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Masnou H, Aguilar A, Iborra I, Sala M, Torner M, Clos-Parals A, Ardèvol A, Giménez M, Fortuny M, Sarrias MR, Morillas RM, Domènech E. Incidence, risk factors and clinical outcomes of multidrug-resistant microorganism infections among patients admitted for decompensated cirrhosis: a prospective study. Gastroenterología y Hepatología 2022; 46:288-296. [PMID: 36115630 DOI: 10.1016/j.gastrohep.2022.09.001] [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] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/24/2022] [Accepted: 09/10/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Bacterial infections remain one of the main complications in cirrhosis and worsen patients' prognosis and quality of life. An increase in multidrug resistant microorganism (MDRM) infections among patients with cirrhosis, together with infection-related mortality rates, have been reported in recent years. Therefore, adaptation of the initial empiric antibiotic approach to different factors, particularly the local epidemiology of MDRM infections, has been recommended. We aim to describe the main features, outcomes and risk factors of MDRM infections in patients with cirrhosis. METHODS Prospective registry of all episodes of in-hospital infections occurring among cirrhotic patients admitted within a 2-year period at a single center. Clinical and microbiological data were collected at the time of infection diagnosis, and the in-hospital mortality rate of the infectious episode was registered. RESULTS A total of 139 infectious episodes were included. The disease-causing microorganism was identified in 90 episodes (65%), of which 31 (22%) were caused by MDRM. The only two factors independently associated with MDRM infections were rectal colonization by MDRM and a nosocomial or healthcare-associated source. The infection-related mortality rate was 18.7%. MDRM infection and a past history of hepatic encephalopathy were independently associated with in-hospital mortality. CONCLUSIONS Almost one fourth of bacterial infections occurring in admitted cirrhotic patients were due to MDRM. Rectal colonization was the most important risk factor for MDRM infections in decompensated cirrhosis. Screening for MDRM rectal colonization in patients admitted for decompensated cirrhosis should be assessed as a tool to improve local empiric antibiotic strategies.
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Alemany A, Perez-Zsolt D, Raïch-Regué D, Muñoz-Basagoiti J, Ouchi D, Laporte-Villar C, Baro B, Henríquez N, Prat N, Gianinetto MO, Gutiérrez MV, Sánchez-Paniagua MG, Henríquez NL, Vicente JM, Ara J, Rodriguez-Arias MA, Puig J, Blanco I, Lopez CC, Hernández Á, Bordoy AE, Redondo CE, Soler VG, Giménez M, Blanc V, León R, Gispert J, Clotet B, Izquierdo-Useros N, Mitjà O. Cetylpyridinium Chloride Mouthwash to Reduce Shedding of Infectious SARS-CoV-2: A Double-Blind Randomized Clinical Trial. J Dent Res 2022; 101:1450-1456. [PMID: 35727681 DOI: 10.1177/00220345221102310] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [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: 12/12/2022] Open
Abstract
The airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via respiratory fluids and droplets suggests that mouthwashes containing substances with virucidal activity can help reduce viral spread. We conducted a multicenter, double-blind, placebo-controlled, randomized trial to assess the virucidal activity of cetylpyridinium chloride (CPC) mouthwashes. Outpatients who tested positive for SARS-CoV-2 infection with or without symptoms were randomized to perform washes and gargles for 1 min with 15 mL of either colored distilled water or 0.07% CPC (Vitis CPC Protect) mouthwash. The study outcomes were the SARS-CoV-2 log10 viral RNA load and the nucleocapsid protein levels, both in saliva at 1 and 3 h after the intervention. In total, 118 patients were enrolled and randomized (mean [SD], age 46 [14] y). Thirteen of 118 participants (11%) did not complete follow-up or had insufficient sample volume for testing and were excluded from the analysis. The assessment of the viral load showed no significant differences between groups at any of the investigated points. However, the levels of SARS-CoV-2 nucleocapsid protein of lysed viruses were significantly higher in the CPC group compared with the control group at 1 h (adjusted difference 269.3 pg/mL; 95% confidence interval [CI], 97.1-441.5) and at 3 h postintervention (561.1 pg/mL; 95% CI, 380.0-742.2). In nonhospitalized patients with asymptomatic or mild symptomatic SARS-CoV-2 infection, a 0.07% CPC mouthwash, compared to placebo, was associated with a significant increase of nucleocapsid protein levels in saliva, indicating enhanced disruption of viral particles.
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Affiliation(s)
- A Alemany
- Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.,Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Facultat de Medicina-Universitat de Barcelona, Barcelona, Spain
| | | | | | | | - D Ouchi
- Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - B Baro
- ISGlobal, Hospital Clinic Universitat de Barcelona, Barcelona, Spain
| | - N Henríquez
- Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - N Prat
- Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - M Ochoa Gianinetto
- Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - M Viaplana Gutiérrez
- Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | | | - N Larrosa Henríquez
- Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - J Moreno Vicente
- Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - J Ara
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - M A Rodriguez-Arias
- Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.,Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - J Puig
- Fight AIDS and Infectious Diseases Foundation, Badalona, Spain
| | - I Blanco
- Metropolitana Nord Laboratory, Institut Català de la Salut, Badalona, Spain
| | - C Casañ Lopez
- Microbiology Department, Clinical Laboratory Metropolitana Nord, Badalona, Barcelona, Spain
| | - Á Hernández
- Universitat Autònoma de Barcelona, Barcelona, Spain.,Microbiology Department, Clinical Laboratory Metropolitana Nord, Badalona, Barcelona, Spain
| | - A E Bordoy
- Microbiology Department, Clinical Laboratory Metropolitana Nord, Badalona, Barcelona, Spain
| | - C Esteban Redondo
- Microbiology Department, Clinical Laboratory Metropolitana Nord, Badalona, Barcelona, Spain
| | - V González Soler
- Microbiology Department, Clinical Laboratory Metropolitana Nord, Badalona, Barcelona, Spain.,Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain.,CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - M Giménez
- Microbiology Department, Clinical Laboratory Metropolitana Nord, Badalona, Barcelona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - V Blanc
- DENTAID Research Center, Cerdanyola del Vallès, Spain
| | - R León
- DENTAID Research Center, Cerdanyola del Vallès, Spain
| | - J Gispert
- DENTAID Research Center, Cerdanyola del Vallès, Spain
| | | | - B Clotet
- Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.,Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,IrsiCaixa AIDS Research Institute, Badalona, Spain.,Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain
| | - N Izquierdo-Useros
- IrsiCaixa AIDS Research Institute, Badalona, Spain.,Germans Trias i Pujol Research Institute, Badalona, Spain
| | - O Mitjà
- Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.,Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain.,Lihir Medical Centre, International SOS, Lihir Island, Papua New Guinea
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Davrieux CF, Palermo M, Cilfone C, Ronchi A, Giménez M. Laparoscopic-Percutaneous Combined Gastrostomy: Initial Experience and Description of a Technique. J Laparoendosc Adv Surg Tech A 2021; 31:1150-1155. [PMID: 34388357 DOI: 10.1089/lap.2021.0431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Gastrostomy is a widely used procedure that aims to obtain access to the stomach. Its purpose may be feeding or gastric decompression. Currently, the most common techniques are endoscopic and radiologic. Sometimes, these accesses are not available due to technical or patient-specific factors. In these cases, laparoscopic and percutaneous approaches combined could be an option. The aim of this study was to describe a laparoscopic-percutaneous combined gastrostomy procedure, feasibility, and complications. Materials and Methods: Retrospective descriptive observational study. All patients underwent laparoscopic-percutaneous combined gastrostomy required for feeding or decompressive gastrostomy. We analyzed variables: demographics, surgical indication, operation time, hospitalization stay, success, and morbidity/mortality associated to the procedure. Results: A total of n = 17 patients were recruited (58.8% women and 41.2% men), with mean age of 53. Regarding the indications of laparoscopic-percutaneous combined gastrostomy, 47% were due to upper gastrointestinal/head and neck tumor, 29.4% stomach location in a retrocostal position, 17.7% colonic interposition, and 5.9% acute gastric dilation of remnant after Roux-en-Y gastric bypass. The mean time of the procedure was 25 minutes, and mean hospitalization stay was 1.2 days. The success of the procedure was 100%. No complications and mortality associated with the procedure were reported. Conclusion: Laparoscopic-percutaneous combined gastrostomy is fast, feasible, safe, and cost effective. It is an option in patients where it is not possible to perform standard minimally invasive approaches.
