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Cheung L, Scansen BA, Baden R, Sloan CQ, Garcia M, Han S, Sadar MJ. Spontaneous rupture of the right aortic sinus resulting in a sterile aorto-atrial fistula in a pet rabbit (Oryctolagus cuniculus). J Vet Cardiol 2024; 52:72-77. [PMID: 38458041 DOI: 10.1016/j.jvc.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 01/30/2024] [Accepted: 02/04/2024] [Indexed: 03/10/2024]
Abstract
Aortocardiac fistula is a broad term used to describe defects between the aorta and other cardiac chambers that can occur in humans and animals. A 1.5-year-old, 1.7 kg, male castrated Holland lop rabbit (Oryctolagus cuniculus) was presented for a two-week history of a heart murmur with corresponding cardiomegaly on radiographs. Physical examination confirmed a grade-V/VI continuous heart murmur on the right sternal border with a regular rhythm and a gallop sound. Echocardiography revealed an aortic-to-right-atrial fistula causing severe left-sided volume overload. Based on the echocardiographic findings, rupture of the right aortic sinus was suspected. Due to the poor prognosis, euthanasia was elected. On necropsy, a fistula was found connecting the right aortic sinus with the right atrium, without evidence of an inflammatory response nor evidence of an infectious etiology. The sudden onset of a heart murmur supported acquired fistulation from a ruptured aortic sinus (also known as the sinus of Valsalva), though a congenital malformation could not be completely excluded.
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Affiliation(s)
- L Cheung
- James L. Voss Veterinary Teaching Hospital, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523, USA
| | - B A Scansen
- Department of Clinical Sciences, Colorado State University, Campus Delivery 1678, Fort Collins, CO 80523, USA
| | - R Baden
- James L. Voss Veterinary Teaching Hospital, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523, USA
| | - C Q Sloan
- James L. Voss Veterinary Teaching Hospital, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523, USA
| | - M Garcia
- Larimer County Humane Society, 3501 E 71st St, Loveland, CO 80538, USA
| | - S Han
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Campus Delivery 1619, Fort Collins, CO 80523, USA
| | - M J Sadar
- Department of Clinical Sciences, Colorado State University, Campus Delivery 1678, Fort Collins, CO 80523, USA.
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Liu C, Cyphert EL, Stephen SJ, Wang B, Morales AL, Nixon JC, Natsoulas NR, Garcia M, Blazquez Carmona P, Vill AC, Donnelly EL, Brito IL, Vashishth D, Hernandez CJ. Microbiome-induced Increases and Decreases in Bone Tissue Strength can be Initiated After Skeletal Maturity. bioRxiv 2024:2024.01.03.574074. [PMID: 38260539 PMCID: PMC10802367 DOI: 10.1101/2024.01.03.574074] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Recent studies in mice have indicated that the gut microbiome can regulate bone tissue strength. However, prior work involved modifications to the gut microbiome in growing animals and it is unclear if the same changes in the microbiome, applied later in life, would change matrix strength. Here we changed the composition of the gut microbiome before and/or after skeletal maturity (16 weeks of age) using oral antibiotics (ampicillin + neomycin). Male and female mice (n=143 total, n=12-17/group/sex) were allocated into five study groups:1) Unaltered, 2) Continuous (dosing 4-24 weeks of age), 3) Delayed (dosing only 16-24 weeks of age), 4) Initial (dosing 4-16 weeks of age, suspended at 16 weeks), and 5) Reconstituted (dosing from 4-16 weeks following by fecal microbiota transplant from Unaltered donors). Animals were euthanized at 24 weeks of age. In males, bone matrix strength in the femur was 25-35% less than expected from geometry in mice from the Continuous (p= 0.001), Delayed (p= 0.005), and Initial (p=0.040) groups as compared to Unaltered. Reconstitution of the gut microbiota, however, led to a bone matrix strength similar to Unaltered animals (p=0.929). In females, microbiome-induced changes in bone matrix strength followed the same trend as males but were not significantly different, demonstrating sex-related differences in the response of bone matrix to the gut microbiota. Minor differences in chemical composition of bone matrix were observed (Raman spectroscopy). Our findings indicate that microbiome-induced impairment of bone matrix in males can be initiated and/or reversed after skeletal maturity. The portion of the femoral cortical bone formed after skeletal maturity (16 weeks) is small; however, this suggests that microbiome-induced changes in bone matrix occur without osteoblast/osteoclast turnover using an, as of yet unidentified mechanism. These findings add to evidence that the mechanical properties of bone matrix can be altered in the adult skeleton.
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Affiliation(s)
- C Liu
- Departments of Orthopaedic Surgery and Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - E L Cyphert
- Departments of Orthopaedic Surgery and Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - S J Stephen
- Shirley Ann Jackson, PhD Center for Biotechnology and Interdisciplinary Studies, Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - B Wang
- Shirley Ann Jackson, PhD Center for Biotechnology and Interdisciplinary Studies, Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - A L Morales
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - J C Nixon
- Departments of Orthopaedic Surgery and Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
- Shirley Ann Jackson, PhD Center for Biotechnology and Interdisciplinary Studies, Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, USA
- Escuela Técnica Superior de Ingeniería, Universidad de Sevilla, Spain
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
- Department of Material Science and Engineering, Cornell University, Ithaca, NY, USA
- Reseach Division, Hospital for Special Surgery, New York, NY, USA
- Rensselaer - Icahn School of Medicine at Mount Sinai Center for Engineering and Precision Medicine, New York, NY
- Chan Zuckerberg Biohub San Francisco, CA, US
| | - N R Natsoulas
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - M Garcia
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | | | - A C Vill
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - E L Donnelly
- Department of Material Science and Engineering, Cornell University, Ithaca, NY, USA
- Reseach Division, Hospital for Special Surgery, New York, NY, USA
| | - I L Brito
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - D Vashishth
- Shirley Ann Jackson, PhD Center for Biotechnology and Interdisciplinary Studies, Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, USA
- Rensselaer - Icahn School of Medicine at Mount Sinai Center for Engineering and Precision Medicine, New York, NY
| | - C J Hernandez
- Departments of Orthopaedic Surgery and Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
- Chan Zuckerberg Biohub San Francisco, CA, US
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Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, 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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Escoda T, Garcia M, Stavris C, Genot S, Retornaz F, Chiche L, Brunel V. [A typical facies]. Rev Med Interne 2023; 44:670-672. [PMID: 37451869 DOI: 10.1016/j.revmed.2023.06.012] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 06/26/2023] [Indexed: 07/18/2023]
Affiliation(s)
- T Escoda
- Service de médecine interne, hôpital Européen, 6, rue Désirée-Clary, 13003 Marseille, France.
| | - M Garcia
- Service de dermatologie, hôpital Européen, 6, rue Désirée-Clary, 13003 Marseille, France
| | - C Stavris
- Service de médecine interne, hôpital Européen, 6, rue Désirée-Clary, 13003 Marseille, France
| | - S Genot
- Service de médecine interne, hôpital Européen, 6, rue Désirée-Clary, 13003 Marseille, France
| | - F Retornaz
- Service de médecine interne, hôpital Européen, 6, rue Désirée-Clary, 13003 Marseille, France
| | - L Chiche
- Service de médecine interne, hôpital Européen, 6, rue Désirée-Clary, 13003 Marseille, France
| | - V Brunel
- Service d'onco-hématologie, hôpital Européen, 6, rue Désirée-Clary, 13003 Marseille, France
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Marco L, Cambien G, Garcia M, Broutin L, Cateau E, Lariviere A, Castel O, Thevenot S, Bousseau A. [Respiratory infections: Additional transmission-based precautions in healthcare facilities]. Rev Mal Respir 2023; 40:572-603. [PMID: 37365075 DOI: 10.1016/j.rmr.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 05/04/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION In health care, measures against cross-transmission of microorganisms are codified by standard precautions, and if necessary, they are supplemented by additional precautions. STATE OF THE ART Several factors impact transmission of microorganisms via the respiratory route: size and quantity of the emitted particles, environmental conditions, nature and pathogenicity of the microorganisms, and degree of host receptivity. While some microorganisms necessitate additional airborne or droplet precautions, others do not. PROSPECTS For most microorganisms, transmission patterns are well-understood and transmission-based precautions are well-established. For others, measures to prevent cross-transmission in healthcare facilities remain under discussion. CONCLUSIONS Standard precautions are essential to the prevention of microorganism transmission. Understanding of the modalities of microorganism transmission is essential to implementation of additional transmission-based precautions, particularly in view of opting for appropriate respiratory protection.
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Affiliation(s)
- L Marco
- Unité d'hygiène hospitalière, département des agents infectieux, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France
| | - G Cambien
- Unité d'hygiène hospitalière, département des agents infectieux, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France; Inserm CIC 1402, université de Poitiers, CHU de Poitiers, 86021 Poitiers, France
| | - M Garcia
- Département des agents infectieux, laboratoire de virologie et mycobactériologie, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France; Laboratoire inflammation, tissus épithéliaux et cytokines, EA 4331, université de Poitiers, 86021 Poitiers, France
| | - L Broutin
- Département des agents infectieux, laboratoire de bactériologie, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France
| | - E Cateau
- Laboratoire écologie et biologie des interactions, UMR CNRS 7267, université de Poitiers, 86021 Poitiers, France; Département des agents infectieux, laboratoire de parasitologie et mycologie médicale, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France
| | - A Lariviere
- Département des agents infectieux, laboratoire de virologie et mycobactériologie, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France
| | - O Castel
- Unité d'hygiène hospitalière, département des agents infectieux, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France
| | - S Thevenot
- Unité d'hygiène hospitalière, département des agents infectieux, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France; Inserm CIC 1402, université de Poitiers, CHU de Poitiers, 86021 Poitiers, France
| | - A Bousseau
- Unité d'hygiène hospitalière, département des agents infectieux, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France.
