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Garza-Hernandez D, Sepulveda-Villegas M, Garcia-Pelaez J, Aguirre-Gamboa R, Lakatos PL, Estrada K, Martinez-Vazquez M, Trevino V. A systematic review and functional bioinformatics analysis of genes associated with Crohn's disease identify more than 120 related genes. BMC Genomics 2022; 23:302. [PMID: 35418025 PMCID: PMC9008988 DOI: 10.1186/s12864-022-08491-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/28/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Crohn's disease is one of the two categories of inflammatory bowel diseases that affect the gastrointestinal tract. The heritability estimate has been reported to be 0.75. Several genes linked to Crohn's disease risk have been identified using a plethora of strategies such as linkage-based studies, candidate gene association studies, and lately through genome-wide association studies (GWAS). Nevertheless, to our knowledge, a compendium of all the genes that have been associated with CD is lacking. METHODS We conducted functional analyses of a gene set generated from a systematic review where genes potentially related to CD found in the literature were analyzed and classified depending on the genetic evidence reported and putative biological function. For this, we retrieved and analyzed 2496 abstracts comprising 1067 human genes plus 22 publications regarding 133 genes from GWAS Catalog. Then, each gene was curated and categorized according to the type of evidence associated with Crohn's disease. RESULTS We identified 126 genes associated with Crohn's disease risk by specific experiments. Additionally, 71 genes were recognized associated through GWAS alone, 18 to treatment response, 41 to disease complications, and 81 to related diseases. Bioinformatic analysis of the 126 genes supports their importance in Crohn's disease and highlights genes associated with specific aspects such as symptoms, drugs, and comorbidities. Importantly, most genes were not included in commercial genetic panels suggesting that Crohn's disease is genetically underdiagnosed. CONCLUSIONS We identified a total of 126 genes from PubMed and 71 from GWAS that showed evidence of association to diagnosis, 18 to treatment response, and 41 to disease complications in Crohn's disease. This prioritized gene catalog can be explored at http://victortrevino.bioinformatics.mx/CrohnDisease .
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Affiliation(s)
- Debora Garza-Hernandez
- Tecnologico de Monterrey, Escuela de Medicina, Cátedra de Bioinformática, Av. Morones Prieto No. 3000, Colonia Los Doctores, 64710, Monterrey, Nuevo León, Mexico
| | - Maricruz Sepulveda-Villegas
- Tecnologico de Monterrey, Escuela de Medicina, Cátedra de Bioinformática, Av. Morones Prieto No. 3000, Colonia Los Doctores, 64710, Monterrey, Nuevo León, Mexico
| | - Jose Garcia-Pelaez
- Instituto de Investigação e Inovação em Saude-i3S, Universidade do Porto, Porto, Portugal.,Ipatimup, Institute of Molecular Pathology and Immunology at the University of Porto, Porto, Portugal
| | | | - Peter L Lakatos
- McGill University Health Centre, Division of Gastroenterology, IBD Centre, Montreal General Hospital, 1650 Ave. Cedar, D16.173.1, Montreal, QC, H3G 1A4, Canada
| | - Karol Estrada
- Graduate Professional Studies, Brandeis University, Waltham, MA, 02453, USA
| | - Manuel Martinez-Vazquez
- Tecnologico de Monterrey, Instituto de Medicina Interna, Centro Médico Zambrano Hellion, Av. Batallón de San Patricio No. 112, Colonia Real San Agustín, 66278, San Pedro Garza García, Nuevo León, Mexico
| | - Victor Trevino
- Tecnologico de Monterrey, Escuela de Medicina, Cátedra de Bioinformática, Av. Morones Prieto No. 3000, Colonia Los Doctores, 64710, Monterrey, Nuevo León, Mexico. .,Tecnologico de Monterrey, The Institute for Obesity Research, Integrative Biology Unit, Eugenio Garza Sada 2501 Avenue, 64849, Monterrey, Nuevo Leon, Mexico.
