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Vogel F, Ars S, Wunch D, Lavoie J, Gillespie L, Maazallahi H, Röckmann T, Nęcki J, Bartyzel J, Jagoda P, Lowry D, France J, Fernandez J, Bakkaloglu S, Fisher R, Lanoiselle M, Chen H, Oudshoorn M, Yver-Kwok C, Defratyka S, Morgui JA, Estruch C, Curcoll R, Grossi C, Chen J, Dietrich F, Forstmaier A, Denier van der Gon HAC, Dellaert SNC, Salo J, Corbu M, Iancu SS, Tudor AS, Scarlat AI, Calcan A. Ground-Based Mobile Measurements to Track Urban Methane Emissions from Natural Gas in 12 Cities across Eight Countries. Environ Sci Technol 2024; 58:2271-2281. [PMID: 38270974 PMCID: PMC10851421 DOI: 10.1021/acs.est.3c03160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/26/2024]
Abstract
To mitigate methane emission from urban natural gas distribution systems, it is crucial to understand local leak rates and occurrence rates. To explore urban methane emissions in cities outside the U.S., where significant emissions were found previously, mobile measurements were performed in 12 cities across eight countries. The surveyed cities range from medium size, like Groningen, NL, to large size, like Toronto, CA, and London, UK. Furthermore, this survey spanned across European regions from Barcelona, ES, to Bucharest, RO. The joint analysis of all data allows us to focus on general emission behavior for cities with different infrastructure and environmental conditions. We find that all cities have a spectrum of small, medium, and large methane sources in their domain. The emission rates found follow a heavy-tailed distribution, and the top 10% of emitters account for 60-80% of total emissions, which implies that strategic repair planning could help reduce emissions quickly. Furthermore, we compare our findings with inventory estimates for urban natural gas-related methane emissions from this sector in Europe. While cities with larger reported emissions were found to generally also have larger observed emissions, we find clear discrepancies between observation-based and inventory-based emission estimates for our 12 cities.
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Affiliation(s)
- F. Vogel
- Climate
Research Division, Environment and Climate
Change Canada, Toronto M3H 5T4, Canada
| | - S. Ars
- Climate
Research Division, Environment and Climate
Change Canada, Toronto M3H 5T4, Canada
| | - D. Wunch
- Department
of Physics, University of Toronto, Toronto M5S 1A7, Canada
| | - J. Lavoie
- Department
of Physics, University of Toronto, Toronto M5S 1A7, Canada
| | - L. Gillespie
- Climate
Research Division, Environment and Climate
Change Canada, Toronto M3H 5T4, Canada
- Department
of Physics, University of Toronto, Toronto M5S 1A7, Canada
| | - H. Maazallahi
- Institute
for Marine and Atmospheric Research Utrecht, Utrecht University, Utrecht 3584 CC, The Netherlands
| | - T. Röckmann
- Institute
for Marine and Atmospheric Research Utrecht, Utrecht University, Utrecht 3584 CC, The Netherlands
| | - J. Nęcki
- AGH, University of Kraków, Kraków 30-059, Poland
| | - J. Bartyzel
- AGH, University of Kraków, Kraków 30-059, Poland
| | - P. Jagoda
- AGH, University of Kraków, Kraków 30-059, Poland
| | - D. Lowry
- Department
of Earth Sciences, Royal Holloway University
of London, Egham, Surrey TW20 0EX, U.K.
| | - J. France
- Department
of Earth Sciences, Royal Holloway University
of London, Egham, Surrey TW20 0EX, U.K.
| | - J. Fernandez
- Department
of Earth Sciences, Royal Holloway University
of London, Egham, Surrey TW20 0EX, U.K.
| | - S. Bakkaloglu
- Department
of Earth Sciences, Royal Holloway University
of London, Egham, Surrey TW20 0EX, U.K.
| | - R. Fisher
- Department
of Earth Sciences, Royal Holloway University
of London, Egham, Surrey TW20 0EX, U.K.
| | - M. Lanoiselle
- Department
of Earth Sciences, Royal Holloway University
of London, Egham, Surrey TW20 0EX, U.K.
| | - H. Chen
- Centre for
Isotope Research, Energy and Sustainability Research Institute, University of Groningen, Groningen 9747 AG, Netherlands
| | - M. Oudshoorn
- Centre for
Isotope Research, Energy and Sustainability Research Institute, University of Groningen, Groningen 9747 AG, Netherlands
| | - C. Yver-Kwok
- LSCE,
CEA-CNRS-UVSQ, University Paris-Saclay, Gif-sur-Yvette 91191, France
| | - S. Defratyka
- LSCE,
CEA-CNRS-UVSQ, University Paris-Saclay, Gif-sur-Yvette 91191, France
| | - J. A. Morgui
- ICTA, Autonomous University of Barcelona, Barcelona 08193, Spain
| | - C. Estruch
- Eurecat, Centre
Tecnològic de Catalunya, Barcelona 08290, Spain
| | - R. Curcoll
- ICTA, Autonomous University of Barcelona, Barcelona 08193, Spain
- INTE, Universitat
Politècnica de Catalunya, Barcelona 08028, Spain
| | - C. Grossi
- INTE, Universitat
Politècnica de Catalunya, Barcelona 08028, Spain
| | - J. Chen
- Environmental Sensing and Modelling, Technical
University of Munich, Munich 80333, Germany
| | - F. Dietrich
- Environmental Sensing and Modelling, Technical
University of Munich, Munich 80333, Germany
| | - A. Forstmaier
- Environmental Sensing and Modelling, Technical
University of Munich, Munich 80333, Germany
| | | | - S. N. C. Dellaert
- Netherlands Organisation for Applied Scientific Research—TNO, Utrecht 3584CB, The Netherlands
| | - J. Salo
- Geography and
GIS, University of Northern
Colorado, Greeley, Colorado 80639, United States
| | - M. Corbu
- Faculty
of Physics, University of Bucharest, Bucharest 050663, Romania
- INCAS, National Institute for Aerospace
Research “Elie Carafoli”, Bucharest 061126, Romania
| | - S. S. Iancu
- Faculty
of Physics, University of Bucharest, Bucharest 050663, Romania
- INCAS, National Institute for Aerospace
Research “Elie Carafoli”, Bucharest 061126, Romania
| | - A. S. Tudor
- Faculty
of Physics, University of Bucharest, Bucharest 050663, Romania
- INCAS, National Institute for Aerospace
Research “Elie Carafoli”, Bucharest 061126, Romania
| | - A. I. Scarlat
- Faculty
of Physics, University of Bucharest, Bucharest 050663, Romania
- INCAS, National Institute for Aerospace
Research “Elie Carafoli”, Bucharest 061126, Romania
| | - A. Calcan
- INCAS, National Institute for Aerospace
Research “Elie Carafoli”, Bucharest 061126, Romania
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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Lee D, Usmani A, Wu R, Wicks T, Fernandez J, Huang J, Arroyo L, Rinde-Hoffman D, Kumar S, Feliberti J, Oliveira G, Berman P, Mackie B. Relation Between Individual Blood Gene Expression Profile (GEP) and Tissue GEP in Antibody-Mediated Rejection in Heart Transplant. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.120] [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: 04/05/2023] Open
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Lee D, Usmani A, Wu R, Wicks T, Fernandez J, Huang J, Arroyo L, Rinde-Hoffman D, Kumar S, Feliberti J, Oliveira G, Berman P, Mackie B. Differences in Individual Blood Gene Expression Profile (GEP) Levels in T-Cell Mediated Rejection Assessed by Molecular Microscopy in Heart Transplant. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1213] [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: 04/05/2023] Open
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Bruno-Galarraga M, Fernandez J, Cattaneo L, Bo G, Gibbons A, Cueto M. 240 Superovulatory response and embryo production using a bioactive recombinant equine chorionic gonadotrophin in goats. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Johnson S, Fernandez J. INCIDENCE OF COVID-19 INFECTIONS IN ADULTS WITH PRIMARY IMMUNODEFICIENCY AFTER RECEIVING TIXAGEVIMAB AND CILGAVIMAB. Ann Allergy Asthma Immunol 2022. [PMCID: PMC9646423 DOI: 10.1016/j.anai.2022.08.652] [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: 11/11/2022]
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Yeung S, Kim HK, Carleton A, Munro J, Ferguson D, Monk AP, Zhang J, Besier T, Fernandez J. Integrating wearables and modelling for monitoring rehabilitation following total knee joint replacement. Comput Methods Programs Biomed 2022; 225:107063. [PMID: 35994872 DOI: 10.1016/j.cmpb.2022.107063] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/24/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Wearable inertial devices integrated with modelling and cloud computing have been widely adopted in the sports sector, however, their use in the health and medical field has yet to be fully realised. To date, there have been no reported studies concerning the use of wearables as a surrogate tool to monitor knee joint loading during recovery following a total knee joint replacement. The objective of this study is to firstly evaluate if peak tibial acceleration from wearables during gait is a good surrogate metric for computer modelling predicted functional knee loading; and secondly evaluate if traditional clinical patient related outcomes measures are consistent with wearable predictions. METHODS Following ethical approval, four healthy participants were used to establish the relationship between computer modelling predicted knee joint loading and wearable measured tibial acceleration. Following this, ten patients who had total knee joint replacements were then followed during their 6-week rehabilitation. Gait analysis, wearable acceleration, computer models of knee joint loading, and patient related outcomes measures including the Oxford knee score and range of motion were recorded. RESULTS A linear correlation (R2 of 0.7-0.97) was observed between peak tibial acceleration (from wearables) and musculoskeletal model predicted knee joint loading during gait in healthy participants first. Whilst patient related outcome measures (Oxford knee score and patient range of motion) were observed to improve consistently during rehabilitation, this was not consistent with all patient's tibial acceleration. Only those patients that exhibited increasing peak tibial acceleration over 6-weeks rehabilitation were positively correlated with the Oxford knee score (R2 of 0.51 to 0.97). Wearable predicted tibial acceleration revealed three patients with a consistent knee loading, five patients with improving knee loading, and two patients with declining knee loading during recovery. Hence, 20% of patients did not present with satisfactory joint loading following total knee joint replacement and this was not detected with current patient related outcome measures. CONCLUSIONS The use of inertial measurement units or wearables in this study provided additional insight into patients who were not exhibiting functional improvements in joint loading, and offers clinicians an 'off-site' early warning metric to identify potential complications during recovery and provide the opportunity for early intervention. This study has important implications for improving patient outcomes, equity, and for those who live in rural regions.