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Huzzey JM, Jarrett JP, Sharman ED, Garcia M, Chapman JD, McLean DJ. Effects of OmniGen AF feed supplementation on glucocorticoids, blood leukocyte messenger RNA abundance, and energy metabolism in overstocked Holstein dairy cows. Animal 2023; 17:100805. [PMID: 37149993 DOI: 10.1016/j.animal.2023.100805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/27/2023] [Accepted: 03/31/2023] [Indexed: 05/09/2023] Open
Abstract
The physiological consequences of overstocking require more investigation, and no research has explored whether dietary supplements could mitigate the anticipated negative physiological effects. OmniGen AF (OG, Phibro Animal Health Corporation, Teaneck, NJ, USA) is a nutritional supplement that has been shown to support the immune system of cattle following internal and environmental stressors. This study aimed to determine if a 45-day period of OG feed supplementation would influence whole blood leukocyte messenger RNA abundance, energy metabolism and glucocorticoid concentration, during a two-week period of overstocking. Two stocking density treatments (control: one headlock and lying stall per cow; overstocked: 0.5 headlocks and 0.5 lying stalls per cow) and two diet treatments (control: no added supplement; and OG: 56 g/cow per day) were investigated. Four pens of 15 cows were fed their assigned diet (two pens per diet; control stocking density) for 45 days after which each stocking density treatment was applied for a 14-day period using a cross-over design; this study design was replicated twice. During each 14-day period, blood was collected on day four to measure whole blood leukocyte messenger RNA abundance (cluster of differentiation 80, interleukin 8 receptor-beta, interleukin 10 receptor-beta and L-selectin) and fecal samples were collected every two days to measure fecal cortisol metabolite concentration (11,17-dioxoandrostanes). At the end of each 14-day period, eight cows from each pen were selected for an intravenous glucose tolerance test; glucose, insulin and non-esterified fatty acids were measured. There were no effects of diet or stocking density on leukocyte messenger RNA abundance. Fecal cortisol metabolite concentrations were highest for overstocked cows on the control diet on day four of the stocking density treatment; however, by day 10, overstocked cows fed OG had the highest fecal cortisol metabolite concentrations. Overstocked cows, regardless of diet, had an attenuated insulin response during the glucose tolerance test, represented by a lower area under the curve estimate. Cows fed OG but not overstocked, had a lower non-esterified fatty acid nadir during the glucose challenge, compared to all the other treatments. In conclusion, overstocking prompts a physiological stress response and alters energy metabolism by decreasing the insulin response to an intravenous glucose challenge. Feeding OG during overstocking delayed the increase in fecal cortisol metabolites by several days; however, it is unclear if this altered glucocorticoid response benefited the cow, as OG had no effect on insulin responses or immune parameters.
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Affiliation(s)
- J M Huzzey
- Department of Animal Science, California Polytechnic State University, San Luis Obispo, CA 93407, USA.
| | - J P Jarrett
- Phibro Animal Health Corporation, Teaneck, NJ 07666-6712, USA
| | - E D Sharman
- Phibro Animal Health Corporation, Teaneck, NJ 07666-6712, USA
| | - M Garcia
- Phibro Animal Health Corporation, Teaneck, NJ 07666-6712, USA
| | - J D Chapman
- Phibro Animal Health Corporation, Teaneck, NJ 07666-6712, USA
| | - D J McLean
- Phibro Animal Health Corporation, Teaneck, NJ 07666-6712, USA
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Sentagne T, Zerbola M, Garcia M, Kumsap C, Mungkung V, Mezeix L. Method to map human and infrastructure vulnerability using CNN land cover: Case study of floating tank explosion at petrochemical plants of LaemChabang, Thailand. J Loss Prev Process Ind 2023. [DOI: 10.1016/j.jlp.2023.105057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
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Izquierdo M, Baulies S, Garcia M, Tresserra F, Fabregas R, Ubeda A, Soldevila PB. P141 Prognostic factors breast cancer after pregnancy. Breast 2023. [DOI: 10.1016/s0960-9776(23)00258-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
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Devos S, Bonnet F, Hessamfar M, Neau D, Vareil MO, Leleux O, Cazanave C, Rouanes N, Duffau P, Lazaro E, Dabis F, Wittkop L, Barger D, Blanco P, Bouchet S, Breilh D, Desjardin S, Gaborieau V, Gimbert A, Lacaze-Buzy L, Lacoste D, Lafon ME, Lawson-Ayayi S, Le Marec F, Le Moal G, Malvy D, Marchand L, Mercié P, Pellegrin I, Perrier A, Petrov-Sanchez V, Bernard N, Bronnimann D, Chaussade H, Dondia D, Faure I, Morlat P, Mériglier E, Paccalin F, Riebero E, Rivoisy C, Vandenhende MA, Barthod L, Dauchy FA, Desclaux A, Ducours M, Dutronc H, Duvignaud A, Leitao J, Lescure M, Nguyen D, Pistone T, Puges M, Wirth G, Courtault C, Camou F, Greib C, Pellegrin JL, Rivière E, Viallard JF, Imbert Y, Thierry-Mieg M, Rispal P, Caubet O, Ferrand H, Tchamgoué S, Farbos S, Wille H, Andre K, Caunegre L, Gerard Y, Osorio-Perez F, Chossat I, Iles G, Labasse-Depis M, Lacassin F, Barret A, Castan B, Koffi J, Saunier A, Zabbe JB, Dumondin G, Beraud G, Catroux M, Garcia M, Giraud V, Martellosio JP, Roblot F, Pasdeloup T, Riché A, Grosset M, Males S, Ngo Bell C, Carpentier C, Tumiotto C, Miremeont-Salamé G, Arma D, Arnou G, Blaizeau MJ, Camps P, Decoin M, Delveaux S, Diarra F, Gabrea L, Lai WH, Lenaud E, Plainchamps D, Pougetoux A, Uwamaliya B, Zara K, Conte V, Gapillout M. Tobacco, alcohol, cannabis, and illicit drug use and their association with CD4/CD8 cell count ratio in people with controlled HIV: a cross-sectional study (ANRS CO3 AQUIVIH-NA-QuAliV). BMC Infect Dis 2023; 23:16. [PMID: 36624391 PMCID: PMC9830769 DOI: 10.1186/s12879-022-07963-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND To evaluate drug use (alcohol, tobacco, cannabis and other drugs) and its association with mean CD4/CD8 T cell count ratio, a marker of chronic inflammation, in virally suppressed people living with HIV-1 (PLWH) in Nouvelle Aquitaine, France. METHODS A multi-centric, cross-sectional analysis was conducted in 2018-19 in the QuAliV study-ANRS CO3 AQUIVIH-NA cohort. Tobacco, alcohol, cannabis, and other drug use (poppers, cocaine, amphetamines, synthetic cathinones, GHB/GBL) were self-reported. CD4 and CD8 T cell counts and viral load measures, ± 2 years of self-report, and other characteristics were abstracted from medical records. Univariable and multivariable linear regression models, adjusted for age, sex, HIV risk group, time since HIV diagnosis, and other drug use were fit for each drug and most recent CD4/CD8 ratio. RESULTS 660 PLWH, aged 54.7 ± 11.2, were included. 47.7% [315/660] had a CD4/CD8 ratio of < 1. Their mean CD4/CD8 ratio was 1.1 ± 0.6. 35% smoked; ~ 40% were considered to be hazardous drinkers or have alcohol use disorder; 19.9% used cannabis and 11.9% other drugs. Chemsex-associated drug users' CD4/CD8 ratio was on average 0.226 (95% confidence interval [95% CI] - 0.383, - 0.070) lower than that of non-users in univariable analysis (p = 0.005) and 0.165 lower [95% CI - 0.343, 0.012] in multivariable analysis (p = 0.068). CONCLUSIONS Mean differences in CD4/CD8 ratio were not significantly different in tobacco, alcohol and cannabis users compared to non-users. However, Chemsex-associated drug users may represent a population at risk of chronic inflammation, the specific determinants of which merit further investigation. TRIAL REGISTRATION NUMBER NCT03296202.