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Affiliation(s)
- Carlos Federico Davrieux
- Department of Percutaneous Surgery, DAICIM Foundation (Teaching, Research, Assistance in Minimal Invasive Surgery), Buenos Aires, Argentina.,Department of General Surgery, Sanatorio de la Mujer, Rosario, Argentina
| | - Mariano Palermo
- Department of Percutaneous Surgery, DAICIM Foundation (Teaching, Research, Assistance in Minimal Invasive Surgery), Buenos Aires, Argentina.,School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.,Department of Bariatric Surgery, Diagnomed, Buenos Aires, Argentina
| | - Cecilia Cilfone
- Department of Percutaneous Surgery, DAICIM Foundation (Teaching, Research, Assistance in Minimal Invasive Surgery), Buenos Aires, Argentina.,Department of Pediatric Surgery, DAICIM Foundation, Buenos Aires, Argentina
| | - Antonela Ronchi
- Department of Percutaneous Surgery, DAICIM Foundation (Teaching, Research, Assistance in Minimal Invasive Surgery), Buenos Aires, Argentina
| | - Mariano Giménez
- Department of Percutaneous Surgery, DAICIM Foundation (Teaching, Research, Assistance in Minimal Invasive Surgery), Buenos Aires, Argentina.,School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.,Institut Hospitalo-Universitaire-Strasbourg (IHU-Strasbourg), Strasbourg, France
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4
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Losano M, Palermo M, Giménez M. Toward a Change in Our Work in Surgery: Collaborative Work, Coaching, and Teamwork. J Laparoendosc Adv Surg Tech A 2021; 32:471-475. [PMID: 34357818 DOI: 10.1089/lap.2021.0487] [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: 11/13/2022] Open
Abstract
Background: Until now, working with others has been shaped by a style where 1 person made the main decisions at the top of the hierarchical pyramid. These days this one-directional model no longer makes sense. That is why we need to change to a collaborative style. Methods: An overview on the change in our surgical work and definitions on the collaborative work, coaching, and teamwork will be discussed and analyzed. Results and Discussion: The system is defined by the boundaries that we set; they can often be the type of activity to be carried out or the way it is achieved. Collaboration means accompanying processes with a clear idea of what needs to be achieved and what values need to be followed. In work contexts that are globalized, diverse, virtual, and made up of highly educated specialists, isolation and a lack of collaboration are common. We would like to highlight four of them: (1) Signature relationship practices: The importance of building relationships on the basis of "who I am," not "what I am." (2) Ambidextrous leadership: Collaborative work needs to concentrate first on the task and on performing it effectively. (3) Mentoring versus "tit-for-tat culture": Collaborative work helps the design of individual and team identities. (4) Training in relationship skills: for communication and conflict resolution. Conclusions: Working on relationship building conversations generates a systemic view that allows the creation of a communication context that facilitates collaborative work. They are all key skills to achieve a collaborative culture on work.
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Affiliation(s)
- Mariana Losano
- Department of Minimally Invasive Surgery, DAICIM Foundation, Buenos Aires, Argentina
| | - Mariano Palermo
- Department of Minimally Invasive Surgery, DAICIM Foundation, Buenos Aires, Argentina
| | - Mariano Giménez
- Department of Minimally Invasive Surgery, DAICIM Foundation, Buenos Aires, Argentina
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5
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Giménez M, Gallix B, Costamagna G, Vauthey JN, Moche M, Wakabayashi G, Bale R, Swanström L, Futterer J, Geller D, Verde JM, García Vazquez A, Boškoski I, Golse N, Müller-Stich B, Dallemagne B, Falkenberg M, Jonas S, Riediger C, Diana M, Kvarnström N, Odisio BC, Serra E, Overduin C, Palermo M, Mutter D, Perretta S, Pessaux P, Soler L, Hostettler A, Collins T, Cotin S, Kostrzewa M, Alzaga A, Smith M, Marescaux J. Definitions of Computer-Assisted Surgery and Intervention, Image-Guided Surgery and Intervention, Hybrid Operating Room, and Guidance Systems: Strasbourg International Consensus Study. Ann Surg Open 2020; 1:e021. [PMID: 33392607 PMCID: PMC7771637 DOI: 10.1097/as9.0000000000000021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/05/2020] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To develop consensus definitions of image-guided surgery, computer-assisted surgery, hybrid operating room, and surgical navigation systems. SUMMARY BACKGROUND DATA The use of minimally invasive procedures has increased tremendously over the past 2 decades, but terminology related to image-guided minimally invasive procedures has not been standardized, which is a barrier to clear communication. METHODS Experts in image-guided techniques and specialized engineers were invited to engage in a systematic process to develop consensus definitions of the key terms listed above. The process was designed following review of common consensus-development methodologies and included participation in 4 online surveys and a post-surveys face-to-face panel meeting held in Strasbourg, France. RESULTS The experts settled on the terms computer-assisted surgery and intervention, image-guided surgery and intervention, hybrid operating room, and guidance systems and agreed-upon definitions of these terms, with rates of consensus of more than 80% for each term. The methodology used proved to be a compelling strategy to overcome the current difficulties related to data growth rates and technological convergence in this field. CONCLUSIONS Our multidisciplinary collaborative approach resulted in consensus definitions that may improve communication, knowledge transfer, collaboration, and research in the rapidly changing field of image-guided minimally invasive techniques.
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Affiliation(s)
- Mariano Giménez
- From the Research Institute against Cancer of the Digestive System (IRCAD), Strasbourg, France
- Institut Hospitalo-Universitaire IHU, University of Strasbourg, Strasbourg, France
- DAICIM Foundation, Buenos Aires, Argentina
| | - Benôit Gallix
- Institut Hospitalo-Universitaire IHU, University of Strasbourg, Strasbourg, France
- Department of Radiology, McGill University & Health Centre, Quebec, Canada
| | - Guido Costamagna
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, and Centre for Endoscopic Research Therapeutics and Training (CERTT), Università Cattolica del Sacro Cuore, Rome, Italy
| | - Jean-Nicolas Vauthey
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael Moche
- Department of Interventional Radiology, Helios Park-Klinikum, Leipzig, Germany
| | - Go Wakabayashi
- Department of Surgery, Ageo Central General Hospital, Saitama, Japan
| | - Reto Bale
- Interventional Oncology—Microinvasive Therapy (SIP), University Clinic for Radiology, Medical University, Innsbruck, Austria
| | - Lee Swanström
- Institut Hospitalo-Universitaire IHU, University of Strasbourg, Strasbourg, France
| | - Jürgen Futterer
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - David Geller
- Division of Hepatobiliary and Pancreatic Surgery, University of Pittsburgh, Pittsburgh, PA
| | - Juan M. Verde
- From the Research Institute against Cancer of the Digestive System (IRCAD), Strasbourg, France
- Institut Hospitalo-Universitaire IHU, University of Strasbourg, Strasbourg, France
- DAICIM Foundation, Buenos Aires, Argentina
| | - Alain García Vazquez
- From the Research Institute against Cancer of the Digestive System (IRCAD), Strasbourg, France
- Institut Hospitalo-Universitaire IHU, University of Strasbourg, Strasbourg, France
- DAICIM Foundation, Buenos Aires, Argentina
| | - Ivo Boškoski
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, and Centre for Endoscopic Research Therapeutics and Training (CERTT), Università Cattolica del Sacro Cuore, Rome, Italy
| | - Nicolas Golse
- Centre Hépato-Biliaire, Hôpital Paul Brousse, Villejuif, France
| | - Beat Müller-Stich
- Minimally Invasive Surgery, Surgical Clinic University Hospital, Heidelberg, Germany
| | - Bernard Dallemagne
- From the Research Institute against Cancer of the Digestive System (IRCAD), Strasbourg, France
- Institut Hospitalo-Universitaire IHU, University of Strasbourg, Strasbourg, France
- Service de Chirurgie Digestive & Endocrinienne, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Mårten Falkenberg
- Department of Radiology at the Department of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sven Jonas
- Department of Visceral Surgery, 310Klinik, Nuremberg, Germany
| | - Carina Riediger
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Michele Diana
- From the Research Institute against Cancer of the Digestive System (IRCAD), Strasbourg, France
| | - Niklas Kvarnström
- Department of Surgery at Institute of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Bruno C. Odisio
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | - Didier Mutter
- From the Research Institute against Cancer of the Digestive System (IRCAD), Strasbourg, France
- Institut Hospitalo-Universitaire IHU, University of Strasbourg, Strasbourg, France
- Service de Chirurgie Digestive & Endocrinienne, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Silvana Perretta
- From the Research Institute against Cancer of the Digestive System (IRCAD), Strasbourg, France
- Institut Hospitalo-Universitaire IHU, University of Strasbourg, Strasbourg, France
- Service de Chirurgie Digestive & Endocrinienne, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Patrick Pessaux
- From the Research Institute against Cancer of the Digestive System (IRCAD), Strasbourg, France
- Institut Hospitalo-Universitaire IHU, University of Strasbourg, Strasbourg, France
- Service de Chirurgie Digestive & Endocrinienne, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | | | - Alexandre Hostettler
- From the Research Institute against Cancer of the Digestive System (IRCAD), Strasbourg, France
| | - Toby Collins
- Institut Hospitalo-Universitaire IHU, University of Strasbourg, Strasbourg, France
| | | | - Michael Kostrzewa
- Institut Hospitalo-Universitaire IHU, University of Strasbourg, Strasbourg, France
| | | | - Martin Smith
- ‡‡‡Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa
| | - Jacques Marescaux
- From the Research Institute against Cancer of the Digestive System (IRCAD), Strasbourg, France
- Institut Hospitalo-Universitaire IHU, University of Strasbourg, Strasbourg, France
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Giménez M, Cano M, Martínez-Zalacaín I, Real E, Alonso P, Segalàs C, Munuera J, Kegeles LS, Weinstein JJ, Xu X, Menchón JM, Cardoner N, Soriano-Mas C, Fullana MA. Is glutamate associated with fear extinction and cognitive behavior therapy outcome in OCD? A pilot study. Eur Arch Psychiatry Clin Neurosci 2020; 270:1003-1014. [PMID: 31432262 DOI: 10.1007/s00406-019-01056-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 08/07/2019] [Indexed: 12/15/2022]
Abstract
Cognitive behavioral therapy (CBT) including exposure and response prevention is a well-established treatment for obsessive-compulsive disorder (OCD) and is based on the principles of fear extinction. Fear extinction is linked to structural and functional variability in the ventromedial prefrontal cortex (vmPFC) and has been consistently associated with glutamate neurotransmission. The relationship between vmPFC glutamate and fear extinction and its effects on CBT outcome have not yet been explored in adults with OCD. We assessed glutamate levels in the vmPFC using 3T magnetic resonance spectroscopy, and fear extinction (learning and recall) using skin conductance responses during a 2-day experimental paradigm in OCD patients (n = 17) and in healthy controls (HC; n = 13). Obsessive-compulsive patients (n = 12) then received manualized CBT. Glutamate in the vmPFC was negatively associated with fear extinction recall and positively associated with CBT outcome (with higher glutamate levels predicting a better outcome) in OCD patients. Glutamate levels in the vmPFC in OCD patients were not significantly different from those in HC, and were not associated with OCD severity. Our results suggest that glutamate in the vmPFC is associated with fear extinction recall and CBT outcome in adult OCD patients.