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Affiliation(s)
- S Yeung
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - H K Kim
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; School of Kinesiology, Louisiana State University, United States
| | - A Carleton
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - J Munro
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand
| | - D Ferguson
- Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand
| | - A P Monk
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand; Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand
| | - J Zhang
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - T Besier
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand; Department of Engineering Science, University of Auckland, Auckland, New Zealand
| | - J Fernandez
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand; Department of Engineering Science, University of Auckland, Auckland, New Zealand.
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Burgum M, Saareleinen H, Reinosa J, Alcolea-Rodriguez V, Fernandez J, Dumit V, Portela R, Bañares M, Catalán J, Clift M, Doak S. P08-14 Investigating the cytotoxic and genotoxic potential of carbon nanotubes in human cells in vitro. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Vuillemin M, Fernandez J, Klau L, Pilgaard B, Kiehn E, Meilleur F, Fredslund F, Welner D, Meyer A, Morth J, Rovira C, Aachmann F, Wilkens C. Polyuronic acid degradation by polysaccharide lyase family 7. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322096036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Perez E, Fernandez J, Fitzgerald C, Rouzard K, Tamura M, Savile C. 808 In vitro and Clinical Evaluation of Cannabigerol (CBG) Produced via Yeast Biosynthesis: A Cannabinoid with a Broad Range of Anti-inflammatory and Skin Health Boosting Properties. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Fernandez J, Fitzgerald C, Rouzard K, Tamura M, Healy J, Tao K, Guo L, Hu X, Stock M, Stock J, Perez E. 817 Encapsulated activated-grape seed extract (E-AGSE): A novel liposome-based formulation that promotes anti-aging, brightening and hydration in human skin. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.831] [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: 10/17/2022]
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Hurni JI, Kaiser-Thom S, Gerber V, Keller JE, Collaud A, Fernandez J, Schwendener S, Perreten V. Prevalence and whole genome-based phylogenetic, virulence and antibiotic -resistance characteristics of nasal -Staphylococcus aureus in healthy Swiss horses. SCHWEIZ ARCH TIERH 2022; 164:499-512. [PMID: 35791820 DOI: 10.17236/sat00360] [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] [Indexed: 11/06/2022]
Abstract
INTRODUCTION A total of 100 nasal swabs were collected from healthy horses in Switzerland between January 2020 and August 2020. The samples were taken from horses at 40 different stables in 12 different cantons and screened for both methicillin-resistant (MRSA) and methicillin-susceptible S. aureus (MSSA) using selective agar plates. S. aureus were tested for antibiotic susceptibility by measurement of the minimal inhibitory concentration (MIC) and for virulence factors, antibiotic resistance genes and phylogenetic characteristics using whole genome sequence analysis. Ten horses were found to be positive (10 %, CI: 95 %, 0,0552 - 0,1744) for S. aureus, and four of them harboured MRSA (4 %, CI: 95 %, CI: 1,5 % - 9 %). The MRSA were detected in horses from three different stables in the same region of one canton and MSSA were detected in horses from five different cantons. All the MRSA isolates were genetically related (ST398-t011-IVa), while the MSSA were diverse (ST1-t127/t398/t1508, ST816-t1294, ST133-t1403, ST30-t012). MRSA showed resistance to penicillin (blaZ), cefoxitin (mecA), trimethoprim (dfrK), gentamicin, kanamycin (aac(6')-Ie - aph(2'')-Ia), and tetracycline (tet(M)). MSSA were resistant to either none or one of the antibiotics tested like penicillin (blaZ) and erythromycin (erm(T)). Virulence genes were more abundant in MSSA than in MRSA. This study provides first insight into the prevalence and type of S. aureus in healthy Swiss horses and reveals a source of strains, which may cause infections in both horses and humans.
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Affiliation(s)
- J I Hurni
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern.,Swiss Institute of Equine Medicine (ISME), Vetsuisse Faculty, University of Bern, and Agroscope, Switzerland
| | - S Kaiser-Thom
- Swiss Institute of Equine Medicine (ISME), Vetsuisse Faculty, University of Bern, and Agroscope, Switzerland
| | - V Gerber
- Swiss Institute of Equine Medicine (ISME), Vetsuisse Faculty, University of Bern, and Agroscope, Switzerland
| | - J E Keller
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern
| | - A Collaud
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern
| | - J Fernandez
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern
| | - S Schwendener
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern
| | - V Perreten
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern
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gonsalves D, Fernandez J, Seral A, Sanchez J, Luguera E, Pajaro I, Parra A, Ferrer C, López L, López S, Carreras A, López E. PD-0654 Surface Guided Radiotherapy accuracy vs tattoos position in 5- fractions breast radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02901-2] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bruno-Galarraga M, Fernandez J, Cueto M, Cattaneo L, Prieto C, Antuña S, Tardivo B, Fontana D, Bó G, Gibbons A. 165 Superovulatory response and embryo production using a bioactive recombinant equine chorionic gonadotrophin in sheep. Reprod Fertil Dev 2021; 34:320-321. [PMID: 35231374 DOI: 10.1071/rdv34n2ab165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- M Bruno-Galarraga
- Instituto Nacional de Tecnología Agropecuaria (INTA EEA Bariloche-IFAB INTA-CONICET), Bariloche, Rio Negro, Argentina
| | - J Fernandez
- Instituto Nacional de Tecnología Agropecuaria (INTA EEA Bariloche-IFAB INTA-CONICET), Bariloche, Rio Negro, Argentina
| | - M Cueto
- Instituto Nacional de Tecnología Agropecuaria (INTA EEA Bariloche-IFAB INTA-CONICET), Bariloche, Rio Negro, Argentina
| | - L Cattaneo
- Universidad Nacional del Litoral, Santa Fe, Argentina
| | - C Prieto
- Universidad Nacional del Litoral, Santa Fe, Argentina
| | - S Antuña
- Biotecnofe S.A., Córdoba, Argentina
| | | | - D Fontana
- Universidad Nacional del Litoral, Santa Fe, Argentina
| | - G Bó
- Universidad Nacional de Villa Maria (UNVM), Córdoba, Argentina
| | - A Gibbons
- Instituto Nacional de Tecnología Agropecuaria (INTA EEA Bariloche-IFAB INTA-CONICET), Bariloche, Rio Negro, Argentina
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16
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Fernandez J, Bruno-Galarraga M, Cattaneo L, Prieto C, Antuña S, Tardivo B, Fontana D, Bó G, Gibbons A, Cueto M. 30 Comparison of two vitrification processes on survival rates of ovine embryos. Reprod Fertil Dev 2021; 34:249-250. [PMID: 35231283 DOI: 10.1071/rdv34n2ab30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- J Fernandez
- Instituto Nacional de Tecnología Agropecuaria (INTA EEA Bariloche-IFAB-INTA-CONICET), Bariloche, Río Negro, Argentina
| | - M Bruno-Galarraga
- Instituto Nacional de Tecnología Agropecuaria (INTA EEA Bariloche-IFAB-INTA-CONICET), Bariloche, Río Negro, Argentina
| | - L Cattaneo
- Universidad Nacional del Litoral (UNL), Esperanza, Santa Fé, Argentina
| | - C Prieto
- Universidad Nacional del Litoral (UNL), Esperanza, Santa Fé, Argentina
| | - S Antuña
- Biotecnofe S.A, El Pozo, Córdoba, Argentina
| | - B Tardivo
- Biotecnofe S.A, El Pozo, Córdoba, Argentina
| | - D Fontana
- Universidad Nacional del Litoral (UNL), Esperanza, Santa Fé, Argentina
| | - G Bó
- Universidad Nacional de Villa María (UNVM), Villa María, Córdoba, Argentina
| | - A Gibbons
- Instituto Nacional de Tecnología Agropecuaria (INTA EEA Bariloche-IFAB-INTA-CONICET), Bariloche, Río Negro, Argentina
| | - M Cueto
- Instituto Nacional de Tecnología Agropecuaria (INTA EEA Bariloche-IFAB-INTA-CONICET), Bariloche, Río Negro, Argentina
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17
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Brimhall B, Whitted M, Windham A, Fernandez J. Laboratory Testing Patterns by Day of Hospital Stay for Medical and Surgical Hospitalizations. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.248] [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: 11/13/2022] Open
Abstract
Abstract
Introduction/Objective
Studies of laboratory test utilization and costs by specific hospital day of stay (DOS) have yet to be widely published. Evaluation of laboratory test use by DOS would be helpful to better predict laboratory test reduction as hospital length of stay (LOS) is shortened, since testing on the final day of hospitalization is likely to differ from the average daily figures.