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Parra-Cantu C, Zaldivar-Ruenes A, Martinez-Vazquez M, Martinez HR. Prevalence of Gastrointestinal Symptoms, Severity of Dysphagia, and Their Correlation with Severity of Amyotrophic Lateral Sclerosis in a Mexican Cohort. NEURODEGENER DIS 2021; 21:42-47. [PMID: 34139704 DOI: 10.1159/000517613] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/03/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Our study aimed to identify the prevalence and severity of gastrointestinal (GI) symptoms and dysphagia in patients with amyotrophic lateral sclerosis (ALS) and to assess whether a correlation exists between these symptoms and the severity of ALS progression. METHODS The presence and severity of GI symptoms and dysphagia were identified by means of the Gastrointestinal Symptom Rating Scale (GSRS) and the Functional Outcome Swallowing Scale (FOSS). The Revised ALS Functional Rating Scale (ALSFRS-R) was utilized to determine the severity of ALS. Analysis of data was performed with Spearman correlations in semi-qualitative variables of clinical scales. ALSFRS-R scores were divided into 2 categories: those with mild to moderate ALS (≥40-30 points) and patients with moderate to advanced ALS (29-≤20 points). RESULTS We studied 43 patients with definite ALS. The most frequent GI symptoms were constipation (60.5%), rectal tenesmus (57.5%), hard stools (55.0%), and borborygmus (42.5%). The moderate to advanced ALS stage was correlated with constipation (r = 0.334; p = 0.028), acid regurgitation (r = 0.384; p = 0.013), eructation (r = 0.334; p = 0.032), rectal tenesmus (r = 0.498; p = 0.001), and functional dysphagia (r = 0.656; p = <0.001). CONCLUSIONS Early detection of these GI symptoms can guide timely therapeutic decisions to avoid weight loss, a predictor for worse prognosis. This study highlights the relevance of the detection of these symptoms in ALS patients who score ≤29 points in the ALSFRS-R scale to establish an appropriate treatment, prevent systemic complications, provide more comfort, and improve quality of life.
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Affiliation(s)
- Carolina Parra-Cantu
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico, .,ALS Clinic, Institute of Neurology and Neurosurgery, Zambrano Hellion Hospital, San Pedro Garza Garcia, Mexico,
| | | | - Manuel Martinez-Vazquez
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico.,Institute of Internal Medicine, Zambrano Hellion Hospital, San Pedro Garza Garcia, Mexico
| | - Hector R Martinez
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico.,ALS Clinic, Institute of Neurology and Neurosurgery, Zambrano Hellion Hospital, San Pedro Garza Garcia, Mexico
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Feuerstein JD, Papamichael K, Popejoy S, Nadelson A, Lewandowski JJ, Geissler K, Martinez-Vazquez M, Leffler DA, Ariyabuddhiphongs K, Thukral C, Cheifetz AS. Targeted Physician Education and Standardizing Documentation Improves Documented Reporting with Inflammatory Bowel Disease Quality Measures in a Large Academic and Private Practice. Dig Dis Sci 2018; 63:36-45. [PMID: 29147880 DOI: 10.1007/s10620-017-4845-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 11/07/2017] [Indexed: 01/25/2023]
Abstract
BACKGROUND Prior studies have shown poor compliance with quality measures for IBD at academic and private practices. We sought to provide focused interventions to improve compliance and documentation with the IBD measures. METHODS Two centers, academic practice (AP) and private practice (PP), initially reviewed their compliance with eight established IBD quality measures in consecutive charts. A multi-faceted intervention was developed to improve awareness and documentation of these measures. The initial data and the quality measures were reviewed at a group meeting. Following this, a handout summarizing the measures was placed in each exam room. The AP added a new screen to the EHR that summarized the relevant IBD history, while the PP added a new template that was filled out and imported into the charts. Three months after this intervention, charts were reviewed for compliance with the measures. RESULTS The intervention cohort consisted of 768 patients (AP = 569/PP = 199) compared to the initial cohort of 566 patients (AP = 367/PP = 199). Improvement was seen throughout all measures compared to the initial cohort. The AP reported compliance with all relevant measures in 21% and the PP in 60% compared to 7 and 10% in the initial cohort. PP had ≥ 75% compliance with every measure, of which only assessment for bone loss and pneumococcal vaccination was under 80%. In contrast, the AP compliance ranged from 35 to 100% with assessment for bone loss, influenza, and pneumococcal vaccination scoring lowest. CONCLUSION Our study demonstrates that focused low-cost interventions can significantly improve compliance with IBD quality measures in different practice settings.
