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Moturu A, Mehl SC, Miranda J, Mills J, Rosenfeld E, Naik-Mathuria B. Management of Concurrent Pediatric Blunt Aortic and Traumatic Brain Injury. Am Surg 2023; 89:6235-6237. [PMID: 35969423 DOI: 10.1177/00031348221121541] [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] [Indexed: 11/16/2022]
Abstract
This is the case of a pediatric blunt trauma patient who presented with a concurrent blunt traumatic aortic and severe brain injury. We describe successful simultaneous management of the aortic and brain injury with delayed endovascular repair of the aorta. This report details the importance of multidisciplinary discussion in definitive management of children with these concurrent injuries and the endovascular technical considerations in children.
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Affiliation(s)
- Anoosha Moturu
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Steven C Mehl
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- Department of Surgery, Division of Pediatric Surgery, Texas Children's Hospital, Houston, TX
| | - Jorge Miranda
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- Department of Surgery, Division of Vascular Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Joseph Mills
- Department of Surgery, Division of Vascular Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Eric Rosenfeld
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Bindi Naik-Mathuria
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- Department of Surgery, Division of Pediatric Surgery, Texas Children's Hospital, Houston, TX
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Mehl SC, Moturu A, Miranda J, Mills J, Rosenfeld E, Stapleton G, Naik-Mathuria B. Management of Pediatric Aortic Pseudoaneurysm Due to Penetrating Trauma. Am Surg 2023; 89:5024-5026. [PMID: 37496491 DOI: 10.1177/00031348231192071] [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] [Indexed: 07/28/2023]
Abstract
Due to the increasing frequency of pediatric penetrating trauma, pediatric surgeons need to be prepared to evaluate and manage complex penetrating injuries. In this report, we discuss the endovascular management of a traumatic aortic pseudoaneurym and subsequent bullet retrieval following penetrating chest trauma in a child. The key to successful management included multidisciplinary decision making and use of an expandable covered stent generally used for management of aortic coarctation.
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Affiliation(s)
- Steven C Mehl
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- Department of Surgery, Division of Pediatric Surgery, Texas Children's Hospital, Houston, TX, USA
| | - Anoosha Moturu
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Jorge Miranda
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- Department of Surgery, Division of Vascular Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Joseph Mills
- Department of Surgery, Division of Vascular Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Eric Rosenfeld
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Gary Stapleton
- Department of Pediatrics, Division of Pediatric Cardiology, Texas Children's Hospital, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Bindi Naik-Mathuria
- Department of Surgery, Division of Pediatric Surgery, University of Texas Medical Branch, Galveston, TX, USA
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Miranda J, Caires A, Botelho C, Rodrigues Cernadas J. Anaphylaxis in a Central University Hospital: A 2-Decade Comparison Study. J Investig Allergol Clin Immunol 2023; 33:417-418. [PMID: 36789838 DOI: 10.18176/jiaci.0889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Affiliation(s)
- J Miranda
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - A Caires
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - C Botelho
- Consulta de Imunoalergología, Hospital de Braga EPE, Braga, Portugal
| | - J Rodrigues Cernadas
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
- Unidade de Imunoalergología, Hospital Lusíadas, Porto, Portugal
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Tique-Salleg V, Chevel-Mejia J, Miranda J, Mattar S. Unusual coinfection of Malaria and Hantavirus in the Colombian Caribbean Region. Travel Med Infect Dis 2023; 55:102631. [PMID: 37580000 DOI: 10.1016/j.tmaid.2023.102631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 08/16/2023]
Affiliation(s)
- Vaneza Tique-Salleg
- Universidad de Córdoba, Instituto de investigaciones Biológicas del trópico, Montería, Córdoba, Colombia
| | - Jairo Chevel-Mejia
- MD Internista - Infectologo, jefe de servicio Infectologia, Hospital San Jerónimo de Montería, Montería, Córdoba, Colombia
| | - Jorge Miranda
- Universidad de Córdoba, Instituto de investigaciones Biológicas del trópico, Montería, Córdoba, Colombia
| | - Salim Mattar
- Universidad de Córdoba, Instituto de investigaciones Biológicas del trópico, Montería, Córdoba, Colombia.
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Serrano-Coll H, Arrieta A, Miranda J, López A, Mattar AS, Arrieta G, Mattar S. Case Report: A Case of Sepsis due to Shewanella algae Infection in the Colombian Caribbean. Am J Trop Med Hyg 2023:tpmd220786. [PMID: 37160277 DOI: 10.4269/ajtmh.22-0786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/18/2023] [Indexed: 05/11/2023] Open
Abstract
Shewanella algae is an opportunistic Gram-negative bacillus that inhabits marine ecosystems and can cause sepsis in humans. This case report describes an 80-year-old obese woman with liver cirrhosis who presented with neurological and respiratory impairment. Shewanella algae were isolated in the blood cultures. Due to age and comorbidities, sepsis could be the cause of the patient's fatal outcome. Shewanella algae infection is a risk for immunocompromised people in the tropics.
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Affiliation(s)
- Héctor Serrano-Coll
- Instituto Colombiano de Medicina Tropical, Universidad CES, Medellín, Colombia
| | - Andres Arrieta
- Facultad de Medicina, Universidad del Norte, Barranquilla, Colombia
| | - Jorge Miranda
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Montería, Colombia
| | | | | | - Germán Arrieta
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Montería, Colombia
- Clínica Salud Social, Sincelejo, Colombia
| | - Salim Mattar
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Montería, Colombia
- Clínica Salud Social, Sincelejo, Colombia
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Choi JCB, Miranda J, Greenleaf E, Conte MS, Gerhard-Herman MD, Mills JL, Barshes NR. Lower-extremity pressure, staging, and grading thresholds to identify chronic limb-threatening ischemia. Vasc Med 2023; 28:45-53. [PMID: 36759932 DOI: 10.1177/1358863x221147945] [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: 02/11/2023]
Abstract
INTRODUCTION The Society for Vascular Surgery Threatened Limb Classification System ('WIfI') is used to predict risk of limb loss and identify peripheral artery disease in patients with foot ulcers or gangrene. We estimated the diagnostic sensitivity of multiple clinical and noninvasive arterial parameters to identify chronic limb-threatening ischemia (CLTI). METHODS We performed a single-center review of 100 consecutive patients who underwent angiography for foot gangrene or ulcers. WIfI stages and grades were determined for each patient. Toe, ankle, and brachial pressure measurements were performed by registered vascular technologists. CLTI severity was characterized using Global Limb Anatomic Staging System (GLASS stages) and angiosomes. Medial artery calcification in the foot was quantified on foot radiographs. RESULTS GLASS NA (not applicable), I, II, and III angiographic findings were seen in 21, 21, 23, and 35 patients, respectively. A toe-brachial index < 0.7 and minimum ipsilateral ankle-brachial index < 0.9 performed well in identifying GLASS II and III angiographic findings, with sensitivity rates 97.8% and 91.5%, respectively. The diagnostic accuracy rates of noninvasive measures peaked at 74.7% and 89.3% for identifying GLASS II/III and GLASS I+ angiographic findings, respectively. The presence of medial artery calcification significantly diminished the sensitivity of most noninvasive parameters. CONCLUSIONS The use of alternative noninvasive arterial testing parameters improves sensitivity for detecting PAD. Abnormal noninvasive results should suggest the need for diagnostic angiography to further characterize arterial anatomy of the affected limb. Testing strategies with better accuracy are needed.
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Affiliation(s)
- Justin Chin-Bong Choi
- Michael E. DeBakey Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Jorge Miranda
- Michael E. DeBakey Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Baylor College of Medicine, Houston, TX, USA
| | - Erin Greenleaf
- Michael E. DeBakey Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Michael S Conte
- Division of Vascular & Endovascular Surgery, University of California at San Francisco, San Francisco, CA, USA
| | | | - Joseph L Mills
- Michael E. DeBakey Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Baylor College of Medicine, Houston, TX, USA.,Baylor-St Luke's Medical Center, Houston, TX, USA
| | - Neal R Barshes
- Michael E. DeBakey Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
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Diaz E, Serrano-Coll H, Mattar AS, Miranda J, López A, Arrieta G, Mattar S. Case Report: Septic shock due to Pasteurella multocida in an immunocompetent elderly from a rural area of the Colombian Caribbean. Front Trop Dis 2023. [DOI: 10.3389/fitd.2022.1047842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Pasteurella multocida is a germ known to present opportunistic pathologies in most cases associated with contact with animals or their secretions. Systemic infections are rare and tend to occur in patients with risk factors or those who have contact with animals. A case of P. multocida bacteremia is presented in a 76-year-old male patient from a rural area of the Colombian Caribbean who was admitted due to a neurological condition with no personal history and no relevant epidemiological data. His deterioration was torpid, and he died possibly from P. multocida.
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Berrocal J, Tique-Salleg V, Miranda J, Arrieta G, Echeverri D, Peñate G, Spath D, Mattar AS, Mattar S. Seroprevalence of antibodies against to SARS-CoV 2 in umbilical cord blood in two hospital centers in Córdoba and Sucre, Colombia. J Infect Public Health 2022; 15:1076-1080. [PMID: 36113400 PMCID: PMC9433339 DOI: 10.1016/j.jiph.2022.08.017] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/14/2022] [Accepted: 08/24/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Pregnant women continue to be vulnerable to COVID-19, and their immunosuppressed state could put them at greater risk of developing more severe forms of the disease. In Colombia and Latin America, there are few studies on the immune response of the newborn against SARS-CoV-2. AIM To determine the prevalence of SARS-CoV-2 infection in umbilical cord blood in two hospital centers in Córdoba and Sucre. METHODS Between March and June 2021, a prospective descriptive cross-sectional study was carried out. Two hospitals from the departments of Córdoba and Sucre, located in the Northwest Caribbean area of Colombia, participated. Three hundred sixty umbilical cord blood samples were taken at the two hospitals. A commercial ELISA was performed to detect total IgG, IgM, and IgA antibodies against the N protein of SARS-CoV-2. The ethics committee approved the study of the participating institutions. RESULTS Of 3.291 women who gave birth in the hospital centers included in the study, 360 (11%) participated. Complete clinical data were obtained for 223 women. The mean age of the women was 24 years (range, 15-42). 29.4% (106/360) of the umbilical cord samples had total antibodies against SARS-CoV-2. Pregnant women did not have blood samples taken. 58% of the women were asymptomatic. There was no association between umbilical cord samples, clinical, epidemiological characteristics, and serological response to antibodies to SARS-CoV-2 (p > 0.05). CONCLUSIONS The prevalence of umbilical cord blood samples was 29.4% for total SARS-CoV-2 antibodies. The study provides essential aspects for the epidemiological approach to neonates infected with SARS-CoV-2.
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Affiliation(s)
| | - Vaneza Tique-Salleg
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Colombia.
| | - Jorge Miranda
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Colombia.
| | - German Arrieta
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Clínica Salud Social Sincelejo, Corporación Universitaria del Caribe: (CECAR). Sucre, Colombia.
| | - Daniel Echeverri
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Colombia.
| | | | - Doris Spath
- E.S.E Vida Sinú, Montería, Córdoba, Colombia
| | | | - Salim Mattar
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Colombia.
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Pinto Marin A, Trilla L, Miranda J, Vasudev N, García E, López-Vacas R, Miranda N, Wilson M, López-Camacho E, Pertejo-Fernández A, Lumbreras Herrera M, Brown J, Zapater Moros A, De Velasco Oria G, Castellano Gauna D, González-Peramato M, Espinosa E, Banks R, Fresno-Vara J, Gámez A. 1473P A prognostic microRNA-based signature for relapse risk prediction and definition of therapeutic targets in patients with high-risk localized clear cell renal cell carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Martínez C, Serrano-Coll H, Faccini Á, Contreras V, Galeano K, Botero Y, Herrera Y, Garcia A, Garay E, Rivero R, Contreras H, López Y, Guzmán C, Miranda J, Arrieta G, Mattar S. SARS-CoV-2 in a tropical area of Colombia, a remarkable conversion of presymptomatic to symptomatic people impacts public health. BMC Infect Dis 2022; 22:644. [PMID: 35883062 PMCID: PMC9321267 DOI: 10.1186/s12879-022-07575-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
Background The ability of SARS-CoV-2 to remain in asymptomatic individuals facilitates its dissemination and makes its control difficult. Objective. To establish a cohort of asymptomatic individuals, change to the symptomatic status, and determine the most frequent clinical manifestations. Methods Between April 9 and August 9, 2020, molecular diagnosis of SARS-CoV-2 infection was confirmed in 154 asymptomatic people in contact with subjects diagnosed with COVID-19. Nasopharyngeal swabs were performed on these people in different hospitals in Córdoba, the Caribbean area of Colombia. The genes E, RdRp, and N were amplified with RT-qPCR. Based on the molecular results and the Cq values, the patients were subsequently followed up through telephone calls to verify their health conditions. Results Overall, of 154 asymptomatic individuals, 103 (66.9%) remained asymptomatic, and 51 (33.1%) changed to symptomatic. The most frequent clinical manifestations in young people were anosmia and arthralgia. Adults showed cough, ageusia, and odynophagia; in the elderly were epigastralgia, dyspnea, and headache. Mortality was 8%. Conclusions A proportion of 33% of presymptomatic individuals was found, of which four of them died. This high rate could indicate a silent transmission, contributing significantly to the epidemic associated with SARS-CoV-2. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07575-0.