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Affiliation(s)
- M Giménez
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain
| | - M Cano
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - I Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - E Real
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain
| | - P Alonso
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - C Segalàs
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain
| | - J Munuera
- Diagnostic Imaging Department, Fundació de Recerca Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, Esplugues de Llobregat, 08950, Barcelona, Spain
| | - L S Kegeles
- Department of Psychiatry and Radiology, Columbia University, 622 W 168th St, New York, 10032, USA.,New York State Psychiatric Institute, 1051 Riverside Dr, New York, 10032, USA
| | - J J Weinstein
- Department of Psychiatry and Radiology, Columbia University, 622 W 168th St, New York, 10032, USA.,New York State Psychiatric Institute, 1051 Riverside Dr, New York, 10032, USA.,Department of Psychiatry, Stony Brook University, Stony Brook, 101 Nicolls Rd, Stony Brook, New York, 11794, USA
| | - X Xu
- Department of Psychiatry and Radiology, Columbia University, 622 W 168th St, New York, 10032, USA.,New York State Psychiatric Institute, 1051 Riverside Dr, New York, 10032, USA
| | - J M Menchón
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - N Cardoner
- Depression and Anxiety Program, Department of Mental Health, Parc Taulí Sabadell, Hospital Universitari, Parc Taulí 1, 08208, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Av. de Can Domènech, 737, 08193, Cerdanyola Del Vallès Barcelona, Barcelona, Spain
| | - C Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain.,Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Building B1, Ca n'Altayó, s/n, Bellaterra, 08193, Barcelona, Spain
| | - M A Fullana
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain. .,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Av. de Can Domènech, 737, 08193, Cerdanyola Del Vallès Barcelona, Barcelona, Spain. .,Psychiatry Department, Hospital Clínic-Institute of Neurosciences, CIBERSAM, C/Rosselló 140, 08036, Barcelona, Spain.
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Viñals C, Conget I, Pané A, Boswell L, Perea V, Blanco AJ, Ruiz S, Giménez M, Vinagre I, Esmatjes E, Ortega E, Amor AJ. Steno type 1 risk engine and preclinical atherosclerosis in Mediterranean individuals with type 1 diabetes. Diabetes Metab Res Rev 2020; 36:e3320. [PMID: 32239693 DOI: 10.1002/dmrr.3320] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/31/2020] [Accepted: 03/18/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIMS Tools to detect type 1 diabetes (T1D) individuals at overt cardiovascular disease (CVD) risk are scarce. We aimed to assess the usefulness of the score 'Steno Type 1 Risk Engine' (Steno-Risk) to identify T1D patients with advanced carotid atherosclerosis. MATERIAL AND METHODS T1D patients without CVD with at least one of the following were included: ≥40 years, diabetic nephropathy, or diabetes duration ≥10 years with ≥1 CVD risk factor. Intima-media thickness (IMT) and plaque presence (IMT ≥1.5 mm) were assessed by standardized B-mode ultrasonography. Steno-Risk was used to estimate 10-year risk (<10% low; 10%-20% moderate; ≥20% high risk). Associations between Steno-Risk and preclinical atherosclerosis were assessed after adjusting for other CVD risk factors. RESULTS We evaluated 302 patients (55% men, age 47.8 ± 9.8 years, T1D duration 26.3 ± 9.3 years). The prevalence of carotid plaque and ≥2 plaques were 36.4% and 19.2%, respectively; without sex differences. Age (57.4 ± 7.4 vs 37.1 ± 6.2 years), T1D duration (31.3 ± 10.4 vs 21.5 ± 7.1 years), hypertension (52.3% vs 6.3%), nephropathy (25.6% vs 5.1%) and retinopathy (53.5% vs 32.9%) were higher in high-risk (n = 86) vs low-risk participants (n = 79; P < .001 for all). Preclinical atherosclerosis (IMT and plaque) increased in parallel with Steno-Risk (P < .001). In logistic regression analysis, both age ≥40 years and Steno-Risk ≥20% were associated with the presence of plaque (OR 4.22 [1.57-11.36] and 3.79 [1.61-6.80]; respectively), but only high Steno-Risk remained independently associated with ≥2 plaques (OR 3.31 [1.61-6.80]). CONCLUSION Steno-Risk is independently associated with preclinical atherosclerosis. Further studies are needed to ascertain its usefulness in this high-risk population.
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Affiliation(s)
- C Viñals
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - I Conget
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Institut d'investigacions biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - A Pané
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - L Boswell
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - V Perea
- Endocrinology and Nutrition Department, Hospital Universitari Mútua de Terrassa, Terrassa, Spain
| | - A J Blanco
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'investigacions biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - S Ruiz
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - M Giménez
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Institut d'investigacions biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - I Vinagre
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'investigacions biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - E Esmatjes
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Institut d'investigacions biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - E Ortega
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'investigacions biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - A J Amor
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
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Affiliation(s)
- Mariano Palermo
- Division of Minimally Invasive Surgery, DAICIM Foundation, Buenos Aires, Argentina
| | - Mariano Giménez
- Division of Minimally Invasive Surgery, DAICIM Foundation, Buenos Aires, Argentina
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Alvear Castro D, Gómez Rodríguez D, Houghton E, Pasten M, Finger López C, Acquafresca P, Palermo M, Giménez M. Transhepatic Percutaneous Sustained Dilation with Multiple Catheters for the Management of Hepaticojejunostomy Benign Stricture. J Laparoendosc Adv Surg Tech A 2020; 30:948-952. [DOI: 10.1089/lap.2020.0418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
| | | | - Eduardo Houghton
- DAICIM Foundation, Percutaneous Surgery, Buenos Aires, Argentina
- Minimally Invasive Surgery, Hospital Bernardino Rivadavia, Buenos Aires, Argentina
- Surgery Department, University of Buenos Aires, Buenos Aires, Argentina
| | - Mauricio Pasten
- DAICIM Foundation, Percutaneous Surgery, Buenos Aires, Argentina
| | - Caetano Finger López
- DAICIM Foundation, Percutaneous Surgery, Buenos Aires, Argentina
- Percutaneous Surgery, Hospital Fernández, Buenos Aires, Argentina
| | | | - Mariano Palermo
- DAICIM Foundation, Percutaneous Surgery, Buenos Aires, Argentina
- Surgery Department, University of Buenos Aires, Buenos Aires, Argentina
- DIAGNOMED, Bariatric Surgery, Buenos Aires, Argentina
| | - Mariano Giménez
- DAICIM Foundation, Percutaneous Surgery, Buenos Aires, Argentina
- Surgery Department, University of Buenos Aires, Buenos Aires, Argentina
- Percutaneous Surgery, IHU IRCAD, University of Strasbourg, Strasbourg, France
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Palermo M, Davrieux F, Serra E, Giménez M. Percutaneous Image-Guided Surgery in Complications After Bariatric Surgery. J Laparoendosc Adv Surg Tech A 2020; 30:967-972. [DOI: 10.1089/lap.2020.0410] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Mariano Palermo
- CIEN-DIAGNOMED Center Affiliated to the University of Buenos Aires, Buenos Aires, Argentina
- DAICIM Foundation, Buenos Aires, Argentina
- School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Federico Davrieux
- DAICIM Foundation, Buenos Aires, Argentina
- Department of General Surgery, Sanatorio de la Mujer, Rosario, Argentina
| | - Edgardo Serra
- CIEN-DIAGNOMED Center Affiliated to the University of Buenos Aires, Buenos Aires, Argentina
- DAICIM Foundation, Buenos Aires, Argentina
| | - Mariano Giménez
- DAICIM Foundation, Buenos Aires, Argentina
- School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
- Institute of Image-Guided Surgery, Institut Hospitalo-Universitaire-Strasbourg, Strasbourg, France
- IRCAD, Research Institute Against Cancer of the Digestive System, Strasbourg, France
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Ciruela P, Broner S, Izquierdo C, Pallarés R, Muñoz-Almagro C, Hernández S, Grau I, Domínguez A, Jané M, Ciruela P, Izquierdo C, Broner S, Hernández S, Jané M, Muñoz-Almagro C, Esteva C, de Sevilla M, Henares D, Pallarés R, Ardanuy C, Grau I, Marco F, Margall N, González-Cuevas A, Díaz A, Martin M, Llaberia J, Curriu M, Gallés C, Capdevila E, Gassiot P, Martínez-Zurita M, Martí C, Morta M, Sauca G, Gassós A, Sanfeliu E, Ballester F, Pujol I, Olsina M, Raga X, Gómez-Bertomeu F, Pérez-Moreno M, Vilamala A, Navarro M, Ribelles M, Garcia M, Padilla E, Prim N, Fontanals D, Sanfeliu I, Benitez M, Jou E, Sanjosé C, Giménez M, Quesada M, de la Fuente J, Calderon A, Ayala P, Vega L, Pérez-Jové J, Blanco A, Balado C, Valle I, Bastida M, Gonzalez-Moreno O, Ubanell A, Fenoll A, Yuste J. Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults. Int J Infect Dis 2019; 86:122-130. [DOI: 10.1016/j.ijid.2019.06.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/28/2019] [Accepted: 06/30/2019] [Indexed: 12/29/2022] Open