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Affiliation(s)
- Joseph D Feuerstein
- Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street 8e Gastroenterology, Boston, MA, 02215, USA.
| | - Konstantinos Papamichael
- Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street 8e Gastroenterology, Boston, MA, 02215, USA
| | - Sara Popejoy
- Rockford Gastroenterology Associates, Rockford, IL, USA
| | - Adam Nadelson
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jeffrey J Lewandowski
- Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street 8e Gastroenterology, Boston, MA, 02215, USA
| | | | - Manuel Martinez-Vazquez
- Gastroenterology Service Dr. José Eleuterio González University Hospital, Monterrey, Nuevo León, Mexico
| | - Daniel A Leffler
- Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street 8e Gastroenterology, Boston, MA, 02215, USA
| | - Kim Ariyabuddhiphongs
- Department of Medicine and Division of Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Chandrashekhar Thukral
- Rockford Gastroenterology Associates, Rockford, IL, USA
- University of Illinois at Chicago College of Medicine, Rockford, IL, USA
| | - Adam S Cheifetz
- Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street 8e Gastroenterology, Boston, MA, 02215, USA
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Levy RA, Guzman R, Castañeda-Hernández G, Martinez-Vazquez M, Damian G, Cara C. Biology of anti-TNF agents in immune-mediated inflammatory diseases: therapeutic implications. Immunotherapy 2016; 8:1427-1436. [PMID: 27737604 DOI: 10.2217/imt-2016-0067] [Citation(s) in RCA: 8] [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] [Indexed: 01/13/2023] Open
Abstract
Biologics are increasingly being used to modify the course of immune-mediated inflammatory diseases. Some main agents are monoclonal antibodies and a fusion-protein that target TNF. This group includes adalimumab, infliximab, certolizumab pegol, golimumab and etanercept. Although the efficacy of anti-TNFs is supported by numerous randomized clinical trials, their pharmacokinetics depend on many factors, in particular immunogenicity, which can cause marked and rapid clearance and a consequent decrease in efficacy. Kinetics involve receptors that recognize the Fc fragment of the antibody and are responsible for various processes. Pharmacological advances permit optimizing the pharmacokinetics of anti-TNFs. In this review, we examine the kinetics of anti-TNF biologics, and consequent therapeutic implications, and overview some latest developments in the field. First draftsubmitted: 17 May 2016; Accepted for publication: 15 September2016; Published online: 14 October 2016.