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Affiliation(s)
- Caty Martínez
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Héctor Serrano-Coll
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia.,Instituto Colombiano de Medicina Tropical-Universidad CES, Medellín, Colombia
| | - Álvaro Faccini
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Verónica Contreras
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Ketty Galeano
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Yesica Botero
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Yonairo Herrera
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Alejandra Garcia
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Evelin Garay
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Ricardo Rivero
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Héctor Contreras
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Yesica López
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Camilo Guzmán
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Jorge Miranda
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Germán Arrieta
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia
| | - Salim Mattar
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Campus Berastegui, Córdoba, Montería, Colombia.
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M M de Souza S, Medeiros-Ribeiro AC, Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Botelho R, Brenol C, Da Silveira DE Carvalho HM, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, De Leon de Lima H, Pereira I, Ohira Gazzeta M, Kakehasi A, Louzada P, Hayata ALS, Pina F, Alves Ferreira M, Balarini L, Silveira IG, Kowalski S, Titton D, Mendonça Da Silva Chakr R, Ranzolin A, Laurindo I, Xavier R. AB1173 INCIDENT CASES OF COVID-19 AND VACCINATION ADHERENCE IN A MULTICENTRIC COHORT OF INFLAMMATORY ARTHRITIS IN BRAZIL. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe SARS-CoV-2 virus has caused a worldwide health crisis. Patients with inflammatory arthritis are at higher risk of hospitalization and death by COVID-19 due to comorbidities or immunosuppressive treatments. Vaccination is one the most important strategies to control the pandemic.ObjectivesTo evaluate the incident cases of SARS-CoV-2 infection in a multicentric cohort of inflammatory arthritis in Brazil.MethodsBiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients with rheumatic diseases starting their first bDMARD or tsDMARD (1). The present analysis is a retrospective evaluation of adult patients with inflammatory arthritis (rheumatoid arthritis – RA, spondylarthritis -SpA and psoriatic arthritis-PsA) that were alive since the beginning of the COVID-19 pandemics in Brazil in February 2020. We evaluated the incidence and severity of COVID-19 infection and the adherence to anti- SARS-CoV-2 vaccines schedules, up to January 2022.ResultsA total of 300 patients were interviewed and 69 (23.0%) reported confirmed anti-SARS-CoV infection and 5 (1.7%) had a second infection. Among known infected patients, 18.8% need hospitalization and oxygen support, 7.2% were admitted at ICU, and 5.8% died. After COVID-19 infection, 31.8% reported worsening of disease activity but only 6.1% had modification in medication due to disease activity. Distribution of cases followed the pattern of waves observed in Brazil (Figure 1). Regarding vaccination, 285 (95%) reported to have received at least one dose of any anti-SARS-CoV-2 vaccine: 43% received the first with the adenovirus ChAdOx1 nCoV-19 (AstraZeneca) adenovirus vaccine, 32% received the Sinovac-CoronaVac inactivated vaccine, 22% received the BNT162b2 (Pfizer-BioNtech) mRNA vaccine and 3% received the BNT162b2 (Pfizer-BioNtech) adenovirus vaccine. Almost all (98.1%) of these patients had already received the second dose of vaccine and after the first and second vaccine doses, 6% and 4% of patients, respectively, reported worsening of articular disease activity, while, after the third dose, no patient reported disease activity worsening.Figure 1.ConclusionDuring the pandemics, patients with inflammatory arthritis had a pattern of distribution of cases very similar to general population. Adherence to vaccination is high and well tolerated.References[1]Bredemeier et al. J Rheumatol 2021;48:1519-27Disclosure of InterestsNone declared
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Miranda J, Barbosa M, Tarelho A, Guedes R. Living on the edge: a review on potential risk factors for suicide in adult attention-deficit/hyperactivity disorder. Eur Psychiatry 2022. [PMCID: PMC9565194 DOI: 10.1192/j.eurpsy.2022.485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms including inattention, hyperactivity and/or impulsivity that commonly persists into adulthood. Suicide is a major cause of death in adult ADHD (aADHD) patients. Suicidality is higher in these patients, in possible relationship to various clinical and socio-demographic factors. Objectives To review the current literature concerning potential risk factors for suicide in aADHD patients. Methods A research was made using the Medline database through the Pubmed search engine, with the following keywords: “adhd”, “suicide”, “risk factors”. Results Comorbid psychiatric disorders (major depressive disorder, sleep disturbances, behavior disorders and addictive disorders) are powerful predictors of suicidal behavior in aADHD. Depression is the most frequent diagnosis among aADHD patients with previous suicide attempts. Subtype (mostly the combined type) and severity of ADHD were also associated with a higher number of prior suicide attempts. Impulsiveness, poor emotional self-regulation, recklessness, persistent hyperactivity, inability to relax, engagement in risk behavior (often found in ADHD), common personality traits in aADHD like low frustration tolerance, maladaptive coping and poor problem-solving, as well as interpersonal relationship problems, were associated with higher suicidality. Financial distress caused by unemployment is associated with higher suicidal behaviors. The suicidality is higher in females, mostly associated to self-concept, whereas in males is typically related to impulsivity. Conclusions Clinicians should be aware of the potential risk factors for suicide in aADHD patients because the early detection of these factors is fundamental to improve the patients’ quality of life and could contribute to the design of more effective treatments. Disclosure No significant relationships.
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Basso A, Youssef L, Nakaki A, Paules C, Miranda J, Casu G, Salazar L, Gratacos E, Eixarch E, Crispi F, Crovetto F. Fetal neurosonography at 31-35 weeks reveals altered cortical development in pre-eclampsia with and without small-for-gestational-age fetus. Ultrasound Obstet Gynecol 2022; 59:737-746. [PMID: 35015926 DOI: 10.1002/uog.24853] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To explore the pattern of fetal cortical development in pregnancies complicated by pre-eclampsia (PE), with and without a small-for-gestational-age (SGA) fetus, compared to uncomplicated pregnancies. METHODS This was a prospective observational study including singleton pregnancies complicated by normotensive SGA (birth weight < 10th centile) (n = 77), PE with an appropriate-for-gestational-age (AGA) fetus (n = 76) or PE with a SGA fetus (n = 67), and 128 uncomplicated pregnancies (normotensive AGA) matched by gestational age at ultrasound. All pregnancies underwent detailed neurosonography, using a transabdominal and transvaginal approach, at 31-35 weeks' gestation to assess the depth of the insula, Sylvian fissure, parieto-occipital sulcus, cingulate sulcus and calcarine sulcus. All measurements were adjusted for biparietal diameter (BPD). In addition, a grading score of cortical development was assigned to each brain structure, ranging from Grade 0 (no development) to Grade 5 (maximum development). Univariate and multiple regression analyses were conducted. RESULTS Similar to findings in previous studies, normotensive pregnancies with a SGA fetus showed significant differences in cortical development compared with controls, with reduced Sylvian fissure depth adjusted for BPD (14.5 ± 2.4 vs 16.6 ± 2.3; P < 0.001) and increased insula depth adjusted for BPD (33.2 ± 2.0 vs 31.8 ± 2.0; P < 0.001). Interestingly, a similar cortical development pattern was observed in PE pregnancies with a SGA fetus and in PE pregnancies with an AGA fetus, manifested by reduced Sylvian fissure depth adjusted for BPD (14.2 ± 2.3 and 14.3 ± 2.3 vs 16.6 ± 2.3; P < 0.001 for both) and greater insula depth adjusted for BPD (33.2 ± 2.1 and 32.8 ± 1.7 vs 31.8 ± 2.0; P < 0.001 for both) compared with controls. No significant differences were observed in parieto-occipital, cingulate sulcus or calcarine sulcus depth across the study groups. The Sylvian fissure was scored as Grade 4 in significantly more (93.2% vs 59.5%) and as Grade 5 in significantly fewer (2.7% vs 37.3%) PE pregnancies with an AGA fetus compared with controls (P < 0.05 for both). These differences remained significant even after statistical adjustment for potential confounders, including ethnicity, low socioeconomic status, nulliparity, chronic hypertension, pregestational diabetes, assisted reproductive technologies, smoking and fetal gender, with the application of Benjamini-Hochberg procedure for multiple comparisons. CONCLUSIONS PE with or without SGA is associated with a differential fetal cortical development pattern which is similar to that described previously in small fetuses. Future research is warranted to elucidate better the mechanism(s) underlying these changes. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- A Basso
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - L Youssef
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - A Nakaki
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - C Paules
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - J Miranda
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - G Casu
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - L Salazar
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - E Gratacos
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - E Eixarch
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - F Crispi
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - F Crovetto
- BCNatal-Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
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Chakr R, Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Medeiros-Ribeiro AC, Botelho R, Brenol C, Da Silveira De Carvalho HM, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, Pereira I, De Leon de Lima H, Ohira Gazzeta M, Kakehasi A, Louzada P, Hayata ALS, Pina F, Lupo C, Balarini L, Silveira I, Schowalski S, Titton D, Ranzolin A, Laurindo I, Xavier R. POS0650 THE IMPACT OF OLD AGE ON THE PERSISTENCE AND SAFETY OF TREATMENT WITH BIOLOGIC AGENTS OR JAK INHIBITORS IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe effect of age on persistence and safety of treatment with biologic disease modifying anti-rheumatic drugs (bDMARDs) in rheumatoid arthritis has been a subject to research interest. Two recently published studies did not observe significantly different survival of treatment with bDMARDs among older age (≥ 65 years) individuals (1,2); incidence of serious adverse events was higher in these patients (2).Objectivesto evaluate association of the age with treatment survival and overall safety among patients receiving one or multiple courses of bDMARDs or targeted synthetic (ts-) DMARDs.MethodsBiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients with rheumatic diseases starting their first bDMARD or tsDMARD (3). The present analysis includes RA patients recruited from Jan 2009 to Oct 2019, followed-up over one or multiple (up to six) courses of treatment necessarily involving a bDMARD or tsDMARD (latest date, Nov 19, 2019). Treatment course is defined as a period during which the medication scheme does not change, except for dose adjustments. Primary outcome was the incidence treatment interruption for any reason (except for pregnancy or disease remission), while interruption due to adverse events (AEs; including death) and due to inefficacy served as secondary outcomes. Incidence of serious adverse events (SAEs) also served as a secondary outcome. Extended (frailty) multivariate Cox proportional hazards models and negative binomial regression with generalized estimating equations (to calculate incidence rate ratios [IRRs]) were used for statistical analyses (both types of analyses