradients in Mediterranean forests: implications for regeneration in current and future environmental scenarios. OIKOS 2008. [DOI: 10.1111/j.0030-1299.2008.16814.x] [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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Zerpa O, Ulrich M, Blanco B, Polegre M, Avila A, Matos N, Mendoza I, Pratlong F, Ravel C, Convit J. Diffuse cutaneous leishmaniasis responds to miltefosine but then relapses. Br J Dermatol 2007; 156:1328-35. [PMID: 17441955 DOI: 10.1111/j.1365-2133.2007.07872.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [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: 11/27/2022]
Abstract
BACKGROUND Diffuse cutaneous leishmaniasis (DCL), although rare, is profoundly incapacitating. At present there is no successful treatment for this progressive protozoan infection, which is associated with the absence of specific cell-mediated immunity (CMI) to Leishmania. This disease shares features with visceral leishmaniasis (VL), including specific CMI inactivity during active disease and a heavy parasitic burden, but VL responds well to treatment. Miltefosine is the first orally administered drug which has shown efficacy in the treatment of VL; it has not been adequately evaluated in the treatment of DCL. OBJECTIVES To evaluate the efficacy of miltefosine in the treatment of DCL, using clinical, parasitological, histopathological and immunological criteria. METHODS Sixteen patients with DCL were treated with miltefosine, 2.0-2.5 mg kg(-1) daily, for variable periods of time (75-218 days). Patients were hospitalized for the first month and evaluated every 2 weeks until the termination of treatment with routine laboratory chemistry, percentage clinical improvement, presence of parasites in skin smears, growth of parasites in culture medium and in hamsters, histopathological characteristics of the granulomas, adverse side-effects, and reactivity to leishmanin skin test antigen. Further cycles of treatment were given in some of these patients, particularly after suspension of treatment was followed by relapse. RESULTS Patients showed dramatic clinical improvement and reduction in the parasite burden by day 15 after the initiation of treatment, which continued while treatment was maintained. By day 45, 15 patients showed 80-90% clinical improvement. Nevertheless, suspension of treatment was followed by the development of new lesions in all but one patient. Inoculation in hamsters was observed to be the most sensitive technique to detect persisting parasites. Adverse events were very mild. CONCLUSIONS Miltefosine produced a dramatic clinical and parasitological response in patients with DCL and improvement continued during drug administration, but with a single exception all patients presented new lesions after suspension of treatment. There was no histological or skin test evidence to suggest the development of CMI during treatment, which may be an indispensable criterion for the evaluation of potentially effective drugs against DCL.
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Affiliation(s)
- O Zerpa
- Institute of Biomedicine, Ministry of Health, Central University of Venezuela, Esq. San Nicolás, San José, Caracas, Venezuela.
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Mendoza I, Moleiro F, Marques J, Guerrero J, Matheus Á, Rodriguez F, Rodriguez A, Britto IM, Bayes de Luna A, Castellanos A. IMPLICATIONS OF SUDDEN DEATH IN CHAGAS DISEASE. Rev Patol Trop 2007. [DOI: 10.5216/rpt.v26i2.17228] [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: 11/20/2022] Open
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Mendoza JM, Guttentag A, Krasner M, Mendoza I, Pomerantz SC, Eiger G. UTILITY OF PORTABLE CHEST RADIOGRAPH MEASUREMENTS IN DIFFERENTIATING CONGESTIVE HEART FAILURE FROM OTHER CAUSES OF DYSPNEA IN PATIENTS PRESENTING TO EMERGENCY ROOM. Chest 2006. [DOI: 10.1378/chest.130.4_meetingabstracts.195s-c] [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: 11/01/2022] Open
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Valdés-Ramos R, Cervantes I, Mendoza I, Solomons NW, Anderson AS. Weight of Foods and Number of Portions Consumed Are Not Proxies for Expressing Nutrient Intakes in Field Studies. Food Nutr Bull 2004; 25:166-71. [PMID: 15214262 DOI: 10.1177/156482650402500209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In order to determine whether simplified indicators for usual consumption of selected food groups, specifically those derived from either the percentage of the number of daily portions, the percentage of total daily weight consumed, or both, could serve as proxies for the conventional expression of daily energy intake, these indicators were computed and compared from food-frequency data in a data set. Food consumption was reported in frequency categories and portion sizes per month, per week, or per day, and the cumulative sum was divided by 365 to provide a daily average. The survey was done in the township of Santa Cruz and three hamlets of a rural county seat in Guatemala. Data from food-frequency questionnaires from 269 individuals (55 men and 214 women aged 16 to 86 years) were analyzed. For foods of plant origin, the percentage of total energy, percentage of total food weight, and percentage of total number of portions consumed showed low correlations (r < .45). When subdivided into specific foods and food groups (fruits and vegetables, red meat, etc.), marked differences were revealed across sites and among different indicators of consumption. Despite the simplicity of calculation, neither the percentage of weight of food in a group nor the percentage of portions consumed could serve reliably as proxies for their contributions to the percentage of total energy in this rural population in Guatemala.