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Amor A, Vinagre I, Valverde M, Pané A, Urquizu X, Meler E, López E, Quirós C, Giménez M, Codina L, Alonso N, Conget I, Barahona M, Perea V. Preeclampsia: A Risk Factor On Preclinical Carotid Atherosclerosis With Similar Impact To Type 1 Diabetes. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.255] [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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13
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Quirós C, Giménez M, Ríos P, Careaga M, Roca D, Vidal M, Conget I. Long-term outcome of insulin pump therapy: reduction of hypoglycaemia and impact on glycaemic control. Diabet Med 2016; 33:1422-6. [PMID: 26870914 DOI: 10.1111/dme.13094] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 12/14/2015] [Accepted: 02/09/2016] [Indexed: 11/28/2022]
Abstract
AIMS To determine the long-term outcome of continuous subcutaneous insulin infusion (CSII) in Type 1 diabetes according to Catalan National Health Service indications. METHODS Retrospective observational study including 178 patients with Type 1 diabetes who started CSII treatment in our centre (2003-2008). All patients were followed in our CSII programme for outpatients for at least 5 years. Data on annual HbA1c levels were collected, and the main indication for starting CSII was analysed. RESULTS Twenty-seven of 178 patients were excluded because of loss to follow-up or withdrawal from CSII, thus 151 patients (aged 37.4 ± 10.5 years, 64% women) were analysed. The main indications for starting CSII were suboptimal metabolic control (60.9%), severe hypoglycaemia/hypoglycaemia unawareness (25.5%) and others (13.6%). HbA1c was 64 ± 13 mmol/mol (8.0 ± 1.2%) at the start of CSII and 62 ± 13 mmol/mol (7.8 ± 1.2%) after 5 years in the total cohort (P = 0.1). The severe hypoglycaemia rates were 0.66 ± 1.61 and 0.17 ± 0.42 episodes/patient/year (P < 0.001). In patients with suboptimal metabolic control, HbA1c decreased from 68 ± 12 mmol/mol (8.4 ± 1.1%) to 64 ± 14 mmol/mol (8.0 ± 1.3%) (P = 0.016), with 37.4% of those in this group having an HbA1c ≤ 58 mmol/mol (7.5%) after 5 years. In patients starting CSII due to severe hypoglycaemia the problem was considered resolved in 93%, and in 64% of those starting CSII because of suboptimal glycaemic control, HbA1c improved significantly. CONCLUSIONS CSII therapy achieves and maintains its efficacy mainly in terms of reducing severe hypoglycaemia. In the whole group of patients, the reduction in HbA1c is transient and disappears after 5 years.
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Affiliation(s)
- C Quirós
- Diabetes Unit, Endocrinology, Department, Hospital Clínic i Universitari, Barcelona, Spain.
| | - M Giménez
- Diabetes Unit, Endocrinology, Department, Hospital Clínic i Universitari, Barcelona, Spain
| | - P Ríos
- Diabetes Unit, Endocrinology, Department, Hospital Clínic i Universitari, Barcelona, Spain
| | - M Careaga
- Diabetes Unit, Endocrinology, Department, Hospital Clínic i Universitari, Barcelona, Spain
| | - D Roca
- Diabetes Unit, Endocrinology, Department, Hospital Clínic i Universitari, Barcelona, Spain
| | - M Vidal
- Diabetes Unit, Endocrinology, Department, Hospital Clínic i Universitari, Barcelona, Spain
| | - I Conget
- Diabetes Unit, Endocrinology, Department, Hospital Clínic i Universitari, Barcelona, Spain
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Palermo M, Domínguez ML, Acquafresca P, Duza G, Giménez M. Single Port Laparoscopic Gastrostomy: description of a technique and initial experience. ACTA GASTROENTEROLOGICA LATINOAMERICANA 2015; 45:280-287. [PMID: 28586182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Since the first classic descriptions of surgical gastrostomies for feeding by supra-umbilical medial incisions, patients were operated under general anesthesia, with prolonged time of surgery; these were patients in poor health status, undernourished due to inadequate intake or to neurological or tumor involvement, with prolonged hospitalization, both for the recovery of the intestinal motility as well as for the recovery of post-surgical wounds. Therefore, we describe a new minimally invasive technique as an alternative to the percutaneous or endoscopic gastrostomy, in patients where we are not allowed to place a nasogastric tube to insufflate the stomach. This is mostly seen in patients with tumors, which cause obstruction. MATERIAL AND METHODS Between July 2012 and June 2013, 8 patients underwent a single port laparoscopic gastrostomy. Five were females, mean age: 77 years (range: 67-87). In all the patients, it was impossible to place a nasogastric tube, due to obstructive tumor. RESULTS The mean time of the procedure was 45 minutes. Seven patients underwent tolerance of dextrose 10% through the catheter after 12 hours and one 24 hours after the procedures. Enteral feeding was indicated after the dextrose 10% tolerance was performed. No complications related to the procedure were observed. DISCUSSION Currently, the gold standard technique to perform a gastrostomy is the percutaneous or endoscopic approach. In patients with head and neck tumors, when it is not possible to insert a nasogastric tube to insufflate the stomach, a laparoscopic gastrostomy would be indicated. We describe a new technique, step by step, to perform less invasive laparoscopic surgery by a single port laparoscopic gastrostomy. CONCLUSION The diameter created is the same as the one performed with an open technique, but in this case, with a minimally invasive approach, that allows us to start feeding the patient with a high quality of feeding, because of the wider lumen.
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15
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Palermo M, Mendaro E, Houghton E, Verde JM, Giménez M. [Not Available]. Acta Gastroenterol Latinoam 2015; 45:279-338. [PMID: 28586181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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16
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Vidal M, Jansà M, Levy I, Giménez M, Herrera F, Lorente I, Marin MC, Oriell J, Sanhonorato J, Sanz O, Conget I. Therapeutic education seminars for patients with type 1 diabetes and their relatives. ACTA ACUST UNITED AC 2015. [DOI: 10.1002/edn.59] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Vidal M, Jansa M, Anguita C, Torres M, Giménez M, Esmatjes E, Levy I, Conget I. Impact of a special therapeutic education programme in patients transferred from a paediatric to an adult diabetes unit. ACTA ACUST UNITED AC 2015. [DOI: 10.1002/edn.5] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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18
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Riveros A, Mateo L, Martínez-Morillo M, Tejera B, Rodríguez S, Sanint J, Holgado S, Cañellas J, Tena X, Olivé A, Giménez M. THU0434 Pyogenic Arthritis: Clinical and Epidemiological Features of 101 Cases at a University Hospital. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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19
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Pardo J, Mena A, Chiaramello C, Giménez M, Romero F, Mateos P, Sintes M, Alastuey I, Aymar N, Peña C. EP-1416: Impact of PET-CT simulation in lung cancer patients treatment. Preliminary results. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31534-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Riveros A, Mateo L, Martínez-Morillo M, Tejera B, Rodríguez S, Sanint J, Holgado S, Cañellas J, Tena X, Olivé A, Giménez M. THU0433 A Study of 101 Septic Arthritis: Debridement and not Debridement. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.961] [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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Pujol J, Giménez M, Ortiz H, Soriano-Mas C, López-Solà M, Farré M, Deus J, Merlo-Pich E, Harrison BJ, Cardoner N, Navinés R, Martín-Santos R. Neural response to the observable self in social anxiety disorder. Psychol Med 2013; 43:721-731. [PMID: 22895096 DOI: 10.1017/s0033291712001857] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Distorted images of the observable self are considered crucial in the development and maintenance of social anxiety. We generated an experimental situation in which participants viewed themselves from an observer's perspective when exposed to scrutiny and evaluation by others. Method Twenty patients with social anxiety disorder (SAD) and 20 control subjects were assessed using functional magnetic resonance imaging (fMRI) during the public exposure of pre-recorded videos in which they were each shown performing a verbal task. The examiners acted as the audience in the experiment and rated performance. Whole-brain functional maps were computed using Statistical Parametric Mapping. RESULTS Robust activation was observed in regions related to self-face recognition, emotional response and general arousal in both study groups. Patients showed significantly greater activation only in the primary visual cortex. By contrast, they showed significant deactivation or smaller activation in dorsal frontoparietal and anterior cingulate cortices relevant to the cognitive control of negative emotion. Task-related anxiety ratings revealed a pattern of negative correlation with activation in this frontoparietal/cingulate network. Importantly, the relationship between social anxiety scores and neural response showed an inverted-U function with positive correlations in the lower score range and negative correlations in the higher range. CONCLUSIONS Our findings suggest that exposure to scrutiny and evaluation in SAD may be associated with changes in cortical systems mediating the cognitive components of anxiety. Disorder severity seems to be relevant in shaping the neural response pattern, which is distinctively characterized by a reduced cortical response in the most severe cases.