including time-varying covariates over multiple courses of treatment).ResultsIn total, 1316 patients (2335 treatment courses, 6508 patient-years [PY]) were enrolled. Of these, 160 patients (643 PY; 237 treatment courses) were ≥ 65 years old, mean age at starting treatment = 71 ± 5 yrs (84% female). Old age was not significantly associated with treatment interruption for any reason, but presented higher risk of interruption due to adverse events (after multivariate adjustment) and lower risk of stopping because of inefficacy (see Table 1). Older patients presented higher incidence of SAEs than younger ones (16.0 vs 8.4/100 PY, respectively; multivariate IRR: 2.06, 95% CI: 1.51 to 2.80, P<0.001). Among old patients, tocilizumab (HR: 2.73, 95% CI: 1.13 to 6.64, P=0.026), etanercept (2.13, 1.12 to 4.07, P=0.022), and infliximab (2.39, 1.19 to 4.79, P=0.014) presented higher risk of treatment termination as compared with adalimumab. In this subgroup (age ≥65 yrs), there was no significant difference in the risk of SAEs between different bDMARDs/tsDMARDs.Table 1.Univariate and multivariate hazard ratios (HRs) of interruption of treatment course comparing older (≥65 years) versus younger patients (reference category). Results are HRs, 95% CIs, and P values.Cause of interruption (n of events)Crude analysisAdjusted covariates*Interruption - any reason (1321)0.96 (0.75 to 1.23), P=0.7601.09 (0.82 to 1.43), P=0.550Interruption - adverse events (368)1.33 (0.75 to 0.89), P=0.1601.59 (1.07 to 2.35), P=0.020Interruption - inefficacy (680)0.56 (0.39 to 0.80), P=0.0020.57 (0.38 to 0.87), P=0.009* Age, baseline DAS28, disease duration, gender, smoking, RF or anti-CCP, previous malignancy, interstitial lung disease, diabetes, hypertension, hypercholesterolemia, renal failure, ischemic cardiomyopathy, COPD, heart failure, concomitant use of each cs-, b-, and tsDMARDs, corticosteroids, starting year, osteoporosis, hepatitis B,C, treatment sequence.ConclusionThe overall risk of treatment interruption with biologic or targeted synthetic DMARDs is not higher in older patients. Higher risk of interruption due to AE was balanced by a lower risk of stopping treatment due to inefficacy. Older patients had a higher incidence of SAEs.References[1]Mathieu et al. Rheumatol Int 2021;41:879-85.[2]Freitas et al. Drugs Aging 2020;37:899-907.[3]Bredemeier et al. J Rheumatol 2021;48:1519-27.Disclosure of InterestsNone declared
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Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Medeiros-Ribeiro AC, Botelho R, Brenol C, Da Silveira DE Carvalho HM, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, De Leon de Lima H, Pereira I, Ohira Gazzeta M, Kakehasi A, Louzada P, Hayata ALS, Pina F, Alves Ferreira M, Balarini L, Silveira IG, Kowalski S, Titton D, Mendonça Da Silva Chakr R, Ranzolin A, Laurindo I, Xavier R. POS0242 THE EFFECT OF ANTIMALARIALS ON THE OVERALL SAFETY AND PERSISTENCE OF TREATMENT WITH BIOLOGIC AGENTS OR JAK INHIBITORS IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundAntimalarials (AM) are frequently part of the initial scheme of conventional synthetic DMARDs in the treatment of rheumatoid arthritis (RA), and have been associated with lower incidence of diabetes and better lipid profile in these patients (1). However, the role of AM in schemes involving biologic (b-) or targeted synthetic (ts-) DMARDs has been much less extensively studied. In addition, a recent large scale study (2) and a consensus article (1) casted doubt on the long-term cardiovascular safety of AM.ObjectivesTo evaluate the association of concomitant use of AM with the overall safety and survival oftreatment course among patients receiving one or multiple courses of bDMARDs or tsDMARDsMethodsBiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients with rheumatic diseases starting their first bDMARD or tsDMARD (3). The present analysis includes RA patients recruited from Jan 2009 to Oct 2019, followed-up over one or multiple (up to six) courses of treatment (latest date, Nov 19, 2019). A treatment course is defined as a period during which the medication scheme does not change. The primary outcome was the incidence of serious adverse events (SAEs). Total and system-specific adverse events (AEs), treatment interruption for any reason, interruption due to AEs and due to inefficacy served as secondary outcomes. Negative binomial regression with generalized estimating equations (to calculate the incidence rate ratios [ÌRRs]) and extended (frailty) Cox proportional hazards models were used for statistical analyses (both types of analyses including time-varying covariates over multiple courses of treatment).ResultsIn total, 1316 patients (2335 treatment courses, 6711 patient-years [PY]) were enrolled. The overall incidence of serious adverse events was 9.2/100 PY. AM were used over 354 courses (1254.5 PY) of therapy. The IRRs for the primary and secondary outcomes are presented in Table 1. AM were also associated with better treatment course survival (Figure 1), reducing the risk of interruption due to AEs (multivariate hazard ratio: 0.56, 95% CI: 0.39 to 0.81, P=0.002) and inefficacy (0.65, 0.48 to 0.87, P=0.003).Figure 1.Table 1.Univariate and multivariate incidence rate ratios (IRRs) of adverse events comparing use versus non-use (reference category) of antimalarials. Results are IRRs, 95% CIs, and P values.Type of adverse event (n of events)Crude analysisAdjusted covariates*Serious adverse events (617)0.60 (0.41 to 0.87), P=0.0070.51 (0.37 to 0.69), P<0.001Any adverse event (3494)0.65 (0.54 to 0.77), P<0.0010.68 (0.57 to 0.81), P<0.001Cardiovascular‡Serious (52)1.04 (0.49 to 2.20), P=0.9241.06 (0.45 to 2.50), P=0.891Total (163)0.90 (0.59 to 1.38), P=0.6420.93 (0.59 to 1.45), P=0.737InfectionsSerious (277)0.78 (0.44 to 1.39), P=0.4040.53 (0.34 to 0.83), P=0.006Total (1400)0.77 (0.61 to 0.98), P=0.0330.75 (0.60 to 0.94), P=0.014Hepatic‡Total (66)0.20 (0.07 to 0.64), P=0.0070.16 (0.04 to 0.57), P=0.005Glicemic control-relatedTotal (34)0.74 (0.29 to 1.92), P=0.5400.73 (0.26 to 2.00), P=0.535DyslipidemiaTotal (83)0.60 (0.31 to 1.13), P=0.1140.55 (0.28 to 1.06), P=0.074*Age, baseline DAS28, disease duration, gender, smoking, seropositivity (RF or anti-CCP), previous malignancy, interstitial lung disease, diabetes, hypertension, hypercholesterolemia, renal failure, ischemic cardiomyopathy, COPD, heart failure, concomitant use of each cs-, b-, and tsDMARDs, corticosteroids, starting year, osteoporosis, hepatitis B and C, and treatment sequence. ‡ Excluding infections.ConclusionAmong RA patients on treatment with bDMARDs or tsDMARDs, concomitant use of antimalarials reduced the incidence of serious and total AEs, including infections and hepatic AEs, and prolonged treatment course survival. No significant increase in the risk of cardiovascular AEs was observed.References[1]Desmarais et al. Arthritis Rheumatol 2021;73:2151-60.[2]Lane et al. Lancet Rheumatol 2020;2:e698–e711[3]Bredemeier et al. J Rheumatol 2021;48:1519-27.Disclosure of InterestsNone declared
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Serrano-Coll H, Miller H, Guzmán C, Rivero R, Gastelbondo B, Miranda J, Galeano K, Montaña-Restrepo J, Mattar S. Effectiveness of the CoronaVac® vaccine in a region of the Colombian Amazon, was herd immunity achieved? Trop Dis Travel Med Vaccines 2022; 8:2. [PMID: 35031076 PMCID: PMC8760104 DOI: 10.1186/s40794-021-00159-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/02/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Currently, more than 4.5 billion doses of SARS-CoV-2 vaccines have been applied worldwide. However, some developing countries are still a long way from achieving herd immunity through vaccination. In some territories, such as the Colombian Amazon, mass immunization strategies have been implemented with the CoronaVac® vaccine. Due to its proximity to Brazil, where one of the variants of interest of SARS-CoV-2 circulates. Objective To determine the effectiveness of the CoronaVac® vaccine in a population of the Colombian Amazon. Methods Between February 24, 2021, and August 10, 2021, a descriptive observational study was carried out in which a population of individuals over 18 years of age immunized with two doses of the CoronaVac® vaccine was evaluated. The study site was in the municipality of Mitú, Vaupés, in southeastern Colombia, a region located in the Amazon bordering Brazil. Results. 99% of the urban population of the Mitú municipality were vaccinated with CoronaVac®. To date, 5.7% of vaccinated individuals have become ill, and only 0.1% of these require hospitalization. One death was attributable to COVID-19 has been reported among vaccinated individuals, and the vaccine has shown 94.3% effectiveness against mild disease and 99.9% against severe infection. Conclusions The herd immunity achieved through mass vaccination in this population has made it possible to reduce the rate of complicated cases and mortality from COVID-19 in this region of the Colombian Amazon. Highlights CoronaVac® has shown 94.3% effectiveness against mild disease and 99.9% against severe infection in this indigenous population. CoronaVac® reduces the mortality rate from 2.2% in 2020 to 0.22% in 2021. The herd immunity was achieved through mass vaccination in this region of the Colombian Amazon.
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Affiliation(s)
- Héctor Serrano-Coll
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Montería, Colombia.,Instituto Colombiano de Medicina Tropical-Universidad CES, Medellín, Colombia
| | | | - Camilo Guzmán
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Montería, Colombia
| | - Ricardo Rivero
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Montería, Colombia
| | - Bertha Gastelbondo
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Montería, Colombia
| | - Jorge Miranda
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Montería, Colombia
| | - Ketty Galeano
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Montería, Colombia
| | | | - Salim Mattar
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Montería, Colombia.
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McAteer C, Sullivan R, McRory C, O’Domhnaill O, Murphy DE, Rehman MA, Muller T, Gallagher M, Miranda J, Parihar V, Mulpeter K. 95 DOCUMENTATION OF URINARY CATHETER INDICATION AND INSERTION PROCEDURE FOR MEDICAL INPATIENTS AT A UNIVERSITY TEACHING HOSPITAL. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.95] [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: 02/25/2023] Open
Abstract
Abstract
Background
Approximately 25% of inpatients have urinary catheters at some point during their hospital stay; over half are deemed inappropriate. This is significant as catheter-associated urinary tract infections (CAUTI) increase morbidity, mortality and length of hospitalisation. Lack of medical documentation and clinician awareness of catheters have been identified as risk factors for inappropriate catheterisation. The aim of this audit was to assess inpatient urinary catheter use among medical inpatients to determine if the indication and insertion procedure were clearly documented.
Methods
The audit was conducted over one day and included all medical inpatients aged 18 years and above. Emergency Department and High Dependency patients were excluded. Data was collected using standardised data collection sheets and involved a review of medical/nursing notes. Data was benchmarked against Health Service Executive guidelines.
Results
27 of 132 medical inpatients (20%) had a urinary catheter in situ on the day of audit. 37% (n = 10) had long-term urinary catheters in situ prior to admission and are not considered further. Of the remaining 63% (n = 17), 9 were female (53%), 8 were male (47%), and the average age was 75 years. Indication was documented in nursing notes for 76% and in medical notes for 53%. Indications included monitoring urinary output (29%), urinary retention (24%), sepsis (18%), comfort (6%) and haematuria (6%). Catheter insertion procedure was documented in nursing notes for 59% and in medical notes for 12%.
Conclusion
One fifth of medical inpatients had urinary catheters on the day of audit. 63% of these patients did not have a catheter prior to admission. Overall medical documentation of catheter indication and insertion procedure is poor. Better documentation would likely improve clinician awareness of their patient’s catheters and prompt earlier review of appropriateness. Education sessions, insertion proforma stickers and catheter review reminder systems are suggested to improve documentation.
