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Pérez N, Gargiulo MDLÁ, Khoury M, Suárez L, Correa MDLÁ, Pera M, Saravia N, Gómez G. Elderly-onset rheumatoid arthritis receives less aggressive therapies than young-onset rheumatoid arthritis in an Argentinian cohort. Reumatol Clin (Engl Ed) 2024; 20:136-141. [PMID: 38443231 DOI: 10.1016/j.reumae.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/26/2023] [Indexed: 03/07/2024]
Abstract
OBJECTIVES When rheumatoid arthritis (RA) starts after the age of 60 it is called elderly-onset rheumatoid arthritis (EORA) and when it starts earlier, young-onset rheumatoid arthritis. (YORA). There are few Latin American studies that compared both groups. The objective of the study was to evaluate differences in the clinical characteristics, evolution and treatment among patients with RA with onset before or after 60 years of age. MATERIALS AND METHODS Observational study of patients with RA attended consecutively in four centers in Argentina. Sociodemographic data, comorbidities, clinical manifestations at diagnosis, presence of rheumatoid factor and/or anti-CCP (cyclic citrullinated peptide) and treatments received were collected. At the last visit, swollen and tender joints, assessment of disease activity by the patient and physician, the presence of radiographic erosions, and functional status using the HAQ-DI were recorded. RESULTS 51 patients from each group were analyzed. The EORA group had a significantly higher proportion of smokers (58.8% vs. 35.3%, p = 0.029), cardiovascular history (54.9% vs. 21.6%, p = 0.001), abrupt onset (49% vs. 29.4%, p = 0.034) or with symptoms similar to PMR (19.6% vs. 0%, p = 0.001). Lower methotrexate doses were used in the EORA group: 19 mg (15-25) vs. 21.9 mg (20-25) (p = 0.0036) and more frequently did not receive bDMARDs or tsDMARDs. DISCUSSION AND CONCLUSIONS The benefits of intensive treatment in patients with RA have been described. In this study, the use of DMARDs in the EORA group was less intensive, suggesting that advanced age constitutes a barrier in the therapeutic choice.
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Affiliation(s)
- Nicolás Pérez
- Servicio de Inmunología, Instituto de Investigaciones Médicas "Dr. Alfredo Lanari", Ciudad Autónoma de Buenos Aires, Argentina.
| | - María de Los Ángeles Gargiulo
- Servicio de Inmunología, Instituto de Investigaciones Médicas "Dr. Alfredo Lanari", Ciudad Autónoma de Buenos Aires, Argentina.
| | - Marina Khoury
- Docencia e Investigación, Instituto de Investigaciones Médicas "Dr. Alfredo Lanari", Ciudad Autónoma de Buenos Aires, Argentina.
| | - Lorena Suárez
- Servicio de Inmunología, Instituto de Investigaciones Médicas "Dr. Alfredo Lanari", Ciudad Autónoma de Buenos Aires, Argentina.
| | | | - Mariana Pera
- Servicio de Reumatología, Hospital Ángel Cruz Padilla, San Miguel de Tucumán, Tucumán, Argentina.
| | - Natali Saravia
- Servicio de Reumatología, Hospital Tornú, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Graciela Gómez
- Servicio de Inmunología, Instituto de Investigaciones Médicas "Dr. Alfredo Lanari", Ciudad Autónoma de Buenos Aires, Argentina.