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Herman DR, Solomons NW, Mendoza I, Qureshi AK. Self-rated health and its relationship to functional status and well-being in a group of elderly Guatemalan subjects. Asia Pac J Clin Nutr 2002; 10:176-82. [PMID: 11708304 DOI: 10.1046/j.1440-6047.2001.00245.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study examined the association of self-rated health with physical function and emotional well-being, while controlling for differences in sex, age and anthropometry. Subjects were participants in a multicentre study originated by the International Union of Nutritional Sciences (IUNS). A total of 151 elderly Guatemalan subjects were examined using a questionnaire which included information on self-rated health, activities of daily living, well-being, and a common battery of anthropometric variables. Adjusted odds ratios (OR) obtained with polytomous logistic regression showed that subjects with the highest score on the well-being index compared with those with the lowest were 1.67 times more likely (P-value <0.001, confidence interval (C.I.) = 1.31-2.14) to rate themselves in 'good' health versus 'fair' and 'poor' health. Subjects with the highest score versus those with the lowest on the mobility index were 1.15 times more likely (P-value <0.05, (C.I.) = 1.00-1.32) to rate themselves in 'good' health versus the other health ratings. These are the first results to examine the relationship of self-rated health to physical function and emotional well-being of elderly, free-living Guatemalans.
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Affiliation(s)
- D R Herman
- Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, USA.
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Copeland DL, Sullivan KM, Houston R, May W, Mendoza I, Salamatullah Q, Solomons N, Nordenberg D, Maberly GF. Comparison of neonatal thyroid-stimulating hormone levels and indicators of iodine deficiency in school children. Public Health Nutr 2002; 5:81-7. [PMID: 12001982 DOI: 10.1079/phn2001306] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To compare thyroid-stimulating hormone (TSH) levels in neonatal cord blood between study sites in Bangladesh, Guatemala and the United States. Also, to compare neonatal TSH results with indicators of iodine deficiency in school children. DESIGN Consecutive births and, in school children, cross-sectional surveys. SETTING Savar, Bangladesh; San Pedro Sacatepequez, Guatemala; and Atlanta, United States. SUBJECTS In each study site, cord blood was spotted on to filter paper and TSH levels determined using a sensitive monoclonal assay. In the USA, heel stick blood specimens from newborns spotted on to filter paper were also obtained as well as exposure to iodine-containing antiseptics during the birthing process. Urine specimens were collected from mothers of newborns and tested for iodine concentration. School children in the same areas were surveyed for thyroid size by palpation and ultrasonography, and urine specimens collected for iodine concentration. RESULTS Between 141 and 243 cord blood specimens were collected from each study site. The prevalence of elevated cord blood TSH levels (> 5 mUl(-1)) was high in all study sites, from 58% to 84%. All sites would be categorised as having 'severe' iodine deficiency based on WHO/UNICEF/ICCIDD criteria. Iodine-containing antiseptics were used during 98% of the births in the USA but not in Bangladesh or Guatemala. The neonatal TSH classification indicated more severe iodine deficiency levels than classifications based on urinary iodine and goitre in school children. CONCLUSIONS In the USA, elevated TSH levels may be partially attributed to use of beta-iodine-containing antiseptics prior to birth. We recommend the cautious interpretation of TSH results in newborns for the assessment of iodine deficiency disorders when iodine-containing antiseptics are used during the birthing process.