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Affiliation(s)
- C McAteer
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - R Sullivan
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - C McRory
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - O O’Domhnaill
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - D E Murphy
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - M A Rehman
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - T Muller
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - M Gallagher
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - J Miranda
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - V Parihar
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - K Mulpeter
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
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Miranda J, Dongarwar D, Salihu HM, Montero-Baker M, Gilani R, Pallister ZS, Mills JL, Chung J. Gender, Racial and Ethnic Disparities in Iatrogenic Vascular Injuries among the Ten Most Frequent Surgical Procedures in the United States. Ann Vasc Surg 2021; 80:18-28. [PMID: 34780954 DOI: 10.1016/j.avsg.2021.09.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/05/2021] [Accepted: 09/21/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Iatrogenic vascular injuries (IaVI's) appear to be increasing, with disparate prevalence across gender, race and ethnicity. We aim to assess the risk of IaVI's across these characteristics. METHODS Using the Nationwide Inpatient Sample for the years 2008 to 2015, we identified rates of IaVI's among the top ten most frequently performed inpatient procedures in the United States. Joint point regression was employed to examine the trends in the rates of IaVI's. We also calculated the adjusted odds ratios for IaVI's using survey logistic regression. RESULTS During the eight-year study period, a total of 29,877,180 procedures were performed (33.6% hip replacement, 14% knee arthroplasty, 11.2% cholecystectomy, 10.3% spinal fusion, 8.9% lysis of adhesions, 8% colorectal resection, 7.9% partial bone excision, 5% appendectomy, 0.6% percutaneous coronary angioplasty, 0.6% laminectomy). A total of 194,031 (0.65%) IaVI's were associated with these procedures. The incidence of IaVI's increased over time with an average annual percentage change (AAPC) of 4.2% (95% CI: 3.1, 5.4; P < 0.01). More females (105,747; 54.5%) than males (88,284; 45.5%) suffered IaVI's during their hospital admission (P < 0.01). Patients 70 years of age and older had the highest incidence of IaVI's (12,244,082; 34.3%; P ≤ 0.01). Among the ten index procedures, Non-Hispanic (NH) Whites underwent the highest proportion of procedures (14.1 procedures/100 hospitalizations; P < 0.01) and cholecystectomy was associated with the highest rate of IaVI's (19.4 per 1000 hospitalizations, P ≤ 0.01). Overall, patients from the lowest income quartile were least likely to suffer IaVI's (0.83 95% CI 0.79-0.88, P < 0.01) compared to the highest income quartile. All form of healthcare coverage increased the odds of IaVI's: Medicaid (1.07 95% CI 1.07-1.13, P < 0.01); Private insurance (1.35 95% CI 1.3-1.39, P < 0.01); Self-pay or no charge (1.45 95% CI 1.38-1.52, P < 0.01). IaVI's increased the odds of in-hospital mortality in all groups (1.25 95% CI 1.14-1.35, P < 0.01) and more pronounced in NH-Blacks (1.51 95% CI 1.15-1.99, P < 0.01). In the overall cohort, urban teaching hospitals observed the highest odds of in-hospital mortality (1.11 95% CI 1.07-1.15, P < 0.01). CONCLUSION Between 2008 to 2015, IaVI's rates for the top ten most frequently performed inpatient procedures increased by 33.6% (4.2% annually; P < 0.01). The elderly, females, and Hispanics more frequently had hospitalizations complicated by IaVI's. Overall, IaVI's independently increased the adjusted odds of mortality by 25%. IaVI's were most fatal among Blacks, about 50% elevated risk of death compared to NH-Whites. These benchmarks will be critical to future efforts to reduce IaVI, and associated healthcare disparities.
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Affiliation(s)
- Jorge Miranda
- Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston Texas
| | - Deepa Dongarwar
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston Texas
| | - Hamisu M Salihu
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston Texas; Department of Family and Community Medicine, Baylor College of Medicine, Houston Texas
| | - Miguel Montero-Baker
- Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston Texas
| | - Ramyar Gilani
- Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston Texas
| | - Zachary S Pallister
- Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston Texas
| | - Joseph L Mills
- Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston Texas
| | - Jayer Chung
- Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston Texas.
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Paules C, Miranda J, Policiano C, Crovetto F, Youssef L, Hahner N, Nakaki A, Crispi F, Gratacós E, Eixarch E. Fetal neurosonography detects differences in cortical development and corpus callosum in late-onset small fetuses. Ultrasound Obstet Gynecol 2021; 58:42-47. [PMID: 33438307 DOI: 10.1002/uog.23592] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/17/2020] [Accepted: 12/24/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore whether neurosonography can detect differences in cortical development and corpus callosal length in late-onset small fetuses subclassified into small-for-gestational age (SGA) or growth restricted (FGR). METHODS This was a prospective cohort study in singleton pregnancies, including normally grown fetuses (birth weight between the 10th and 90th centiles) and late-onset small fetuses (estimated fetal weight < 10th centile, diagnosed after 32 weeks of gestation and confirmed by birth weight < 10th centile). Small fetuses were subclassified into SGA (birth weight between the 3rd and 9th centiles and normal fetoplacental Doppler) and FGR (birth weight < 3rd centile and/or abnormal cerebroplacental ratio and/or abnormal uterine artery Doppler). Neurosonography was performed at 33 ± 1 weeks of gestation to assess the depth of the insula, Sylvian fissure and parieto-occipital sulcus in the axial views and corpus callosal length in the midsagittal plane. Measurements were performed offline using Alma Workstation software and were adjusted by biparietal diameter or cephalic index. Linear regression analysis was used to assess the association between the neurosonographic variables and study group, adjusting for confounding factors such as gender, gestational age at neurosonography, nulliparity and pre-eclampsia. RESULTS In total, 318 fetuses were included, of which 97 were normally grown and 221 were late-onset small fetuses that were further subdivided into late-onset SGA (n = 67) or late-onset FGR (n = 154). Compared to controls, both SGA and FGR cases showed significantly increased insular depth adjusted for biparietal diameter (median (interquartile range), controls 0.329 (0.312-0.342) vs SGA 0.339 (0.321-0.347) vs FGR 0.336 (0.325-0.349); P = 0.006). A linear tendency to reduced Sylvian fissure depth adjusted for biparietal diameter was also observed across the study groups (mean ± SD, controls 0.148 ± 0.021 vs SGA 0.142 ± 0.025 vs FGR 0.139 ± 0.022; P = 0.003). However, differences were significant only between the FGR and control groups. Corpus callosal length adjusted for cephalic index was significantly reduced in FGR cases compared with both controls and SGA cases, while there was no difference between SGA cases and controls (median (interquartile range), controls 0.500 (0.478-0.531) vs SGA 0.502 (0.487-0.526) vs FGR 0.475 (0.447-0.508); P = 0.005). No differences were found in parieto-occipital sulcus depth between the three study groups. CONCLUSION Neurosonography seems to be a sensitive tool to detect subtle structural differences in brain development in late-onset small fetuses. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- C Paules
- BCNatal - Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
- Instituto de Investigación Sanitaria Aragón (IISAragon), Red de Salud Materno Infantil y del Desarrollo (SAMID), RETICS, Instituto de Salud Carlos III (ISCIII), Subdirección General de Evaluación y Fomento de la Investigación y Fondo Europeo de Desarrollo Regional (FEDER), Zaragoza, Spain
| | - J Miranda
- BCNatal - Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
| | - C Policiano
- BCNatal - Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
- Departamento de Obstetrícia, Ginecologia e Medicina da Reproduçao, Hospital Universitário de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - F Crovetto
- BCNatal - Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - L Youssef
- BCNatal - Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - N Hahner
- BCNatal - Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - A Nakaki
- BCNatal - Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - F Crispi
- BCNatal - Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - E Gratacós
- BCNatal - Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - E Eixarch
- BCNatal - Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
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Garay E, Serrano-Coll H, Rivero R, Gastelbondo B, Faccini-Martínez Á, Berrocal J, Pérez A, Badillo M, Martínez-Bravo C, Botero Y, Arrieta G, Calderón A, Galeano K, López Y, Miranda J, Guzmán C, Contreras V, Arosemena A, Contreras H, Brango-Tarra E, Oviedo M, Mattar S. SARS-CoV-2 in eight municipalities of the Colombian tropics: high immunity, clinical and sociodemographic outcomes. Trans R Soc Trop Med Hyg 2021; 116:139-147. [PMID: 34185868 PMCID: PMC8344518 DOI: 10.1093/trstmh/trab094] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/19/2021] [Accepted: 06/11/2021] [Indexed: 12/26/2022] Open
Abstract
Background Serological evaluation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an alternative that allows us to determine the prevalence and dynamics of this infection in populations. The goal of this study was to determine the clinical and sociodemographic dynamics of SARS-CoV-2 infection in a region of the Colombian Caribbean. Methods Between July and November 2020, a cross-sectional observational study was carried out in Córdoba, located in northeast Colombia in the Caribbean area. Eight municipalities with the largest populations were chosen and 2564 blood samples were taken. A commercial enzyme-linked immunosorbent assay was used with the recombinant protein antigen N of SARS-CoV-2. The people included in the study were asked for sociodemographic and clinical data, which were analysed by statistical methods. Results A seroprevalence of 40.8% was obtained for SARS-CoV-2 in the Córdoba region. In the bivariate analysis, no differences were observed in seropositivity against SARS-CoV-2 for gender or age range (p>0.05). Higher seropositivity was found in low socio-economic status and symptomatic patients (p<0.0001). A total of 30.7% of the asymptomatic patients were seropositive for SARS-CoV-2, which could be linked to the spread of this infection. In the multivariate analysis, seroconversion was related to poverty and clinical manifestations such as anosmia and ageusia (p<0.05). Conclusions The high seropositivity in Córdoba is due to widespread SARS-CoV-2 in this population. The relationship between seropositivity and socio-economic status suggests a higher exposure risk to the virus caused by informal economic activities in low-income groups. Clinical manifestations such as anosmia and ageusia could be clinical predictors of infection by the new emergent coronavirus.
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Affiliation(s)
- Evelin Garay
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - Héctor Serrano-Coll
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - Ricardo Rivero
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - Bertha Gastelbondo
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - Álvaro Faccini-Martínez
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - José Berrocal
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - Alejandra Pérez
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - María Badillo
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - Caty Martínez-Bravo
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - Yesica Botero
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - Germán Arrieta
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia.,Clínica Salud Social, Sincelejo, Sucre Colombia
| | - Alfonso Calderón
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - Ketty Galeano
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - Yesica López
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - Jorge Miranda
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - Camilo Guzmán
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - Verónica Contreras
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - Alejandra Arosemena
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | - Héctor Contreras
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
| | | | - Misael Oviedo
- Corporación Colombiana de Investigación Agropecuaria - Agrosavia, Centro de investigación Turipaná, Cereté, Córdoba, Colombia
| | - Salim Mattar
- Instituto de Investigaciones Biológicas del Trópico, Colombia-Universidad de Córdoba, Montería, Colombia
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Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Medeiros A, Botelho R, Brenol C, Negrão Gonçalo Dias D, Carvalho H, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, Pereira I, Ohira Gazzeta M, Maria Kakehasi A, Louzada P, Hayata ALS, Pina F, Lupo C, Balarini L, Silveira I, Kowalski S, Titton D, Chakr R, Ranzolin A, Laurindo I, Xavier R. POS0676 SURVIVAL OF THE FIRST COURSE OF BIOLOGIC OR JAK INHIBITOR IN RHEUMATOID ARTHRITIS: ASSOCIATION WITH THE CHOICE OF AGENT AND CONCOMITANT CONVENTIONAL SYNTHETIC DMARDS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:After failure of conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) in the therapy of rheumatoid arthritis (RA), treatment may be escalated to biologic (bDMARDs) or JAK inhibitors (JAKi) (1). Analysis of drug survival can provide useful information on the effectiveness of these therapeutic schemes.Objectives:to evaluate the association of the choice of therapeutic agent with the survival of treatment course in RA patients receiving their first bDMARD or JAKi.Methods:BiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients starting their first bDMARD/JAKi (2). This analysis includes RA patients recruited from Jan 2009 to Oct 2019, followed-up over the first course of treatment with a bDMARD/JAKi until censoring (latest date, Nov 19, 2019) or occurrence of the outcome of interest. A treatment course is defined as a period during which the medication scheme does not change, except for dose adjustments. The primary outcome was the interruption of treatment course for any reason (except for pregnancy or disease remission); interruption of treatment due to adverse events (AEs) or death and due to inefficacy served as secondary outcomes. Multivariate Cox proportional hazards models were used for analyses.Results:In total, 1177 patients (3800 patient-years [PY]) were enrolled. The overall incidence of treatment interruption was 17.5/100 PY. Adalimumab was the most frequently prescribed agent, followed by infliximab (n= 267). The hazards ratios (HR) of the primary and secondary outcomes are presented in Table 1. Figure 1 compares the survival of treatment curves of different bDMARDs/JAKi.Table 1.Hazard ratios (HR) of interruption of therapy course of each therapeutic agent (the reference category for bDMARDs/ JAKi is infliximab). Results are HR, 95% CIs, and P values*.Agent (number of patients)Interruption for any reason (665 events)Interruption due to adverse events or death (196 events)Interruption due to inefficacy (319 events)Adalimumab (354)0.83 (0.68 to 1.01), P= 0.0620.68 (0.48 to 0.96), P=0.0291.08 (0.80 to 1.44), P=0.621Etanercept (257)0.81 (0.66 to 1.01), P=0.0630.56 (0.37 to 0.83), P=0.0040.93 (0.68 to 1.29), P=0.674Certolizumab (80)0.74 (0.47 to 1.16), P=0.1850.33 (0.13 to 0.86), P=0.0241.32 (0.74 to 2.35), P=0.350Golimumab (53)0.86 (0.53 to 1.38), P=0.5300.46 (0.18 to 1.19), P=0.1111.07 (0.53 to 2.15), P=0.849JAKi (tofacitinib) (59)0.54 (0.30 to 0.99), P=0.0470.19 (0.04 to 0.82), P=0.0260.89 (0.41 to 1.96), P=0.779Rituximab (48)0.87 (0.55 to 1.37), P=0.5400.48 (0.20 to 1.18), P=0.1090.58 (0.26 to 1.34), P=0.205Abatacept (30)0.52 (0.25 to 1.07), P=0.0770.46 (0.14 to 1.56), P=0.2150.46 (0.14 to 1.52), P=0.203Tocilizumab (29)0.29 (0.14 to 0.63), P=0.0020.40 (0.12 to 1.30), P=0.1260.28 (0.09 to 0.90), P=0.033Methotrexate (792)0.95 (0.79 to 1.14), P=0.5610.86 (0.62 to 1.19), P=0.3620.98 (0.75 to 1.28), P=0.860Leflunomide (497)1.17 (0.99 to 1.39), P=0.0611.44 (1.06 to 1.96), P=0.0201.02 (0.80 to 1.30), P=0.856Sulfasalazine (48)1.18 (0.80 to 1.75), P=0.4011.94 (1.07 to 3.54), P=0.0300.85 (0.45 to 1.59), P=0.605Antimalarials (230)0.80 (0.65 to 0.98), P=0.0270.67 (0.45 to 0.99), P=0.0430.67 (0.50 to 0.92), P=0.011* All tests adjusted for other variables presented in the table and for age, baseline DAS28, disease duration, gender, smoking, seropositivity (RF/anti-CCP), previous malignancy, diabetes, hypertension, hypercholesterolemia, renal failure, ischemic cardiomyopathy, COPD, heart failure, use of corticosteroids, starting year, hypercholesterolemia, osteoporosis, hepatitis B and C.Conclusion:In our study, infliximab was related to an overall higher hazard of treatment course interruption than tolicizumab and tofacitinib, and higher hazard of interruption due to AEs than most other anti-TNF agents and tofacitinib. Maintaining antimalarials in patients receiving advanced therapies for RA may reduce interruption of treatment due to inefficacy and AEs.Disclosure of Interests:None declared
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Figueiredo I, Viegas F, Ferreira F, Santos A, Ramos J, Miranda J. Therapeutic interventions for PTSD – current evidence on the the role of psychedelics. Eur Psychiatry 2021. [PMCID: PMC9475922 DOI: 10.1192/j.eurpsy.2021.1209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionPost-traumatic stress disorder (PTSD) is often a chronic condition, despite the existence of evidence-based treatment options. Psychotherapy is the designated first line treatment for PTSD, although high rates of psychiatric and medical comorbidity are observed among patients who have undergone treatment. The psychoactive properties of psychedelics may be of particular interest within a substance-assisted psychotherapy approach, offering new treatment opportunities for this debilitating disorder.ObjectivesReview current evidence, therapeutic context, and possible mechanisms of action of different types of psychedelics in the treatment of PTSD.MethodsLiterature review using Medline database.Results3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy appears to be a potentially safe, effective, and durable treatment for individuals with treatment-refractory PTSD. Based on a small number of studies, ketamine administration appears to result in temporary symptom relief and may, in combination with psychotherapy, lead to lasting reductions in PTSD symptoms. Although these have not yet been investigated in controlled studies, it is known that psilocybin and LSD induce psychoactive effects that could as well contribute to the psychotherapeutic treatment of PTSD.ConclusionsThe use of psychedelic compounds within a substance-assisted psychotherapy framework offers a novel method for pharmacotherapy-psychotherapy integration, although there is still much to learn from both a clinical and neurobiological perspective. It is necessary to generate more data regarding the safety and efficacy of psychedelics, in addition to research on cost-effectiveness, its use in mental health care infrastructure and also regarding the training of specialized therapists.