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Iglicki M, Khoury M, Donato L, Quispe DJ, Negri HP, Melamud JI. Comparison of subretinal aflibercept vs ranibizumab vs bevacizumab in the context of PPV, pneumatic displacement with subretinal air and subretinal tPA in naïve submacular haemorrhage secondary to nAMD. "The Submarine Study". Eye (Lond) 2024; 38:292-296. [PMID: 37537388 PMCID: PMC10810790 DOI: 10.1038/s41433-023-02676-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 06/29/2023] [Accepted: 07/17/2023] [Indexed: 08/05/2023] Open
Abstract
OBJECTIVE To compare efficacy and safety profile of subretinal aflibercept, ranibizumab, and bevacizumab in the context of pars plana vitrectomy, pneumatic displacement with subretinal air and subretinal tPA for subretinal macular haemorrhage (SMH) due to naïve neovascular age-related macular degeneration (nAMD). DESIGN Retrospective interventional cohort study. PARTICIPANTS 123 eyes of 123 patients treated with subretinal aflibercept (n = 41, 33%), ranibizumab (n = 41,33%), and bevacizumab (n = 41, 33%). METHODS Review of electronic medical records for best corrected visual acuity (BCVA), central subfoveal thickness (CST), and intraocular pressure (IOP) at baseline and 24 months after treatment. MAIN OUTCOME MEASURES BCVA, CST, and number of intravitreal anti VEGF over 24 months. RESULTS Mean age of patients was 80.5 ± 5.5 years, 43.9% were female. Mean time from symptom onset until surgery was 1.1 days (range 0-3 days). In all cases, the SMH did not reach the arcades. CST at baseline was 627 ± 140 µ, 739 ± 54 µ, and 793 ± 93 µ (p = 0.0001) for aflibercept, ranibizumab, or bevacizumab, respectively. Baseline BCVA (logMAR) was 0.65 ± 0.13, 0.69 ± 0.96, and 0.74 ± 0.81 (p = 0.0041) for aflibercept, ranibizumab, and bevacizumab, respectively. All three groups showed statistically significant improvement in BCVA and CST (for all groups: p < 0.001). There was no statistically significant difference at the final BCVA (p = 0.789). The mean number of anti VEGF given during follow-up period was 5.2 ± 0.81, 4.4 ± 0.63, and 5.5 ± 0.95 (p = 0.0001) for aflibercept, ranibizumab, and bevacizumab, respectively. CONCLUSION This study shows that aflibercept, ranibizumab, and bevacizumab in a subretinal manner in the context of PPV, pneumatic displacement with subretinal air and subretinal tPA for subretinal macular haemorrhage secondary to naïve nAMD work with the same efficacy and safety profile.
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Affiliation(s)
- Matias Iglicki
- Private Retina Office, University of Buenos Aires, Buenos Aires, Argentina.
| | - Marina Khoury
- Medical Investigation Institute "Alfredo Lanari", University of Buenos Aires, Buenos Aires, Argentina
| | - Lucas Donato
- Ophthalmologic Institute, Buenos Aires, Argentina
| | | | | | - Javier Ignacio Melamud
- Medical Investigation Institute "Alfredo Lanari", University of Buenos Aires, Buenos Aires, Argentina
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De Luca G, Lev PR, Camacho MF, Goette NP, Sackmann F, Castro Ríos MA, Moiraghi B, Cortes Guerrieri V, Bendek G, Carricondo E, Enrico A, Vallejo V, Varela A, Khoury M, Gutierrez M, Larripa IB, Marta RF, Glembotsky AC, Heller PG. High cell-free DNA is associated with disease progression, inflammasome activation and elevated levels of inflammasome-related cytokine IL-18 in patients with myelofibrosis. Front Immunol 2023; 14:1161832. [PMID: 38035089 PMCID: PMC10687201 DOI: 10.3389/fimmu.2023.1161832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 10/25/2023] [Indexed: 12/02/2023] Open
Abstract
Myelofibrosis (MF) is a clonal hematopoietic stem cell disorder classified among chronic myeloproliferative neoplasms, characterized by exacerbated myeloid and megakaryocytic proliferation and bone marrow fibrosis. It is induced by driver (JAK2/CALR/MPL) and high molecular risk mutations coupled to a sustained inflammatory state that contributes to disease pathogenesis. Patient outcome is determined by stratification into risk groups and refinement of current prognostic systems may help individualize treatment decisions. Circulating cell-free (cf)DNA comprises short fragments of double-stranded DNA, which promotes inflammation by stimulating several pathways, including inflammasome activation, which is responsible for IL-1β and IL-18 maturation and release. In this