Methods/Case Report
Using an internal cost accounting database, we evaluated laboratory tests and costs by hospital DOS over one year (2017) at a large health system (N=133,139 hospital days). To evaluate changes over the first days of hospitalization, we set day 1 of hospitalization as a baseline and determined subsequent days as a percentage of day 1 figures. We also calculated laboratory variable cost as a percent of aggregate variable costs per DOS. We limited our analysis to the first week of hospitalization. We employed Medicare Severity Diagnosis Related Groups (MSDRG), used by the US Centers for Medicare and Medicaid Services (CMS), to aggregate hospital encounters into medical or surgical hospitalizations using MSDRG grouping methods.
Results (if a Case Study enter NA)
For medical inpatient stays, average laboratory tests (variable costs) were 10.8 ($74.11) on day 1, 7.7 ($38.53) on day 2, and 5.8 ($23.75) on day 3, with little change over the next four hospital DOS. Laboratory testing, as a percent of day 1 testing, for days 2-7 was: 70.7%, 53.4%, 54.3%, 54.5%, 55.1%, and 54.0%. Laboratory variable costs represented 7.8% of aggregate variable costs on hospital day 1 and declined sequentially over days 2-7: 5.6%, 4.3%, 3.9%, 3.8%, 3.8%, and 3.5%. For surgical hospitalizations, average laboratory tests (variable costs) were 18.2 ($130.02) on day 1, 11.9 ($57.38) on day 2, and 8.4 ($35.32) on day 3. As with medical stays, there was little change over the next four hospital DOS. Laboratory testing, as a percent of day 1 testing, for days 2-7 was: 65.6%, 46.1%, 44.6%, 46.3%, 45.9%, and 44.9%. Laboratory variable costs represented 3.2% of aggregate variable costs on hospital day 1 and remained essentially unchanged over the following days (range 3.3%-3.7%).
Conclusion
Laboratory variable costs are highest on the first day of hospitalization and decline over subsequent days to flatten by day 3.
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Affiliation(s)
- B Brimhall
- Department of Pathology & Laboratory Medicine, University of Texas Health, San Antonio and University Health System, San Antonio, Texas, UNITED STATES
| | - M Whitted
- Department of Pathology & Laboratory Medicine, University of Texas Health, San Antonio and University Health System, San Antonio, Texas, UNITED STATES
| | - A Windham
- Department of Pathology & Laboratory Medicine, University of Texas Health, San Antonio and University Health System, San Antonio, Texas, UNITED STATES
| | - J Fernandez
- University Health System, Department of Finance Decision Support, San Antonio, Texas, UNITED STATES
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Palmeiro E, Ibañez M, Hernández C, Chocarro L, Arasanz H, Bocanegra A, Fernandez J, Santamaria E, Vera R, Smerdou C, Escors D, Kochan G. 24P The STAT3 phosphorylation status discriminates tumor associated populations in myeloid cell tumor-infiltrating model. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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19
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Kaur H, Fernandez J, Locher J, Demark-Wahnefried W. Rural and Urban Differences in Vegetable and Fruit Consumption Among Older Cancer Survivors in the Deep South. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Ulloa S, Bravo C, Ramirez E, Fasce R, Fernandez J. Inactivation of SARS-CoV-2 isolates from lineages B.1.1.7 (Alpha), P.1 (Gamma) and B.1.110 by heating and UV irradiation. J Virol Methods 2021; 295:114216. [PMID: 34171342 PMCID: PMC8219296 DOI: 10.1016/j.jviromet.2021.114216] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 06/19/2021] [Accepted: 06/20/2021] [Indexed: 12/24/2022]
Abstract
Currently, the rapid global spread of SARS-CoV-2 is related to G clade (including GH, GR, GRY and GV clades), which are associated with more than 98 % of sequenced viral isolates worldwide. The unprecedented velocity of spread of SARS-CoV-2 outbreak represents a critical need for prevention strategies. Vaccines are recently being available and antiviral drugs have shown limited efficacy in COVID-19 patients. Thus, it is needed to know how to reduce the infectivity of the virus by different physicochemical conditions in order to prevent exposure to contaminated material. This work describes heating and irradiating UV-C light procedures to reduce the infectivity of SARS-CoV-2 belonging to different three lineages. Results of physicochemical treatment showed no differences among viral lineages. Analytical conditions for efficient inactivation of SARS-CoV-2 were determined.
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Affiliation(s)
- S Ulloa
- Molecular Genetics Sub Department, Institute of Public Health of Chile, Santiago, Chile
| | - C Bravo
- Molecular Genetics Sub Department, Institute of Public Health of Chile, Santiago, Chile
| | - E Ramirez
- Viral Diseases Sub Department, Institute of Public Health of Chile, Santiago, Chile
| | - R Fasce
- Viral Diseases Sub Department, Institute of Public Health of Chile, Santiago, Chile
| | - J Fernandez
- Molecular Genetics Sub Department, Institute of Public Health of Chile, Santiago, Chile.
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21
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Maghfour J, Rietcheck H, Szeto MD, Rundle CW, Sivesind TE, Dellavalle RP, Lio P, Dunnick CA, Fernandez J, Yardley H. Tolerability profile of topical cannabidiol and palmitoylethanolamide: a compilation of single-centre randomized evaluator-blinded clinical and in vitro studies in normal skin. Clin Exp Dermatol 2021; 46:1518-1529. [PMID: 34022073 DOI: 10.1111/ced.14749] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 04/12/2021] [Accepted: 05/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND An increasing number of studies have investigated the adverse effect profile of oral cannabinoids; however, few studies have provided sufficient data on the tolerability of topical cannabinoids in human participants. AIM To assess the tolerability profile of several commercial topical formulations containing cannabidiol (CBD) and palmitoylethanolamide (PEA) on the skin of healthy human participants. METHODS Three human clinical trials and one in vitro study were conducted. The potential for skin irritation, sensitization and phototoxicity of several products, were assessed via patch testing on healthy human skin. The products assessed included two formulations containing CBD and PEA, one containing hemp seed oil and four concentrations of CBD alone. Ocular toxicity was tested using a traditional hen's egg chorioallantoic membrane model with three CBD, PEA and hemp seed oil formulations. RESULTS There was no irritation or sensitization of the products evident via patch testing on healthy participants. Additionally, mild phototoxicity of a hemp seed oil product was found at the 48-h time point compared with the negative control. The in vitro experiment demonstrated comparable effects of cannabinoid products with historically nonirritating products. CONCLUSION These specific formulations of CBD- and PEA-containing products are nonirritating and nonsensitizing in healthy adults, and further encourage similar research assessing their long-term safety and efficacy in human participants with dermatological diseases. There are some limitations to the study: (i) external validity may be limited as formulations from a single manufacturer were used for this study, while vast heterogeneity exists across unregulated, commercial CBD products on the market; and (ii) products were assessed only on normal, nondiseased human skin, and therefore extrapolation to those with dermatological diseases cannot be assumed.