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Affiliation(s)
- Sophie Devos
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France
| | - Fabrice Bonnet
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France ,grid.7429.80000000121866389Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-P 1401, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
| | - Mojgan Hessamfar
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France
| | - Didier Neau
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service des Maladies Infectieuses et Tropicales, INSERM, U1219, Pl. Amélie Raba Léon, U121933000 Bordeaux, France
| | - Marc-Olivier Vareil
- grid.418076.c0000 0001 0226 3611Centre Hospitalier de la Côte Basque, Service de Maladies Infectieuses, 13 Avenue de l’interne Jacques Loëb, BP 8, 64109 Bayonne Cedex, France
| | - Olivier Leleux
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-P 1401, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
| | - Charles Cazanave
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service des Maladies Infectieuses et Tropicales, INSERM, U1219, Pl. Amélie Raba Léon, U121933000 Bordeaux, France
| | - Nicolas Rouanes
- Centre Hospitalier de Périgueux, Service de Médecine Polyvalente, 80 Av. Georges Pompidou, 22400 Périgueux, France
| | - Pierre Duffau
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France ,grid.4444.00000 0001 2112 9282Univ. Bordeaux, Department of Immunology, CNRS, ImmunoConcEpT, UMR 5164, 33000 Bordeaux, France
| | - Estibaliz Lazaro
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne, 1 Avenue de Magellan, 33600 Pessac, France
| | - François Dabis
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France
| | - Linda Wittkop
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.7429.80000000121866389Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-P 1401, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,Univ. Bordeaux, INSERM, INRIA, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.508062.90000 0004 8511 8605CHU de Bordeaux, Service d’information médicale, INSERM, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
| | - Diana Barger
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
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Blanc P, Bonnet F, Leleux O, Perrier A, Bessede E, Pereyre S, Cazanave C, Neau D, Vareil MO, Lazaro E, Duffau P, Saunier A, André K, Wittkop L, Vandenhende MA, Blanco P, Bonnet F, Bouchet S, Breilh D, Cazanave C, Desjardin S, Gaborieau V, Gimbert A, Hessamfar M, Lacaze-Buzy L, Lacoste D, Lafon ME, Lawson-Ayayi S, Lazaro E, Leleux O, Le Marec F, Le Moal G, Malvy D, Marchand L, Mercié P, Neau D, Pellegrin I, Perrier A, Petrov-Sanchez V, Vareil MO, Wittkop L, Bernard N, Bonnet F, Bronnimann D, Chaussade H, Dondia D, Duffau P, Faure I, Hessamfar M, Mercié P, Morlat P, Mériglier E, Paccalin F, Riebero E, Rivoisy C, Vandenhende MA, Barthod L, Cazanave C, Dauchy FA, Desclaux A, Ducours M, Dutronc H, Duvignaud A, Leitao J, Lescure M, Neau D, Nguyen D, Malvy D, Pistone T, Puges M, Wirth G, Courtault C, Camou F, Greib C, Lazaro E, Pellegrin JL, Rivière E, Viallard JF, Imbert Y, Thierry-Mieg M, Rispal P, Caubet O, Ferrand H, Tchamgoué S, Farbos S, Vareil MO, Wille H, Andre K, Caunegre L, Gerard Y, Osorio-Perez F, Chossat I, Iles G, Gerard Y, Labasse-Depis M, Lacassin F, Barret A, Courtault C, Castan B, Koffi J, Rouanes N, Saunier A, Zabbe JB, Dumondin G, Gaborieau V, Gerard Y, Beraud G, Le Moal G, Catroux M, Garcia M, Giraud V, Martellosio JP, Roblot F, Pasdeloup T, Riché A, Grosset M, Males S, Bell CN, Pasdeloup T, Pasdeloup T, Blanco P, Pellegrin I, Carpentier C, Pellegrin I, Bellecave P, Lafon ME, Tumiotto C, Bouchet S, Breilh D, Miremeont-Salamé G, Arma D, Arnou G, Blaizeau MJ, Camps P, Decoin M, Delveaux S, Diarra F, Gabrea L, Lawson-Ayayi S, Lenaud E, Plainchamps D, Pougetoux A, Uwamaliya B, Zara K, Conte V, Gapillout M, Leleux O, Perrier A, Peyrouny-Mazeau A. Severe bacterial non-AIDS infections in persons with HIV: the epidemiology and evolution of antibiotic resistance over an 18-year period (2000-2017) in the ANRS CO3 AquiVih-Nouvelle-Aquitaine cohort. Clin Infect Dis 2023; 76:1814-1821. [PMID: 36610063 DOI: 10.1093/cid/ciac978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Severe non-AIDS bacterial infections (SBIs) are one of the leading causes of hospital admissions among persons with HIV (PWH) in regions with high ART coverage. METHODS This large prospective cohort study of PWH examined the types of infections, bacterial documentation, and evolution of antibiotic resistance among PWH hospitalized with SBIs over an 18-year period. RESULTS Between 2000 and 2017, 459 PWH had at least one SBI with bacterial documentation. Among the 847 SBIs, there were 280 cases of bacteremia, 269 cases of pneumonia, and 240 urinary tract infections. The 1025 isolated bacteria included Enterobacteriaceae (n = 394; mainly Escherichia coli), Staphylococcus aureus (n = 153) and Streptococcus pneumoniae (n = 82). The proportion of S. pneumoniae as the causative agent in pneumonia and bacteremia decreased sharply over time, from 34% to 8% and from 21 to 3%, respectively.The overall antibiotic resistance of S. aureus and S. pneumoniae decreased progressively but it increased for Enterobacteriaceae (from 24% to 48% for amoxicillin-clavulanate, from 4 to 18% for cefotaxime, and from 5% to 27% for ciprofloxacin). Cotrimoxazole prophylaxis was associated with higher nonsusceptibility of S. pneumoniae to amoxicillin and erythromycin, higher nonsusceptibility of Enterobacteriaceae to beta-lactams and fluoroquinolones, and a higher risk of extended-spectrum β-lactamase producing Enterobacteriaceae. CONCLUSIONS The bacterial resistance pattern among PWH between 2014 and 2017 was broadly similar to that in the general population, with the exception of a higher resistance profile of Enterobacteriaceae to fluoroquinolones. The use of cotrimoxazole as prophylaxis was associated with an increased risk of antibiotic resistance.
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Affiliation(s)
- Peggy Blanc
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Fabrice Bonnet
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France.,Université de Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Olivier Leleux
- Université de Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Adélaïde Perrier
- Université de Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Emilie Bessede
- Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - Sabine Pereyre
- Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, Hôpital Pellegrin, F-33000 Bordeaux, France.,Université de Bordeaux, CNRS, UMR 5234 Fundamental Microbiology and Pathogenicity, F-33000 Bordeaux, France
| | - Charles Cazanave
- Centre Hospitalier Universitaire de Bordeaux, Service des maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - Didier Neau
- Centre Hospitalier Universitaire de Bordeaux, Service des maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - Marc-Olivier Vareil
- Centre Hospitalier de la Côte Basque, Service de Maladies Infectieuses, F-64109 Bayonne, France
| | - Estibaliz Lazaro
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne, Hôpital du Haut-Lévêque, F-33600 Pessac, France
| | - Pierre Duffau
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Immunologie Clinique, Hôpital Saint-André, UMR 5164, F-33000 Bordeaux, France.,Université de Bordeaux, CNRS, Immuno ConcEpT, UMR 5164, F-33000 Bordeaux, France
| | - Aurélie Saunier
- Centre Hospitalier de Périgueux, Service de Médecine Interne, F-24000 Périgueux, France
| | - Katell André
- Centre Hospitalier de Dax, Service de Maladies Infectieuses, F-40100 Dax, France
| | - Linda Wittkop
- Université de Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, F-33000, Bordeaux, France.,INRIA SISTM Team, F-33405, Talence, France.,Centre Hospitalier Universitaire de Bordeaux, Service d'information médicale, INSERM, Institut Bergonié, CIC-EC 1401, F-33000 Bordeaux, France
| | - Marie-Anne Vandenhende
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne, Hôpital Pellegrin, INSERM, Institut Bergonié, CIC-EC 1401, F-33000 Bordeaux, France.,Université de Bordeaux, INSERM, Institut Bergonié, CIC-EC 1401, F-33000 Bordeaux, France
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De Falla V, Figueroa F, Michalski J, van Rheenen J, Gay H, Ruiz Furlan E, Kihn A, Hugo G, Sobrevilla L, Garcia M, Davila S, Powderly W, Velarde A, Sun B, Lee K, Huang Y, Ma K, Najera K, García C, Reyes F, Ixquiac M, Henke L. Quality of Life of Patients Treated with Radiotherapy in an Upper Middle-Income Country. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Perea S, Mendes SL, Sousa-Santos C, Ondina P, Amaro R, Castro J, San-Miguel E, Lima CS, Garcia M, Velasquez V, Garcia-Roves P, Fernández D, Araujo R, Sousa VC, Reis J. Applying genomic approaches to delineate conservation strategies using the freshwater mussel Margaritifera margaritifera in the Iberian Peninsula as a model. Sci Rep 2022; 12:16894. [PMID: 36207367 PMCID: PMC9546909 DOI: 10.1038/s41598-022-20947-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/21/2022] [Indexed: 11/09/2022] Open
Abstract
Effective conservation actions to counteract the current decline of populations and species require a deep knowledge on their genetic structure. We used Single Nucleotide Polymorphisms (SNPs) to infer the population structure of the highly threatened freshwater pearl mussel Margaritifera margaritifera in the Iberian Peninsula. A total of 130 individuals were collected from 26 locations belonging to 16 basins. We obtained 31,692 SNPs through Genotyping by Sequencing (GBS) and used this dataset to infer population structure. Genetic diversity given as observed heterozygosity was low. Pairwise FST comparisons revealed low levels of genetic differentiation among geographically close populations. Up to 3 major genetic lineages were determined: Atlantic, Cantabrian and Douro. This structure suggests a close co-evolutionary process with brown trout (Salmo trutta), the primordial fish host of this mussel in the studied area. Some sub-basins showed some genetic structuring, whereas in others no intrapopulation differentiation was found. Our results confirm that genetic conservation units do not match individual basins, and that knowledge about the genetic structure is necessary before planning recovery plans that may involve relocation or restocking. The same reasoning should be applied to strictly freshwater species that are sessile or have restricted dispersal abilities and are currently imperiled worldwide.
