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Peiyao R, Mengjie Y, Xiaogang S, Wenfang H, Danna Z, Yuqun Z, Juan J, Qiang H. Immunogenicity and safety of SARS-CoV-2 vaccine in hemodialysis patients: A systematic review and meta-analysis. Front Public Health 2022; 10:951096. [PMID: 36211647 PMCID: PMC9539993 DOI: 10.3389/fpubh.2022.951096] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/30/2022] [Indexed: 01/24/2023] Open
Abstract
Rationale and objective COVID-19 vaccination is the most effective way to prevent COVID-19. For chronic kidney disease patients on long-term dialysis, there is a lack of evidence on the pros and cons of COVID-19 vaccination. This study was conducted to investigate the immunogenicity and safety of COVID-19 vaccines in patients on dialysis. Methods PubMed, MEDLINE, EMBASE, and the Cochrane Library were systemically searched for cohort, randomized controlled trials (RCTs), and cross-sectional studies. Data on immunogenicity rate, antibody titer, survival rate, new infection rate, adverse events, type of vaccine, and patient characteristics such as age, sex, dialysis vintage, immunosuppression rate, and prevalence of diabetes were extracted and analyzed using REVMAN 5.4 and Stata software. A random effects meta-analysis was used to perform the study. Results We screened 191 records and included 38 studies regarding 5,628 participants. The overall immunogenicity of dialysis patients was 87% (95% CI, 84-89%). The vaccine response rate was 85.1 in hemodialysis patients (HDPs) (1,201 of 1,412) and 97.4% in healthy controls (862 of 885). The serological positivity rate was 82.9% (777 of 937) in infection-naive individuals and 98.4% (570 of 579) in patients with previous infection. The Standard Mean Difference (SMD) of antibody titers in dialysis patients with or without previous COVID-19 infection was 1.14 (95% CI, 0.68-1.61). Subgroup analysis showed that the immunosuppression rate was an influential factor affecting the immunogenicity rate (P < 0.0001). Nine studies reported safety indices, among which four local adverse events and seven system adverse events were documented. Conclusions Vaccination helped dialysis patients achieve effective humoral immunity, with an overall immune efficiency of 87.5%. Dialysis patients may experience various adverse events after vaccination; however, the incidence of malignant events is very low, and no reports of death or acute renal failure after vaccination are available, indicating that vaccine regimens may be necessary. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42022342565, identifier: CRD42022342565.
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Affiliation(s)
- Ren Peiyao
- Second Clinical Medical School, Zhejiang Chinese Medical University, Hangzhou, China,Urology and Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Yu Mengjie
- Urology and Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Shen Xiaogang
- Department of Nephrology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
| | - He Wenfang
- Urology and Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Zheng Danna
- Urology and Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Zeng Yuqun
- Urology and Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China,*Correspondence: Zeng Yuqun
| | - Jin Juan
- Urology and Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China,Jin Juan
| | - He Qiang
- Department of Nephrology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China,He Qiang
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Juan J, Yang HX, Wei YM, Song G, Su RN, Chen X, Yang QH, Yan JY, Xiao M, Li Y, Cui SH, Hu YL, Zhao XL, Fan SR, Feng L, Zhang MH, Ma YY, You ZS, Meng HX, Liu HW, Zhu Y, Wu CF, Cai Y, Hu KJ, Ding HJ. [Effects of interpregnancy interval on pregnancy outcomes of subsequent pregnancy: a multicenter retrospective study]. Zhonghua Fu Chan Ke Za Zhi 2021; 56:161-170. [PMID: 33874710 DOI: 10.3760/cma.j.cn112141-20201010-00767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy. Methods: A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO's recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics. Results: A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant (P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% (OR=1.42, 95%CI: 1.07-1.88, P=0.015), 46% (OR=1.46, 95%CI: 1.13-1.88, P=0.004), and 64% (OR=1.64, 95%CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study (P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age (OR=2.87, 95%CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 (OR=1.59, 95%CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes (OR=1.58, 95%CI: 1.18-2.13, P=0.002) and premature delivery (OR=1.52, 95%CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM (OR=5.34, 95%CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM (OR=1.44, 95%CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia (OR=4.11, 95%CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia (OR=1.46, 95%CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery (OR=1.47, 95%CI: 1.13-1.92, P=0.004). Conclusions: Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.