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Affiliation(s)
- Daphne L Copeland
- Department of Epidemiology, Rollins School of Publilc Health of Emory University, Atlanta, GA 30322, USA
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Valdés-Ramos R, Solomons NW, Anderson AS, Mendoza I, Garcés MA, Benincasa L. Can the degree of concordance with recommendations for a cancer prevention diet and lifestyle be assessed from existing survey information data? Am J Clin Nutr 2001; 74:848-51. [PMID: 11722968 DOI: 10.1093/ajcn/74.6.848] [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: 11/14/2022] Open
Abstract
BACKGROUND The World Cancer Research Fund convened an expert committee who analyzed the literature related to the causation of human cancers. Recommendations for preventing cancer through behavioral practices were formatted into a 14-point guideline. OBJECTIVE We parsed the cancer prevention guidelines to determine to what extent relevant information on individual behavior could be assessed from conventional food-frequency questionnaires, which are being used in surveys conducted in developing countries. DESIGN We examined a convenience sample of archival forms completed during 2 independent studies (a case-control and a field study) that used an adapted Willett food-frequency questionnaire that was translated into Spanish for use in Guatemala. RESULTS All dietary related guidelines, except for salt, were evaluated by both questionnaires. Physical activity, food handling, and food preparation were not addressed by either of the questionnaires, although body mass index and dietary supplements were addressed in the case-control study and field-study questionnaires, respectively. CONCLUSIONS Although concordance with some of the cancer prevention goals and guidelines can be evaluated from the existing questionnaires, adjustments and additions must be made with respect to salt and supplement use, physical activity, and food handling. Actual weight and height measurements are also needed, particularly in low-income populations.
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Affiliation(s)
- R Valdés-Ramos
- Instituto Nacional de Perinatología, Mexico City, Mexico.
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Moleiro F, Misticchio F, Mendoza I, Rodriguez A, Castellanos A, Myerburg RJ. Paradoxical behavior of PR interval dynamics during exercise and recovery and its relationship to cardiac memory at the atrioventricular node. J Electrocardiol 2001; 34:31-4. [PMID: 11239368 DOI: 10.1054/jelc.2001.22027] [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
This preliminary study deals with the dynamics of the PR interval during exercise testing by using a Bruce protocol in 31 nonmedicated, normal patients with ages of 33 +/- 14 years. The behavior of the PR interval permitted its categorization into 2 groups. In Group I (27 of 31, 87.1% of patients) the PR interval showed the expected biphasic behavior with a gradual shortening with increasing exercise and a gradual lengthening during recovery. In contrast, the PR interval in Group II (4 of 31, 12.9% of patients) showed a triphasic behavior since, toward the end of recovery, there was a second decrease in duration. Because of this temporal relation to the phases of exercise, this paradoxical response, in analogy to what happened to the QT interval during exercise, could have been caused by a form of short-term memory or to varying, but normal, intergroup differences in autonomic function. However, further studies involving a greater number of patients are required to reach definite conclusions.
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Affiliation(s)
- F Moleiro
- Universidad Central de Venezuela, Caracas, Venezuela.
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Valdés-Ramos R, Mendoza I, Solomons N. Concordance of dietary intake with the “Dietary Guidelines for Americans” among adults in rural “Santa Rosa” province, Guatemala. Nutr Res 2001. [DOI: 10.1016/s0271-5317(00)00249-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Blanco Castro SD, Martínez Arias A, Cano Velásquez OR, Tello Granados R, Mendoza I. [Introduction of Bacillus sphaericus strain-2362 (GRISELESF) for biological control of malaria vectors in Guatemala]. Rev Cubana Med Trop 2000; 52:37-43. [PMID: 11107892] [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: 02/18/2023]
Abstract
Malaria continues to be an important health problem in a number of countries of Central and South America where it is considered as a highly prevent endemic disease. The objective of this paper is to assess the entomo-epidemiological impact of a pilot program for the biological control of malaria-transmitting vectors, which was implemented in 1998 in Escuintla, Republic of Guatemala. This program was based on the use of 20,000 L of biolarvicide Bacillus sphaericus- strain-2362 (GRISELESF) which was applied in the 46 localities of highest epidemiological risk at a rate of 10 mL/m2 of effective area of breeding. The entomologic effectiveness of this biolarvicide was monitored from the first 72 hours to 4 months after the application. There was a total larval reduction of 94.57 in the maturity stage of the water phase of Anopheles albimanus vector. The epidemiological analysis was carried out by comparing the rate of malaria prevalence (per 1000 pop) during 1997 and 1998. The five treated municipalities showed a statistically significant reduction of 50% (p 0.01). The results obtained in this paper coincided with those reported by comparable studies, so, this allowed us to recommend the use of the biolarvicide Bacillus sphaericus (strain-2362) as part of a comprehensive program of malaria-transmitting vector control in the Republic of Guatemala and other countries of the region.