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Affiliation(s)
- J Maghfour
- Department of Dermatology, Henry Ford Health System, Detroit, MI, USA
| | - H Rietcheck
- Dermatology, University of Colorado, Aurora, CO, USA
| | - M D Szeto
- Dermatology, University of Colorado, Aurora, CO, USA
| | - C W Rundle
- Dermatology, University of Colorado, Aurora, CO, USA
| | - T E Sivesind
- Dermatology, University of Colorado, Aurora, CO, USA
| | | | - P Lio
- Department of Dermatology, Northwestern University, Chicago, IL, USA
| | - C A Dunnick
- Dermatology, University of Colorado, Aurora, CO, USA
| | | | - H Yardley
- CQ Science, Denver, CO, USA.,Naturally Curious Consulting, Boulder, CO, USA
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22
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Fernandez J, Sanders H, Henn J, Wilson JM, Malone D, Buoninfante A, Willms M, Chan R, DuMont AL, McLahan C, Grubb K, Romanello A, van den Dobbelsteen G, Torres VJ, Poolman JT. Vaccination with Detoxified Leukocidin AB Reduces Bacterial Load in a Staphylococcus aureus Minipig Deep Surgical Wound Infection Model. J Infect Dis 2021; 225:1460-1470. [PMID: 33895843 PMCID: PMC9016470 DOI: 10.1093/infdis/jiab219] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/19/2021] [Indexed: 12/15/2022] Open
Abstract
Vaccines against Staphylococcus aureus have eluded researchers for >3 decades while the burden of staphylococcal diseases has increased. Early vaccine attempts mainly used rodents to characterize preclinical efficacy, and all subsequently failed in human clinical efficacy trials. More recently, leukocidin AB (LukAB) has gained interest as a vaccine antigen. We developed a minipig deep surgical wound infection model offering 3 independent efficacy readouts: bacterial load at the superficial and at the deep-seated surgical site, and dissemination of bacteria. Due to similarities with humans, minipigs are an attractive option to study novel vaccine candidates. With this model, we characterized the efficacy of a LukAB toxoid as vaccine candidate. Compared to control animals, a 3-log reduction of bacteria at the deep-seated surgical site was observed in LukAB-treated minipigs and dissemination of bacteria was dramatically reduced. Therefore, LukAB toxoids may be a useful addition to S. aureus vaccines and warrant further study.
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Affiliation(s)
| | - H Sanders
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | - J Henn
- Bacterial Vaccines, Spring House, PA, USA
| | | | - D Malone
- Bacterial Vaccines, Spring House, PA, USA
| | - A Buoninfante
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | - M Willms
- Bacterial Vaccines, Spring House, PA, USA
| | - R Chan
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, USA
| | - A L DuMont
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, USA
| | - C McLahan
- In Vivo Sciences, Spring House, PA, USA
| | - K Grubb
- Bacterial Vaccines, Spring House, PA, USA
| | | | | | - V J Torres
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, USA
| | - J T Poolman
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
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23
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Mur T, Sambhu KM, Mahajan A, Payabvash S, Fernandez J, Edwards HA. Choice of imaging modality for pre-treatment staging of head and neck cancer impacts TNM staging. Am J Otolaryngol 2020; 41:102662. [PMID: 32858370 DOI: 10.1016/j.amjoto.2020.102662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE The purpose of this retrospective cohort study was to determine whether there is a difference in the sensitivity of chest computed tomography (CT) versus 18F-fluorodeoxyglucose positron emission tomography with low-dose nonenhanced CT (18F-FDG PET/CT or PET/CT) in the detection of distant metastases in head and neck cancer, within a tertiary care setting. MATERIALS AND METHODS Patients with head and neck cancer, and known distant metastases, who underwent both 18F-FDG PET/CT with integrated low-dose nonenhanced CT and diagnostic chest CT prior to initiation of therapy from 2008 to 2017 were included. Two head and neck radiologists, blinded to all patient information and to each other's readings, reviewed the PET/CT or CT chest images for each patient and identified whether distant metastases were present. No radiologist read both modalities for a single patient. Concordance between imaging modalities was quantitatively analyzed using McNemar's test. RESULTS 27 patients were included. McNemar's mid p-value analysis showed no significant difference in the detection of distant metastases (p = .6875). However, PET/CT detected distant metastases in three patients that chest CT did not, while chest CT identified distant metastatic disease in two patients that were negative on PET/CT. CONCLUSIONS While this study did not identify a statistically significant difference in sensitivity, five patients had distant metastases identified on only one of the two modalities. Use of a single modality would have resulted in inaccurate staging in 7-11% of patients in our study. The use of both modalities offers the greatest accuracy when providing stage-adapted oncologic treatment.
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Affiliation(s)
- Taha Mur
- Department of Otolaryngology, Boston Medical Center, Boston, MA, United States of America
| | | | - Amit Mahajan
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, United States of America
| | - Seyedmehdi Payabvash
- Neuroradiology Section, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, United States of America
| | - Jeyanth Fernandez
- Department of Otolaryngology, Yale New Haven Hospital, New Haven, CT, United States of America
| | - Heather A Edwards
- Department of Otolaryngology, Boston Medical Center, Boston, MA, United States of America; Boston University School of Medicine, Boston, MA, United States of America.
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24
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Ferrando C, Mellado-Artigas R, Gea A, Arruti E, Aldecoa C, Bordell A, Adalia R, Zattera L, Ramasco F, Monedero P, Maseda E, Martínez A, Tamayo G, Mercadal J, Muñoz G, Jacas A, Ángeles G, Castro P, Hernández-Tejero M, Fernandez J, Gómez-Rojo M, Candela Á, Ripollés J, Nieto A, Bassas E, Deiros C, Margarit A, Redondo F, Martín A, García N, Casas P, Morcillo C, Hernández-Sanz M. Patient characteristics, clinical course and factors associated to ICU mortality in critically ill patients infected with SARS-CoV-2 in Spain: A prospective, cohort, multicentre study. Revista Española de Anestesiología y Reanimación (English Edition) 2020. [PMCID: PMC7833676 DOI: 10.1016/j.redare.2020.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background The clinical course of COVID-19 critically ill patients, during their admission in the intensive care unit (UCI), including medical and infectious complications and support therapies, as well as their association with in-ICU mortality has not been fully reported. Objective This study aimed to describe clinical characteristics and clinical course of ICU COVID-19 patients, and to determine risk factors for ICU mortality of COVID-19 patients. Methods Prospective, multicentre, cohort study that enrolled critically ill COVID-19 patients admitted into 30 ICUs from Spain and Andorra. Consecutive patients from March 12th to May 26th, 2020 were enrolled if they had died or were discharged from ICU during the study period. Demographics, symptoms, vital signs, laboratory markers, supportive therapies, pharmacological treatments, medical and infectious complications were reported and compared between deceased and discharged patients. Results A total of 663 patients were included. Overall ICU mortality was 31% (203 patients). At ICU admission non-survivors were more hypoxemic [SpO2 with non-rebreather mask, 90 (IQR 83–93) vs 91 (IQR 87–94); p < 0.001] and with higher sequential organ failure assessment score [SOFA, 7 (IQR 5–9) vs 4 (IQR 3–7); p < 0.001]. Complications were more frequent in non-survivors: acute respiratory distress syndrome (ARDS) (95% vs 89%; p = 0.009), acute kidney injury (AKI) (58% vs 24%; p < 10−16), shock (42% vs 14%; p < 10−13), and arrhythmias (24% vs 11%; p < 10−4). Respiratory super-infection, bloodstream infection and septic shock were higher in non-survivors (33% vs 25%; p = 0.03, 33% vs 23%; p = 0.01 and 15% vs 3%, p = 10−7), respectively. The multivariable regression model showed that age was associated with mortality, with every year increasing risk-of-death by 1% (95%CI: 1–10, p = 0.014). Each 5-point increase in APACHE II independently predicted mortality [OR: 1.508 (1.081, 2.104), p = 0.015]. Patients with AKI [OR: 2.468 (1.628, 3.741), p < 10−4)], cardiac arrest [OR: 11.099 (3.389, 36.353), p = 0.0001], and septic shock [OR: 3.224 (1.486, 6.994), p = 0.002] had an increased risk-of-death. Conclusions Older COVID-19 patients with higher APACHE II scores on admission, those who developed AKI grades II or III and/or septic shock during ICU stay had an increased risk-of-death. ICU mortality was 31%.