work, we assessed the contribution of cfDNA as a marker of disease progression and mediator of inflammation in MF. cfDNA was increased in MF patients and higher levels were associated with adverse clinical outcome, a high-risk molecular profile, advanced disease stages and inferior overall survival, indicating its potential value as a prognostic marker. Cell-free DNA levels correlated with tumor burden parameters and markers of systemic inflammation. To mimic the effects of cfDNA, monocytes were stimulated with poly(dA:dT), a synthetic double-stranded DNA. Following stimulation, patient monocytes released higher amounts of inflammasome-processed cytokine, IL-18 to the culture supernatant, reflecting enhanced inflammasome function. Despite overexpression of cytosolic DNA inflammasome sensor AIM2, IL-18 release from MF monocytes was shown to rely mainly on the NLRP3 inflammasome, as it was prevented by NLRP3-specific inhibitor MCC950. Circulating IL-18 levels were increased in MF plasma, reflecting in vivo inflammasome activation, and highlighting the previously unrecognized involvement of this cytokine in MF cytokine network. Monocyte counts were higher in patients and showed a trend towards correlation with IL-18 levels, suggesting monocytes represent a source of circulating IL-18. The close correlation shown between IL-18 and cfDNA levels, together with the finding of enhanced DNA-triggered IL-18 release from monocytes, suggest that cfDNA promotes inflammation, at least in part, through inflammasome activation. This work highlights cfDNA, the inflammasome and IL-18 as additional players in the complex inflammatory circuit that fosters MF progression, potentially providing new therapeutic targets.
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Affiliation(s)
- Geraldine De Luca
- División Hematología Investigación, Instituto de Investigaciones Médicas Dr. Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
- Instituto de Investigaciones Médicas (IDIM), UBA-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Paola R. Lev
- División Hematología Investigación, Instituto de Investigaciones Médicas Dr. Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
- Instituto de Investigaciones Médicas (IDIM), UBA-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Maria F. Camacho
- Laboratorio de Genética Hematológica, Instituto de Medicina Experimental, IMEX-CONICET/Academia Nacional de Medicina, Buenos Aires, Argentina
| | - Nora P. Goette
- División Hematología Investigación, Instituto de Investigaciones Médicas Dr. Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
| | | | | | - Beatriz Moiraghi
- Departamento de Hematología, Hospital Ramos Mejía, Buenos Aires, Argentina
| | - Veronica Cortes Guerrieri
- División Hematología Clínica, IDIM Dr. Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
| | - Georgina Bendek
- Departamento de Hematología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Emiliano Carricondo
- Departamento de Hematología, Hospital Universitario Austral, Buenos Aires, Argentina
| | - Alicia Enrico
- Departamento de Hematología, Hospital Italiano de La Plata, Buenos Aires, Argentina
| | - Veronica Vallejo
- Departamento de Hematología, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - Ana Varela
- Departamento de Hematología, Hospital Ramos Mejía, Buenos Aires, Argentina
| | - Marina Khoury
- Departamento de Docencia e Investigación, IDIM Dr. Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Marina Gutierrez
- Unidad Genómica, Laboratorio Stamboulian, Buenos Aires, Argentina
| | - Irene B. Larripa
- Laboratorio de Genética Hematológica, Instituto de Medicina Experimental, IMEX-CONICET/Academia Nacional de Medicina, Buenos Aires, Argentina
| | - Rosana F. Marta
- División Hematología Investigación, Instituto de Investigaciones Médicas Dr. Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
- Instituto de Investigaciones Médicas (IDIM), UBA-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Ana C. Glembotsky
- División Hematología Investigación, Instituto de Investigaciones Médicas Dr. Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
- Instituto de Investigaciones Médicas (IDIM), UBA-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Paula G. Heller
- División Hematología Investigación, Instituto de Investigaciones Médicas Dr. Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