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Affiliation(s)
- S Perea
- MARE-Marine and Environmental Sciences Centre/ARNET-Aquatic Research Network, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, 1749-016, Lisbon, Portugal.,Instituto de Biología, Departamento de Zoología, Universidad Nacional Autónoma de México, Tercer Circuito Exterior S/N, C.P. 04510, Mexico City, Mexico
| | - S L Mendes
- MARE-Marine and Environmental Sciences Centre/ARNET-Aquatic Research Network, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, 1749-016, Lisbon, Portugal.,cE3c-Centre for Ecology, Evolution and Environmental Changes, Department of Animal Biology, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, 1749-016, Lisbon, Portugal
| | - C Sousa-Santos
- MARE-Marine and Environmental Sciences Centre/ARNET-Aquatic Research Network, ISPA-Instituto Superior de Ciências Psicológicas, Sociais e da Vida, Rua Jardim do Tabaco, 34, 1149-041, Lisbon, Portugal
| | - P Ondina
- Departamento de Zooloxía, Xenética e Antropoloxía Física, Universidade de Santiago de Compostela, Campus Terra, 27002, Lugo, Spain.,IBADER-Instituto de Biodiversidade Agraria E Desenvolvemento Rural, Campus, Universidade de Santiago de Compostela, Campus Terra, 27002, Lugo, Spain
| | - R Amaro
- Departamento de Zooloxía, Xenética e Antropoloxía Física, Universidade de Santiago de Compostela, Campus Terra, 27002, Lugo, Spain.,IBADER-Instituto de Biodiversidade Agraria E Desenvolvemento Rural, Campus, Universidade de Santiago de Compostela, Campus Terra, 27002, Lugo, Spain
| | - J Castro
- Departamento de Zooloxía, Xenética e Antropoloxía Física, Universidade de Santiago de Compostela, Campus Terra, 27002, Lugo, Spain.,IBADER-Instituto de Biodiversidade Agraria E Desenvolvemento Rural, Campus, Universidade de Santiago de Compostela, Campus Terra, 27002, Lugo, Spain
| | - E San-Miguel
- Departamento de Zooloxía, Xenética e Antropoloxía Física, Universidade de Santiago de Compostela, Campus Terra, 27002, Lugo, Spain.,IBADER-Instituto de Biodiversidade Agraria E Desenvolvemento Rural, Campus, Universidade de Santiago de Compostela, Campus Terra, 27002, Lugo, Spain
| | - C S Lima
- MARE-Marine and Environmental Sciences Centre/ARNET-Aquatic Research Network, ISPA-Instituto Superior de Ciências Psicológicas, Sociais e da Vida, Rua Jardim do Tabaco, 34, 1149-041, Lisbon, Portugal
| | - M Garcia
- MARE-Marine and Environmental Sciences Centre/ARNET-Aquatic Research Network, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, 1749-016, Lisbon, Portugal
| | - V Velasquez
- Dirección General del Medio Natural y Desarrollo Rural, Oviedo, Principado de Asturias, Spain
| | - P Garcia-Roves
- Dirección General del Medio Natural y Desarrollo Rural, Oviedo, Principado de Asturias, Spain
| | - D Fernández
- Biosfera-Consultoría Medioambiental, C/Candamo no. 5,, C.P. 33012, Oviedo, Asturias, Spain
| | - R Araujo
- Museo Nacional de Ciencias Naturales - CSIC, C/José Gutierrez Abascal, 2, 28006, Madrid, Spain
| | - V C Sousa
- cE3c-Centre for Ecology, Evolution and Environmental Changes, Department of Animal Biology, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, 1749-016, Lisbon, Portugal
| | - J Reis
- MARE-Marine and Environmental Sciences Centre/ARNET-Aquatic Research Network, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, 1749-016, Lisbon, Portugal.
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Anguita Gamez M, Esteban A, Bonilla JL, Garcia M, Bernal JL, Del Prado N, Fernandez Perez C, Gomez Doblas JJ, Perez Villacastin J, Marin F, Elola FJ, Anguita Sanchez M. Clinical features and short-term prognosis in the very elderly, >90 year-old, patients hospitalized with heart failure. A population-based study (2016–2019). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Heart failure (HF) is a main health problem in western countries, and a major cause of hospitalizations and death, particularly in older people. Few data are available about clinical features and prognosis of very old patients, those aged 90 or more years.
Purpose
To analyse the clinical features and short-term prognosis (in-hospital mortality and 30-day readmission rate) of patients aged 90 or more years hospitalized with HF in Spain in the last years.
Methods
We conducted a retrospective analysis of patients discharged with an ICD-10 main diagnosis of HF from the Spanish National Health System (SNHS) public hospitals between 2016 and 2019, using as source of data the Minimum Basic Data Set of the SNHS. A comparison of clinical profile, in-hospital mortality and 30-day cardiovascular readmission rate between patients aged 75 to 89 years and those with 90 or more years was performed.
Results
From 2016 to 2019, 354,792 episodes of people older than 74-year and principal diagnosis of HF were included, being 59.2% female. Mean age of the whole population was 85.2±5.5 years, crude in-hospital mortality rate was 12.7% and crude cardiovascular 30-day readmission rate, 11.8%. The very older patients' subgroup (90 or more year-old) comprised 78.777 patients (22.2%). Table 1 shows the differences in clinical features between these patients and those aged 75 to 89 (77.8%). Patients aged 90 or more years were female in a higher proportion and showed a higher prevalence of cognitive impairment and renal failure, but a lower prevalence of most comorbidities (coronary artery revascularization, valve heart disease, cancer, diabetes mellitus, chronic liver disease). The diagnosis of previous myocardial infarction, stroke and systemic hypertension was similar in both groups (Table 1). Crude 30-day cardiovascular readmission rate was slightly but significantly lower in the oldest subgroup (10.9% vs 12%, p<0.001), while crude in-hospital mortality was higher (18.5% vs 11%, p<0.001).
Conclusions
Patients aged 90 or more years represents almost a fourth part of elderly patients hospitalized with HF in Spain within the last years. In general, prevalence of comorbidities and associated heart disease was similar or lower, but in-hospital mortality was twice higher, as compared with less older patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - A Esteban
- University Hospital Severo Ochoa, Cardiology , Leganes , Spain
| | - J L Bonilla
- Hospital San Juan de la Cruz, Cardiology , Ubeda , Spain
| | - M Garcia
- Interhospital Foundation for Cardiovascular Research, Fundacion IMAS , Madrid , Spain
| | - J L Bernal
- Interhospital Foundation for Cardiovascular Research, Fundacion IMAS , Madrid , Spain
| | - N Del Prado
- Interhospital Foundation for Cardiovascular Research, Fundacion IMAS , Madrid , Spain
| | - C Fernandez Perez
- Interhospital Foundation for Cardiovascular Research, Fundacion IMAS , Madrid , Spain
| | - J J Gomez Doblas
- Virgin of Victory University Hospital, Cardiology , Malaga , Spain
| | | | - F Marin
- University Hospital Virgen de la Arrixaca, Cardiology , Murcia , Spain
| | - F J Elola
- Interhospital Foundation for Cardiovascular Research, Fundacion IMAS , Madrid , Spain
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Esteban Fernandez A, Anguita M, Bonilla JL, Anguita M, Ruesgas R, Molina M, Garcia M, Bernal JL, Del Prado N, Fernandez Perez C, Marin F, Perez Villacastin J, Gomez Doblas JJ, Fernandez Rozas I, Elola FJ. 1-year hospital readmissions due to cardiovascular causes after a heart failure episode in elderly patients in Spain. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The prevalence of heart failure (HF) increases with age, one of the leading causes of hospitalization and death in the elderly. However, there are little data about the long-term readmission rate of elderly patients after an episode of HF admission in Spain.
Purpose
Study 1-year hospital readmissions due to cardiovascular causes in patients ≥75 years discharged to a hospital due to HF in Spain.
Methods
We performed a retrospective analysis of the Minumum basic dataset of Spain, including all episodes of HF discharged from public hospitals in Spain between 2016 and 2019. The codification was made with ICD-10. We selected patients ≥75 years with HF as the principal diagnosis. We analyzed predictors of readmissions 365 days after the index episode of HF hospitalization with Poisson regression.
Results
236,463 index episodes of HF in>75 years were included. 59.1% were female, and the mean age was 85 (SD 5.6) years. 35.0% had HF-pef, 4.3% HF-ref, and 60.7% had unknown LVEF HF.
39.6% of patients had at least one readmission (mean 1.7 readmissions by year for these patients), with no differences in sex or age. Patients with non-cardiovascular comorbidities (renal failure, chronic lung disorders, and severe hematological disorders) as well as coronary atherosclerosis and diabetes were more likely to be readmitted (Table 1).