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25
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Ulloa S, Bravo C, Parra B, Ramirez E, Acevedo A, Fasce R, Fernandez J. A simple method for SARS-CoV-2 detection by rRT-PCR without the use of a commercial RNA extraction kit. J Virol Methods 2020; 285:113960. [PMID: 32835738 PMCID: PMC7442555 DOI: 10.1016/j.jviromet.2020.113960] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 12/23/2022]
Abstract
The World Health Organization (WHO) has declared a pandemic caused by a new coronavirus named SARS-CoV-2. The growing demand for commercial kits used for automated extraction of SARS-CoV-2 RNA, a key step before rRT-PCR diagnosis, could cause a shortage of stocks that hinders the rapid processing of samples. Although the recommendation is to use automated methods for nucleic acid extraction, alternatives are necessary to replace commercial kits. However, these alternatives should be as reliable as automated methods. This work describes a simple method to detect SARS-CoV-2 from specimens collected in different preservation media. Samples were previously inactivated by heating and precipitating with a PEG/NaCl solution before rRT-PCR assays for Orf1ab, N and S genes. The new method was compared with an automated protocol of nucleic acid extraction. Both procedures showed similar analytical results. Consequently, this simple and inexpensive method is a suitable procedure for laboratory diagnosis of SARS-CoV-2 infection.
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Affiliation(s)
- S Ulloa
- Molecular Genetics Sub Department, Institute of Public Health of Chile, Santiago, Chile
| | - C Bravo
- Molecular Genetics Sub Department, Institute of Public Health of Chile, Santiago, Chile
| | - B Parra
- Molecular Genetics Sub Department, Institute of Public Health of Chile, Santiago, Chile
| | - E Ramirez
- Viral Diseases Sub Department, Institute of Public Health of Chile, Santiago, Chile
| | - A Acevedo
- Viral Diseases Sub Department, Institute of Public Health of Chile, Santiago, Chile
| | - R Fasce
- Viral Diseases Sub Department, Institute of Public Health of Chile, Santiago, Chile
| | - J Fernandez
- Molecular Genetics Sub Department, Institute of Public Health of Chile, Santiago, Chile.
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26
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Labbe D, Abdulshakoor A, Fernandez J. Retrograde vs spot botulinium toxin facial injection. ANN CHIR PLAST ESTH 2020; 66:223-233. [PMID: 32718771 DOI: 10.1016/j.anplas.2020.06.006] [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: 04/20/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND In this study we have based our research on botulinium toxin injection via targeted neuromuscular end plate zones, specifically in muscles with diffuse distribution of the latter. The muscular surface anatomical variety was also taken into consideration with thorough pre-injection examination of every subject. METHOD With consideration of the facial muscles anatomical variation and neuromuscular bundle distribution, we have applied the method of retrograde botulinium toxin injection on a series of 10 patients on the right side of the face with the left side as a control side, it was injected in a regular perpendicular manner in order to conclude the efficacy of targeted motor end zone injection. Using an auto-injecting syringe, we have delivered 6 Allergan units per zone (frontalis, glabellar lines of corrugator supercilii and orbicularis oculi crow's feet). RESULTS On control day 8 we have noticed a more prominent effect mainly on the level of the orbicularis oculi muscle and the corrugator supercilii muscle on 9 out of 10 patients. Nine patients out of 10 needed the delivery of an additional 6 Allergan units per zone on the control side's glabellar lines and crow's feet rhytids. Where 1 out of 10 patients needed the reinjection of the control side on the glabellar lines zone. CONCLUSION The musculature of the face varies when it comes to neuromuscular plate distribution. Muscles with scattered distribution patterns show an optimal response to botulinum toxin injections when delivered in a retrograde manner. This has allowed us to achieve of optimal results while minimizing injection sites and hence pain, the use of lower dosage and hence treatment cost, as well as lowering the unwanted product dissemination to the neighboring mimic muscles.
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Affiliation(s)
- D Labbe
- Hôpital privé Saint-Martin, Caen, France.
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27
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Ferrando C, Mellado-Artigas R, Gea A, Arruti E, Aldecoa C, Bordell A, Adalia R, Zattera L, Ramasco F, Monedero P, Maseda E, Martínez A, Tamayo G, Mercadal J, Muñoz G, Jacas A, Ángeles G, Castro P, Hernández-Tejero M, Fernandez J, Gómez-Rojo M, Candela Á, Ripollés J, Nieto A, Bassas E, Deiros C, Margarit A, Redondo FJ, Martín A, García N, Casas P, Morcillo C, Hernández-Sanz ML. Patient characteristics, clinical course and factors associated to ICU mortality in critically ill patients infected with SARS-CoV-2 in Spain: A prospective, cohort, multicentre study. ACTA ACUST UNITED AC 2020; 67:425-437. [PMID: 32800622 PMCID: PMC7357496 DOI: 10.1016/j.redar.2020.07.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Antecedentes No se ha reportado plenamente la evolución clínica de los pacientes críticos de COVID-19 durante su ingreso en la unidad de cuidados intensivos (UCI), incluyendo las complicaciones médicas e infecciosas y terapias de soporte, así como su asociación con la mortalidad en UCI. Objetivo El objetivo de este estudio es describir las características clínicas y la evolución de los pacientes ingresados en UCI por COVID-19 y determinar los factores de riesgo de la mortalidad en UCI de dichos pacientes. Métodos Estudio prospectivo, multicéntrico y de cohorte, que incluyó a los pacientes críticos de COVID-19 ingresados en 30 UCI de España y Andorra. Se incluyó a los pacientes consecutivos del 12 de marzo al 26 de mayo del 2020 si habían fallecido o habían recibido el alta de la UCI durante el periodo de estudio. Se reportaron los datos demográficos, los síntomas, los signos vitales, los marcadores de laboratorio, las terapias de soporte, terapias farmacológicas y las complicaciones médicas e infecciosas, realizándose una comparación entre los pacientes fallecidos y los pacientes dados de alta. Resultados Se incluyó a un total de 663 pacientes. La mortalidad general en UCI fue del 31% (203 pacientes). Al ingreso en UCI los no supervivientes eran más hipoxémicos (SpO2 con mascarilla de no reinhalación, de 90 [RIC 83-93] vs. 91 [RIC 87-94]; p < 0,001] y con mayor puntuación en la escala SOFA-Evaluación de daño orgánico secuencial (SOFA, 7 [RIC 5-9] vs. 4 [RIC 3-7]; p <0,001]). Las complicaciones fueron más frecuentes en los no supervivientes: síndrome de distrés respiratorio agudo (SDRA) (95% vs. 89%; p = 0,009), insuficiencia renal aguda (IRA) (58% vs. 24%; p < 10–6), shock (42% vs. 14%; p < 10–13) y arritmias (24% vs. 11%; p < 10–4). Las superinfecciones respiratorias, infecciones del torrente sanguíneo y los shock sépticos fueron más frecuentes en los no supervivientes (33% vs. 25%; p = 0,03, 33% vs. 23%; p = 0,01 y 15% vs. 3%, p = 10–7, respectivamente). El modelo de regresión multivariable reflejó que la edad estaba asociada a la mortalidad y que cada año incrementaba el riesgo de muerte en un 1% (IC del 95%: 1-10, p = 0,014). Cada incremento de 5 puntos en la escala APACHE II predijo de manera independiente la mortalidad (odds ratio [OR]: 1,508 [1,081, 2,104], p = 0,015). Los pacientes con IRA (OR: 2,468 [1,628, 3,741], p < 10–4)], paro cardiaco (OR: 11,099 [3,389, 36,353], p = 0,0001] y shock séptico [OR: 3,224 [1,486, 6,994], p= 0,002) tuvieron un riesgo de muerte incrementado. Conclusiones Los pacientes mayores de COVID-19 con puntuaciones APACHE II más altas al ingreso, que desarrollaron IRA en grados ii o iii o shock séptico durante la estancia en UCI tuvieron un riesgo de muerte incrementado. La mortalidad en UCI fue del 31%.