- Instituto de Investigaciones Médicas (IDIM), UBA-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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Durlach M, Khoury M, Donato CL, Pérez EA, Iezzi NH, López R, Echavarría GL. Delirium and subsyndromal delirium in the intensive care unit: In-hospital outcomes and prognosis at discharge. Med Clin (Barc) 2023; 161:286-292. [PMID: 37516584 DOI: 10.1016/j.medcli.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND AND OBJECTIVE The characteristics and outcomes of patients with subsyndromal delirium (SSD) at hospitalization are still under discussion. The objectives were to describe the incidence of delirium and SSD in the intensive care unit (ICU), to analyze the association with risk factors and to explore outcomes of delirium and SSD at hospitalization and three months after discharge. PATIENTS AND METHODS A prospective study, with telephone follow-up three months after discharge. The study included 270 patients over one year. Delirium and SSD were assessed with the CAM-ICU. RESULTS 22.96% developed delirium and 17.03% SSD. The main risk factors associated with the development of delirium were cognitive impairment (P=.000), age ≥75years (P=.019), neurological admission (P=.003), shock (P=.043), bedsores (P=.010), polypharmacy (P=.017), ARM (P=.001) and fast (P=.028), and with the development of SSD were low schooling (P=.014), Charlson >5 (P=.028), AIVD <8 (P=.001), enteral feeding (P=.000) and non-cardiovascular admission (P=.019). Overall mortality was 6% in the group without delirium (reference), 8% in SSD (P=.516) and 30% in delirium (P=.000). Median ICU length of stay was 2 (IQR, 1-2) days in the group without delirium, 3 (IQR, 2-4) days in SSD (P=.0001), and 3 (IQR, 2-7) days in delirium group (P=.0001). Three months after discharge, instrumental ADL were preserved in 50% of the group without delirium, 30% of SSD (P=.026) and 26% of delirium (P=.005). CONCLUSIONS The SSD group presented an intermediate prognosis between no delirium and delirium groups. It is advisable to promote its diagnosis for better risk classification.
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Affiliation(s)
- Martin Durlach
- Servicio de Clínica Médica, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina.
| | - Marina Khoury
- Departamento de Docencia e Investigación, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Carla Lujan Donato
- Servicio de Clínica Médica, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Eduardo Adrian Pérez
- Servicio de Kinesiología y Fisiatría, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Nicolas Hector Iezzi
- Servicio de Kinesiología y Fisiatría, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Rodolfo López
- Servicio de Terapia Intensiva, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Gonzalo L Echavarría
- Servicio de Clínica Médica, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina
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Desai V, Mutsaers A, Fu R, Khoury M, Khalil C, Leventis P, Eskander A, Husain ZA. Surgeon, Pathologist and Pathology Technician Effects on Nodal Yield after a Neck Dissection. Int J Radiat Oncol Biol Phys 2023; 117:e590-e591. [PMID: 37785787 DOI: 10.1016/j.ijrobp.2023.06.1940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) A minimum nodal count of 18 lymph nodes has been associated with improved survival after neck dissection and has been suggested as a head and neck cancer quality metric. Despite its critical importance, factors affecting nodal yield are poorly studied. In particular, the relative contribution of surgeons, pathologists, and pathology technicians has not been evaluated. The purpose of this study was to understand both patient and provider related factors that affect nodal yield after neck dissection for patients with oral cavity squamous cell carcinoma (OCSCC). MATERIALS/METHODS This retrospective cohort study involved review of all adult patients with OCSCC undergoing primary neck dissection between 2000-2020 at an academic medical center. The outcome of interest was a continuous variable denoting the number of nodes removed per side during neck surgery. Surgeon and pathologist year of experience were calculated and represented in quartiles. A multilevel multivariable linear regression model was used to assess the association of surgeon/pathologist experience quartiles with nodal