Conclusions
After a hospital discharge for HF in patients ≥75 years, the crude ratio of readmission due to cardiovascular causes at 1-year was 39.6%. Readmissions were more likely in patients with non-cardiovascular comorbidities, predominantly renal, hematological, and chronic respiratory disorders, and those with diabetes and coronary atherosclerosis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - M Anguita
- University Hospital Reina Sofia , Cordoba , Spain
| | - J L Bonilla
- Hospital San Juan de la Cruz , Ubeda , Spain
| | - M Anguita
- Hospital Clinico San Carlos , Madrid , Spain
| | - R Ruesgas
- Severo Ochoa Hospital , Leganes , Spain
| | - M Molina
- Severo Ochoa Hospital , Leganes , Spain
| | | | | | | | | | - F Marin
- Virgen of the Arrixaca University Hospital , Murcia , Spain
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Garcia M, Rouchy E, Michel G. Temperament and character profiles of adolescent participants in the choking game. Arch Pediatr 2022; 29:475-479. [PMID: 36109289 DOI: 10.1016/j.arcped.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 04/25/2022] [Accepted: 06/18/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The role of personality traits in self-asphyxial behaviors remains largely unexplored. The aim of this study was to explore temperament and character profiles of youth reporting participation in the choking game using Cloninger's biopsychosocial model of personality. METHODS Data were collected among French middle-school students (N=1771) aged 9-16 years (mean age=13.0, SD=1.3) and randomly selected from 13 public establishments located in different regions of France. Logistic regression models were run to identify Cloninger's temperamental and character dimensions associated with engagement in the choking game. RESULTS Descriptive analysis revealed that participants showed high scores of novelty-seeking (Cohen's d=0.293, p<0.001) and low levels of cooperativeness (Cohen's d=0.182, p<0.01), persistence (Cohen's d=0.182, p<0.05), and reward dependence (Cohen's d=0.241, p<0.01). However, multivariate modeling indicated that only the novelty-seeking dimension tended to slightly differentiate participants from non-participants within the global sample (OR=1.03, 95% CI: 1-1.06). When we compared girls and boys, we found a slight trend in association only in boys (OR=1.04, 95% CI: 1-1.08). CONCLUSIONS Our study, which contributes to the growing literature on the psychological correlates of choking activities and is the first to investigate the potential predictive role of personality traits in this risky behavior, suggests to some extent that (a) the choking game could possibly be influenced by some temperamental characteristics, and that (b) it might not have the same function according to the gender considered.
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Affiliation(s)
- M Garcia
- Institut de Sciences Criminelles et de la Justice (ISCJ), University of Bordeaux, France; Department of Psychology, University of Bordeaux, France.
| | - E Rouchy
- Institut de Sciences Criminelles et de la Justice (ISCJ), University of Bordeaux, France; Department of Psychology, University of Bordeaux, France
| | - G Michel
- Institut de Sciences Criminelles et de la Justice (ISCJ), University of Bordeaux, France; Department of Psychology, University of Bordeaux, France
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Hoxha T, Pienkowski M, Khan K, Moore A, Balaratnam K, Chowdhury M, Walia P, Sabouhanian A, Herman J, Strom E, Hueniken K, Corke L, Leighl N, Shepherd F, Bradbury P, Sacher A, Cheng S, Brown M, Mai V, Garcia M, Zhan L, Xu W, Liu G. EP02.04-009 Real World Survival Outcome Analysis of Adjuvant Therapies in Non-EGFR, Non-ALK Early Stage Resected NSCLC. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Lee J, Mai V, Garcia M, Cheng S, Khan K, Balaratnam K, Thakral A, Brown M, Zhan L, Corke L, Leighl N, Shepherd F, Bradbury P, Sacher A, Liu G. EP08.02-082 Treatment Patterns and Outcomes of First-line Osimertinib-treated Advanced EGFR Mutated NSCLC Patients: A Real-world Study. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.764] [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: 11/25/2022]
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Arregui M, Garcia M, Martinez I, Aparicio I, Tirado V, Galera M, Alvarez R, Calles A. EP08.02-110 Plasma-based Molecular Profiling to Guide Treatment Decisions in Patients with Advanced NSCLC and Limited Tissue Biopsy. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Schmid S, Zhan L, Garcia M, Cheng S, Khan K, Chowdhury M, Sabouhanian A, Herman J, Walia P, Strom E, Brown M, Patel D, Xu W, Shepherd F, Sacher A, Leighl N, Bradbury P, Shultz D, Liu G. 1144P Clinical outcomes of NSCLC patients (pts) who had brain-only metastasis at time of stage IV diagnosis, by presence versus absence of EGFR/ALK mutations. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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21
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Garcia M, Garcia de Herreros M, Auclin E, Caravaca G, Sart J, Riudavets M, Vasseur D, Albarran-Artahona V, Laguna J, Gorria T, Castro RL, Teixido C, Castellano G, Martinez AB, Arcocha A, Vinolas N, Reyes R, Prat A, Reguart N, Elio J, Leighl N, Besse B, Mezquita L. OA13.04 Prevalence of Molecular Alterations in NSCLC and Estimated Indoor Radon in Europe: RADON EUROPE Study. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Garcia M, Rouchy E, Garcia M, Michel G. The network structure of psychopathic personality traits in a community sample of young adult females. Encephale 2022:S0013-7006(22)00101-4. [DOI: 10.1016/j.encep.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 10/15/2022]
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Perez-Cervera J, Arce J, Fattouh M, Kuno T, Schenone A, Brahmanandam V, Jung Lee U, Haramati L, Levsky J, Villines T, Garcia M, Slipczuk L. 493 Influence Of BMI On Virtual Coronary Artery Calcium Scoring. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fattouh M, Kuno T, Skendelas J, Duarte G, Fernandez-Hazim C, Rodriguez-Guerra M, Neshiwat P, Schenone A, Zhang L, Arbab-Zadeh A, Blaha M, Berman D, Slomka P, Dey D, Garcia M, Slipczuk L. 500 Power Of Zero In Underrepresented Minorities With Chest Pain. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Dinamarca Cáceres F, Garcia M, Casanovas F, Oller Canet S, Sauras R, Fonseca F, Torrens M. Dual disorders in liaison-consultation psychiatry. A descriptive study of patients with substance use disorder admitted to a general hospital. Eur Psychiatry 2022. [PMCID: PMC9565504 DOI: 10.1192/j.eurpsy.2022.248] [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
Several studies describe that the coexistence of a substance use disorder with another psychiatric condition or “dual disorder” (DD) is associated with a worse evolution at all levels, including a greater burden of medical illnesses and greater mortality.
Objectives
To describe the presence of DD and related factors in patients admitted to a General Hospital that required assessment by a psychiatry service.
Methods
A descriptive study that includes patients admitted to the Hospital del Mar in Barcelona for all medical-surgical reasons and attended by the specific addiction psychiatry consultation service between January 2016 and October 2021. Sociodemographic and clinical data are collected including the history of consumption and the diagnosis of dual disorder. Chi-square test was used for comparison between groups.
Results
The sample was 1796 patients (Women: 345. Mean age: 50.3 years; SD: 12.6). 43.7% of the sample presented DD, with axis 1 disorders being the most frequent. There was an association of DD to factors as: being woman (54 vs 41.2% p <0.001), HIV positive serologies (54 vs 42.7% p <0.001), being homeless (49 vs 31.7% p <0.001) and cocaine consumption compared to other substances (53.4 vs 39.8% p <0.001).
Conclusions
In our sample, almost half of patients had DD. The representation of women was significantly lower, however they presented a higher proportion of DD. In this study we describe an association of DD with other biopsychosocial problems, and further studies are necessary to determine in which sense they are related and optimize patient care.
Disclosure
No significant relationships.
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Nicholls J, Leonard A, Garcia M, Sadasivam N, Charlesworth M. Sickle cell-related fat embolism syndrome: the need for venovenous extracorporeal membrane oxygenation with exchange transfusion, renal replacement therapy and plasma exchange. J Cardiothorac Vasc Anesth 2022; 36:3859-3862. [DOI: 10.1053/j.jvca.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/11/2022] [Accepted: 06/15/2022] [Indexed: 11/11/2022]
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Garcia M, Rouchy E, Colins O, Andershed H, Michel G. Validation of the French Youth Psychopathic Traits Inventory-Short Version in a general population sample of emerging adults in France. Psychologie Française 2022. [DOI: 10.1016/j.psfr.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Garcia M, Jeyaraj S. Abstract No. 575 Renal tumors image-guided core needle biopsy: coaxial or non-coaxial? J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Yuan N, Chung T, Ray E, Sioni C, Jimenez A, Garcia M. Requirement of Mental-health Referral Letters for Staged and Revision Genital Gender-Affirming Surgeries: An Unsanctioned Barrier to Care. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.169] [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: 10/18/2022]
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30
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Walton A, Garcia M. Anal Sex and Sexual Function Satisfaction: A Comprehensive (and Critical) Review of Current Medical Literature. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.393] [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: 10/18/2022]
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Volod O, Lam L, Robert C, Moriguchi J, Yur J, Garcia M, Zhou J, Wilde A, Czer L. Determining Cause for Activated Partial Thromboplastin Time and Anti-Factor Xa Discordance in Mechanical Circulatory Support Patients on Heparin; Can Thromboelastogram Help? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1170] [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: 10/18/2022] Open
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Yuan N, Gupta A, Garcia M. An Alternative Option for Gender-Affirming Revision Vaginoplasty: The Tubularized Urachus-Peritoneal Hinge Flap. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Caruso G, Ciattaglia S, Colling B, Pace LD, Dongiovanni D, D'Onorio M, Garcia M, Jin X, Johnston J, Leichtle D, Pinna T, Porfiri M, Raskob W, Taylor N, Terranova N, Vale R. DEMO – The main achievements of the Pre – Concept phase of the safety and environmental work package and the development of the GSSR. Fusion Engineering and Design 2022. [DOI: 10.1016/j.fusengdes.2022.113025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Alancay A, Esposto S, Sormani M, Torre V, Maydana M, Garcia M, Lagala Y, Fagnani M, Bastons S, Uriarte V, Sosa M, Vinuesa M, Morales J. Myopericarditis, Hepatitis and Meningitis in a patient with Congenital Chagas Disease (CCD). Int J Infect Dis 2022. [DOI: 10.1016/j.ijid.2021.12.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Mengual L, Ingelmo-Torres M, Carrasco R, Roldan F, Garcia M, Alcaraz A, Izquierdo L, Ribal M. Utility of bladder EpiCheck methylation test for the surveillance of bladder cancer patients treated with bacillus Calmette-Guérin. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00165-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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37