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Miranda J, Barbosa M, Figueiredo I, Mota P, Tarelho A. Treating addiction with psychedelics - are we waking up? Eur Psychiatry 2021. [PMCID: PMC9480123 DOI: 10.1192/j.eurpsy.2021.1536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionClassic psychedelics have been administered in sacramental contexts since ancient times. They were of prominent interest within psychiatry and neuroscience in the 1950s to 1960s, but the association between classic psychedelics and the emerging counterculture put an end to their research. Modern research with classic psychedelics has reinitiated interest in the treatment of both cancer-related distress and addiction, with really promising results.ObjectivesWe aim to provide a review about history and new insights regarding research with psychedelics specially as treatment of addictive disorders.MethodsA framing analysis of articles, searched on Pubmed (articles between 2010-2020) with the key words: “ psychedelics”, “psilocybin”, “substance use disorder”, “addiction”.ResultsClassic psychedelics are 5HT2AR agonists such as LSD, mescaline, and psilocybin. They were shown to occasion mystical experiences, which are experiences reported throughout different cultures and religions involving a strong sense of unity. These experiences are scientifically important because they appear to cause abrupt and sustained changes in behavior and perception, that can be very useful in the substance use disorder field. From this analysis is possible to understand that the use of psychadelics in the treatment of some addictions is currently at an early stage of research. However, they show interesting results with no clinically significant adverse events when risk individuals are excluded.ConclusionsIn comparison to psychedelic research about cancer-related psychological distress, studies with addictions are less developed, but if they continue to suggest safety and efficacy, may be the use of psilocybin for the treatment of specific addiction can happen in a close future.
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Miranda J, Silva L, Almeida C, Figueiredo I, Machado D, Fonseca S. Bleuler’s a or autism spectrum disorder in adults? Eur Psychiatry 2021. [PMCID: PMC9475672 DOI: 10.1192/j.eurpsy.2021.1442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Introduction Nowadays we know that autism spectrum disorders (ASD) and Schizophrenic spectrum (SS) are different types of disorders in their etiology, symptoms and prognosis, but the clinical distinction is often difficult to make due to comorbidity and similar symptoms. Objectives With this project, the authors intend to explore the differential diagnosis between ASD and SS specially when we talk about critical ages of onset. Methods An analysis of articles searched on Pubmed (articles between 2010-2020) with the key words “adult autism”, “childhood onset schizophrenia”, “childhood psychosis”. Results Early-onset schizophrenia (EOS) is defined as occurring before age 18 years. The condition share key diagnostic symptoms with adult-onset schizophrenia (AOS) but his prognoses and comorbidities differ. Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by difficulties since early childhood across reciprocal social communication and restricted interests and behaviors. ASD is a lifelong neurodevelopmental disorder, however there is a lack of answers and research for adults with ASD. There are shared aspects of odd thinking, rigid behaviors and impaired socialization in schizophrenia and ASD and COS seems to have a strong relationship with ASD, being comorbid in up to 50% of cases. Conclusions Usually the evaluation of the developmental history of the person, prodrome and onset, its course and the presence of positive symptoms of schizophrenia is enough to help us find a diagnosis. Unfortunately, in some ages the conclusion is not so easy to find. However is essential to determine whether the clinical manifestations belong to the autistic spectrum, the schizophrenic or result from comorbidity.
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Gómez-Zorita S, Milton-Laskibar I, Macarulla MT, Biasutto L, Fernández-Quintela A, Miranda J, Lasa A, Segues N, Bujanda L, Portillo MP. Pterostilbene modifies triglyceride metabolism in hepatic steatosis induced by high-fat high-fructose feeding: a comparison with its analog resveratrol. Food Funct 2021; 12:3266-3279. [PMID: 33877249 DOI: 10.1039/d0fo03320k] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The use of phenolic compounds as a new therapeutic approach against NAFLD has emerged recently. In the present study, we aim to study the effect of pterostilbene in the prevention of liver steatosis developed as a consequence of high-fat (saturated) high-fructose feeding, by analysing the changes induced in metabolic pathways involved in triglyceride accumulation. Interestingly, a comparison with the anti-steatotic effect of its parent compound resveratrol will be made for the first time. Rats were distributed into 5 experimental groups and fed either a standard laboratory diet or a high-fat high-fructose diet supplemented with or without pterostilbene (15 or 30 mg per kg per d) or resveratrol (30 mg per kg per d) for 8 weeks. Serum triglyceride, cholesterol, NEFA and transaminase levels were quantified. Liver histological analysis was carried out by haematoxylin-eosin staining. Different pathways involved in liver triglyceride metabolism, including fatty acid synthesis, uptake and oxidation, triglyceride assembly and triglyceride release, were studied. Pterostilbene was shown to partially prevent high-fat high-fructose feeding induced liver steatosis in rats, demonstrating a dose-response pattern. In this dietary model, it acts mainly by reducing de novo lipogenesis and increasing triglyceride assembly and release. Improvement in mitochondrial functionality was also appreciated. At the same dose, the magnitude of pterostilbene and resveratrol induced effects, as well as the involved mechanisms of action, were similar.
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Affiliation(s)
- S Gómez-Zorita
- Nutrition and Obesity group, Department of Nutrition and Food Science, Faculty of Pharmacy, University of the Basque Country (UPV/EHU), Lucio Lascaray Research Center, 01006 Vitoria-Gasteiz, Spain.
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Torrents D, Miranda J, Gauger PC, Ramirez A, Linhares DCL. Effect of PRRSV stability on productive parameters in breeding herds of a swine large integrated group in Spain. Porcine Health Manag 2021; 7:21. [PMID: 33637120 PMCID: PMC7908702 DOI: 10.1186/s40813-021-00203-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In breeding herds, porcine reproductive and respiratory syndrome (PRRS) clinically manifests as increased abortions, number of stillbirths, and pre-weaning mortality, and as a direct consequence, results in a decrease of the number of piglets weaned per sow per year. Breeding farm classification according the PRRS virus (PRRSV) status (unstable or stable) is a key control strategy for this disease. The aim of this study was to evaluate the production improvement related to achieving a PRRSV stable status in breeding herds in Spain. For this purpose, epidemiological and productivity data were collected from a systematic PRRSV monitoring program in 35 breeding herds from a large integrated swine group in Spain. A comparative statistical analysis was conducted using four key production indicators (KPI) between different PRRSV status and a generalized linear mixed model: weekly abortions/1000 sows (ABTHS), born-alive rate (BAR), pre-weaning mortality rate (PWMR), and number of weaned piglets per 1000 sows (WPTHS). RESULTS From the 35 monitored farms during a total period of 58 weeks, we collected 49 to 58 weeks of production data and PRRSV classification status for each study farm. This represented a total of 1997 (741 unstable and 1256 stable) weekly data collected that was eligible for the KPI comparative study. PRRSV stability was associated with significant improvement in BAR (+ 1.10 %, p < 0.001), PWMR (-0.88 %, p < 0.002) and WPTHS (+ 24.52, p < 0.0001). CONCLUSIONS These results demonstrate for the first time the improved production due to achieving PRRSV stability in breeding herds under field conditions in a European country. Increased number of born-alive piglets and a reduction of piglet pre-weaning mortality represents an increase of 1.28 weaned piglets per sow per year if PRRSV stability was achieved and maintained for one-year period in a breeding farm.