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Affiliation(s)
- J Pujol
- Institut d'Alta Tecnologia-PRBB, CRC Mar, Hospital de Mar, Barcelona, Spain.
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Szulman C, Giménez M, Sierre S. Antegrade papillary balloon dilation for extrahepatic bile duct stone clearance: lessons learned from treating 300 patients. J Vasc Interv Radiol 2011; 22:346-53. [PMID: 21277793 DOI: 10.1016/j.jvir.2010.11.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 10/28/2010] [Accepted: 11/14/2010] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To report the authors' experience with percutaneous papillary balloon dilation for extrahepatic bile duct stone clearance to the duodenum in 300 patients. MATERIALS AND METHODS During a 16-year period, 300 patients with extrahepatic bile duct stones who underwent papillary balloon dilation were retrospectively evaluated. Two hundred eighty-six patients with retained extrahepatic bile duct stones were treated through a postoperative drain placed during cholecystectomy; 245 patients were treated through a T-tube route and 41 through a transcystic approach. In the remaining 14 patients, the procedure was performed through a newly created percutaneous transhepatic route. Success rates, technical features, reasons for failure, and complications were evaluated. RESULTS Biliary duct stone removal after papillary dilation was successful in 288 patients (96%). In 244 patients, the procedure was successfully completed on the first attempt. Forty-three patients needed two sessions, and in one patient it took three sessions. Stone diameters ranged from 4 mm to 18 mm (mean, 8 mm). Two hundred fourteen patients had four or fewer stones (mean, 2.3), and 86 patients had more than four (mean, 8.8; range, 5-25). Two patients required surgical intervention after loss of transcystic drainage, with subsequent development of peritonitis. During the follow-up period (mean, 26.6 months), no clinical or laboratory abnormalities were observed. CONCLUSIONS Percutaneous antegrade papillary balloon dilation and stone clearance is a safe and effective tool in removing common bile duct stones. Some technical issues should be considered to achieve complete stone removal while minimizing the incidence of complications.
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Affiliation(s)
- Carlos Szulman
- Department of Interventional Radiology, Sanatorio Nuestra Señora del Rosario, San Salvador de Jujuy, Jujuy, Argentina
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González J, Zanocco P, Giménez M, Schivo M, Mazzantini O, Caputo M, Bedrossian G, Serrano P, Vertullo A. PSA-Oriented Analysis of Transients in Atucha Unit II PHWR with a RELAP Model. NUCL TECHNOL 2010. [DOI: 10.13182/nt10-a10769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- J. González
- Comisión Nacional de Energía Atómica, Centro Atómico Bariloche San Carlos de Bariloche, R8402AGP, Argentina
- Consejo Nacional de Investigaciones Científicas y TecnológicasSan Carlos de Bariloche, R8402AGP, Argentina
- Instituto Balseiro, Centro Atómico Bariloche, San Carlos de Bariloche R8402AGP, Argentina
| | - P. Zanocco
- Comisión Nacional de Energía Atómica, Centro Atómico Bariloche San Carlos de Bariloche, R8402AGP, Argentina
- Instituto Balseiro, Centro Atómico Bariloche, San Carlos de Bariloche R8402AGP, Argentina
| | - M. Giménez
- Comisión Nacional de Energía Atómica, Centro Atómico Bariloche San Carlos de Bariloche, R8402AGP, Argentina
- Instituto Balseiro, Centro Atómico Bariloche, San Carlos de Bariloche R8402AGP, Argentina
| | - M. Schivo
- Nucleoeléctrica Argentina S. A., Central Nuclear Atucha II, Lima (Bs. As.) B2800XAD, Argentina
| | - O. Mazzantini
- Nucleoeléctrica Argentina S. A., Central Nuclear Atucha II, Lima (Bs. As.) B2800XAD, Argentina
| | - M. Caputo
- Comisión Nacional de Energía Atómica, Centro Atómico Bariloche San Carlos de Bariloche, R8402AGP, Argentina
- Instituto Balseiro, Centro Atómico Bariloche, San Carlos de Bariloche R8402AGP, Argentina
| | - G. Bedrossian
- Comisión Nacional de Energía Atómica, Central Nuclear Atucha II, Lima (Bs. As.) B2800XAD, Argentina
| | - P. Serrano
- Nucleoeléctrica Argentina S. A., Central Nuclear Atucha II, Lima (Bs. As.) B2800XAD, Argentina
| | - A. Vertullo
- Comisión Nacional de Energía Atómica, Centro Atómico Bariloche San Carlos de Bariloche, R8402AGP, Argentina
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Sampol C, Giménez M, Torrecabota J, Serra C, Canet R, Daumal J, Peña C, Gonzalez L, Hernandez E, Graner A, Pozo A, Vega F. [Axillary recurrences after sentinel lymph node biopsy in initial breast cancer]. ACTA ACUST UNITED AC 2010; 29:241-5. [PMID: 20466461 DOI: 10.1016/j.remn.2010.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Revised: 02/17/2010] [Accepted: 02/20/2010] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aim of our study was to analyze the application of the Selective Sentinel Lymph Node Biopsy (SLNB) in early Breast Cancer of our population, through the analysis of axillary recurrences in patients with false negative sentinel node procedures without complete axillary lymphadenectomy, after a subsequent clinical follow-up. MATERIAL AND METHODS A total of 218 early Breast Cancer patients who underwent SLNB after being diagnosed of early breast cancer (T1-2N0) with complete axillary dissection only when the SLNB was positive in the histopathological analysis. In every case, a 2-day protocol was used to localize the sentinel node after injection of (⁹⁹m)Tc-Nanocolloid. RESULTS The mean subsequent clinical follow-up was 27 months. A total of 413 sentinel nodes were removed with a median of 1.89/p (range 1-5). Infiltration was detected in 33.9% of patients (59.45% macrometastasis, 22.97% micrometastasis and 17.5% Isolated Tumor Cells (ITC)) and negative for the other nodes excised after conventional lymphadenectomy in 60% of cases. In our population, there was only one case of false negative (FN) SLN due to massive lymphatic blockage, and an abnormal lymph node without uptake adjacent to the SLN was identified intraoperatively. No case of axillary recurrence was detected during an average follow-up of 27 months. CONCLUSION The absence of axillary recurrences in our population with negative SLNB without complete axillary dissection demonstrates the appropriate local control offered by this procedure in early Breast Cancer.
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Affiliation(s)
- C Sampol
- Servicio de Medicina Nuclear, Hospital Universitario Son Dureta, Palma de Mallorca, España.
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Quesada MD, Giménez M, Molinos S, Fernández G, Sánchez MD, Rivelo R, Ramírez A, Banqué G, Ausina V. Performance of VITEK-2 Compact and overnight MicroScan panels for direct identification and susceptibility testing of Gram-negative bacilli from positive FAN BacT/ALERT blood culture bottles. Clin Microbiol Infect 2009; 16:137-40. [PMID: 19778301 DOI: 10.1111/j.1469-0691.2009.02907.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We describe the reliability of the VITEK-2 Compact and overnight MicroScan panels for direct identification and susceptibility testing from the BacT/ALERT blood culture system when using FAN (FA and FN) bottles. A simple procedure, in two centrifugation steps, was designed to remove the charcoal particles present in FA and FN bottles. A total of 113 positive blood cultures showing Gram-negative rods were investigated. Enterobacteriaceae were isolated in 104 cases, and Pseudomonas aeruginosa in nine. The MicroScan system correctly identified 106 (93.8%) of the 113 isolates. The seven identificaction errors included P. aeruginosa (three), Enterobacter cloacae (one), Escherichia coli (one), Klebsiella oxytoca (one), and Klebsiella pneumoniae (one). The VITEK-2 system correctly identified 109 (96.5%) of the 113 samples obtained directly from the blood culture bottles. The four unidentified isolates were Enterobacter cloacae (two), Escherichia coli (one), and P. aeruginosa (one). MicroScan yielded 4/779 (0.5%) very major errors and 28/2825 (0.9%) minor errors. VITEK-2 yielded 2/550 (0.36%) very major errors, 1/1718 (0.05%) major error, and 32/2373 (1.3%) minor errors. Both systems provided excellent identification (correlation of >90%) and susceptibility (correlation of >98%) results. The average times required to obtain identification and susceptibility results using the direct test applied to the VITEK-2 Compact system were 4.57 +/- 1.37 h and 6.52 +/- 1.64 h, respectively. The VITEK-2 compact system provided results on the same day that the blood culture was found to be positive.