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Vali A, Dalle H, Gilleron J, Havis E, Garcia M, Beaupère C, Denis C, Poussin K, Roblot N, Ledent T, Bouillet B, Cormont M, Tanti JF, Capeau J, Vatier C, Fève B, Grosfeld A, Moldes M. Rôle du récepteur adipocytaire des glucocorticoïdes dans l’expansion et la vascularisation du tissu adipeux. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.175] [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: 10/18/2022]
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38
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Carrera-Salinas A, González-Díaz A, Vázquez-Sánchez DA, Camoez M, Niubó J, Càmara J, Ardanuy C, Martí S, Domínguez MÁ, Garcia M, Marco F, Chaves F, Cercenado E, Tapiol J, Xercavins M, Fontanals D, Loza E, Rodríguez-López F, Olarte I, Mirelis B, Ruiz de Gopegui E, Lepe J, Larrosa N. Staphylococcus aureus surface protein G (sasG) allelic variants: correlation between biofilm formation and their prevalence in methicillin-resistant S. aureus (MRSA) clones. Res Microbiol 2022; 173:103921. [DOI: 10.1016/j.resmic.2022.103921] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 01/02/2023]
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39
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van Wifferen F, de Jonge L, Worthington J, Greuter MJ, Lew JB, Nadeau C, van den Puttelaar R, Feletto E, Yong JH, Lansdorp-Vogelaar I, Canfell K, Coupé VM, Anderson L, Besó Delgado M, Binefa G, Cust A, Dekker E, Dell’Anna V, Essue B, Espinas J, Flander L, Garcia M, Hahn A, Idigoras I, Katanoda K, Laghi L, Lamrock F, McFerran E, Majek O, Molina-Barceló A, Ledger M, Musa O, Njor S, O’Connor K, Portillo I, Salas D, Senore C, Smith H, Symonds E, Tachecí I, Taksler G, Tolani M, Treby M, Zauber A, Zheng Y. Prioritisation of colonoscopy services in colorectal cancer screening programmes to minimise impact of COVID-19 pandemic on predicted cancer burden: A comparative modelling study. J Med Screen 2021; 29:72-83. [PMID: 35100894 PMCID: PMC9087314 DOI: 10.1177/09691413211056777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objectives Colorectal cancer (CRC) screening with a faecal immunochemical test (FIT) has
been disrupted in many countries during the COVID-19 pandemic. Performing
catch-up of missed screens while maintaining regular screening services
requires additional colonoscopy capacity that may not be available. This
study aimed to compare strategies that clear the screening backlog using
limited colonoscopy resources. Methods A range of strategies were simulated using four country-specific CRC
natural-history models: Adenoma and Serrated pathway to Colorectal CAncer
(ASCCA) and MIcrosimulation SCreening ANalysis for CRC (MISCAN-Colon) (both
in the Netherlands), Policy1-Bowel (Australia) and OncoSim (Canada).
Strategies assumed a 3-month screening disruption with varying recovery
period lengths (6, 12, and 24 months) and varying FIT thresholds for
diagnostic colonoscopy. Increasing the FIT threshold reduces the number of
referrals to diagnostic colonoscopy. Outcomes for each strategy were
colonoscopy demand and excess CRC-related deaths due to the disruption. Results Performing catch-up using the regular FIT threshold in 6, 12 and 24 months
could prevent most excess CRC-related deaths, but required 50%, 25% and
12.5% additional colonoscopy demand, respectively. Without exceeding usual
colonoscopy demand, up to 60% of excess CRC-related deaths can be prevented
by increasing the FIT threshold for 12 or 24 months. Large increases in FIT
threshold could lead to additional deaths rather than preventing them. Conclusions Clearing the screening backlog in 24 months could avert most excess
CRC-related deaths due to a 3-month disruption but would require a small
increase in colonoscopy demand. Increasing the FIT threshold slightly over
24 months could ease the pressure on colonoscopy resources.
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Affiliation(s)
- Francine van Wifferen
- Decision Modeling Center, Department of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Lucie de Jonge
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Joachim Worthington
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia
| | - Marjolein J.E. Greuter
- Decision Modeling Center, Department of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Jie-Bin Lew
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia
| | - Claude Nadeau
- Health Analysis Division, Statistics Canada, Ottawa, Canada
| | | | - Eleonora Feletto
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia
| | | | - Iris Lansdorp-Vogelaar
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Veerle M.H. Coupé
- Decision Modeling Center, Department of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam, The Netherlands
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Brady PC, Cummings ME, Gruev V, Hernandez T, Blair S, Vail A, Garcia M. In situ measurements of reef squid polarization patterns using two-dimensional polarization data mapped onto three-dimensional tessellated surfaces. J R Soc Interface 2021; 18:20210703. [PMID: 34814730 DOI: 10.1098/rsif.2021.0703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Reef squids belong to a group reputed for polarization sensitivity, yet polarization patterns of reef squid have not been quantified in situ. To quantify polarization patterns from video polarimetric data, we developed a protocol to map two-dimensional polarization data onto squid-shaped three-dimensional tessellated surfaces. This protocol provided a robust data container used to investigate three-dimensional regions-of-interest, producing data lineouts derived from the squid's geometry. This protocol also extracted polarimeter and squid body orientations and the solar heading from polarization images. When averaged over the solar heading, the ventral midline gave a low degree of polarization (2.4 ± 5.3%), and the area between the ventral and flank midlines had higher values (9.0 ± 5.3%). These averaged data had a large discontinuity in the angle of polarization (AoP) at the mantle's ventral midline (64 ± 55°), with larger discontinuities measured on individual squid. Ray-tracing calculations demonstrated that the AoP pattern was not related to the squid's surface-normal geometry. However, the AoP followed virtual striation axes on the squid's surface oriented 24° to the squid's long axis, similar in angle (27°) to the striations of birefringent collagen fibres documented in other squid species' skin.
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Affiliation(s)
- P C Brady
- Integrative Biology, University of Texas at Austin School of Biological Sciences, Austin, TX 78712-0128, USA
| | - M E Cummings
- Integrative Biology, University of Texas at Austin School of Biological Sciences, Austin, TX 78712-0128, USA
| | - V Gruev
- University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - T Hernandez
- University of California San Diego, La Jolla, CA, USA
| | - S Blair
- University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - A Vail
- University of Cambridge, Cambridge, UK
| | - M Garcia
- University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Gonzalez Del Hoyo M, Servato L, Fernandez-Galera R, Rodenas E, Garcia M, Casas G, Jordan P, Herrador L, Bach M, Valente F, Gutierrez L, Baneras J, Evangelista A, Ferreira I, Rodriguez-Palomares J. Clinical impact on treatment and prognosis of advanced cardiac imaging with echocardiography in the acute setting of a COVID-19 infection. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and objectives
Despite myocardial injury being related to excess mortality in acute COVID-19 infection, its impact on imaging findings remains unclear. This study aimed to characterize transthoracic echocardiographic (TTE) findings in patients admitted with COVID-19 infections and its impact on management and prognosis.
Methods
A prospective observational cohort study was performed among 66 COVID-19 patients who were admitted to a tertiary center between March 1 and May 25, 2020 and underwent TTE. High-sensitivity troponin I (hs-cTnI) data, echocardiographic assessment of right and left ventricular (LV) functional parameters, strain, and myocardial work analysis were obtained.
Results
2025 patients were admitted with COVID-19 and in 200 a complete TTE study was performed. Due to poor image quality, only 66 studies were included in the final analysis. The median age was 62 years (IQR, 55–70) and 59.1% of patients were males. The most common comorbidity was hypertension (47%), followed by smoking history (30.3%), atrial fibrillation (9.1%), and chronic obstructive pulmonary disease (7.9%). More than half of the patients (39, 59%) were admitted to the ICU, and half of them (33, 50%) required invasive mechanical ventilation. TTE was mainly indicated because of concerns for systemic conditions (50%) and evaluation of hemodynamic assessment (30%). Thirty-six patients (54.5%) had an abnormal TTE result and 57% had elevated hs-cTnI levels. The most common cardiac abnormality was LV diastolic dysfunction in 33% of the patients, followed by right ventricular dysfunction (12%) and LV dysfunction (6%) (Figure 1). LV GLS was reduced in 48.5% of the cases. Myocardial work performance indices were all reduced in patients with an abnormal TTE (GWI 30%, GCW 30%, GWW 40%, and GWE 40%), although differences were not significant (P>0.2 for all parameters). Patients with an abnormal TTE were older and presented a higher cardiovascular risk profile. There were no significant differences in the levels of D-dimer, NTproBNP, and hs-cTnI between patients with and without diastolic dysfunction, RV, or LV dysfunction (P>0.3 for all parameters). Using Spearman rank correlation, there was an inverse relationship between hs-cTnI and LV strain and myocardial work analysis. TTE results impacted clinical management in 60 patients, mainly de-escalation of medical treatment (Figure 2). Abnormal TTE results did not impact in-hospital outcomes.
Conclusions
Severe echocardiographic abnormalities are uncommon in hospitalized patients with COVID-19 infections, presenting mostly with subclinical myocardial changes, such as diastolic dysfunction, reduced LV GLS, and myocardial work indices, both associated with high-sensitivity troponin I elevation. An echocardiographic study should be limited to rule out long-term ICU complications or to evaluate hemodynamic instability. Although TTE was a valuable tool for guiding management, it had no significant impact on prognosis.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Findings on TTE studies.Figure 2. Changes in management.