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Affiliation(s)
- D Torrents
- Laboratorios Hipra S.A, Av. de la Selva 135, 17170 Amer, Girona, Spain
- Veterinary Diagnostic and Production Animal Medicine, Iowa State University College of Veterinary Medicine, 1800 Christensen Drive Ames, 50011-1134 Iowa, USA
| | - J Miranda
- Laboratorios Hipra S.A, Av. de la Selva 135, 17170 Amer, Girona, Spain
| | - PC Gauger
- Veterinary Diagnostic and Production Animal Medicine, Iowa State University College of Veterinary Medicine, 1800 Christensen Drive Ames, 50011-1134 Iowa, USA
| | - A Ramirez
- Veterinary Diagnostic and Production Animal Medicine, Iowa State University College of Veterinary Medicine, 1800 Christensen Drive Ames, 50011-1134 Iowa, USA
| | - DCL Linhares
- Veterinary Diagnostic and Production Animal Medicine, Iowa State University College of Veterinary Medicine, 1800 Christensen Drive Ames, 50011-1134 Iowa, USA
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Mattar S, Martinez-Bravo C, Rivero R, Contreras H, Faccini-Martínez ÁA, Guzman-Teran C, Galeano K, Alvis-Guzman N, Contreras V, Arrieta G, Gonzalez-Tous M, Miranda J, Ospina M, Camargo-Assis F, Mercado-Reyes M, Garay E, Garcia-Perez A, Lopez Y, Tique V. Epidemiological and viral features of a cohort of SARS-CoV-2 symptomatic and asymptomatic individuals in an area of the Colombian Caribbean. Ann Clin Microbiol Antimicrob 2020; 19:58. [PMID: 33287846 PMCID: PMC7720255 DOI: 10.1186/s12941-020-00397-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 11/12/2020] [Indexed: 12/16/2022] Open
Abstract
Background Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) is an emerging viral pandemic disease. In the last 6 months, SARS-CoV-2 has caused millions of reported cases and hundreds of thousands of deaths. As other world regions, South America has not contained the pandemic’s advance since it lacks the hospital and economic capacities. Public health implications of transmission, while the asymptomatic/presymptomatic infection is a critical concern at the current pandemic. Objective Describe the socio-demographic, clinical, and viral features of a cohort of SARS-CoV-2 infected individuals from the Colombian Caribbean. Methods Six hundred eighty-six clinical samples of suspected SARS-CoV-2 infection cases and contacts individuals from several hospital centers in the department of Córdoba, Colombia, were received at our laboratory between April 9th and May 16th, 2020. RNA was extracted using lysis buffers and spin columns. The samples were tested for SARS-CoV-2 by reverse transcription real-time polymerase chain reaction (RT-qPCR) using commercially available multiplex real-time PCR assay for simultaneous detection of 3 target genes of SARS-CoV-2 (Allplex™, 2019-nCoV assay, Korea). Viral copies quantification was done using a standard curve constructed from seriated dilutions of a SARS-CoV-2 positive control. Statics descriptive methods were used. Results Thirty-five nasopharyngeal samples were positive for SARS-CoV-2 infection; the average age was 43 (range, 1–95 years). Seventeen of 35 (49%) of the patients showed symptoms. Most of them had a cough, fever, and odynophagia; three of the patients reported having arthralgia. Only two patients required hospitalization. None of the patients had known co-morbidities. RT-qPCR results show that two of the symptomatic patients had significantly higher RNA copies than the rest. Eighteen of 35 (51%) individuals were asymptomatic, and the average age was 30 (range, 6–61 years). Four asymptomatic individuals showed a higher copy than some symptomatic patients; nonetheless, the average of RNA copies 8.26 × 1010 was lower than the symptomatic. Conclusions This study shows that asymptomatic patients may develop infections with a high number of RNA copies. Since a considerable percentage of infections may be asymptomatic/presymptomatic, enhanced testing approaches may be needed to detect these persons. Due the occurrence of a large proportion of infections being a result from transmission originated in asymptomatic/presymptomatic individuals, public health interventions in Colombia should be based on two steps: a massive molecular screening, and viral load quantification. Finally, a remarkable issue in our study is the average age of symptomatic and asymptomatic groups (43 and 30 respectively) which may be important because of the economic impact that has been caused by the coronavirus pandemic and may be probably the cause of the reduced lethality observed in the country and the department at the time of this study.
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Affiliation(s)
- Salim Mattar
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia.
| | - Caty Martinez-Bravo
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | - Ricardo Rivero
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | - Héctor Contreras
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | | | - Camilo Guzman-Teran
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | - Ketty Galeano
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | | | - Verónica Contreras
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | - German Arrieta
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | - Marco Gonzalez-Tous
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | - Jorge Miranda
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | | | | | | | - Evelyn Garay
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | - Alejandra Garcia-Perez
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | - Yesica Lopez
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | - Vaneza Tique
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
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Mattar S, Alvis-Guzman N, Garay E, Rivero R, García A, Botero Y, Miranda J, Galeano K, de La Hoz F, Martínez C, Arrieta G, Faccini-Martínez ÁA, Guzmán C, Kerguelen H, Moscote M, Contreras H, Contreras V. Severe Acute Respiratory Syndrome Coronavirus 2 Seroprevalence Among Adults in a Tropical City of the Caribbean Area, Colombia: Are We Much Closer to Herd Immunity Than Developed Countries? Open Forum Infect Dis 2020; 7:ofaa550. [PMID: 33354587 PMCID: PMC7717429 DOI: 10.1093/ofid/ofaa550] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/05/2020] [Indexed: 12/11/2022] Open
Abstract
A serological survey was carried out in Monteria (500 000 population), a mid-size city in Colombia. An overall prevalence of 55.3% (95% confidence interval, 52.5%–57.8%) was found among a sample of 1.368 people randomly selected from the population. Test positivity was related to economic characteristics with the highest prevalence found in the most impoverished areas, representing 83.8% of the city’s population. We found a prevalence that might be associated with some important level of population immunity.
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Affiliation(s)
- Salim Mattar
- Universidad de Córdoba, Montería, Córdoba, Colombia
| | | | - Evelin Garay
- Universidad de Córdoba, Montería, Córdoba, Colombia
| | | | | | | | | | | | - Fernando de La Hoz
- Universidad Nacional de Colombia, Departamento de Salud Pública, Bogotá, Colombia
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Miranda J, Violet-Lozano L, Barrera S, Mattar S, Monsalve-Buriticá S, Rodas J, Contreras V. Candidatus Rickettsia colombianensi in ticks from reptiles in Córdoba, Colombia. Vet World 2020; 13:1764-1770. [PMID: 33132587 PMCID: PMC7566242 DOI: 10.14202/vetworld.2020.1764-1770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 07/09/2020] [Indexed: 11/16/2022] Open
Abstract
Background and Aim Wildlife animals are reservoirs of a large number of microorganisms pathogenic to humans, and ticks could be responsible for the transmission of these pathogens. Rickettsia spp. are the most prevalent pathogens found in ticks. This study was conducted to detect Rickettsia spp. in ticks collected from free-living and illegally trafficked reptiles from the Department of Córdoba, Colombia. Materials and Methods During the period from October 2011 to July 2014, ticks belonging to the family Ixodidae were collected, preserved in 96% ethanol, identified using taxonomic keys, and pooled (between 1 and 14 ticks) according to sex, stage, host, and collected place for subsequent DNA extraction. Rickettsia detection was performed using real-time polymerase chain reaction (RT-PCR), followed by conventional PCR to amplify a larger fragment of the gltA and 16S rRNA genes. The amplicons were sequenced using the Sanger method, and the nucleotide sequences were subjected to BLAST analysis to identify homologous sequences in GenBank, after which phylogenetic analysis was performed using the MEGA X software. Results In total, 21 specimens of nine species of reptiles were sampled, from which 805 Amblyomma dissimile ticks were collected, but only 180 ticks were selected to create 34 groups. The DNA of Rickettsia spp. was detected in 30/34 (88%) groups. The sequences of the gene gltA and 16S rRNA revealed a 100% identity with Candidatus Rickettsia colombianensi (GenBank: KF905456 and GenBank: KF691750). Conclusion A. dissimile was the only tick found in all the sampled reptiles. The presence of Candidatus Rickettsia colombianensi in reptile ticks could represent a public health problem due to the risk of transmission to humans and the introduction of microorganisms to other geographical areas.
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Affiliation(s)
- Jorge Miranda
- University of Córdoba, Institute of Tropical Biology Research, Córdoba, Colombia
| | - Lina Violet-Lozano
- University of Córdoba, Institute of Tropical Biology Research, Córdoba, Colombia
| | - Samia Barrera
- University of Córdoba, Institute of Tropical Biology Research, Córdoba, Colombia
| | - Salim Mattar
- University of Córdoba, Institute of Tropical Biology Research, Córdoba, Colombia
| | | | - Juan Rodas
- University of Antioquia, Colombia, Colombia
| | - Verónica Contreras
- University of Córdoba, Institute of Tropical Biology Research, Córdoba, Colombia
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Faccini-Martínez ÁA, Rivero R, Garay E, García A, Mattar S, Botero Y, Galeano K, Miranda J, Martínez C, Guzmán C, Arrieta G, Contreras H, Kerguelen H, Moscote M, Brango E, Contreras V. Serological cross-reactivity using a SARS-CoV-2 ELISA test in acute Zika virus infection, Colombia. Int J Infect Dis 2020; 101:191-193. [PMID: 33002616 PMCID: PMC7521368 DOI: 10.1016/j.ijid.2020.09.1451] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES We investigated seroreactivity by using a commercial SARS-CoV-2 ELISA test in samples collected from different groups of individuals, including patients diagnosed to have Dengue, Zika, and Chikungunya infection between 2015 and 2019, from an endemic area in the Caribbean Colombian region. METHODS A total of 127 sera samples obtained from six different groups of individuals were included in this study: Group A: patients with confirmed SARS-CoV-2 infection; Group B: patients with symptoms suggestive of COVID-19 or asymptomatic contacts with confirmed patients; Group C: patients with acute or recent dengue virus infection; Group D: patients with acute Zika virus infection; Group E: patients with previous Chikungunya virus infection; and Group F: individuals with exposure to spotted fever group rickettsiae. RESULTS Overall, group A, group B, and group D showed seroreactivity to SARS-CoV-2 in 92%, 75%, and 26% of samples, respectively; furthermore, group C, group E, and group F showed 100% seronegativity. CONCLUSIONS We found 26% of serological cross-reactivity in patients with acute Zika virus infection by using a commercial SARS-CoV-2 ELISA test. Further studies are needed to evaluate whether serological cross-reaction is maintained with time in nonacute patients with previous exposure to the Zika virus and its effect in SARS-CoV-2 serosurveys in endemic areas for this arbovirus.
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Affiliation(s)
- Álvaro A Faccini-Martínez
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Campus Berástegui, Córdoba, Colombia; Comité de Medicina Tropical, Zoonosis y Medicina del viajero, Asociación Colombiana de Infectología, Bogotá, Colombia
| | - Ricardo Rivero
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Campus Berástegui, Córdoba, Colombia
| | - Evelin Garay
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Campus Berástegui, Córdoba, Colombia
| | - Alejandra García
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Campus Berástegui, Córdoba, Colombia
| | - Salim Mattar
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Campus Berástegui, Córdoba, Colombia; Comité de Medicina Tropical, Zoonosis y Medicina del viajero, Asociación Colombiana de Infectología, Bogotá, Colombia.
| | - Yesica Botero
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Campus Berástegui, Córdoba, Colombia
| | - Ketty Galeano
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Campus Berástegui, Córdoba, Colombia
| | - Jorge Miranda
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Campus Berástegui, Córdoba, Colombia
| | - Caty Martínez
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Campus Berástegui, Córdoba, Colombia
| | - Camilo Guzmán
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Campus Berástegui, Córdoba, Colombia
| | - Germán Arrieta
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Campus Berástegui, Córdoba, Colombia; Comité de Medicina Tropical, Zoonosis y Medicina del viajero, Asociación Colombiana de Infectología, Bogotá, Colombia
| | - Hector Contreras
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Campus Berástegui, Córdoba, Colombia
| | - Hugo Kerguelen
- Alcaldia de Monteria, Gerencia COVID, Montería, Córdoba, Colombia
| | - Maria Moscote
- Secretaria de Salud de Monteria, Alcaldia de Monteria, Montería, Córdoba, Colombia
| | - Eimi Brango
- Clinica Salud Social, Sincelejo, Sucre, Colombia
| | - Veronica Contreras
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Campus Berástegui, Córdoba, Colombia
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Miranda J, Pereira I, Nunes J, Santos F. Encefalitis/encefalopatía leve con lesión reversible del esplenio del cuerpo calloso asociada a pielonefritis aguda; a propósito de un caso clínico. Neurologia 2020; 35:530-534. [DOI: 10.1016/j.nrl.2018.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/11/2018] [Accepted: 07/09/2018] [Indexed: 11/29/2022] Open
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López Y, Miranda J, Mattar S, Gonzalez M, Rovnak J. First report of Lihan Tick virus (Phlebovirus, Phenuiviridae) in ticks, Colombia. Virol J 2020; 17:63. [PMID: 32370779 PMCID: PMC7201772 DOI: 10.1186/s12985-020-01327-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/08/2020] [Indexed: 12/01/2022] Open
Abstract
Background Tick-borne phenuivirus (TBPVs) comprise human and animal viruses that can cause a variety of clinical syndromes ranging from self-limiting febrile illness to fatal haemorrhagic fevers. Objective Detect Phlebovirus (Family Phenuiviridae) in ticks collected from domestic animals in Córdoba, Colombia. Methods We collected 2365 ticks from domestic animals in three municipalities of the Department of Cordoba, Colombia in 2016. Ticks were identified and pooled by species for RNA extraction. A nested real-time PCR with specific primers for Phlebovirus and a specific probe for Heartland virus (HRTV) formerly a Phlebovirus, now a Banyangvirus were performed. Also, a conventional nested PCR, with the same specific primers was used to detect other Phleboviruses, with positive reactions indicated by an amplified cDNA fragment of approximately 244 bp determined by gel electrophoresis. These bands were gel-purified and sequenced by the Sanger method. Results Using real-time RT-PCR, no positive results for HRTV were found. However, using conventional nested PCR 2.2% (5/229 pools) yielded a product of 244 bp. One positive sample was detected in a pool of Dermacentor nitens ticks collected from a horse, and the four remaining positive pools were from Rhipicephalus microplus collected from cattle. The five positive nucleotide sequences had identities of 93 to 96% compared to a section of the L-segment of Lihan Tick virus, a Phlebovirus originally detected in R. microplus ticks in China. The strongest identity (96–99%) was with Lihan Tick virus detected in R. microplus ticks from Brazil. Conclusions This is the first report of viral detection in ticks in Colombia. We detected a Colombian strain of Lihan Tick virus. We recommend expanding the sampling area and carrying out more eco-epidemiological studies related to epidemiological surveillance of viruses on ticks in Colombia.