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Affiliation(s)
- J Juan
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - H X Yang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - Y M Wei
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - G Song
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - R N Su
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - X Chen
- Department of Obstetrics, Tianjin Central Obstetrics and Gynecology Hospital, Tianjin 300052, China
| | - Q H Yang
- Department of Obstetrics, Jinan Maternal and Child Health Hospital, Jinan 250000, China
| | - J Y Yan
- Department of Obstetrics, Fujian Maternal and Child Health Hospital, Fuzhou 350001, China
| | - M Xiao
- Department of Obstetrics, Maternal and Child Hospital of Hubei Province, Wuhan 430070, China
| | - Y Li
- Department of Obstetrics, Dalian Maternity Hospital, Dalian 116033, China
| | - S H Cui
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y L Hu
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - X L Zhao
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - S R Fan
- Department of Obstetrics, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - L Feng
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - M H Zhang
- Department of Obstetrics, Taiyuan Maternal and Child Health Hospital, Taiyuan 030012, China
| | - Y Y Ma
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Z S You
- Department of Obstetrics and Gynecology, Suzhou Jiulong Hospital Affiliated to Shanghai Jiaotong University, Suzhou 320571, China
| | - H X Meng
- Department of Obstetrics, Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010050, China
| | - H W Liu
- Department of Endocrinology, Hainan General Hospital, Haikou 570311, China
| | - Y Zhu
- Department of Obstetrics and Gynecology, Harbin Red Cross Central Hospital, Harbin 150070, China
| | - C F Wu
- Department of Obstetrics, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Y Cai
- Department of Obstetrics and Gynecology, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - K J Hu
- Department of Obstetrics, the Hospital of Shunyi District Beijing, Beijing 101300, China
| | - H J Ding
- Department of Obstetrics, Nanjing Maternal and Child Health Hospital, Nanjing 210000, China
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Noseda Grau E, Román G, Juan J, Compañy AD, Simonetti S. Advance on adsorption of amino-functionalized silica nanocarrier for the delivery of therapeutic ampicillin as drug model. INORG CHEM COMMUN 2021. [DOI: 10.1016/j.inoche.2020.108346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Juan J, Gil MM, Rong Z, Zhang Y, Yang H, Poon LC. Effect of coronavirus disease 2019 (COVID-19) on maternal, perinatal and neonatal outcome: systematic review. Ultrasound Obstet Gynecol 2020; 56:15-27. [PMID: 32430957 PMCID: PMC7276742 DOI: 10.1002/uog.22088] [Citation(s) in RCA: 327] [Impact Index Per Article: 81.8] [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: 05/02/2020] [Revised: 05/17/2020] [Accepted: 05/17/2020] [Indexed: 05/12/2023]
Abstract
OBJECTIVE To evaluate the effect of coronavirus disease 2019 (COVID-19) on maternal, perinatal and neonatal outcome by performing a systematic review of available published literature on pregnancies affected by COVID-19. METHODS We performed a systematic review to evaluate the effect of COVID-19 on pregnancy, perinatal and neonatal outcome. We conducted a comprehensive literature search using PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure Database and Wan Fang Data up to and including 20 April 2020 (studies were identified through PubMed alert after that date). For the search strategy, combinations of the following keywords and medical subject heading (MeSH) terms were used: 'SARS-CoV-2', 'COVID-19', 'coronavirus disease 2019', 'pregnancy', 'gestation', 'maternal', 'mother', 'vertical transmission', 'maternal-fetal transmission', 'intrauterine transmission', 'neonate', 'infant' and 'delivery'. Eligibility criteria included laboratory-confirmed and/or clinically diagnosed COVID-19, patient being pregnant on admission and availability of clinical characteristics, including at least one maternal, perinatal or neonatal outcome. Exclusion criteria were non-peer-reviewed or unpublished reports, unspecified date and location of the study, suspicion of duplicate reporting and unreported maternal or perinatal outcomes. No language restrictions were applied. RESULTS We identified a high number of relevant case reports and case series, but only 24 studies, including a total of 324 pregnant women with COVID-19, met the eligibility criteria and were included in the systematic review. These comprised nine case series (eight consecutive) and 15 case reports. A total of 20 pregnant patients with laboratory-confirmed COVID-19 were included in the case reports. In the combined data from the eight consecutive case series, including 211 (71.5%) cases of laboratory-confirmed and 84 (28.5%) of clinically diagnosed COVID-19, the maternal age ranged from 20 to 44 years and the gestational age on admission ranged from 5 to 41 weeks. The most common symptoms at presentation were fever, cough, dyspnea/shortness of breath, fatigue and myalgia. The rate of severe pneumonia reported amongst the case series ranged from 0% to 14%, with the majority of the cases requiring admission to the intensive care unit. Almost all cases from the case series had positive computed tomography chest findings. All six and 22 cases that had nucleic-acid testing in vaginal mucus and breast milk samples, respectively, were negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Only four cases of spontaneous miscarriage or termination were reported. In the consecutive case series, 219/295 women had delivered at the time of reporting and 78% of them had Cesarean section. The gestational age at delivery ranged from 28 to 41 weeks. Apgar scores at both 1 and 5 min ranged from 7 to 10. Only eight neonates had birth weight < 2500 g and nearly one-third of neonates were transferred to the neonatal intensive care unit. There was one case of neonatal asphyxia and death. In 155 neonates that had nucleic-acid testing in throat swab, all, except three cases, were negative for SARS-CoV-2. There were no cases of maternal death in the eight consecutive case series. Seven maternal deaths, four intrauterine fetal deaths (one with twin pregnancy) and two neonatal deaths (twin pregnancy) were reported in a non-consecutive case series of nine cases with severe COVID-19. In the case reports, two maternal deaths, one neonatal death and two cases of neonatal SARS-CoV-2 infection were reported. CONCLUSIONS Despite the increasing number of published studies on COVID-19 in pregnancy, there are insufficient good-quality data to draw unbiased conclusions with regard to the severity of the disease or specific complications of COVID-19 in pregnant women, as well as vertical transmission, perinatal and neonatal complications. In order to answer specific questions in relation to the impact of COVID-19 on pregnant women and their fetuses, through meaningful good-quality research, we urge researchers and investigators to present complete outcome data and reference previously published cases in their publications, and to record such reporting when the data of a case are entered into one or several registries. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- J. Juan
- Department of Obstetrics and GynaecologyPeking University First HospitalBeijingChina
| | - M. M. Gil
- Obstetrics and Gynecology Department, Hospital Universitario de Torrejón, Torrejón de ArdozMadridSpain
- School of MedicineUniversidad Francisco de Vitoria (UFV), Pozuelo de AlarcónMadridSpain
| | - Z. Rong
- Department of Gynaecology and Obstetrics, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science & TechnologyWuhanChina
| | - Y. Zhang
- Department of Gynaecology and ObstetricsZhongnan Hospital of Wuhan UniversityWuhanChina
- Clinical Medicine Research Center of Prenatal Diagnosis and Birth Health in Hubei ProvinceWuhanChina
| | - H. Yang
- Department of Obstetrics and GynaecologyPeking University First HospitalBeijingChina
| | - L. C. Poon
- Department of Obstetrics and Gynaecology, Prince of Wales HospitalThe Chinese University of Hong KongHong Kong SAR
- Harris Birthright CentreFetal Medicine Research Institute, King's College Hospital, King's College LondonLondonUK
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Lou X, Li Y, Shen H, Juan J, He Q. Physical activity and somatic symptoms among hemodialysis patients: a multi-center study in Zhejiang, China. BMC Nephrol 2019; 20:477. [PMID: 31878896 PMCID: PMC6933661 DOI: 10.1186/s12882-019-1652-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/29/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Somatic symptoms are commonly reported by patients on maintenance hemodialysis. Based on evidence that exercise can improve psychological state among the general population, we aimed to evaluate the effects of physical activity on somatic symptoms specifically in this clinical population. METHODS This was a multicenter, cross-sectional study that included patients receiving hemodialysis treatment ≥3 times per week for > 3 months, aged 18 years or older, and who were willing to complete our study questionnaires and wear a pedometer; they were recruited from four hemodialysis centers in Zhejiang, China. Physical activity was quantified using pedometer data, with somatic symptoms quantified using the Symptom Checklist-90 (SCL-90). Hemodialysis information and blood laboratory tests were obtained from patients' medical record. The score on the somatic dimension of the SCL-90 (S1-score) subdivided into tertiles for analysis: ≤1.17 (Q1), 1.17-1.58 (Q2) and ≥ 1.58 (Q3). A multivariate logistic regression analysis was performed to estimate the crude and adjusted odd ratios (ORs) and 95% confidence intervals (CIs) for the S1- somatic score according to the physical activity level during the last week. For this analysis, patients were stratified in a high and low exercise group using a cutoff of 3000 MET-min/week. Model 1 was adjusted for skinfold thickness of the triceps, upper arm circumference, grip strength, 5-m walking time, and 30-s sit-to-stand test. In model 2, we further adjusted for the leukocyte count, high-sensitivity C-reactive protein level, and albumin level. RESULTS After screening, 320 patients were enrolled into the study group (37.50% male, average age of 58.60 ± 14.2 years and mean average number of steps per day of 3725.92 ± 2663.47). The S1-score (1.51 ± 0.39) was significantly higher for patients than for the normal reference population (P < 0.001). As the S1-score increased, the average number of steps per day decreased, both on dialysis and non-dialysis days. Total physical activity, measured by pedometry, showed the best correlation to S1 scores (r = - 0.813; P < 0.01). The OR of a high S1-score was 1.97 [95% CI, 0.63-4.08] for patients in the low physical activity group. CONCLUSION Higher S1 (somatic symptom) score was related to low physical activity among patients on maintenance hemodialysis.
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Affiliation(s)
- Xiaowei Lou
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310014, People's Republic of China.,Department of Nephrology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, 310014, People's Republic of China.,Peoples' Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China.,Chinese Medical Nephrology Key Laboratory of Zhejiang Province, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Yiwen Li
- Department of Nephrology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, 310014, People's Republic of China.,Peoples' Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China.,Chinese Medical Nephrology Key Laboratory of Zhejiang Province, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Huajuan Shen
- Department of Nephrology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, 310014, People's Republic of China.,Peoples' Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China.,Chinese Medical Nephrology Key Laboratory of Zhejiang Province, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Jin Juan
- Department of Nephrology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, 310014, People's Republic of China.,Peoples' Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China.,Chinese Medical Nephrology Key Laboratory of Zhejiang Province, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Qiang He
- Department of Nephrology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, 310014, People's Republic of China. .,Peoples' Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People's Republic of China. .,Chinese Medical Nephrology Key Laboratory of Zhejiang Province, Hangzhou, Zhejiang, 310014, People's Republic of China.