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Affiliation(s)
- M D Quesada
- Department of Microbiology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
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Andreo F, Prat C, Ruiz-Manzano J, Lores L, Blanco S, Cuesta MA, Giménez M, Domínguez J. Persistence of Streptococcus pneumoniae urinary antigen excretion after pneumococcal pneumonia. Eur J Clin Microbiol Infect Dis 2008; 28:197-201. [DOI: 10.1007/s10096-008-0606-3] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Accepted: 07/24/2008] [Indexed: 11/30/2022]
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Giménez M, Lara M, Vidal M, Jansà M, Conget I. Disturbed eating behaviours and glycaemic control in young subjects with Type 1 diabetes transferred from a paediatric to an adult diabetes unit. Diabet Med 2008; 25:884-5. [PMID: 18644079 DOI: 10.1111/j.1464-5491.2008.02478.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Giménez M, Nicolau J, Vidal J, Casamitjana R, Conget I. Phenotype changes at the onset of type 1 diabetes in young adults from a mediterranean area throughout the last decade. Acta Diabetol 2008; 45:87-90. [PMID: 18270649 DOI: 10.1007/s00592-008-0028-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2007] [Accepted: 12/13/2007] [Indexed: 01/07/2023]
Abstract
The Accelerator hypothesis postulates that Type 1 Diabetes (T1D) and Type 2 Diabetes are mostly the same disorder. Till now, the data testing the hypothesis and the importance of BMI and insulin resistance in the development of T1D comes almost exclusively from childhood. Our study aimed to investigate changes in clinical and metabolic characteristics of young adults at diagnosis of T1D during the last decade in a Mediterranean area. Ninety-three adults (> or =18 years) with newly diagnosed T1D were evaluated from our database. Thirty-one of them were diagnosed in the period 07/1994-1995 (G95), 39 between 07/1998 and 1999 (G99) and 23 in 2003 (G03). Plasma C-peptide measurements were performed before and 6 min after intravenous injection of 1 mg of glucagon. In those subjects with a basal C-peptide > 0.2 nmol/l, insulin resistance was evaluated using the HOMA-2 model. HbAc, GAD, IA2 and insulin autoantibodies were measured. There was not a significant rise in BMI at diagnosis of T1D in young adults admitted to our Hospital. This was also the case when BMI after 4 weeks of diagnosis was considered (23.7 +/- 3.6, 23,6 +/- 2.4 and 23.4 +/- 3.3 kg/m2, G95 G99 and G03, respectively). In the entire group of subjects, we could not observed any relationship between the patients BMI and age at diagnosis. Likewise, we could not observed differences in any of the clinical, immunological or metabolic characteristics. IR was not different between groups (G95 n=18, 0.73 +/- 0.21; G99 n=29, 0.86 +/- 0.33; G3 n=13, 0.66 +/- 0.34) and was not related to the age at diagnosis. In summary, our data collected from young adults with newly diagnosed T1D from a Mediterranean area indicates that the phenotype, including BMI, at the onset of the disease has not substantially varied during the last decade. In spite of our data do not fit with the accelerator hypothesis the postulate could be of interest in a different age group.
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Affiliation(s)
- M Giménez
- Endocrinology and Diabetes Unit, Institut d'Investigacions Biomtdicas August Pi i Sunyer, Hospital Clinic i Universitari, Villarroel 170, 08036 Barcelona, Spain
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Giménez M, Conget I, Jansà M, Vidal M, Chiganer G, Levy I. Efficacy of continuous subcutaneous insulin infusion in Type 1 diabetes: a 2-year perspective using the established criteria for funding from a National Health Service. Diabet Med 2007; 24:1419-23. [PMID: 17941861 DOI: 10.1111/j.1464-5491.2007.02287.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To determine the 2-year efficacy of continuous subcutaneous insulin infusion (CSII) following the current established criteria for funding of a National Health Service. METHODS Longitudinal, prospective, observational unicentre study. Included in the study were 153 Type 1 diabetes (T1D) subjects, previously treated with multiple daily injections (MDI) of insulin, in whom CSII was started in accordance with the criteria for reimbursement of the Catalan National Health Service. At baseline, we recorded data on age, gender, duration of the disease, body mass index (BMI), insulin dose and indications for CSII. Glycated haemoglobin (HbA(1c)) and the frequency of hypoglycaemic events were used to assess glycaemic control. Quality of life was assessed using three different self-report questionnaires. After 24 months, these same items were remeasured in all subjects. Serious adverse events and injection-site complications were also recorded. RESULTS In 96% of subjects, CSII indication included less than optimal glycaemic control using MDI. HbA(1c) fell from 7.9 +/- 1.3 to 7.3 +/- 1.1% (P < or = 0.001) after 24 months of CSII. Insulin requirements were significantly lower at the end of follow-up (0.55 +/- 0.21 U/kg body weight) in comparison with before use of CSII (0.70 +/- 0.20, P < or = 0.001). BMI increased from 24.0 +/- 3.1 to 24.4 +/- 3.2 kg/m(2) after 24 months (P < or = 0.025). The rate of episodes of diabetic ketoacidosis per year remained unchanged. Mild and severe hypoglycaemic episodes were significantly reduced. The scores in all subsets of the Diabetes Quality-of-Life (DQoL) questionnaire significantly improved after 24 months of CSII. CONCLUSIONS CSII, commenced according to the criteria for a nationally funded clinical programme, improves glycaemic control and quality-of-life outcomes with fewer hypoglycaemic episodes in T1D subjects previously conventionally treated with MDI.
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Affiliation(s)
- M Giménez
- Endocrinology and Diabetes Unit, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Hospital Clínic i Universitari, Barcelona, Spain
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Ramírez-Ruiz B, Martí MJ, Tolosa E, Giménez M, Bargalló N, Valldeoriola F, Junqué C. Cerebral atrophy in Parkinson's disease patients with visual hallucinations. Eur J Neurol 2007; 14:750-6. [PMID: 17594330 DOI: 10.1111/j.1468-1331.2007.01768.x] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Although visual hallucinations (VH) are relatively frequent in Parkinson's disease (PD) patients, their neural substrates are only known from neuropathological and functional magnetic resonance studies. The aim of this study was to investigate possible structural brain changes on MRI in non-demented PD patients with VH using voxel-based morphometry. Eighteen PD patients with VH were compared to 20 patients with PD without VH and 21 healthy controls. Compared with both controls and the non-hallucinating PD group, PD patients with VH had grey matter volume reductions in the lingual gyrus and superior parietal lobe. Structural changes in these areas involved in higher visual processing may be important in understanding the VH and visual deficits in PD patients.
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Affiliation(s)
- B Ramírez-Ruiz
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
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Cafini F, Aguilar L, González N, Giménez M, Torrico M, Alou L, Sevillano D, Vallejo P, Prieto J. P2059 Effect of human albumin physiological concentrations on the in vitro bactericidal activity of daptomycin vs. vancomycin Cmax concentrations against Gram-positive isolates exhibiting the main resistance phenotypes. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71898-8] [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: 10/23/2022]
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Giménez M, Conget I, Nicolau J, Pericot A, Levy I. Outcome of pregnancy in women with type 1 diabetes intensively treated with continuous subcutaneous insulin infusion or conventional therapy. A case-control study. Acta Diabetol 2007; 44:34-7. [PMID: 17357884 DOI: 10.1007/s00592-007-0239-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2006] [Accepted: 10/11/2006] [Indexed: 11/29/2022]
Abstract
The aim was to evaluate and compare the outcome of pregnancies of women with type 1 diabetes (T1D) intensively treated with continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI). Twenty-nine women with T1D receiving CSII during pregnancy as intensive insulin therapy (27 started CSII during pregnancy planning while 2 started CSII during the 1st month of gestation) were matched for age, duration of T1D, White's classification, BMI before gestation, parity and HbA1c before pregnancy with 29 women treated with MDI. Metabolic control and acute complications were registered including ketoacidosis and severe hypoglycaemic episodes, and the development of hypertension induced by pregnancy and pre-eclampsia. Perinatal mortality, stillbirth, minor and major congenital malformations, macrosomia, weeks at delivery, caesarean section and perinatal complications were also recorded. As expected, there were no differences between the two groups in terms of age, duration of the disease, White's classification, BMI before gestation, parity and HbA1c before pregnancy. The proportion of subjects who received preconceptional guidance and planned pregnancy did not differ between groups. No differences were observed in HbA1c, insulin dose and BMI throughout gestation in either group of patients. Maternal, foetal and perinatal outcome were similar in women treated with CSII or MDI. The use of CSII in pregestational T1D women is associated with similar results in metabolic control, maternal, foetal and perinatal outcome during pregnancy to those obtained using MDI.