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Affiliation(s)
- Yesica López
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | - Jorge Miranda
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | - Salim Mattar
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia.
| | - Marco Gonzalez
- Instituto de Investigaciones Biológicas del Trópico, Facultad de Medicina Veterinaria y Zootecnia, Universidad de Córdoba, Montería, Colombia
| | - Joel Rovnak
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
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Miranda J, Paz Y Miño F, Borobio V, Badenas C, Rodriguez-Revenga L, Pauta M, Borrell A. Should cell-free DNA testing be used in pregnancy with increased fetal nuchal translucency? Ultrasound Obstet Gynecol 2020; 55:645-651. [PMID: 31301176 DOI: 10.1002/uog.20397] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 12/31/2018] [Revised: 06/11/2019] [Accepted: 06/14/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To assess the frequency of atypical chromosomal and submicroscopic anomalies, as well as fetal structural abnormalities, observed on first-trimester ultrasound scan in fetuses with nuchal translucency (NT) thickness > 99th centile, in order to evaluate the suitability of using standard cell-free DNA (cfDNA) testing as the sole screening test in these pregnancies. METHODS This was a retrospective cohort study of 226 fetuses with NT > 99th centile at 11-14 weeks' gestation, between January 2013 and December 2017, in a clinical setting in which greater than 95% of pregnant women receive first-trimester combined screening. All patients underwent genetic testing by means of quantitative fluorescence polymerase chain reaction and chromosomal microarray analysis, mainly in chorionic villus samples. We assessed the theoretical yield of two cfDNA testing models, targeted cfDNA (chromosomes 21, 18 and 13) and extended cfDNA (chromosomes 21, 18, 13 and sex chromosomes), and compared it with that of cytogenetic testing and ultrasound assessment in the first and second or third trimesters. RESULTS In the 226 fetuses analyzed, cytogenetic testing revealed 84 (37%) anomalies, including 68 typical aneuploidies (involving chromosomes 13, 18 or 21), six sex chromosome aneuploidies (four cases of monosomy X and two of trisomy X), three clinically relevant atypical chromosomal anomalies (one trisomy 22, one trisomy 21 mosaicism and one unbalanced translocation), five submicroscopic pathogenic variants and two cases with Noonan syndrome. Targeted and extended cfDNA testing would miss at least 12% (10/84) and 19% (16/84), respectively, of genetic anomalies, accounting for 4.4% and 7.1% of the fetuses with an increased NT, respectively. Finally, of the 142 fetuses with no identified genetic anomaly, a major fetal malformation was observed in 15 (10.6%) fetuses at the early anomaly scan, and in 19 (13.4%) in the second or third trimester. CONCLUSIONS cfDNA does not appear to be the appropriate genetic test in fetuses with NT > 99th centile, given that it would miss 12-19% of genetic anomalies in this group. Additionally, first-trimester ultrasound will identify a major structural abnormality in 11% of the fetuses with NT > 99th centile and no genetic anomaly. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- J Miranda
- Fetal i+D Fetal Medicine Research, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - F Paz Y Miño
- Fetal i+D Fetal Medicine Research, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - V Borobio
- Fetal i+D Fetal Medicine Research, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - C Badenas
- Biomedical Diagnostic Center, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain
| | - L Rodriguez-Revenga
- Biomedical Diagnostic Center, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain
| | - M Pauta
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, Barcelona, Catalonia, Spain
| | - A Borrell
- Fetal i+D Fetal Medicine Research, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain
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Miranda J, Borrell A. Reply. Ultrasound Obstet Gynecol 2020; 55:698-699. [PMID: 32356931 DOI: 10.1002/uog.22033] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- J Miranda
- Fetal i+D Fetal Medicine Research, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - A Borrell
- Fetal i+D Fetal Medicine Research, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
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Miranda J, Ramiro V, Pasupati S, Nair R. A082 Clinical Outcomes in Patients With Severe Tricuspid Regurgitation (TR). Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.05.087] [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: 10/23/2022]
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Gomes N, Miranda J, Lopes S, Carneiro-Leão L, Torres Costa J, Baudrier T, Azevedo F. Omalizumab in the Treatment of Hyper-IgE Syndrome: 2 Case Reports. J Investig Allergol Clin Immunol 2019; 30:191-192. [PMID: 31820738 DOI: 10.18176/jiaci.0469] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- N Gomes
- Dermatovenereology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - J Miranda
- Allergy and Clinical Immunology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - S Lopes
- Dermatovenereology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - L Carneiro-Leão
- Allergy and Clinical Immunology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - J Torres Costa
- Allergy and Clinical Immunology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - T Baudrier
- Dermatovenereology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - F Azevedo
- Dermatovenereology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
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Mcmullen L, Miranda J, Donnelly R, Sidhu H, Husain M, Gul M. DESIGNING AND IMPLEMENTING A COMPREHENSIVE AGE-RELATED EVALUATION AND SUPPORT (CARES) PROGRAM TO PROMOTE OPTIMAL QUALITY OF LIFE AND REDUCE ONCOLOGY TREATMENT TOXICITY FOR ELDERLY PATIENTS. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31262-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Paules C, Youssef L, Rovira C, Crovetto F, Nadal A, Peguero A, Figueras F, Eixarch E, Crispi F, Miranda J, Gratacós E. Distinctive patterns of placental lesions in pre-eclampsia vs small-for-gestational age and their association with fetoplacental Doppler. Ultrasound Obstet Gynecol 2019; 54:609-616. [PMID: 31115105 DOI: 10.1002/uog.20350] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [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: 03/29/2019] [Revised: 05/03/2019] [Accepted: 05/10/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To describe placental histopathological findings in a large cohort of pregnancies complicated by pre-eclampsia (PE) and/or small-for-gestational age (SGA), and to investigate their association with fetoplacental Doppler parameters. METHODS This was a prospective observational study of normotensive pregnancies with SGA (defined as birth weight < 10th centile) (n = 184), PE pregnancies with a normally grown fetus (n = 102), pregnancies with both PE and SGA (n = 120) and uncomplicated pregnancies (n = 202). Uterine (UtA), umbilical (UA) and fetal middle cerebral (MCA) artery pulsatility indices (PI) were assessed. The cerebroplacental ratio (CPR) was calculated by dividing MCA-PI by UA-PI. Doppler parameters were considered abnormal when UtA-PI or UA-PI was > 95th centile or MCA-PI or CPR was < 5th centile. Placental lesions were categorized as vascular (maternal or fetal side), immunoinflammatory or other, according to the 2014 Amsterdam Placental Workshop Group Consensus Statement. Comparison between the study groups was performed using univariate and multiple regression analysis, and logistic regression was used to determine the relationship between abnormal Doppler parameters and placental lesions. RESULTS Maternal-side vascular lesions were significantly more common in PE pregnancies with SGA than in the other groups (PE + SGA, 73% vs PE, 46% vs SGA, 38% vs controls, 31%; P = 0.01) and included mainly two types of lesion: developmental (PE + SGA, 13% vs PE, 5% vs SGA, 3% vs controls, 1.5%; P < 0.001) and malperfusion (PE + SGA, 70% vs PE, 39% vs SGA, 32% vs controls, 25%; P = 0.001). In contrast, the incidence of fetal-side developmental lesions was significantly higher in normotensive SGA pregnancies than in controls and PE pregnancies (PE + SGA, 0% vs PE, 3% vs SGA, 8% vs controls, 2%; P = 0.001). All cases displayed a lower prevalence of infectious lesions than did controls, with the highest prevalence of immune lesions observed in pregnancies with both PE and SGA (PE + SGA, 18% vs PE, 8% vs SGA, 10% vs controls, 9%; P = 0.001). All fetoplacental Doppler parameters evaluated were associated with maternal-side vascular lesions, mainly malperfusion (mean UtA-PI: odds ratio (OR), 2.45 (95% CI, 1.51-3.97); UA-PI: OR, 2.05 (95% CI, 1.02-4.47); MCA-PI: OR, 2.75 (95% CI, 1.40-5.42); CPR: OR, 1.75 (95% CI, 1.04-2.95)). This association was evident mainly in the normotensive SGA group, being non-significant in controls or PE pregnancies without SGA. No significant associations were observed between fetoplacental Doppler parameters and other placental lesions in any of the study groups. CONCLUSIONS PE and SGA are associated with different patterns of placental histopathological lesions in accordance with the clinical manifestation of the placental disorder (maternal vs fetal). Fetoplacental Doppler findings show an association with placental malperfusion lesions on the maternal side, supporting the use of abnormal Doppler as a surrogate for placental insufficiency. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- C Paules
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Institut Clínic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - L Youssef
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Institut Clínic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - C Rovira
- Department of Pathology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - F Crovetto
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Institut Clínic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - A Nadal
- Department of Pathology, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - A Peguero
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Institut Clínic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - F Figueras
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Institut Clínic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - E Eixarch
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Institut Clínic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - F Crispi
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Institut Clínic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - J Miranda
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Institut Clínic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - E Gratacós
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Institut Clínic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
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Machado-Rugolo J, Balancin M, Martins V, Miranda J, Assato A, Souza N, Velosa A, Falzoni R, Ab'saber A, Teodoro W, Capelozzi V. P1.06-01 Combining Immunoprofile, Immunogenic Collagen and Mismatch Repair Proteins Predicts Risk of Death and Target Therapy in Malignant Mesothelioma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.988] [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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Paules C, Youssef L, Rovira C, Miranda J, Crovetto F, Figueras F, Eixarch E, Nadal A, Crispi F, Gratacós E. Distinctive patterns of placental histopathological lesions in preeclampsia versus fetal growth restriction. Pregnancy Hypertens 2019. [DOI: 10.1016/j.preghy.2019.08.138] [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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Cabrero DS, Cruz P, Miranda J, Higuera O, Pertejo A, Ramón J, Torres J, Gutierrez L, Villamayor J, Viñal D, Esteban I, De Castro Carpeno J. EP1.14-31 Retrospective Study About EGFR Mutations in Lung Cancer: Our Experience in a Spanish Hospital. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2316] [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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Youssef L, Miranda J, Paules C, Garcia-Otero L, Kalapotharakos G, Sepulveda-Martinez A, Crovetto F, Gomez O, Gratacos E, Crispi F. Both preeclampsia and intrauterine growth restriction have implications on fetal cardiac remodeling and dysfunction. Pregnancy Hypertens 2019. [DOI: 10.1016/j.preghy.2019.08.162] [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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Pepe B, Silva B, Dias B, Marques C, Loja D, Fortunato D, Castro F, Melo F, Mousinho H, Palma I, Barriga J, Freitas J, Marques J, Miranda J, Revez M, Amaro P, Bizarro P, Belo A, Ferreira J, Póvoa P, Seromenho V. ‘BLS in medical curriculum: strengthening the survival chain’. Resuscitation 2019. [DOI: 10.1016/j.resuscitation.2019.06.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Betancour P, Mueller B, Sola J, Arancibia J, Ascui R, Araya I, Cerda M, Miranda J, Strube E. Quality of life and preoperative chemotherapy in gastric cancer in Chile: results from the observational study of perioperative chemotherapy in gastric cancer (PRECISO). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Contreras V, F. Londoño A, Miranda J, Mattar S, Acevedo-Gutiérrez LY, J. Diaz F, Rodas JD. Infection by Rickettsia felis in Ctenocephalides felis felis Fleas from North of Colombia. J Arthropod Borne Dis 2019. [DOI: 10.18502/jad.v13i1.927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Rickettsia felis is an emergent Rickettsial agent whose main vector is Ctenocephalides felis, but ticks, mites and lice are also infected. We aimed to search for molecular evidence of Rickettsia spp. in fleas collected from dogs and wild rodents (Heteromys anomalous) from three villages of Córdoba and Antioquia provinces (Northern of Colombia), where outbreaks of rickettsioses have occurred, and discuss the possible role of fleas on endemic/enzootic regions for rickettsia.