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Li M, Wu Y, Tian YH, Cao GY, Yao SS, Ai P, Huang Z, Huang C, Wang XW, Cao YY, Xiang X, Juan J, Hu YH. [A Meta-analysis on the relations between short-term exposure to PM(2.5) and both mortality and related emergency visits in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:1394-1401. [PMID: 30453443 DOI: 10.3760/cma.j.issn.0254-6450.2018.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective: To carry out a quantitative estimate that related to the effects of short-term exposure to PM(2.5) on all-cause mortality and emergency visits in China by using the systematic review and Meta-analysis. Methods: We selected all the studies published before March 2018 from China National Knowledge Infrastructure, Wanfang database, PubMed and EMBASE and data on relative risk (RR), excess risk (ER) and their 95%CIs: appeared in these papers were extracted. According to the differences in the size or direction (heterogeneity) of the results, we computed summary estimates of the effect values using a random-effect or fixed effect model. We also conducted the subgroup analysis and Meta-analysis to have assessed the selected studies for the evidence of study bias. Results: A total of 33 original studies, indexed in databases, were identified. Among those studies, 39 sets of data on mortality and 4 sets of data on emergency were valid to show that within the daily concentration range from 47.7 to 176.7 μg/m(3), for 10 μg/m(3) increases in PM(2.5) concentrations, it would increase the daily numbers of deaths by 0.49% (95%CI: 0.39%-0.59%) and 0.30% (95%CI: 0.10%-0.51%) for all-cause deaths and all-cause emergency-room visits, respectively. For subgroup analysis, the combined effect of PM(2.5) in causing short-term all-cause deaths in the northern areas (ER=0.42%, 95%CI: 0.30%-0.54%) seemed lower than that in the southern areas (ER=0.63%, 95%CI: 0.44%-0.82%). The combined effect of PM(2.5) concentration below 75 μg/m(3) (ER=0.50%, 95%CI: 0.37%-0.62%) was higher than that of PM(2.5) concentration ≥75 μg/m(3) (ER=0.39%, 95%CI: 0.26%-0.52%). Conclusion: Within the concentration range from 47.7 to 176.7 μg/m(3), short-term exposure to current level of PM(2.5) might increase both the all-cause daily mortality and daily emergency visits in China.
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Affiliation(s)
- M Li
- Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing 100191, China
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Ferrándiz-Pulido C, Juan J, Pineda V. Pulsatile Supraclavicular Skin Tumor. Actas Dermo-Sifiliográficas (English Edition) 2016. [DOI: 10.1016/j.adengl.2016.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Abstract
The haemodynamic approach for the treatment of varicose veins is a minimally invasive, non-ablative procedure that preserves the saphenous vein. The strategic principles for the implementation of this treatment include fragmentation of the venous pressure column, interruption of the venous segments where reflux originates, preservation of the superficial venous outflow channels to allow adequate drainage of the residual superficial system, and excision of the superficial varicose veins that remain undrained. This treatment modality requires a thorough understanding of the haemodynamic and anatomic rationale on which haemodynamic surgery is construed to tailor a treatment plan individually for each patient. The principles for the implementation of this strategy for the treatment of varicose veins are described here and the results are discussed.
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Affiliation(s)
- J Juan
- Hospital Vall d'Hebron, Barcelona, Spain
| | | | - E Criado
- Division of Vascular Surgery, Department of Surgery, Stony Brook University, New York, USA
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Abstract
The treatment of varicose veins has traditionally been ablative in nature and implemented without intent to improve the haemodynamic condition of the lower extremity veins. Haemodynamic surgery attempts to treat varicose veins by changing the reflux pattern while preserving the most efficient venous drainage channels. To implement this treatment modality it is necessary to have a clear understanding of the physiologic principles and the different reflux patterns that form the basis of haemodynamic surgery. Haemodynamic surgery is an emerging treatment for varicose veins, and has received little attention in the English literature. The rationale, and functional and anatomic basis of haemodynamic surgery for varicose veins are herein described.
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Bahnini A, Cappelli M, Ermini S, Escribano JM, Franceschi C, Juan J, Mendoza E, Pares O, Passariello F, Zamboni P. Re: 'Editor's Choice - Management of Chronic Venous Disease: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)'. Eur J Vasc Endovasc Surg 2016; 52:268-9. [PMID: 27259683 DOI: 10.1016/j.ejvs.2016.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 04/25/2016] [Indexed: 11/16/2022]
Affiliation(s)
- A Bahnini
- Cardio-Vascular Department, American Hospital of Paris Neuilly/seine, Paris, France
| | | | - S Ermini
- Private Vein Surgery, Florence, Italy
| | - J M Escribano
- Department of Vascular Surgery, Val Ebron Hospital, Barcelona, Spain
| | - C Franceschi
- Centre Marie Thérèse Saint Joseph, Paris, France
| | - J Juan
- Department of Surgery, Val Ebron Hospital, Barcelona, Spain
| | | | - O Pares
- Department of Vascular Surgery, General Hospital Vic, Barcelona, Spain
| | - F Passariello
- Passariello Fausto Vasculab Foundation ONLUS, Naples, Italy
| | - P Zamboni
- Vascular Diseases Center, University of Ferrara, Ferrara, Italy.
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Ferrándiz-Pulido C, Juan J, Pineda V. Pulsatile Supraclavicular Skin Tumor. Actas Dermosifiliogr 2016; 107:524. [PMID: 26768316 DOI: 10.1016/j.ad.2015.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/22/2015] [Accepted: 03/28/2015] [Indexed: 11/15/2022] Open
Affiliation(s)
- C Ferrándiz-Pulido
- Servicio de Dermatología, Hospital Universitari Vall d'Hebron, Barcelona, España.