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Affiliation(s)
- M Giménez
- Endocrinology and Diabetes Unit, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Hospital Clínic i Universitari, Villarroel 170, ES-08036, Barcelona, Spain
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Sánchez F, Fernández MM, Giménez M, Benlloch JM, Rodríguez-Alvarez MJ, García de Quirós F, Lerche CHW, Pavón N, Palazón JA, Martínez J, Sebastiá A. Performance tests of two portable mini gamma cameras for medical applications. Med Phys 2007; 33:4210-20. [PMID: 17153400 DOI: 10.1118/1.2358199] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We have developed two prototypes of portable gamma cameras for medical applications based on a previous prototype designed and tested by our group. These cameras use a CsI(Na) continuous scintillation crystal coupled to the new flat-panel-type multianode position-sensitive photomultiplier tube, H8500 from Hamamatsu Photonics. One of the prototypes, mainly intended for intrasurgical use, has a field of view of 44 x 44 mm2, and weighs 1.2 kg. Its intrinsic resolution is better than 1.5 mm and its energy resolution is about 13% at 140 keV. The second prototype, mainly intended for osteological, renal, mammary, and endocrine (thyroid, parathyroid, and suprarenal) scintigraphies, weighs a total of 2 kg. Its average spatial resolution is 2 mm; it has a field of view of 95 x 95 mm2, with an energy resolution of about 15% at 140 keV. The main advantages of these gamma camera prototypes with respect to those previously reported in the literature are high portability and low weight, with no significant loss of sensitivity and spatial resolution. All the electronic components are packed inside the mini gamma cameras, and no external electronic devices are required. The cameras are only connected through the universal serial bus port to a portable PC. In this paper, we present the design of the cameras and describe the procedures that have led us to choose their configuration together with the most important performance features of the cameras. For one of the prototypes, clinical tests on melanoma patients are presented and images are compared with those obtained with a conventional camera.
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Affiliation(s)
- F Sánchez
- Instituto de Física Corpuscular (CSIC- UV), Edificio Institutos de Paterna, P.O. Box 22085, E-46071, Valencia, Spain.
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Abstract
Prematurely born participants with very low birth weight (VLBW) are at high risk of brain injury in the perinatal period and of later cognitive impairment. Studies of long-term memory sequelae in VLBW participants are scarce and focus on verbal and visual memory assessed by standard clinical memory tests. There is even less research into everyday memory, and the results obtained are contradictory. This study explores long-term memory deficits in VLBW adolescents using 2 standard clinical memory tests and 1 everyday memory test. Results show impairment only in everyday memory. These memory deficits are not specific; they are related to an impaired general cognitive performance. Unlike birth weight, gestational age is a good predictor of intelligence.
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MESH Headings
- Adolescent
- Brain Damage, Chronic/diagnosis
- Brain Damage, Chronic/psychology
- Cerebral Hemorrhage/diagnosis
- Cerebral Hemorrhage/psychology
- Child
- Child, Preschool
- Female
- Follow-Up Studies
- Gestational Age
- Humans
- Infant
- Infant, Newborn
- Infant, Premature, Diseases/diagnosis
- Infant, Premature, Diseases/psychology
- Infant, Very Low Birth Weight/psychology
- Intelligence
- Male
- Memory Disorders/diagnosis
- Memory Disorders/psychology
- Neuropsychological Tests
- Respiration, Artificial
- Risk Factors
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Affiliation(s)
- A Narberhaus
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
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Abstract
OBJECTIVE To investigate the effects of prematurity on sulcal formation. METHODS We evaluated the depth and volume of the primary olfactory sulcus (developed at 16 weeks' gestation) and the secondary orbital sulci (which start to develop at 28 weeks' gestation) in a sample of 22 adolescents with history of very-preterm birth (VPTB). We compared this preterm sample with a sample of subjects born at term and matched by age, gender, and sociocultural status. The Anatomist/BrainVISA 3.0.1 package was used to identify and quantify the sulci. In addition, voxel-based morphometry (VBM) was used to analyze possible reductions of gray and white matter in the orbitofrontal area. RESULTS Compared with controls, we found a significant reduction in the secondary sulci depth but not in the primary sulcus in the VPTB. VBM analysis showed reduced gray-matter volume in VPTB in the orbital region. CONCLUSIONS Premature birth affects cerebral gyrification, and this impairment is not reversible during childhood. Identification of the specific factors involved in abnormal brain maturation may lead to effective interventions.
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Affiliation(s)
- M Giménez
- Department of Psychiatry and Clinical Psychobiology, Faculty of Medicine, University of Barcelona, Spain
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Andreo F, Domínguez J, Ruiz-Manzano J, Prat C, Blanco S, Lores L, Sánchez MD, Latorre I, Giménez M, Ausina V. Usefulness of pneumococcal antigen detection in pleural fluid samples by immunochromatographic assay for diagnosis of pneumococcal pneumonia. Clin Microbiol Infect 2006; 12:682-4. [PMID: 16774569 DOI: 10.1111/j.1469-0691.2006.01484.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study investigated the utility of an immunochromatographic test (ICT) for the detection of Streptococcus pneumoniae antigens in pleural fluid. Antigen was detected in 15 of 19 (79%) patients with pneumococcal pneumonia. The ICT was always negative in patients with non-pneumococcal pneumonia, but was positive in three cases with a non-infectious aetiology. In patients with pneumonia for which no pathogen was identified, antigen was detected in one of 24 pleural fluids tested. The ICT can be a valuable tool for the management of pneumonia because it can detect pneumococcal antigen in pleural effusion samples.
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Affiliation(s)
- F Andreo
- Servei de Pneumologia, Hospital de Sant Boi, Barcelona, Spain
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37
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Medrano E, Lorenzo P, Sánchez-Guerrero M, García M, Caparrós I, Coelho G, Giménez M. WATER AND NUTRIENT USE EFFICIENCY OF A TOMATO CROP AS AFFECTED BY TWO REFRIGERATION METHODS: EXTERNAL MOBILE SHADING AND FOG SYSTEM. ACTA ACUST UNITED AC 2005. [DOI: 10.17660/actahortic.2005.697.58] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Pérez A, Sala P, Giménez M, Sierra M, Esteve A, Alonso A, Quesada M, Raspall F, Ausina V, Rodrigo C. Pneumococcal bacteremia in children: an 8-year review in two hospitals in Barcelona. Eur J Clin Microbiol Infect Dis 2004; 23:677-81. [PMID: 15322935 DOI: 10.1007/s10096-004-1197-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In this study, 90 episodes of pneumococcal bacteremia that occurred over an 8-year period in two hospitals in Barcelona were analyzed retrospectively to determine the clinical and bacteriological characteristics of pneumococcal bacteremia, the risk factors for antibiotic resistance, the outcome, and the vaccine coverage. The mean age of the patients was 3.1 years and the male/female ratio was 1.7. The overall rates of penicillin-non-susceptible, cefotaxime-non-susceptible, and erythromycin-resistant isolates were 48.8, 24.4, and 25.5%, respectively. Antibiotic resistance was associated with children under the age of 2 years and with previous antibiotic treatment. The percentage of antibiotic resistance was higher in the nine episodes that occurred in patients with an underlying illness. The most prevalent serotypes identified were 1, 14, 6B, 18C, 5, and 19A. Serotypes 6A/B, 14, and 19A/F were isolated primarily from children under 2, whereas serotypes 1 and 5 were recovered more frequently from older children. Apparent relationships between serotypes 6A/B, 14, and 19A/F and occult bacteremia and between serotypes 1 and 5 and bacteremic pneumonia were confounded by the age variable. The proportion of bacteremic episodes preventable by all (7-valent, 9-valent, and 11-valent) of the conjugate pneumococcal vaccines was 60% in children under 2. In older children, the serotype coverage rate for the three formulations was 48, 87, and 87%, respectively. In summary, these data expand upon previous Spanish studies in which serotypes 1 and 5 were reported to be among the leading causes of severe systemic pneumococcal infections in children over 2, findings that should be taken into consideration when planning vaccine programmes.
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Affiliation(s)
- A Pérez
- Servicio de Microbiología, Hospital Germans Trias i Pujol, Carretera del Canyet s/n, Badalona, Barcelona, Spain.
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Narberhaus A, Segarra D, Giménez M, Caldú X, Junqué C, Bargalló N, Botet F. Differential cerebral and neuropsychological consequences in dizygotic twins with prenatal alcohol exposure. Alcohol Alcohol 2004; 39:321-4. [PMID: 15208164 DOI: 10.1093/alcalc/agh060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIM To relate structural and functional findings in one adolescent dizygotic twin pair with prenatal alcohol exposure. METHOD Neuropsychological and volumetric magnetic resonance studies were carried out on a 13-year-old preterm dizygotic twin pair with prenatal alcohol exposure. RESULTS Neuropsychological and brain structural findings differed between the twins. The child with the more affected phenotype had large-scale cognitive deficits and presented significant atrophy in several brain structures. Both subjects had white matter volume reductions relative to the whole cerebral volume. CONCLUSION The neuropsychological and neuroimaging data reflect long-term consequences of prenatal alcohol exposure.