Methods: During 2010 and 2012, 649 Ctenocephalides felis felis and 24 Pulex irritans fleas were removed from dogs and wild rodents (Heteromys anomalous), respectively, in 3 locations from Córdoba and Antioquia provinces (Colombia). These fleas were tested into pools for Rickettsial infection by PCR, targeting gltA, ompB, and ompA Rickettsial genes.
Results: Almost 20% (30/153) of C. felis felis pools contained Rickettsial DNA. The fragments of ompB gene showed high identity values between sequences from Necocli and Los Cordobas with R. felis strain from Senegal (100% and 99.7% respectively) and all were highly related by phylogenetic analyses. Rickettsial DNA in pools of P. irritans was not detected.
Conclusion: Our findings highlighted the endemicity of the infection by R. felis in fleas from northern of Colombia and showed the likely importance of dogs as hosts of C. felis felis fleas and their potential role as reservoirs of R. felis.
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Paules C, Dantas AP, Miranda J, Crovetto F, Eixarch E, Rodriguez-Sureda V, Dominguez C, Casu G, Rovira C, Nadal A, Crispi F, Gratacós E. Premature placental aging in term small-for-gestational-age and growth-restricted fetuses. Ultrasound Obstet Gynecol 2019; 53:615-622. [PMID: 30125412 DOI: 10.1002/uog.20103] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [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: 04/09/2018] [Revised: 07/26/2018] [Accepted: 08/10/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To perform a comprehensive assessment of the placental aging process in small term fetuses classified as being small-for-gestational age (SGA) or having fetal growth restriction (FGR) through analysis of senescence and apoptosis markers. METHODS This was a prospective nested case-control study of singleton pregnancies delivered at term, including 21 control pregnancies with normally grown fetuses and 36 with a small fetus classified as SGA (birth weight between the 3rd and 9th percentiles and normal fetoplacental Doppler; n = 18) or FGR (birth weight < 3rd percentile and/or abnormal cerebroplacental ratio and/or uterine artery Doppler; n = 18). Telomerase activity, telomere length (quantified by comparing the amount of amplification product for the telomere sequence (T) to that of a single copy of the gene 36B4 (S)) and RNA expression of senescence (Sirtuins 1, 3 and 6) and apoptosis (p53, p21, BAX and Caspases 3 and 9) markers (analyzed using the 2-ΔΔCt method) were determined in placental samples collected at birth and compared between the three groups. RESULTS Compared to pregnancies with a normally grown fetus, both SGA and FGR pregnancies presented signs of accelerated placental aging, including lower telomerase activity (mean ± SD, 12.8 ± 6.6% in controls vs 7.98 ± 4.2% in SGA vs 7.79 ± 4.6% in FGR; P = 0.008), shorter telomeres (mean ± SD T/S ratio, 1.20 ± 0.6 in controls vs 1.08 ± 0.9 in SGA vs 0.66 ± 0.5 in FGR; P = 0.047) and reduced Sirtuin-1 RNA expression (mean ± SD 2-ΔΔCt , 1.55 ± 0.8 in controls vs 0.91 ± 0.8 in SGA vs 0.63 ± 0.5 in FGR; P = 0.001) together with increased p53 RNA expression (median (interquartile range) 2-ΔΔCt , 1.07 (0.3-3.3) in controls vs 5.39 (0.6-15) in SGA vs 3.75 (0.9-7.8) in FGR; P = 0.040). FGR cases presented signs of apoptosis, with increased Caspase-3 RNA levels (median (interquartile range) 2-ΔΔCt , 0.94 (0.7-1.7) in controls vs 3.98 (0.9-31) in FGR; P = 0.031) and Caspase-9 RNA levels (median (interquartile range) 2-ΔΔCt , 1.21 (0.6-4.0) in controls vs 3.87 (1.5-9.0) in FGR; P = 0.037) compared with controls. In addition, Sirtuin-1 RNA expression, telomerase activity, telomere length and Caspase-3 activity showed significant linear trends across groups as severity of the condition increased. CONCLUSIONS Accelerated placental aging was observed in both clinical forms of late-onset fetal smallness (SGA and FGR), supporting a common pathophysiology and challenging the concept of SGA fetuses being constitutionally small. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- C Paules
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, ICGON, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - A P Dantas
- Cardiovascular Institut, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - J Miranda
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, ICGON, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - F Crovetto
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, ICGON, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - E Eixarch
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, ICGON, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Centre for Biomedical Research on Rare Disease (CIBER-ER), Instituto de Salud Carlos III, Madrid, Spain
| | - V Rodriguez-Sureda
- Centre for Biomedical Research on Rare Disease (CIBER-ER), Instituto de Salud Carlos III, Madrid, Spain
- Biochemistry and Molecular Biology Research Centre for Nanomedicine, Hospital Univeritari Vall d'Hebron, Barcelona, Spain
| | - C Dominguez
- Centre for Biomedical Research on Rare Disease (CIBER-ER), Instituto de Salud Carlos III, Madrid, Spain
- Biochemistry and Molecular Biology Research Centre for Nanomedicine, Hospital Univeritari Vall d'Hebron, Barcelona, Spain
| | - G Casu
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, ICGON, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - C Rovira
- Department of Pathology, Hospital Sant Joan de Deu, Esplugues de Llobregat, Spain
| | - A Nadal
- Department of Pathology, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - F Crispi
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, ICGON, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Centre for Biomedical Research on Rare Disease (CIBER-ER), Instituto de Salud Carlos III, Madrid, Spain
| | - E Gratacós
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Deu, ICGON, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Centre for Biomedical Research on Rare Disease (CIBER-ER), Instituto de Salud Carlos III, Madrid, Spain
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Cabrero D, Cruz P, de Castro J, Higuera O, Pertejo A, Esteban I, Gutierrez L, Villamayor J, Ostios L, Viñal D, Miranda J. Retrospective study about lung carcinoid: Our experience in a Spanish hospital. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz065.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Contreras V, Londoño AF, Miranda J, Mattar S, Acevedo-Gutiérrez LY, Diaz FJ, Rodas JD. Infection by Rickettsia felis in Ctenocephalides felis felis Fleas from North of Colombia. J Arthropod Borne Dis 2019; 13:1-8. [PMID: 31346530 PMCID: PMC6643012] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 07/11/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Rickettsia felis is an emergent Rickettsial agent whose main vector is Ctenocephalides felis, but ticks, mites and lice are also infected. We aimed to search for molecular evidence of Rickettsia spp. in fleas collected from dogs and wild rodents (Heteromys anomalous) from three villages of Córdoba and Antioquia provinces (Northern of Colombia), where outbreaks of rickettsioses have occurred, and discuss the possible role of fleas on endemic/enzootic regions for rickettsia. METHODS During 2010 and 2012, 649 Ctenocephalides felis felis and 24 Pulex irritans fleas were removed from dogs and wild rodents (Heteromys anomalous), respectively, in 3 locations from Córdoba and Antioquia provinces (Colombia). These fleas were tested into pools for Rickettsial infection by PCR, targeting gltA, ompB, and ompA Rickettsial genes. RESULTS Almost 20% (30/153) of C. felis felis pools contained Rickettsial DNA. The fragments of ompB gene showed high identity values between sequences from Necocli and Los Cordobas with R. felis strain from Senegal (100% and 99.7% respectively) and all were highly related by phylogenetic analyses. Rickettsial DNA in pools of P. irritans was not detected. CONCLUSION Our findings highlighted the endemicity of the infection by R. felis in fleas from northern of Colombia and showed the likely importance of dogs as hosts of C. felis felis fleas and their potential role as reservoirs of R. felis.
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Affiliation(s)
- Verónica Contreras
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Colombia
| | - Andrés F. Londoño
- Grupo de Investigación en Ciencias Veterinarias, Centauro, Universidad de Antioquia, Colombia
| | - Jorge Miranda
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Colombia
| | - Salim Mattar
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Colombia,Corresponding author: Dr Salim Máttar, E-mail:
| | | | | | - Juan D. Rodas
- Grupo de Investigación en Ciencias Veterinarias, Centauro, Universidad de Antioquia, Colombia
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Castelo B, Viñal D, Maseda R, Ostios L, Sánchez D, García-Salvatierra B, Escámez MJ, Martínez-Santamaría L, Del Río M, Mora-Rillo M, Vilches Y, Beato MJ, López Gutiérrez JC, Romero N, Santos C, Miranda J, de Lucas R. Epidemiology and natural history of cutaneous squamous cell carcinoma in recessive dystrophic epidermolysis bullosa patients: 20 years' experience of a reference centre in Spain. Clin Transl Oncol 2019; 21:1573-1577. [PMID: 30864020 DOI: 10.1007/s12094-019-02073-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 12/20/2018] [Accepted: 02/23/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Cutaneous squamous cell carcinoma (cSCC) is the leading cause of death in patients with recessive dystrophic epidermolysis bullosa (RDEB). We provide the management and prognosis of cSCC in RDEB patients at a Spanish reference center. MATERIALS AND METHODS We retrospectively included patients with RDEB attended in La Paz University Hospital from November 1988 to October 2018. RESULTS Fourteen patients developed at least one cSCC. Tumors were predominantly well differentiated. Nearly half of the tumors have recurred. Median time to first recurrence was 23.4 months (95% CI: 17.2-29.5). Five patients have developed distant metastases. Median overall survival (mOS) was 136.5 months since the diagnosis of the first cSCC (95% CI: 30.6-242.3). When distant metastases occurred, mOS was 6.78 months (95% CI: 1.94-11.61). CONCLUSIONS cSCC is a life-threatening complication of RDEB patients. Although tumors are usually well differentiated, they tend to relapse. This is the first Spanish report of cSCC arising in RDEB patients.
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Affiliation(s)
- B Castelo
- Department of Medical Oncology, La Paz University Hospital, Paseo de la castellana 261, 28046, Madrid, Spain
| | - D Viñal
- Department of Medical Oncology, La Paz University Hospital, Paseo de la castellana 261, 28046, Madrid, Spain.
| | - R Maseda
- Department of Dermatology, La Paz University Hospital, Madrid, Spain
| | - L Ostios
- Department of Medical Oncology, La Paz University Hospital, Paseo de la castellana 261, 28046, Madrid, Spain
| | - D Sánchez
- Department of Medical Oncology, La Paz University Hospital, Paseo de la castellana 261, 28046, Madrid, Spain
| | | | - M J Escámez
- Department of Bio-Engineering, Centro de Investigaciones Energéticas Medioambientales y Tecnológicas (CIEMAT), IIS-Fundación Jiménez Díaz (IISFJD), CIBER on Rare Diseases (U714 CIBERER-ISCIII), Carlos III University, Madrid (UC3M), Madrid, Spain
| | - L Martínez-Santamaría
- Department of Bio-Engineering, Centro de Investigaciones Energéticas Medioambientales y Tecnológicas (CIEMAT), IIS-Fundación Jiménez Díaz (IISFJD), CIBER on Rare Diseases (U714 CIBERER-ISCIII), Carlos III University, Madrid (UC3M), Madrid, Spain
| | - M Del Río
- Department of Bio-Engineering, Centro de Investigaciones Energéticas Medioambientales y Tecnológicas (CIEMAT), IIS-Fundación Jiménez Díaz (IISFJD), CIBER on Rare Diseases (U714 CIBERER-ISCIII), Carlos III University, Madrid (UC3M), Madrid, Spain
| | - M Mora-Rillo
- Infectious Diseases Unit, Internal Medicine Department, La Paz University Hospital IdiPAZ, Madrid, Spain
| | - Y Vilches
- Department of Palliative Care, La Paz University Hospital, Madrid, Spain
| | - M J Beato
- Department of Pathology, La Paz University Hospital, Madrid, Spain
| | | | - N Romero
- DEBRA (Dystrophic Epidermolysis Bullosa Research Association), Madrid, Spain
| | - C Santos
- DEBRA (Dystrophic Epidermolysis Bullosa Research Association), Madrid, Spain
| | - J Miranda
- Department of Medical Oncology, La Paz University Hospital, Paseo de la castellana 261, 28046, Madrid, Spain
| | - R de Lucas
- Department of Dermatology, La Paz University Hospital, Madrid, Spain
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