| | - J Juan
- Servicio de Cirugía Vascular, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - V Pineda
- Servicio de Radiodiagnóstico, Hospital Universitari Vall d'Hebron, Barcelona, España
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Llamas S, El Mahmoud S, Gutierrez E, Lopez D, Castillo A, Juan J, Ortiz de Urbina J, Ortega L, Medina J, Ruano R. DI-094 Treatment of pulmonary emphysema associated with ALPHA-1-antitrypsin deficiency. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.268] [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: 11/03/2022] Open
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Jewell E, Juan J, Gardner G, Abu-Rustum N, Brown C, Sonoda Y, Barakat R, Levine D, Leitao M. Detection of sentinel lymph nodes using indocyanine green and near-in- frared fluorescence imaging for gynecological malignancies. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Franceschi C, Zamboni P, Pares O, Juan J, Bahnini A, Mendoza E, Cuaranta R, Passariello F, Cappelli M, Ermini S, Delfrate R. Additional information and comments to the article review citing CHIVA. Phlebology 2012; 27:327; author reply 328. [PMID: 23155154 DOI: 10.1258/phleb.2012.012076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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García-Herranz N, Cabellos O, Álvarez-Velarde F, Sanz J, González-Romero E, Juan J. Nuclear data requirements for the ADS conceptual design EFIT: Uncertainty and sensitivity study. ANN NUCL ENERGY 2010. [DOI: 10.1016/j.anucene.2010.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Quick AN, Lim Y, Loke C, Juan J, Swain M, Herbison P. Moments generated by simple V-bends in nickel titanium wires. Eur J Orthod 2010; 33:457-60. [DOI: 10.1093/ejo/cjq103] [Citation(s) in RCA: 2] [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: 11/12/2022]
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Fischkoff K, Juan J, Saltz L, Riedel E, Weiser MR, Nash G, Temple LK, Paty P, Wong WD, Guillem JG. Timing of failure of resected rectal cancer: What is the appropriate duration of postoperative imaging? J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
OBJECTIVE To determine the diagnostic and clinical significance of C4d accumulation in renal allografts followed by acute rejection. METHODS A total of 158 graft biopsies performed from December 1997 to December 2002 were classified, according to the Banff-97 criteria, into hyperacute rejection (HAR, three cases), acute vascular rejection (AVR, 27), acute cellular rejection (ACR, 24), borderline rejection (BR, 38), acute tubular necrosis (ATN, five), stable graft function (SGF, 30) and baseline kidney (31). Immunohistochemical technique was used to determine the C4d deposition level. RESULTS The percentages of C4d positive in HAR, AVR, ACR, BR, ATN, SGF and baseline kidney groups were 100% (3/3), 77.8% (21/27), 37.5% (9/24), 23.7% (9/38), 0% (0/5), 3.3% (1/30), 0% (0/31), respectively. In acute rejection patients, the peak serum creatinine (sCr) level in C4d(ptc)-positive group (41 cases) was 334.82 +/- 238.37 micromol/L, with that of C4d(ptc)-negative group (47 cases) being 220.20 +/- 176.94 micromol/L (p < 0.01). After treatment, the trough sCr level in C4d(ptc)-positive group and C4d(ptc)-negative group were 176.87 +/- 111.80 and 121.75 +/- 34.59 micromol/L (p < 0.01), respectively. In each AVR, ACR and BR subgroups, the peak sCr level, the trough sCr level, after 3 or 6 months of AR, the sCr level in C4d(ptc)-positive subgroup was higher than that of C4d(ptc)-negative subgroup. There were more resistance against steroid therapy [65.9% (27/41) vs. 36.2% (17/47), p = 0.005] and a higher rate of graft loss [29.3% (12/41) vs. 6.4% (3/47), p = 0.001] in C4d(ptc)-positive group than those of C4d(ptc)-negative group. In each C4d(ptc)-positive subgroup of AVR, ACR and BR the complete reversion was 57.1, 56 and 66.7%, respectively, it is almost same. CONCLUSION The C4d deposition level is of great value in diagnosis of acute rejection caused by humoral immune components. It is a significant predictor of graft survival and will be of great help when treating acute rejection.
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Affiliation(s)
- Chen Jianghua
- Kidney Disease Center of the First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, China.
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Escribano JM, Juan J, Bofill R, Rodríguez-Mori A, Maeso J, Fuentes JM, Matas M. Haemodynamic Strategy for Treatment of Diastolic Anterograde Giacomini Varicose Veins. Eur J Vasc Endovasc Surg 2005; 30:96-101. [PMID: 15933990 DOI: 10.1016/j.ejvs.2005.03.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the diagnosis and outcome of a haemodynamic strategy for the treatment of primary varicose veins associated with anterograde diastolic flow (ADF) in the Giacomini vein (GV). METHODS ADF in the GV, with the escape point located at the saphenopopliteal junction, was demonstrated in 15 patients (15 limbs) by duplex ultrasound. No other escape points were seen in this group. ADF was defined as the flow present in the relaxing phase after isometric contraction of the lower limb, measured in the standing position. Duplex and clinical follow-up was performed prospectively at 1 week, at 1, 3, 6, and 12 months and once per year thereafter, between 1998 and 2001. Surgery consisted of flush division of the GV from the small saphenous vein (SSV) and division of the incompetent collateral veins from the GV. RESULTS GV diameter showed an average reduction from 6 to 4 mm 33 months after surgery. Fourteen patients (93%) showed no symptoms or varicose veins. GV reconnection and recurrent ADF was demonstrated in two patients (13%). CONCLUSIONS ADF is a rare condition associated with primary varicose veins. ADF occurs when there is a closed venovenous shunt with recirculation in the muscular diastole. This implies that, although a part of the circuit is ascendant, the re-entry point must be located downstream to the escape point. Accurate duplex assessment is required to distinguish this atypical haemodynamic condition from an abnormal systolic circuit bypassing a deep vein obstruction. Interruption of the GV above its junction with the SSV abolished ADF with an acceptable rate of recurrences.