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Affiliation(s)
| | - L Servato
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | | | - E Rodenas
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - M Garcia
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - G Casas
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - P Jordan
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - L Herrador
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - M Bach
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - F Valente
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - L Gutierrez
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - J Baneras
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - A Evangelista
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - I Ferreira
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
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Herman J, Schmid S, Zhan L, Garcia M, Brown M, Khan K, Chowdhury M, Sabouhanian A, Walia P, Strom E, Sacher A, Bradbury P, Shepherd F, Leighl N, Cheng S, Patel D, Shultz D, Liu G. FP12.07 Clinico-demographic Factors, EGFR status and their association with Stage at Diagnosis in Lung Adenocarcinoma Patients. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.247] [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: 10/20/2022]
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Garcia M, Schmid S, Hueniken K, Zhan L, Balaratnam K, Khan K, Fares A, Chan S, Smith E, Aggarwal R, Brown M, Patel D, Sacher A, Bradbury P, Shepherd F, Leighl N, Liu G. P48.05 Is Relapse-Free Survival at 2-Years an Appropriate Surrogate for Overall Survival at 5-Years in EGFR-mutated Resected NSCLC? J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.516] [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: 11/25/2022]
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Croquette M, Fonlupt C, Faugeroux A, Godet J, Frouin E, Garcia M, Dirikoc SC, Pedretti N, Heymann D, Lecron J, Morel F, Jégou J. 216 Downregulation of interleukin-34 in psoriatic lesions and potential immunoregulatory role in skin inflammation. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.221] [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: 10/20/2022]
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Hernando-Requejo O, Lopez M, Chen X, Alonso R, Sanchez E, Montero A, Ciervide R, Alvarez B, Valero J, Garcia M, Zucca D, Garcia J, Garcia de Azilu P, Alonso L, De la Casa M, Prado A, Marti J, Fernandez Leton P, Nuñez M, Izquierdo M, Rossi K, Cañadillas C, Rubio C. PO-1240 Complete pathological response after high dose radiotherapy for locally advanced esophageal cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07691-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Garcia M, David B, Sierra-Garcia IN, Faustino MAF, Alves A, Esteves AC, Cunha A. Photodynamic inactivation of Lasiodiplodia theobromae: lighting the way towards an environmentally friendly phytosanitary treatment. Biol Lett 2021; 17:20200820. [PMID: 33878276 DOI: 10.1098/rsbl.2020.0820] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The fungus Lasiodiplodia theobromae is one of the main causal agents of trunk canker and dieback of grapevine. The objective of this work was to evaluate the efficiency of photodynamic inactivation (PDI) of L. theobromae with synthetic and natural photosensitizers and irradiation with either sunlight or artificial photosynthetically active radiation. Although the growth of the mycelium could not be completely prevented with natural sunlight irradiation, phenothiazine dyes (methylene blue, MB; toluidine blue O, TBO), riboflavin and a cationic porphyrin (Tetra-Py+-Me) caused complete inhibition under continuous irradiation with artificial light. Free radicals were the main cytotoxic agents in the PDI with MB, indicating the predominance of the type I mechanism. PDI with MB or Tetra-Py+-Me may represent a promising approach for the sanitation of vine material in greenhouse nurseries, in order to reduce the risk of infection upon grafting.
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Affiliation(s)
- M Garcia
- Department of Biology, University of Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - B David
- Department of Biology, University of Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - I N Sierra-Garcia
- Department of Biology, University of Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal.,Department of Biology and CESAM, University of Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - M A F Faustino
- Department of Chemistry and LAQV-REQUIMTE, University of Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - A Alves
- Department of Biology and CESAM, University of Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - A C Esteves
- Department of Biology and CESAM, University of Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - A Cunha
- Department of Biology and CESAM, University of Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
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Yuan N, Ray E, Garcia M. 142 Use of the Deep Inferior Epigastric Vessels for Arterial-venous Anastomosis with Free-flap Phallo-urethroplasty: Technique, Key points, and Lessons Learned. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Garcia M, Montgomery SR, Moisá SJ, Hanzlicek GA, Hulbert LE, Bradford BJ. Effects of milk feeding strategies on short- and long-term productivity of Holstein heifers. J Dairy Sci 2021; 104:4303-4316. [PMID: 33589255 DOI: 10.3168/jds.2020-19364] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/10/2020] [Indexed: 01/06/2023]
Abstract
Research investigating the effects of feeding raw or pasteurized nonsaleable milk (NSM) on heifers' performance beyond the period of supplementation is limited. This study aimed to examine the effects of type of milk [NSM or milk replacer (MR)] and pasteurization of NSM on preweaning and first-lactation performance of heifers born with low (<36.3 kg) or normal birth weight (≥36.3 kg). Holstein heifers (n = 154) were sequentially assigned to 1 of 3 treatments: MR, pasteurized NSM, or raw NSM. Heifers assigned to raw NSM were fed raw colostrum, whereas heifers assigned to MR and pasteurized NSM were fed pasteurized colostrum. The low birth weight heifers were fed 1.4 L at each feeding until they reached 36.3 kg body weight, whereas normal birth weight heifers were fed 1.9 L at each feeding. A grain mix starter was offered throughout the study. Heifers were weaned ≥42 d old if consuming at least 0.9 kg/d of starter for 3 consecutive days. Data were analyzed with the MIXED procedure of SAS (SAS Institute Inc., Cary, NC), and the basic model included milk treatments, birth weight group, and treatment × birth weight group. The low birth weight heifers fed raw colostrum and NSM versus pasteurized colostrum and NSM had lower serum protein concentrations. Heifers fed MR versus NSM had or tended to have greater concentrations of hematocrit, red blood cells, and eosinophils but lesser concentrations of platelets, although some of those responses were temporary. Pasteurization tended to increase blood lymphocyte concentrations. Heifers with normal birth weight had greater concentrations of blood neutrophils, lymphocytes, and monocytes, compared with low birth weight heifers. For the first 42 d of life, low birth weight heifers fed pasteurized versus raw NSM had greater weight gain, grain intake, and feed efficiency and were weaned earlier (hazard ratio for weaning by 56 d: 2.90). These pasteurization effects for low birth weight heifers tended to be sustained through 24 wk of age, indicated by greater weight gain and hip height growth. In their first lactation, low birth weight heifers produced less mature-equivalent (MEq) protein and tended to produce less MEq milk and fat than normal birth weight heifers. However, the negative effects of low birth weight on MEq milk and fat yield was only evident in heifers fed raw NSM, whereas the performance of low birth weight heifers was similar to that of normal birth weight when fed MR or pasteurized NSM. These findings confirm that calf management practices influence future performance; in this case, failing to pasteurize milk and colostrum for low birth weight heifers had effects that remained apparent for more than 2 years.
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Affiliation(s)
- M Garcia
- Department of Animal Sciences and Industry, Kansas State University, Manhattan 66506
| | - S R Montgomery
- Department of Animal Sciences and Industry, Kansas State University, Manhattan 66506
| | - S J Moisá
- Department of Animal Sciences and Industry, Kansas State University, Manhattan 66506
| | - G A Hanzlicek
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan 66506
| | - L E Hulbert
- Department of Animal Sciences and Industry, Kansas State University, Manhattan 66506
| | - B J Bradford
- Department of Animal Sciences and Industry, Kansas State University, Manhattan 66506.