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Affiliation(s)
- C Ferrando
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, España.
| | - R Mellado-Artigas
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España
| | - A Gea
- Departamento de Medicina Preventiva y Salud Pública, Escuela Médica, Universidad de Navarra, Pamplona, España
| | - E Arruti
- Tecnología Ubikare, Bilbao, Vizcaya, España
| | - C Aldecoa
- Departamento de Anestesiología y Cuidados Críticos, Hospital Universitario Río Hortega, Valladolid, España
| | - A Bordell
- Departamento de Anestesiología y Cuidados Críticos, Hospital Universitario Río Hortega, Valladolid, España
| | - R Adalia
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Mar, Barcelona, España
| | - L Zattera
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Mar, Barcelona, España
| | - F Ramasco
- Departamento de Anestesiología y Cuidados Críticos, Hospital La Princesa, Madrid, España
| | - P Monedero
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínica Universidad de Navarra, Pamplona, Navarra, España
| | - E Maseda
- Departamento de Anestesiología y Cuidados Críticos, Hospital Universitario La Paz, Madrid, España
| | - A Martínez
- Departamento de Anestesiología y Cuidados Críticos, Hospital de Cruces, Barakaldo, Vizcaya, España
| | - G Tamayo
- Departamento de Anestesiología y Cuidados Críticos, Hospital de Cruces, Barakaldo, Vizcaya, España
| | - J Mercadal
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España
| | - G Muñoz
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España
| | - A Jacas
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España
| | - G Ángeles
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España
| | - P Castro
- Unidad de Cuidados Intensivos Médicos, Hospital Clínic, Institut D'investigació August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona, España
| | - M Hernández-Tejero
- Unidad Hepática, Hospital Clínic, Universidad de Barcelona, Barcelona, España
| | - J Fernandez
- Unidad Hepática, Hospital Clínic, Universidad de Barcelona, Barcelona, España
| | - M Gómez-Rojo
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Ramón y Cajal, Madrid, España
| | - Á Candela
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Ramón y Cajal, Madrid, España
| | - J Ripollés
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Universitario Infanta Leonor, Madrid, España
| | - A Nieto
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Universitario Infanta Leonor, Madrid, España
| | - E Bassas
- Departamento de Anestesiología y Cuidados Críticos, Hospital San Joan Despí Moises Broggi, Barcelona, España
| | - C Deiros
- Departamento de Anestesiología y Cuidados Críticos, Hospital San Joan Despí Moises Broggi, Barcelona, España
| | - A Margarit
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Mar, Barcelona, España
| | - F J Redondo
- Departamento de Anestesiología y Cuidados Críticos, Hospital Nostra Senyora de Meritxell SAAS, Andorra, Andorra
| | - A Martín
- Departamento de Anestesiología y Cuidados Críticos, Hospital de Ciudad Real, Ciudad Real, España
| | - N García
- Departamento de Anestesiología y Cuidados Críticos, Hospital de Urdúliz, Urdúliz, Vizcaya, España
| | - P Casas
- Departamento de Anestesiología y Cuidados Críticos, Hospital de Terrasa, Terrasa, Barcelona, España
| | - C Morcillo
- Departamento de Anestesiología y Cuidados Críticos, Hospital Universitario a Coruña, A Coruña, España
| | - M L Hernández-Sanz
- Departamento de Anestesiología y Cuidados Críticos, Hospital Sanitas CIMA, Barcelona, España
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Hang T, Hanh T, Anh D. International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2012-2017: Device-associated module. Am J Infect Control 2020; 48:423-432. [PMID: 31676155 DOI: 10.1016/j.ajic.2019.08.023] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS During the 6-year study period, prospective data from 532,483 ICU patients hospitalized in 242 hospitals, for an aggregate of 2,197,304 patient days, were collected through the INICC Surveillance Online System (ISOS). The Centers for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI) were applied. RESULTS Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the medical-surgical ICUs, the pooled central line-associated bloodstream infection rate was higher (5.05 vs 0.8 per 1,000 central line-days); the ventilator-associated pneumonia rate was also higher (14.1 vs 0.9 per 1,000 ventilator-days,), as well as the rate of catheter-associated urinary tract infection (5.1 vs 1.7 per 1,000 catheter-days). From blood cultures samples, frequencies of resistance, such as of Pseudomonas aeruginosa to piperacillin-tazobactam (33.0% vs 18.3%), were also higher. CONCLUSIONS Despite a significant trend toward the reduction in INICC ICUs, DA-HAI rates are still much higher compared with CDC-NHSN's ICUs representing the developed world. It is INICC's main goal to provide basic and cost-effective resources, through the INICC Surveillance Online System to tackle the burden of DA-HAIs effectively.
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Schmitz G, McNeilly C, Hoebee S, Phillips C, Ortega H, Kang C, Blutinger E, Fernandez J, Schneider S. 308 Cardiopulmonary Resuscitation and Skill Retention in Emergency Physicians. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Romero M, Hidalgo F, Ojeda S, Segura J, Suarez De Lezo J, Mazuelos F, Luque A, Lostalo A, Fernandez J, Pan M. P5753Jailed pressure wire to assess the side branch result for bifurcation lesions treated by provisional stenting strategy: iFR as a new index. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0693] [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: 11/12/2022] Open
Abstract
Abstract
Purpose
To analyze the feasibility and efficacy of the jailed pressure wire technique for bifurcation lesions treated by provisional stenting strategy and to assess the physiological side branch (SB) result using instantaneous wave free ratio (iFR).
Methods
Between June 2017 and December 2018, 50 patients who presented a bifurcation lesion considered appropriate for provisional stenting strategy were included in the study. Pressure wire was passed to side branch before treatment. Main vessel (MV) and side branch (SB) was predilated at the operator criteria. iFR determination was obtained in the SB baseline and after MV stenting (leaving the pressure wire jailed). Afterwards, the wire was removed to MV ostium to discard the possibility of drift. SB postdilation was performed if SB iFR was less than 0,89 (according to vessel thresholds established in clinical trials), evaluating the result by a new iFR determination.
Results
The mean age was 64±10 years. Sixteen patients (32%) had diabetes. Clinical presentation was stable angina in 26 patients (52%), non-STEMI in 19 patients (38%) and STEMI (non culprit lesion) in 5 patients (10%). The most frequent bifurcation type according to Medina classifications was 1,1,0 (21 patients, 42%). Seventeen patients (34%) had a true bifurcation lesion. The MV and SB reference diameter was 3,0±0,5 mm and 2,25±0,5 mm respectively. Most of the bifurcations were located at the left anterior descending artery/diagonal branch (27 bifurcations, 54%). Ten patients (20%) presented a distal left main bifurcation. Baseline SB iFR was 0,78±0,2. Under continuous SB iFR monitoring MV stenting was performed by trapping the pressure wire. After MV stenting, the SB iFR changed to 0,90±0,1. We confirmed the presence of drift in 5 patients (10%). In these cases, recalibration of the wire and SB rewiring was performed in 4 cases. In the remaining patient, rewiring was not possible even using specific coronary wires.
According to SB IFR, postdilation was necessary in 14 patients (28%). Final SB iFR was 0,94±0,03. A second stent was not necessary in any patient because final SB iFR was higher than 0.89 in all cases. We observed discordance between angiographic and physiological result in 17 cases (34%). All the wires could be removed. Forty wires (80%) were microscopically analyzed. Some grade of microscopic damage was found in 32 wires (80%), all of them distal to the pressure sensor. However, only one of these wires (2%) presented severe damage, and no case of fracture was observed.
After a mean follow up time of 10±6 months only one patient (2%) presented a major cardiac adverse event (acute coronary syndrome due to voluntary cessation of dual antiplatelet therapy).
Conclusions
The use of jailed pressure wire to monitor SB results for bifurcations treated by provisional stenting seems to be safe. The iFR index seems to provide new physiological information about the significance of the SB stenosis.