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Affiliation(s)
- J M Escribano
- Department of Angiology and Vascular/Endovascular Surgery, Hospital General Vall d'Hebron, UAB, barcelona, Spain.
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Abstract
OBJECTIVE To evaluate the burden of Crohn's disease in Spain. DESIGN Observational, cross-sectional study of patients affected with Crohn's disease who were attended to in hospitals in Spain. METHODS Three structured questionnaires were used: one completed by the gastroenterologists to obtain demographic, clinical and disease activity data; a phone interview to obtain epidemiological and drug utilisation data; and the Spanish version of the Short-Form Health Survey (SF-36). RESULTS The annual cost per patient was estimated at Euro 6808-Euro 2104 from direct medical costs and Euro 4704 from indirect costs. Approximate effect sizes for health-related quality of life were as follows: 0.8 for general health, social function, role functioning--physical and vitality; 0.5 for role functioning--emotional, body pain and mental health; and 0.2 for physical function. CONCLUSION Crohn's disease causes a significant decrease in health-related quality of life for patients and a considerable economic cost to society, mainly due to hospitalisations and loss of productivity. This burden indicates the importance of health programmes and interventions in reducing the heavy impact of the disease on both patients and society.
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Affiliation(s)
- J Juan
- Ediciones Doyma, Barcelona, Spain
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Escribano JM, Juan J, Bofill R, Maeso J, Rodríguez-Mori A, Matas M. Durability of reflux-elimination by a minimal invasive CHIVA procedure on patients with varicose veins. A 3-year prospective case study. Eur J Vasc Endovasc Surg 2003; 25:159-63. [PMID: 12552478 DOI: 10.1053/ejvs.2002.1825] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES to assess the outcome of a conservative and haemodynamic method for insufficient veins on an ambulatory basis (French acronym, "CHIVA") with preservation of the greater saphenous vein (GSV) for treatment of primary varicose veins. METHODS duplex incompetence of the sapheno-femoral junction (SFJ) and the GSV trunk, with the re-entry perforating point located on a GSV tributary was demonstrated in 58 patients with varices (58 limbs). The re-entry point was defined as the perforator, whose compression of the superficial vein above its opening eliminates reflux in the GSV. Duplex scanning was performed preoperatively and at 7 days, and patients were followed prospectively at 1, 3, 6, 12, 24, and 36 months after CHIVA. Operation consisted in flush ligation and division from the GSV of the tributary containing the re-entry perforating vein (no additional high ligation is included). If reflux returned, SFJ interruption was performed in a second surgical procedure. RESULTS the GSV diameter showed an average reduction from 6.6 to 3.9 mm 36 months after surgery. Reflux in the GSV system was demonstrated in all but five (8%) patients. Of the 53 patients with recurrent reflux, 46 underwent SFJ interruption. CONCLUSIONS elimination of reflux in the GSV after the interruption of insufficient collaterals is only temporary.
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Affiliation(s)
- J M Escribano
- Department of Angiology and Vascular/Endovascular Surgery, Hospital General Vall d'Hebron, C/Laforja 26, ático 2a, E-08006 Barcelona, Spain
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Maeso J, Juan J, Escribano J, Allegue NM, Di Matteo A, Gonzalez E, Matas M. Comparison of clinical outcome of stripping and CHIVA for treatment of varicose veins in the lower extremities. Ann Vasc Surg 2001; 15:661-5. [PMID: 11769147 DOI: 10.1007/s10016-001-0009-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The purpose of this nonrandomized case-review study was to compare the outcome of stripping and CHIVA for treatment of varicose veins in the lower extremities in our department. Outcome was evaluated by independent physicians. A total of 85 patients underwent saphenous vein stripping in association with phlebectomy and 90 patients underwent CHIVA cure. The duration of follow-up was 3 years. Study criteria were (1) presence of varicose veins as a cause of failure (1.1% in the CHIVA group vs. 15.3% in the stripping group), (2) appearance of telangiectasia (8.9% in the CHIVA group vs. 65.9% in the stripping group), (3) patient dissatisfaction rate (3.3% in the CHIVA group vs. 16.5% in the stripping group), (4) postoperative symptoms as a cause of failure (1.1% in the CHIVA group vs. 21.2% in the stripping group), and (5) saphenous nerve injury (1 patient in the CHIVA group vs. 16 in the stripping group). Differences between all five criteria were significantly in favor of the CHIVA group as compared to saphenous vein stripping with phlebectomy. Clinical results at 3 years are better for patients treated with CHIVA than stripping with regard to presence of varicose veins, clinical symptoms, presence of telangiectasia, cosmetic satisfaction, and neurologic complications. Data in our series of CHIVA treatments are comparable to those reported in the literature and better than those described in three series of stripping procedures with 3-year follow-up. A prospective randomized study is now underway to confirm these findings.