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Affiliation(s)
- Roger A Levy
- Discipline of Rheumatology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Gilberto Castañeda-Hernández
- Departamento de Farmacología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Ciudad de México, Mexico
| | - Manuel Martinez-Vazquez
- Gastroenterology Service, Dr José Eleuterio González University Hospital, Monterrey, Nuevo León, Mexico
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Feuerstein JD, Castillo NE, Siddique SS, Lewandowski JJ, Geissler K, Martinez-Vazquez M, Thukral C, Leffler DA, Cheifetz AS. Poor Documentation of Inflammatory Bowel Disease Quality Measures in Academic, Community, and Private Practice. Clin Gastroenterol Hepatol 2016; 14:421-428.e2. [PMID: 26499928 DOI: 10.1016/j.cgh.2015.09.042] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 08/26/2015] [Accepted: 09/28/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Quality measures are used to standardize health care and monitor quality of care. In 2011, the American Gastroenterological Association established quality measures for inflammatory bowel disease (IBD), but there has been limited documentation of compliance from different practice settings. METHODS We reviewed charts from 367 consecutive patients with IBD seen at academic practices, 217 patients seen at community practices, and 199 patients seen at private practices for compliance with 8 outpatient measures. Records were assessed for IBD history, medications, comorbidities, and hospitalizations. We also determined the number of patient visits to gastroenterologists in the past year, whether patients had a primary care physician at the same institution, and whether they were seen by a specialist in IBD or in conjunction with a trainee, and reviewed physician demographics. A univariate and multivariate statistical analysis was performed to determine which factors were associated with compliance of all core measures. RESULTS Screening for tobacco abuse was the most frequently assessed core measure (89.6% of patients; n = 701 of 783), followed by location of IBD (80.3%; n = 629 of 783), and assessment for corticosteroid-sparing therapy (70.8%; n = 275 of 388). The least-frequently evaluated measures were pneumococcal immunization (16.7% of patients; n = 131 of 783), bone loss (25%; n = 126 of 505), and influenza immunization (28.7%; n = 225 of 783). Only 5.8% of patients (46 of 783) had all applicable core measures documented (24 in academic practice, none in clinical practice, and 22 in private practice). In the multivariate model, year of graduation from fellowship (odds ratio [OR], 2.184; 95% confidence interval [CI], 1.522-3.134; P < .001), year of graduation from medical school (OR, 0.500; 95% CI, 0.352-0.709; P < .001), and total number of comorbidities (OR, 1.089; 95% CI, 1.016-1.168; P = .016) were associated with compliance with all core measures. CONCLUSIONS We found poor documentation of IBD quality measures in academic, clinical, and private gastroenterology practices. Interventions are necessary to improve reporting of quality measures.
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Affiliation(s)
- Joseph D Feuerstein
- Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
| | - Natalia E Castillo
- Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Sana S Siddique
- Department of Medicine, Mt Auburn Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jeffrey J Lewandowski
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Kathy Geissler
- Rockford Gastroenterology Associates, Rockford, Illinois
| | - Manuel Martinez-Vazquez
- Gastroenterology Service, Dr. José Eleuterio González University Hospital, Monterrey, Nuevo León, Mexico
| | - Chandrashekhar Thukral
- University of Illinois at Chicago College of Medicine, Rockford, Illinois; Rockford and Rockford Gastroenterology Associates, Rockford, Illinois
| | - Daniel A Leffler
- Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Adam S Cheifetz
- Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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Feuerstein JD, Lewandowski JJ, Martinez-Vazquez M, Leffler DA, Cheifetz AS. Documented compliance with inflammatory bowel disease quality measures is poor. Dig Dis Sci 2015; 60:339-44. [PMID: 25311583 DOI: 10.1007/s10620-014-3385-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 10/03/2014] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIMS Quality metrics allows health care to be standardized and monitored. The American Gastroenterological Association (AGA) established quality metrics for inflammatory bowel disease (IBD) in 2011, but compliance is unknown. METHODS Patients with IBD seen in the gastroenterology clinics at a tertiary care medical center during April 2013 were included. Charts were reviewed for the current state of compliance with the publicized AGA measures over the prior 12 months. Records were assessed for type of IBD, year of diagnosis, number of medications, comorbidities, hospitalizations and gastroenterology clinic visits in the last year, presence of primary care physician (PCP) at the institution, and involvement of a specialist in IBD or a trainee. Univariate and multivariate logistic regression analyses were done using SPSS. RESULTS Only 6.5 % (24/367) of patients had all applicable core measures documented. In univariate analysis, year of IBD diagnosis (p = 0.014), number of comorbidities (p = 0.024), seen by a specialist in IBD (p = 0.002), seen by a gastroenterology fellow or resident (p = 0.034), and having a PCP at the institution (p = 0.006) were significant. In multivariate analysis, seen by a specialist in IBD (5.36, 95 % CI 1.22-23.63, p = 0.027), having a PCP at the institution (3.24, 95 % CI 1.23-8.54, p = 0.018), and year of IBD diagnosis (0.967, 95 % CI 0.937-0.999, p = 0.042) remained significant. Screening for tobacco abuse was the most frequently assessed (96 %, n = 352/367) core measure, while pneumococcal immunization (21 %, n = 76/367) was the least. CONCLUSION Our study demonstrates poor compliance with IBD quality metrics. Additional studies are needed to determine the causes of failure to comply with the quality metrics.