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Affiliation(s)
- M Romero
- Reina Sofia Hospital, Cordoba, Spain
| | - F Hidalgo
- Reina Sofia Hospital, Cordoba, Spain
| | - S Ojeda
- Reina Sofia Hospital, Cordoba, Spain
| | - J Segura
- Reina Sofia Hospital, Cordoba, Spain
| | | | | | - A Luque
- Reina Sofia Hospital, Cordoba, Spain
| | - A Lostalo
- Reina Sofia Hospital, Cordoba, Spain
| | | | - M Pan
- Reina Sofia Hospital, Cordoba, Spain
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Fernandez J, Alfaro T, Martine G, Rivera E, Oksenberg S, Pichon J, Fica M. P2.06-24 Mesothelioma Survival in 2 Health Centres in Santiago de Chile. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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32
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Fernandez J, Bruno- Galarraga M, Soto A, de la Sota R, Cueto M, Lacau- Mengido I, Gibbons A. Effect of GnRH or hCG administration on Day 4 post insemination on reproductive performance in Merino sheep of North Patagonia. Theriogenology 2019; 126:63-67. [DOI: 10.1016/j.theriogenology.2018.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 12/02/2018] [Accepted: 12/02/2018] [Indexed: 11/16/2022]
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Falcone A, Fernandez J. The 2019 TOPRA (Organization for Professionals in Regulatory Affairs) Annual Symposium (September 30-October 2, 2019 - Dublin, Ireland). Drugs Today (Barc) 2019; 55:653-659. [DOI: 10.1358/dot.2019.55.10.3084505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kathirgamanathan B, Silva P, Fernandez J. Implication of obesity on motion, posture and internal stress of the foot: an experimental and finite element analysis. Comput Methods Biomech Biomed Engin 2018; 22:47-54. [PMID: 30398076 DOI: 10.1080/10255842.2018.1527320] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Obesity causes increased loading on the foot which can damage the soft tissue and bone ultimately leading to foot problems. Experimental and computational methods were used to analyse the chain of biomechanical changes in the lower limb due to obesity. The experimental study shows some changes in foot posture and gait where obese subjects were more likely to have pronated feet, smaller joint angles in the sagittal and frontal planes, smaller cadence, and smaller stride length. Anatomically correct finite element models generated on obese subjects showed increased and altered internal and plantar stress. Altered foot posture was identified as a key indicator of increased internal stress indicating the importance of foot posture correction.
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Affiliation(s)
- B Kathirgamanathan
- a Department of Electronic and Telecommunication Engineering , University of Moratuwa , Moratuwa , Sri Lanka
| | - P Silva
- a Department of Electronic and Telecommunication Engineering , University of Moratuwa , Moratuwa , Sri Lanka
| | - J Fernandez
- b Auckland Bioengineering Institute , University of Auckland , Auckland , New Zealand.,c Department of Engineering Science , University of Auckland , Auckland , New Zealand
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Dominguez C, Sanchez Cunto M, Chediack V, Gregori Sabelli R, Caceres S, Gonzalez L, Lamberto Y, Vera Sanchez A, Velasquez Lopez P, Cortez E, Romano R, Fernandez J, Villar O, Cunto E. AIDS-related Pneumocystis jirovecci pneumonia in an intensive care unit: a descriptive study. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.4063] [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] Open
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36
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Dominguez C, Cunto MS, Sabelli RG, Fernandez J, Llanos MR, Zbinden FG, Cortez E, Martin P, Lopez PV, Mammoliti G, Rollet R, Chediack V, Cunto E. Clinical features of Clostridium difficile infection in an intensive care unit: from 2009 to 2017. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.4085] [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: 10/28/2022] Open
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37
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Mendez G, Niveyro C, Villamandos S, Apestegui PAV, Fernandez J, Villalba C. Acute vertebral osteomyelitis a descriptive study of a series of 40 cases in a tertiary care hospital. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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38
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Adibe C, Varghese S, Patel K, Erowele G, Birtcher K, Fernandez J. Impact of a Pharmacy-Led Medication History Program In the Emergency Center of an Academic Hospital. Res Social Adm Pharm 2018. [DOI: 10.1016/j.sapharm.2018.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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39
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Gines F, Santos M, Guinot J, Moreno A, Fernandez J, Peña M, Boso C, Tortajada M, Arribas L. OC-0398: HDR brachytherapy boost for ductal carcinoma in situ of the breast with close or positive margins. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30708-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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40
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Kotandeniya D, Seiler CL, Fernandez J, Pujari SS, Curwick L, Murphy K, Wickramaratne S, Yan S, Murphy D, Sham YY, Tretyakova NY. Can 5-methylcytosine analogues with extended alkyl side chains guide DNA methylation? Chem Commun (Camb) 2018; 54:1061-1064. [PMID: 29323674 DOI: 10.1039/c7cc06867k] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
5-Methylcytosine (MeC) is an endogenous modification of DNA that plays a crucial role in DNA-protein interactions, chromatin structure, epigenetic regulation, and DNA repair. MeC is produced via enzymatic methylation of the C-5 position of cytosine by DNA-methyltransferases (DNMT) which use S-adenosylmethionine (SAM) as a cofactor. Hemimethylated CG dinucleotides generated as a result of DNA replication are specifically recognized and methylated by maintenance DNA methyltransferase 1 (DNMT1). The accuracy of DNMT1-mediated methylation is essential for preserving tissue-specific DNA methylation and thus gene expression patterns. In the present study, we synthesized DNA duplexes containing MeC analogues with modified C-5 side chains and examined their ability to guide cytosine methylation by the human DNMT1 protein. We found that the ability of 5-alkylcytosines to direct cytosine methylation decreased with increased alkyl chain length and rigidity (methyl > ethyl > propyl ∼ vinyl). Molecular modeling studies indicated that this loss of activity may be caused by the distorted geometry of the DNA-protein complex in the presence of unnatural alkylcytosines.
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Affiliation(s)
- D Kotandeniya
- Masonic Cancer Center, 2231 6th St SE, Minneapolis, MN 55455, USA.
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41
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Santos A, Fernandez J, Rodriguez S, Dominguez CM, Lominchar MA, Lorenzo D, Romero A. Abatement of chlorinated compounds in groundwater contaminated by HCH wastes using ISCO with alkali activated persulfate. Sci Total Environ 2018; 615:1070-1077. [PMID: 29751410 DOI: 10.1016/j.scitotenv.2017.09.224] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 09/21/2017] [Accepted: 09/21/2017] [Indexed: 06/08/2023]
Abstract
In this work, in situ chemical oxidation (ISCO) with alkali activated persulfate has been tested for the elimination of HCH isomers and other chlorinated compounds in groundwater from Sabiñanigo (Sardas landfill), which was contaminated by solid and liquid wastes illegally dumped in the area by a company producing lindane. Due to the site lithology and the type of pollutants found in groundwater (HCHs and chlorobenzenes) alkali (NaOH) activated persulfate (PS) was selected as oxidant. The influence of variables such as PS concentration (42-200mM) and NaOH:PS molar ratio (2:1 to 4:1) on chlorinated compound abatement has been studied and a kinetic model to predict the composition of all chlorinated organic compounds (COCs) in the aqueous phase with time was obtained. It was found that a fast initial hydrodechlorination reaction took place in which HCH isomers reacted to trichlorobenzenes (mainly 1,2,4 TCB) at pH≥12. Mono-, di-, tri and tetrachlorobenzenes remaining were oxidized without producing aromatic intermediates. At the condition tested a first order kinetic model for COCs and PS concentration was obtained. Zero order alkali concentration was obtained while pH was being kept at 12 for the whole reaction time.
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Affiliation(s)
- A Santos
- Chemical Engineering Department, University Complutense of Madrid, Spain.