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Affiliation(s)
- J Maeso
- Vascular/Endovascular Surgery Department, Vall d'Hebron General Hospital, Barcelona, Spain
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Escribano JM, Juan J, Rodríguez Mori A, Bellmunt S, Matas M. [Mobile carotid plaque]. Rev Neurol 2001; 33:836-9. [PMID: 11784986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
INTRODUCTION In the literature only seven cases have been published describing a mobile carotid plaque, and lack of precise description makes it difficult to differentiate these lesions from mobile thrombotic lesions. The natural history of these lesions is not known and their treatment is controversial, although there is a tendency to choose the type of treatment to be given according to the embologenic potential of the lesion. CLINICAL CASES We report two cases with mobile carotid plaques. In both cases diagnosis was made on ultrasound Doppler. The first patient had neurological symptoms and a mobile plaque associated with stenosis of over 70%. Surgical treatment was indicated. The second patient had no neurological symptoms. On ultrasound Doppler studies there was a fragment of mobile plaque in the common carotid artery, in the region of the carotid sinus with stenosis of 30 50%. Distal to this zone, in the bulb of the internal carotid artery there was stenosis of >70%. In this case medical treatment was given in view of deterioration in the patient s general state. Both patients improved. CONCLUSIONS Including our second case, three patients with mobile carotid plaques (neurologically asymptomatic) have now been reported to have made good progress with medical treatment. Until there is more data regarding the natural history of these lesions, they should not be considered to be in themselves sufficient reason for carrying out carotid endarterectomy. The possibility of indicating surgical treatment depends on the degree of carotid stenosis.
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Affiliation(s)
- J M Escribano
- Depto. Angiología y Cirugía Vascular.; Hospital Universitari de la Vall d'Hebron, Barcelona, 08035, España.
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Juan J, Ruiz MA, Arnedo L, Ramos JA, Tornero C. [Fever and skin lesion in 70 year old men with Hodgkin's lymphoma]. Enferm Infecc Microbiol Clin 2001; 19:181-2. [PMID: 11333607 DOI: 10.1016/s0213-005x(01)72601-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- J Juan
- Servicio de Medicina Interna, Hospital Francisco de Borja, Gandía, Valencia
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Fernández V, Bellmunt S, Escribano JM, Juan J, Allegue N, Alvarez-Sabín J, Matas M. [Indications for carotid endarterectomy without arteriography. A validation study using eco-Doppler]. Rev Neurol 2000; 31:412-6. [PMID: 11027090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
INTRODUCTION The possibility of diagnosing carotid stenosis and carrying out surgery without arteriography has increased with the use of different diagnostic methods. The eco-Doppler has been shown to be a useful method, although it requires previous individualised validation. OBJECTIVE We aim to validate our Vascular Diagnostic Laboratory in the diagnosis of stenosis of the carotid bifurcation using eco-Doppler as compared with angiography, and the therapeutic indication thus obtained. PATIENTS AND METHODS We made a prospective study for one year of 62 consecutive patients diagnosed on eco-Doppler as having carotid stenosis of over 70% and subsequent carotid arteriography. The treatment indicated is given, without waiting for the result of the angiography, on clinical evaluation, computerized tomography or cranial magnetic resonance and eco-Doppler, and subsequently on angiography. The degree of correlation of both methods, both for the therapeutic indication and for the degree of stenosis was determined. RESULTS In five cases there was discrepancy and the therapeutic indication was different. Three of these were related to the diagnosis of carotid occlusion and in the other two cases there were bilateral lesions of over 50% on eco-Doppler, which were classified as minor on angiographic study. In the group with stenosis of over 70% with < 50% contralateral stenosis, eco-Doppler showed sensitivity and specificity of 100%, with a kappa correlation index = 1. CONCLUSION It is possible to indicate carotid endarterectomy in patients with unilateral stenosis greater than 70% and contralateral stenosis < 50%, based on the eco-Doppler studies done in our Vascular Diagnostic Laboratory.
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Affiliation(s)
- V Fernández
- Servicio de Angiología, Cirugía Vascular y Endovascular, Hospital General Universitario Vall d'Hebron, Barcelona, España
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Abstract
Silica phytoliths (microscopic remains originating in plant tissues) have been identified on the enamel surface and dental calculus of a sample of teeth selected from well preserved skeletons from a Late Roman necropolis in Tarragona (Spain). Phytoliths were observed by scanning electron microscopy (SEM) and their siliceous nature was confirmed by X-ray microanalysis. The phytoliths were compared to those of soil samples from both the areas of the tombs corresponding to the abdomen and the periphery of the skeletons, and were classified taxonomically by comparison with a large collection of silica particles from modern plants in the Mediterranean area. Most of the phytoliths identified on the enamel and the dental calculus belong to the family of Poaceae, while the phytoliths from the abdominal area belong to Poaceae, Leguminosae, Cyperaceae, and Chenopodiaceae. Results are concordant with archaeological, ecological, and historical data from the same site, and with the human Mediterranean diet. If done properly, the study of phytoliths can provide direct information about the vegetable diet of past human populations, and could be applied to the study of human fossils.
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Affiliation(s)
- C L Fox
- Departmento Biologia Animal, Facultat Biologia, Universitat de Barcelona, Spain
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Abstract
The risk of agranulocytosis associated with anti-arrhythmic drugs has been assessed by studying previous drug exposure of all cases collected through a multicentre surveillance network in a defined geographical area during the period 1980-1988. One hundred and eighty-one patients with agranulocytosis (less than 500 granulocytes mm-3 at least in two different blood counts) were interviewed with a structured questionnaire. Eight cases attributable to anti-arrhythmic drugs were identified, all of them related to aprindine. Data on the consumption of several anti-arrhythmic drugs were identified, all of them related to aprindine. Data on the consumption of several anti-arrhythmic drugs (amiodarone, aprindine, quinidine, propafenone) were obtained in order to estimate the risk of agranulocytosis related with the previous use of these drugs. A relevant risk was identified only for aprindine, of the order of two cases per 1000 patient-years. Our data suggest that the risk of agranulocytosis associated with aprindine is lower than previously found.