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Moreno-González G, Mussetti A, Albasanz-Puig A, Salvador I, Sureda A, Gudiol C, Salazar R, Marin M, Garcia M, Navarro V, de la Haba Vaca I, Coma E, Sanz-Linares G, Dura X, Fontanals S, Serrano G, Cruz C, Mañez R. A Phase I/II Clinical Trial to evaluate the efficacy of baricitinib to prevent respiratory insufficiency progression in onco-hematological patients affected with COVID19: A structured summary of a study protocol for a randomised controlled trial. Trials 2021; 22:116. [PMID: 33546739 PMCID: PMC7862837 DOI: 10.1186/s13063-021-05072-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 01/15/2021] [Accepted: 01/24/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Baricitinib is supposed to have a double effect on SARS-CoV2 infection. Firstly, it reduces the inflammatory response through the inhibition of the Januse-Kinase signalling transducer and activator of transcription (JAK-STAT) pathway. Moreover, it reduces the receptor mediated viral endocytosis by AP2-associated protein kinase 1 (AAK1) inhibition. We propose the use of baricinitib to prevent the progression of the respiratory insufficiency in SARS-CoV2 pneumonia in onco-haematological patients. In this phase Ib/II study, the primary objective in the safety cohort is to describe the incidence of severe adverse events associated with baricitinib administration. The primary objective of the randomized phase (baricitinib cohort versus standard of care cohort) is to evaluate the number of patients who did not require mechanical oxygen support since start of therapy until day +14 or discharge (whichever it comes first). The secondary objectives of the study (only randomized phase of the study) are represented by the comparison between the two arms of the study in terms of mortality and toxicity at day+30. Moreover, a description of the immunological related changes between the two arms of the study will be reported. TRIAL DESIGN The trial is a phase I/II study with a safety run-in cohort (phase 1) followed by an open label phase II randomized controlled trial with an experimental arm compared to a standard of care arm. PARTICIPANTS The study will be performed at the Institut Català d'Oncologia, a tertiary level oncological referral center in the Catalonia region (Spain). The eligibility criteria are: patients > 18 years affected by oncological diseases; ECOG performance status < 2 (Karnofsky score > 60%); a laboratory confirmed infection with SARS-CoV-2 by means of real -time PCR; radiological signs of low respiratory tract disease; absence of organ dysfunction (a total bilirubin within normal institutional limits, AST/ALT≤2.5 X institutional upper limit of normal, alkaline phosphatase ≤2.5 X institutional upper limit of normal, coagulation within normal institutional limits, creatinine clearance >30 mL/min/1.73 m2 for patients with creatinine levels above institutional normal); absence of HIV infection; no active or latent HBV or HCV infection. The exclusion criteria are: patients with oncological diseases who are not candidates to receive any active oncological treatment; hemodynamic instability at time of study enrollment; impossibility to receive oral medication; medical history of recent or active pulmonary embolism or deep venous thrombosis or patients at high-risk of suffering them (surgical intervention, immobilization); multi organ failure, rapid worsening of respiratory function with requirement of fraction of inspired oxygen (FiO2) > 50% or high-flow nasal cannula before initiation of study treatment; uncontrolled intercurrent illness (ongoing or severe active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements); allergy to one or more of study treatments; pregnant or breastfeeding women; positive pregnancy test in a pre-dose examination. Patients should have the ability to understand, and the willingness to sign, a written informed consent document; the willingness to accept randomization to any assigned treatment arm; and must agree not to enroll in another study of an investigational agent prior to completion of Day +28 of study. An electronic Case Report Form in the Research Electronic Data Capture (REDCap) platform will be used to collect the data of the trial. Removal from the study will apply in case of unacceptable adverse event(s), development of an intercurrent illness, condition or procedural complication, which could interfere with the patient's continued participation and voluntary patient withdrawal from study treatment (all patients are free to withdraw from participation in this study at any time, for any reasons, specified or unspecified, and without prejudice). INTERVENTION AND COMPARATOR Treatment will be administered on an inpatient basis. We will compare the experimental treatment with baricitinib plus the institutional standard of care compared with the standard of care alone. During the phase I, we will define the dose-limiting toxicity of baricitinib and the dose to be used in the phase 2 part of the study. The starting baricitinib dose will be an oral tablet 4 mg-once daily which can be reduced to 2 mg depending on the observed toxicity. The minimum duration of therapy will be 5 days and it can be extended to 7 days. The standard of care will include the following therapies. Antibiotics will be individualized based on clinical suspicion, including the management of febrile neutropenia. Prophylaxis of thromboembolic disease will be administered to all participants. Remdesivir administration will be considered only in patients with severe pneumonia (SatO2 <94%) with less than 7 days of onset of symptoms and with supplemental oxygen requirements but not using high-flow nasal cannula, non-invasive or invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO). In the randomized phase, tocilizumab or interferon will not be allowed in the experimental arm. Tocilizumab can be used in patients in the standard of care arm at the discretion of the investigator. If it is prescribed it will be used according to the following criteria: patients who, according to his baseline clinical condition, would be an ICU tributary, interstitial pneumonia with severe respiratory failure, patients who are not on mechanical ventilation or ECMO and who are still progressing with corticoid treatment or if they are not candidates for corticosteroids. Mild ARDS (PAFI <300 mmHg) with radiological or blood gases deterioration that meets at least one of the following criteria: CRP >100mg/L D-Dimer >1,000μg/L LDH >400U/L Ferritin >700ng/ml Interleukin 6 ≥40ng/L. The use of tocilizumab is not recommended if there are AST/ALT values greater than 10 times the upper limit of normal, neutrophils <500 cells/mm3, sepsis due to other pathogens other than SARS-CoV-2, presence of comorbidity that can lead to a poor prognosis, complicated diverticulitis or intestinal perforation, ongoing skin infection. The dose will be that recommended by the Spanish Medicine Agency in patients ≥75Kg: 600mg dose whereas in patients <75kg: 400mg dose. Exceptionally, a second infusion can be assessed 12 hours after the first in those patients who experience a worsening of laboratory parameters after a first favourable response. The use of corticosteroids will be recommended in patients who have had symptoms for more than 7 days and who meet all the following criteria: need for oxygen support, non-invasive or invasive mechanical ventilation, acute respiratory failure or rapid deterioration of gas exchange, appearance or worsening of bilateral alveolar-interstitial infiltrates at the radiological level. In case of indication, it is recommended: dexamethasone 6mg/d p.o. or iv for 10 days or methylprednisolone 32mg/d orally or 30mg iv for 10 days or prednisone 40mg day p.o. for 10 days. MAIN OUTCOMES Phase 1 part: to describe the toxicity profile of baricitinib in COVID19 oncological patients during the 5-7 day treatment period and until day +14 or discharge (whichever it comes first). Phase 2 part: to describe the number of patients in the experimental arm that will not require mechanical oxygen support compared to the standard of care arm until day +14 or discharge (whichever it comes first). RANDOMISATION For the phase 2 of the study, the allocation ratio will be 1:1. Randomization process will be carried out electronically through the REDcap platform ( https://www.project-redcap.org/ ) BLINDING (MASKING): This is an open label study. No blinding will be performed. NUMBERS TO BE RANDOMISED (SAMPLE SIZE) The first part of the study (safety run-in cohort) will consist in the enrollment of 6 to 12 patients. In this population, we will test the toxicity of the experimental treatment. An incidence of severe adverse events grade 3-4 (graded by Common Terminology Criteria for Adverse Events v.5.0) inferior than 33% will be considered sufficient to follow with the next part of the study. The second part of the study we will perform an interim analysis of efficacy at first 64 assessed patients and a definitive one will analyze 128 assessed patients. Interim and definitive tests will be performed considering in both cases an alpha error of 0.05. We consider for the control arm this rate is expected to be 0.60 and for the experimental arm of 0.80. Considering this data, a superiority test to prove a difference of 0.20 with an overall alpha error of 0.10 and a beta error of 0.2 will be performed. Considering a 5% of dropout rate, it is expected that a total of 136 patients, 68 for each study arm, will be required to complete study accrual. TRIAL STATUS Version 5.0. 14th October 2020 Recruitment started on the 16th of December 2020. Expected end of recruitment is June 2021. TRIAL REGISTRATION AEMPs: 20-0356 EudraCT: 2020-001789-12, https://www.clinicaltrialsregister.eu/ctr-search/search (Not publically available as Phase I trial) Clinical trials: BARCOVID19, https://www.clinicaltrials.gov/ (In progress) FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol."
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Affiliation(s)
- G Moreno-González
- Intensive Care Department, Hospital Universitari de Bellvitge, L'Hospitalet de LL., Barcelona, Spain. .,Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.
| | - A Mussetti
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.,Clinical Hematology Department, Institut Català d' Oncologia, L'Hospitalet de LL., Barcelona, Spain
| | - A Albasanz-Puig
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.,Infectious Disease Department, Hospital Universitari de Bellvitge, L'Hospitalet de LL., Barcelona, Spain.,Spanish Network for Research in Infectious Disease (REIPI), Instituto de Salud Carlos III, Madrid, Spain
| | - I Salvador
- Immunology Department, Hospital Universitari de Bellvitge, L'Hospitalet de LL., Barcelona, Spain
| | - A Sureda
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.,Clinical Hematology Department, Institut Català d' Oncologia, L'Hospitalet de LL., Barcelona, Spain.,Barcelona University, Barcelona, Spain
| | - C Gudiol
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.,Infectious Disease Department, Hospital Universitari de Bellvitge, L'Hospitalet de LL., Barcelona, Spain.,Spanish Network for Research in Infectious Disease (REIPI), Instituto de Salud Carlos III, Madrid, Spain.,Barcelona University, Barcelona, Spain
| | - R Salazar
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.,Clinical Oncology Department, Institut Català d' Oncologia, L'Hospitalet de LL., Barcelona, Spain
| | - M Marin
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.,Clinical Oncology Department, Institut Català d' Oncologia, L'Hospitalet de LL., Barcelona, Spain
| | - M Garcia
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.,Clinical Trials Unit, Institut Català d' Oncologia, L'Hospitalet de LL., Barcelona, Spain
| | - V Navarro
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.,Clinical Trials Unit, Institut Català d' Oncologia, L'Hospitalet de LL., Barcelona, Spain
| | - I de la Haba Vaca
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.,Oncology Emergency Unit, Institut Català d' Oncologia, L'Hospitalet de LL., Barcelona, Spain
| | - E Coma
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.,Oncology Emergency Unit, Institut Català d' Oncologia, L'Hospitalet de LL., Barcelona, Spain
| | - G Sanz-Linares
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.,Clinical Hematology Department, Institut Català d' Oncologia, L'Hospitalet de LL., Barcelona, Spain
| | - X Dura
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.,Infectious Disease Department, Hospital Universitari de Bellvitge, L'Hospitalet de LL., Barcelona, Spain
| | - S Fontanals
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.,Pharmacology Department, Institut Català d' Oncologia, L'Hospitalet de LL., Barcelona, Spain
| | - G Serrano
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.,Palliative Department, Institut Català d' Oncologia, L'Hospitalet de LL., Barcelona, Spain
| | - C Cruz
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain.,Palliative Department, Institut Català d' Oncologia, L'Hospitalet de LL., Barcelona, Spain
| | - R Mañez
- Intensive Care Department, Hospital Universitari de Bellvitge, L'Hospitalet de LL., Barcelona, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de LL., Barcelona, Spain
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Rajaratnam D, Hyun K, Wong C, Garcia M, Lau J, Lowe H, Yong A, Kritharides L, Brieger D, Roy P. Longer-Term Safety and Efficacy of Contemporary Percutaneous Coronary Intervention – Insights from 2-Year Follow-Up of a Single Australian Centre Registry. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.487] [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: 10/20/2022]
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