| | - J Fernandez
- Department of Agriculture, Livestock and Environment, Government of Aragon, Spain
| | - S Rodriguez
- Chemical Engineering Department, University Complutense of Madrid, Spain
| | - C M Dominguez
- Chemical Engineering Department, University Complutense of Madrid, Spain
| | - M A Lominchar
- Chemical Engineering Department, University Complutense of Madrid, Spain
| | - D Lorenzo
- Chemical Engineering Department, University Complutense of Madrid, Spain
| | - A Romero
- Chemical Engineering Department, University Complutense of Madrid, Spain
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Fernandez J, Bruno- Galarraga M, Soto A, de la Sota R, Cueto M, Lacau I, Gibbons A. Hormonal therapeutic strategy on the induction of accessory corpora lutea in relation to follicle size and on the increase of progesterone in sheep. Theriogenology 2018; 105:184-188. [DOI: 10.1016/j.theriogenology.2017.09.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 09/13/2017] [Accepted: 09/16/2017] [Indexed: 10/18/2022]
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Cueto MI, Fernandez J, Bruno-Galarraga MM, Pereyra-Bonnet F, Gibbons A. 196 Fertilization Rate in Superovulated Criolla Goats Following Artificial Insemination or Natural Mating. Reprod Fertil Dev 2018. [DOI: 10.1071/rdv30n1ab196] [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: 11/23/2022] Open
Abstract
The Criolla breed is a local genetic resource, distributed in Patagonia, Argentina, whose primary production is meat. In the Criolla goat, efforts were made to locate productively superior males and to conserve their genetic material. Studies were carried on the feasibility of obtaining superior offspring through the implementation of embryo transfer programs. We assessed the fertilization rate and embryo production following AI with frozen semen or natural mating in Criolla goats subjected to a superovulation program. During the breeding season (May, 41° S), 26 Criolla goats were treated for oestrus with sponges (60 mg of medroxyprogesterone acetate, Progespon®, Syntex, Buenos Aires, Argentina) placed for 13 days. Goat donors were superovulated with a total of 80 mg of porcine (p)FSH (Folltropin V®, Bioniche, Ontario, Canada) every 12 h in 6 decreasing doses (18, 18, 14, 14, 8, and 8 mg) during the last 3 days of progestagen treatment. A dose of 125 μg of cloprostenol (Estrumate®, Schering-Plough, Quebec, Canada) was given in conjunction with the first dose of pFSH. Oestrus detection was performed every 12 h, starting at 24 h after sponge removal. Females were considered to be in oestrus if they passively accepted buck mounting. Goats were randomly assigned to the following treatments: (1) natural mating (NM, n = 12): donors detected in oestrus were individually mated with one proven fertile buck at oestrus and 12 h post-oestrus; does were remove from the male in between (Conventionally accepted treatment); (2) AI (n = 14): donors detected in oestrus were inseminated 12 ± 2 h after the onset of oestrus by laparoscopy with frozen-thawed semen (200 × 106 spermatozoa) from the same fertile buck. Embryo recovery was done by surgical prepubic laparotomy at Day 8 after sponge removal. Superovulation response was estimated by counting the number of corpora lutea (CL). Analysis of variance was used to compare fertilization rate (total number of embryos recovered for each animal, expressed as a proportion of the total number of embryos/oocytes recovered) and embryo production between treatments. Results were expressed as mean ± SEM. Statistical significance was accepted at P < 0.05. A total of 92.3% goats were recorded in oestrus (24/26) between 24 and 48 h after sponge removal (10 and 14 goats for NM and AI, respectively). An average of 16.6 ± 2.0 CL (range: 2–32) was observed in response to superovulation treatment. The recovery rate of embryos/oocytes was 60.0 ± 6.9%. No statistical difference was observed in the fertilization rate (52.1 ± 12.1 and 68.6 ± 12.1% for AI and NM, respectively) or the number of total (6.8 ± 2.0 and 4.8 ± 2.4 for AI and NM, respectively) and transferable embryos (5.6 ± 1.4 and 4.0 ± 1.7 for AI and NM, respectively) between treatments (P > 0.05). In conclusion, fertilization rates did not differ following laparoscopic insemination with frozen semen compared to natural mating in superovulated Criolla goats.
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Toro MA, Saura M, Fernandez J, Villanueva B. Accuracy of genomic within-family selection in aquaculture breeding programmes. J Anim Breed Genet 2017; 134:256-263. [PMID: 28508478 DOI: 10.1111/jbg.12272] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 11/15/2016] [Accepted: 03/07/2017] [Indexed: 01/27/2023]
Abstract
In aquaculture breeding programmes, selection within families cannot be applied for traits that cannot be recorded on the candidates (e.g., disease resistance or fillet quality). However, this problem can be overcome if genomic evaluation is used. Within-family genomic evaluation has been proposed for these programmes as large family sizes are available and substantial levels of linkage disequilibrium (LD) within families can be attained with a limited number of markers even in populations in global linkage equilibrium. Here, we compare by computer simulation: (i) within-family and population-wide LD; and (ii) the accuracy of within-family genomic selection when genomic evaluations are carried out either at the population level or within families. The population simulated was composed by a varying number of families of full-sibs (half for training and half for testing). The results indicate that, to practice within-family selection, performing the genomic evaluation separately for each family using only molecular information from the family could be recommended for populations either in linkage equilibrium or with a low level of disequilibrium.
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Affiliation(s)
- M A Toro
- Departamento de Producción Agraria, Universidad Politécnica de Madrid, Madrid, Spain
| | - M Saura
- Departamento de Mejora Genética Animal, INIA, Madrid, Spain
| | - J Fernandez
- Departamento de Mejora Genética Animal, INIA, Madrid, Spain
| | - B Villanueva
- Departamento de Mejora Genética Animal, INIA, Madrid, Spain
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Volpei C, Fernandez J, Chignon-Sicard B. [The eyelid-cheek junction]. ANN CHIR PLAST ESTH 2017; 62:435-448. [PMID: 28919134 DOI: 10.1016/j.anplas.2017.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 07/28/2017] [Indexed: 11/18/2022]
Abstract
The eyelid-cheek junction is a key area which generates many comments: from looking tired to looking good or rested, without forgetting charm, beauty, and a youthful appearance. In spite of many interesting medical and surgical procedures, treating this area is sometimes difficult and results are not always up to our expectations. Standardized blepharoplasty, which has often been improperly used, has shown its limits. Since the latest refinements, lipostructure has revolutionised blepharoplasty and serving as a reference, it has become an established technique. Subperiostal mediofacial lift allows outstanding results at the cost of a certain technical aggressiveness. Aesthetic medicine proposes worthy alternative and/or appropriate complementary solutions. Different procedures we dispose of have been reviewed together with their assets and their limits. A codification of therapeutic indications is proposed. The positioning of the eyelid-cheek clinical junction in relation with the low orbital bone rim influences our strategy in choosing the appropriate technique.
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Affiliation(s)
- Ch Volpei
- Chirurgie plastique et esthétique, 88, boulevard de Cimiez, 06000 Nice, France.
| | - J Fernandez
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Pasteur 2, 30, voie Romaine, 06000 Nice, France
| | - B Chignon-Sicard
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Pasteur 2, 30, voie Romaine, 06000 Nice, France
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Grande M, Fernandez J, Dahmani B, Stanel S, Albin N, Guillevin L, Belorgey C, D'Andon A. How to assess a cancer therapy? Feedback from the French HTA body on the ESMO-MCBS. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.064] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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47
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Zapata H, Bustince H, Montes S, Bedregal B, Dimuro G, Takáč Z, Baczyński M, Fernandez J. Interval-valued implications and interval-valued strong equality index with admissible orders. Int J Approx Reason 2017. [DOI: 10.1016/j.ijar.2017.05.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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48
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Correa EM, Osorio J, Osorio A, Fernandez J, Cruz W, Moya E, Rojas P, Brinckmann J, Villar M. The effect of a natural supplement containing glucosinolates, β-sitosterol and citrus flavonoids over menopausal symptoms in postmenopausal women. Maturitas 2017. [DOI: 10.1016/j.maturitas.2017.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Petitjeans P, Kurowski P, Fernandez J, Hoyos M. Instabilités à "l'interface" entre deux fluides miscibles. Émergence d'une tension de surface effective. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp:1999185] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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50
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Efanov JI, Giot JP, Fernandez J, Danino MA. Breast-implant texturing associated with delamination of capsular layers: A histological analysis of the double capsule phenomenon. ANN CHIR PLAST ESTH 2017; 62:196-201. [PMID: 28284510 DOI: 10.1016/j.anplas.2017.02.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 02/05/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Macro-texturing of breast implants was developed with the double goal of improving implant stabilization within the breast cavity and decreasing the rate of capsular contractures. However, recent evidence suggests that double capsular formation, a potentially worrisome phenomenon associated with late seromas and biofilms, occurs with preponderance in macro-textured implants. Our objective was to analyze histologically different regions of double capsules to determine if they are more prone to mechanical movements. METHODS A prospective analysis including patients undergoing second-stage expander to definitive breast-implant reconstruction post-mastectomy was conducted after intraoperative identification of the double capsule phenomenon. Two samples were collected from each capsules around the implant, located centrally and laterally. The specimens were sent for histological analysis by the institution's pathologist. RESULTS In total, 10 patients were identified intraoperatively with partial double capsule phenomenon. Among samples retrieved from the lateral aspect of the breast implant, all were associated with delamination and fractures in the collagen matrix of the double capsules. This phenomenon was not observed in any sample from the dome of the breast. CONCLUSIONS Breast-implant macro-texturing plays an important role on delamination of capsules on lateral portions of the breast, which may have an etiologic role in double capsule formation. Manufacturing implants with macro-texturing on one side and smooth surface on the other could diminish mechanical shear forces responsible for these findings.
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Affiliation(s)
- J I Efanov
- Division of plastic surgery, department of surgery, CHUM Montreal university health center, 1650, Sherbrooke East, Montreal, Quebec, H2L 4M1, Canada
| | - J P Giot
- Division of plastic and maxillo-facial surgery, CHU Grenoble Alpes, avenue Maquis-du-Grésivaudan, 38700 La-Tronche, France
| | - J Fernandez
- Division of plastic, reconstructive and aesthetic surgery, hôpital Saint-Roch, CHU de Nice, 5, rue Pierre-Dévoluy, 06000 Nice, France
| | - M A Danino
- Division of plastic surgery, department of surgery, CHUM Montreal university health center, 1650, Sherbrooke East, Montreal, Quebec, H2L 4M1, Canada.
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