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Affiliation(s)
- A Narberhaus
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Passeig de la Vall d'Hebron 171, E-08035, Spain
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González V, Padilla E, Giménez M, Vilaplana C, Pérez A, Fernández G, Quesada MD, Pallarés MA, Ausina V. Rapid diagnosis of Staphylococcus aureus bacteremia using S. aureus PNA FISH. Eur J Clin Microbiol Infect Dis 2004; 23:396-8. [PMID: 15112062 DOI: 10.1007/s10096-004-1112-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In the study presented here, the performance of the S. aureus PNA FISH assay was evaluated using 285 blood cultures (from 104 patients) that had gram-positive cocci resembling staphylococci on Gram stain. The new molecular test is based on a fluorescence in situ hybridization assay using peptide nucleic acid probes targeting Staphylococcus aureus 16S rRNA and is designed for the rapid identification of Staphylococcus aureus directly from positive blood cultures. The sensitivity, specificity, and positive and negative predictive values of the S. aureus PNA FISH for the rapid identification of Staphylococcus aureus directly from positive blood culture bottles were 100, 99.4, 99.2 and 100%, respectively.
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Affiliation(s)
- V González
- Servicio de Microbiología, Hospital Universitario Germans Trias i Pujol, Carretera. del Canyet s/n, Badalona, 08916 Barcelona, Spain
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Vilaplana C, Blanco S, Domínguez J, Giménez M, Ausina V, TUral C, Muñoz C. Noninvasive method for diagnosis of visceral leishmaniasis by a latex agglutination test for detection of antigens in urine samples. J Clin Microbiol 2004; 42:1853-4. [PMID: 15071070 PMCID: PMC387579 DOI: 10.1128/jcm.42.4.1853-1854.2004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Prat C, Domínguez J, Rodrigo C, Giménez M, Azuara M, Blanco S, Ausina V. Use of Quantitative and Semiquantitative Procalcitonin Measurements to Identify Children with Sepsis and Meningitis. Eur J Clin Microbiol Infect Dis 2004; 23:136-8. [PMID: 14689316 DOI: 10.1007/s10096-003-1066-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- C Prat
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, C/Canyet s/n, 08916 Badalona, Spain.
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Giménez M, Grinblat P, Schlamp M. A cost-effective methodology to internalize nuclear safety in nuclear reactor conceptual design. Nuclear Engineering and Design 2003. [DOI: 10.1016/s0029-5493(03)00209-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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45
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Richter JA, Torre W, García MJ, Aramendia JM, Giménez M, Brugarolas A. PET-FDG in the Preoperative Evaluation of Non Small Cell Lung Cancer (NSCLC) Staging. A Comparison with CT Scanning and MRI. ACTA ACUST UNITED AC 2003; 1:247. [PMID: 14516570 DOI: 10.1016/s1095-0397(98)00037-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- J A. Richter
- Departments of Nuclear Medicine Thoracic Surgery, Pamplona, Spain
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46
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Pérez López A, Giménez M, Rodrigo C, Alonso A, Prat C, Ausina V. Seven-year review of paediatric bacteraemias diagnosed in a Spanish university hospital. Acta Paediatr 2003; 92:854-6. [PMID: 12892168 DOI: 10.1080/08035250310002966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
UNLABELLED This study analysed the clinical and bacteriological patterns of paediatric bacteraemia in a university hospital, by a review of 213 episodes over a period of 7 y. Streptococcus pneumoniae was the most frequent aetiological agent after the neonatal period and Streptococcus agalactiae in neonatal sepsis. Almost half of pneumococci and meningococci were penicillin non-susceptible. Four neonatal deaths attributed to bacteraemia were recorded. CONCLUSION Streptococcus pneumoniae is the leading cause of community-acquired bacteraemia. Mortality due to bacteraemia in children without underlying conditions is rare.
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Affiliation(s)
- A Pérez López
- Servicio de Microbiología y Parasitología, Hospital Universitario Germans Trias i Pujol, Universidad Autónoma de Barcelona, Spain.
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47
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Abstract
AIM Optimal conditions for chlorine application to obtain a reasonable decrease in the microbial counts without damaging the appearance of artichoke and borage have been established. METHODS AND RESULTS The influence of chlorine concentration (0-200 mg l(-1)), pH, addition of organic acids, contact time and presence of protective structures on the microflora and vegetal appearance were studied. When pH was not controlled the effect of chlorine depended on its concentration until the pH increase caused by addition of chlorine reached 8.8. Any further increase in chlorine concentration was nullified by the pH increase. When pH was adjusted to 4.5 with acetic acid, the effectiveness increased with concentration. However, the use of citric acid to control pH caused a sharp decrease in effectiveness at concentration about 250 mg l(-1). The higher effectiveness of chlorine on homogenized plant extracts compared with the whole plant showed the impact of the vegetal structures on the resistance of the microorganisms. For artichoke, a relationship between the effectiveness of chlorine disinfection and its structures was also found. Extended washing times did not affect the total counts. However, in both vegetables, the appearance was affected by the extended contact times. CONCLUSIONS The solutions rendering the highest microbial reduction with minimum damages were: 50 mg l(-1) free chlorine without pH control for artichoke and 100 mg l(-1) free chlorine at pH 7.0 for borage. SIGNIFICANCE AND IMPACT OF THE STUDY Specific conditions for chlorine disinfection of artichoke and borage were determined to reduce the microorganisms in minimally processed artichoke and borage without damaging their appearance.
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Affiliation(s)
- S Sanz
- Universidad de La Rioja, Departamento de Agricultura y Alimentación, Logroño (La Rioja), Spain.
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48
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Giménez M, Olarte C, Sanz S, Lomas C, Echávarri J, Ayala F. Relation between spoilage and microbiological quality in minimally processed artichoke packaged with different films. Food Microbiol 2003. [DOI: 10.1016/s0740-0020(02)00146-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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49
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Abstract
BACKGROUND Biliary stents constitute an alternative for the palliative treatment of benign or malignant biliary obstruction, biliary strictures, choledocholithiasis, biliary fistulas from lateral lesions of the biliary duct or cystic duct leaks due to slippage of clip closure. Obstruction resulting in cholangitis is common. Proximal migration to the biliary duct or distal migration to the duodenum with subsequent passage per rectum are relatively frequent, but impaction and perforation of the bowel are rare. CASE OUTLINES Two cases are reported. In one patient a migrated stent impacted in the caecal wall, and in the other the impaction produced a perforation of an adherent small bowel loop. Both patients were treated surgically and made an uneventful recovery. DISCUSSION Biliary stents migrate in 8-10% of patients and are generally eliminated by natural means. Occasionally they impact and perforate the digestive tract, usually in the duodenum or other fixed areas or in bowel affected by adhesions due to a previous operation. Although endoscopy is the treatment of choice to retrieve them, operation should be performed whenever there is suspicion of perforation of the intestinal wall.
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Affiliation(s)
- C Cerisoli
- Instituto del CallaoBuenos AiresArgentina
| | - J Diez
- Division of Gastrointestinal Surgery, Hospital de Clinicas, University HospitalBuenos AiresArgentina
| | - M Giménez
- Department of Surgery, Hospital A RoffoBuenos AiresArgentina
| | - M Oria
- Department of General Surgery, Division of Laparoscopic Surgery, Hospital de Clinicas, University HospitalBuenos AiresArgentina
| | - R Pardo
- Salvador UniversityBuenos AiresArgentina
| | - M Pujato
- Instituto Argentino de Diagnostico y TratamientoArgentina
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50
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Giménez M, Prat C, Vallés X, Matas L, Arnal J, Ausina V. Evaluation of the VITAL (bioMérieux) automated blood culture system using blind subculture. Clin Microbiol Infect 2002; 8:222-8. [PMID: 12047414 DOI: 10.1046/j.1469-0691.2002.00417.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This study was performed to determine the ability of the VITAL system to detect and allow recovery of microorganisms that are difficult to grow, such as Brucella spp., yeasts, or anaerobes, as well as to determine the need for blind subcultures after the incubation period. METHODS A prospective evaluation of the system was performed, and 8247 blood culture bottles were processed. The standard was blind subculture from all the bottles after 5 days of incubation. RESULTS There were 3.2% false-positive and 0.6% false-negative results (72% of clinical importance). The system sensitivity for yeasts was 41%. The mean time for detection of Neisseria meningitidis was 31.9 +/- 2.8 h, for Brucella spp. 119.7 +/- 2 h, and for yeast 51.5 +/- 27.8 h. CONCLUSIONS The VITAL system poses has serious difficulties in the detection of N. meningitidis, Brucella spp., yeast and methicillin- and aminoglycoside-resistant Staphylococcus aureus (MARSA). The low system sensitivity for yeast detection makes the blind subculture necessary after the incubation period.
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Affiliation(s)
- M Giménez
- Servicio de Microbiologia, Hospital Universitario Germans Trias i Pujol, C/Canyet s/n 08916, Badalona, Barcelona, Spain.
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