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Affiliation(s)
- S D Blanco Castro
- Ministerio de Salud Pública y Asistencia Social de La República De Guatemala
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Moleiro F, Misticchio F, Torres JM, Pulido M, Luque M, Rodriguez A, Mendoza I, Guerrero J, Ruesta V, Castellanos A, Myerburg RJ. Paradoxical behavior of the QT interval during exercise and recovery and its relationship with cardiac memory. Clin Cardiol 1999; 22:413-6. [PMID: 10376181 PMCID: PMC6656178 DOI: 10.1002/clc.4960220609] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/1998] [Accepted: 12/02/1998] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Few studies have dealt with the behavior of the corrected (QTc) and uncorrected QT intervals during exercise and recovery. HYPOTHESIS Based on previously published dynamics of the QT interval during treadmill testing, this study attempted to reevaluate the computer-proposed underlying mechanisms of these dynamics and to determine whether the so-called memory phenomenon could be operative in some subjects without evidence of structural heart disease. METHODS This study included 42 unmedicated healthcare volunteers, 23 men and 19 women aged between 20 and 42 (mean 31.7) years. All had normal physical examinations, x-rays, and transthoracic echocardiograms. The electrocardiograms were also normal with 12-lead QT interval dispersions of < 90 ms. RESULTS During exercise and recovery, the behavior of the QT intervals permitted the categorization into two groups. In Group 1 (31/42; 73.8% of subjects) the uncorrected QT interval showed a biphasic pattern consisting of a gradual decrease during incremental exercise followed by a gradual increase during recovery. In contrast, the QTc interval had a triphasic pattern resulting from a slight increase during the early phase of exercise, a gradual decrease at the highest rates, and a final increase during recovery as the rate slowed to control values. In Group 2 (11/42; 36.2% of subjects) the behavior was considered as paradoxical since the uncorrected QT interval displayed in a triphasic pattern whereas the QTc interval yielded a tetraphasic pattern due to the fact that both showed a second decrease during recovery while the rate was decreasing. CONCLUSIONS Analysis of dynamics behavior of the QTc and the uncorrected QT intervals during exercise showed that some normal subjects had a paradoxical behavior which, because of its temporal relation to the phases of exercise, could be an expression of the so-called memory phenomenon.
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Affiliation(s)
- F Moleiro
- Universidad Central de Venezuela, Caracas
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Mazariegos M, Pithan C, Meyer A, Mendoza I, Fürst P, Solomons NW. Bioelectrical impedance spectroscopy (BIS) in young children with acute and semi-acute hydration disorders: potentials and limitations. Appl Radiat Isot 1998; 49:611-4. [PMID: 9569556 DOI: 10.1016/s0969-8043(97)00267-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study aimed to evaluate the feasibility and reliability of bioelectrical impedance spectroscopy in young children suffering of acute hydrational disorders. Whole body and segmental measurements were carried out in a group of 42 of children aged 4 to 147 months, using a BIS analyzer (Xitron 4000B). This phase of the study involved several hundred of BIS measurement, which showed the feasibility of using this technique in young children. Using the sweep mode and the modeling software provided for the manufacturer of the instrument, the resistance of the extracellular (RECW) and intracellular (RICW) compartment was calculated. Correlation coefficient (r) and technical error of measurement (TEM) were obtained from paired BIS measurements. RECW showed to be highly reproducible (r = 0.99), with a relatively low TEM (from 1 to 3.5%), across all segments. The reliability was markedly lower respect to RICW, which shows the potential application of BIS technique even in critically ill young child populations.
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Affiliation(s)
- M Mazariegos
- Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Guatemala City, Guatemala
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