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Affiliation(s)
- L Ibáñez
- Servei de Farmacologia Clinica, CS Vall d'Hebron, Barcelona, Spain
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Fernández Valenzuela V, Matas M, Maeso J, Díaz J, Juan J, de Sobregrau RC. [New criteria for the classification of the popliteal artery entrapment syndrome. Our experience with 14 extremities]. Angiologia 1991; 43:69-74, 76. [PMID: 2069271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Authors explain their experiences with eight patients (14 affected limbs) with a popliteal artery entrapment syndrome. Classification, diagnosis and treatment were reviewed. Six limbs, with any malformation and presenting as a unique sign an important hypertrophy of their intern gastrocnemius muscle, couldn't be classified. As a result, a new classification of this pathology is presented being based on the anatomical and arteriographic aspects as well as oh the surgical indication. The important correlation between anomaly, physical complexion typus athletic and sports is noted.
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Affiliation(s)
- V Fernández Valenzuela
- Servicio de Angiología y Cirugía Vascular, Ciudad Sanitaria del Valle de Hebrón, Barcelona, España
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Laporte JR, Carné X, Vidal X, Moreno V, Juan J. Upper gastrointestinal bleeding in relation to previous use of analgesics and non-steroidal anti-inflammatory drugs. Catalan Countries Study on Upper Gastrointestinal Bleeding. Lancet 1991; 337:85-9. [PMID: 1670734 DOI: 10.1016/0140-6736(91)90744-a] [Citation(s) in RCA: 228] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
To assess the risk of upper gastrointestinal bleeding associated with the use of individual non-narcotic analgesics and non-steroidal anti-inflammatory drugs (NSAIDs), a multicentre study of 875 cases of upper gastrointestinal bleeding and 2682 hospital controls was done. With control for confounding factors, the overall odds ratio estimate for aspirin taken at least once during the week before the first symptom was 7.2 (95% confidence interval 5.4-9.6). Non-aspirin NSAIDs associated with upper gastrointestinal bleeding were diclofenac (7.9 [4.3-14.6]), indomethacin (4.9 [2.0-12.2]), naproxen (6.5 [2.2-19.6]), and piroxicam (19.1 [8.2-44.3]). Paracetamol, propyphenazone, and dipyrone did not increase the risk. A previous history of gastrointestinal bleeding or peptic ulcer did not greatly affect odds ratio estimates, which differed according to sex and were higher for younger than for older patients. However, the incidence of upper gastrointestinal bleeding was higher among the elderly.
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Affiliation(s)
- J R Laporte
- Department of Pharmacology, Universitat Autònoma de Barcelona, Spain
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Menéndez I, Rivera H, Morales E, Juan J, Jiménez M. [11q distal trisomy due to a familial 11;18 translocation]. Bol Med Hosp Infant Mex 1990; 47:792-4. [PMID: 2285470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
A seven-month-old boy with a distal trisomy 11q resulting from a maternal t(11;18)(q23;p11) is described. His main clinical features were microbrachycephaly, long philtrum, retracted lower lip, short neck, cardiac septal defect, and psychomotor retardation. It is concluded that the phenotype of the trisomy 11q is independent of the size of the duplication whenever the segment 11q23----qter is involved.
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Affiliation(s)
- I Menéndez
- División de Genética, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco
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Affiliation(s)
- J R Laporte
- Division of Clinical Pharmacology, Universitat Autònoma de Barcelona, Spain
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Monsó E, Vidal R, Riba A, Juan J, Boyé R, Aguadé S. [Pulmonary thromboembolism. Prospective and follow-up clinical study]. Med Clin (Barc) 1987; 89:309-14. [PMID: 3695721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Juan J, Sigaux F, Flandrin G. Automated classification of lymphoid cells. Anal Quant Cytol Histol 1985; 7:38-46. [PMID: 4003963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A morphometric study using a commercially manufactured automated analyzer was carried out on 18,742 circulating blood lymphoid cells obtained from patients suffering from a lymphoid blood disorder and from healthy controls. A sequence of statistical procedures was applied to the multiparameter morphometric data, enabling us to divide up the cell population into classes and to represent a given cell sample by a vector whose coordinates correspond to the distribution of the cells among the different classes (the lymphoid differential count). Automatic classification of the samples was carried out using this model. The groups obtained roughly matched the cytologic diagnosis, even though no diagnostic indications were added to the morphometric data. The lymphoid differential also permits good discrimination between chronic lymphoid leukemia and acute lymphoblastic leukemia. The method, suitable for large data sets, performs a reduction of the data that, because of its flexibility, achieves a compromise between loss of information and ease of application. It appears well suited for multiparameter studies of cell subpopulations whose morphologic features form a continuum and for which prior delimitation of classes is difficult, poorly reproducible or artificial.
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Arqueros J, Navarro J, Carrasco F, Juan J, Santaolaya A. [Utility of laparoscopy associated to the ovaric biopsy in the study of gonadal function (author's transl)]. Rev Esp Obstet Ginecol 1979; 38:165-71. [PMID: 451314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Tapella PA, Fuksman A, Krasnov CM, Buroni JR, Juan J. [Biopsy of pre-scalenus fat using Daniels' technic. Findings on 25 cases]. Prensa Med Argent 1968; 55:569-71. [PMID: 5669162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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