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Affiliation(s)
- Joseph D Feuerstein
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave E/DANA 501, Boston, MA, 02215, USA,
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Vaughn BP, Martinez-Vazquez M, Patwardhan VR, Moss AC, Sandborn WJ, Cheifetz AS. Proactive therapeutic concentration monitoring of infliximab may improve outcomes for patients with inflammatory bowel disease: results from a pilot observational study. Inflamm Bowel Dis 2014. [PMID: 25192499 DOI: 10.1987/mib.0000000000000156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Infliximab (IFX) is effective in the treatment of inflammatory bowel disease; however, the effect is often not durable. It is unknown if proactive therapeutic concentration monitoring (TCM) of IFX improves outcomes. METHODS This is a retrospective observational study examining the use of proactive TCM and titration of IFX to a target concentration for patients with inflammatory bowel disease in clinical remission at a tertiary care center. The primary aim was to describe the clinical course of patients who had proactive TCM. A secondary analysis was done to assess if this strategy was superior to the standard of care. RESULTS Forty-eight patients were identified as having proactive TCM. Fifteen percent had an initial undetectable trough concentration. Twenty-five percent (12 of 48) of patients escalated IFX after the first proactive TCM while 15% (7 of 48) of patients de-escalated IFX therapy over the study period. A control group of 78 patients was identified. Patients who had proactive TCM had a greater probability of remaining on IFX than controls (hazard ratio, 0.3; 95% confidence interval, 0.1-0.6; log rank test; P = 0.0006). The probability of remaining on IFX was greatest for patients who achieved a trough concentration >5 μg/mL (hazard ratio, 0.03; 95% confidence interval, 0.01-0.1; P < 0.0001 versus trough <5 μg/mL). Fewer patients in the proactive TCM group stopped IFX (10% versus 31%, P = 0.009). CONCLUSIONS In this pilot observational study, proactive TCM of IFX frequently identified patients with low or undetectable trough concentrations and resulted in a greater probability of remaining on IFX.
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Affiliation(s)
- Byron P Vaughn
- *Center for Inflammatory Bowel Diseases, Division of Gastroenterology, Beth-Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; and †Division of Gastroenterology, University of California San Diego, La Jolla, California
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Martinez-Vazquez M, Cardenas J, Godoy L, Martinez-Bahena M, Miranda R. Oxidative transformations of guaia-1(10)-en-12,8-olides into xanthanolides. J Nat Prod 1999; 62:920-922. [PMID: 10395522 DOI: 10.1021/np980571t] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Dihydropsuedoivalin (1) was isolated from Stevia tomentosa, which, when treated with base, afforded epidihydropseudoivalin (2). The stereochemistry of 1 and 2 was established by crystallographic X-ray studies of the two derivatives of epidihydropseudoivalin. Treatment of 1 and 2 with Jones's reagent afforded the xanthanolides 3 and 4, respectively.
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Affiliation(s)
- M Martinez-Vazquez
- Instituto de Quimica, Universidad Nacional Autonoma de Mexico, Circuito Exterior, Ciudad Universitaria Coyoacan 04510, Mexico D. F., Mexico, and Departamento de Ciencias Quimicas FES-C, Universidad Nacional Autonoma de Mexico
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