yield, controlling for patient age, comorbidity index, previous cancer, tumor grade, and clinical nodal status. RESULTS The 508 patients included in our cohort were treated by 5 surgeons and 6 pathologists and involved 44 pathology technicians. Of these patients, 310 (61.0%) were male with a mean age of 63. Oral tongue primary tumors were 46.7% of the cohort, while 64.4% of patients had cT1-T2 tumors, and 65.2% were cN0. The mean nodal yield was 24.2 nodes. The ANOVA analysis revealed significant difference in mean nodal yield by surgeon (p-value = 0.03), pathologist (p-value<0.01) and pathology technician (p-value = 0.037). After accounting for patient-level characteristics and patient clustering by surgeon, increasing surgeon experience was found to be significantly associated with a higher nodal yield (joint significance of surgeon years of experience quartiles < 0.01). Specifically, when compared to surgeons with the least experience (1st quartile), those whose years of experience fell into the 2nd, 3rd, and 4th quartile removed 4.69 (95% CI: 0.97 to 7.92), 4.47 (95% CI: 0.33 to 7.87), and 7.37 (95% CI: 0.73 to 11.27) more lymph nodes. Meanwhile, there was no association between pathologist experience and nodal yield (joint significance of pathologist years of experience quartiles = 0.27). Additionally, previous cancer diagnosis and cN0 disease were significantly associated with lower nodal yield (all p-values = 0.02). CONCLUSION This study demonstrates an independent association between increasing surgeon experience and higher nodal yields. Importantly, it also demonstrates that pathologists and pathology technicians contribute to the variation in nodal yield, and their contribution should not be overlooked in the implementation of a lymph node yield-based quality metric.
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Affiliation(s)
- V Desai
- Queens University School of Medicine, Kingston, ON, Canada
| | - A Mutsaers
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - R Fu
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - M Khoury
- University of Toronto School of Medicine, Toronto, ON, Canada
| | - C Khalil
- University of Toronto School of Medicine, Toronto, ON, Canada
| | - P Leventis
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - A Eskander
- Department of Otolaryngology - Head and Neck Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Z A Husain
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Southern California Permanente Medical Group, Los Angeles, CA
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Iglicki M, Khoury M, Melamud JI, Donato L, Barak A, Quispe DJ, Zur D, Loewenstein A. Naïve subretinal haemorrhage due to neovascular age-related macular degeneration. pneumatic displacement, subretinal air, and tissue plasminogen activator: subretinal vs intravitreal aflibercept-the native study. Eye (Lond) 2023; 37:1659-1664. [PMID: 36038720 PMCID: PMC10220048 DOI: 10.1038/s41433-022-02222-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/09/2022] [Accepted: 08/17/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE We aimed to compare visual and anatomical outcome in subretinal aflibercept vs. intravitreal aflibercept in the context of Pars Plana Vitrectomy (PPV), pneumatic displacement with subretinal air and subretinal tPA in patients with naïve submacular haemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD). DESIGN Retrospective interventional cohort study. PARTICIPANTS 80 patients treated with subretinal aflibercept vs. intravitreal aflibercept in the context of PPV, subretinal air and subretinal tPA in patients with SMH secondary to naïve nAMD. METHODS Records were reviewed. Best corrected visual acuity (BCVA), central subfoveal thickness (CST), and intraocular pressure (IOP) were recorded at baseline and 24 months after treatment. MAIN OUTCOME MEASURES BCVA, CST, and number of anti VEGF treatment over follow-up period. RESULTS The average duration from onset of symptoms to surgery was 1.26 days (range 0-3 days). Based on review of OCT images, SMH was subretinal in all 80 patients (100%), and sub-RPE in 29 patients (36.3%). Forty-one patients (51.25%) were treated with subretinal aflibercept ("subretinal group"), and 39 patients (48.75%) were treated with intravitreal aflibercept injections ("intravitreal group"). The groups were well balanced for age and gender p = 0.6588, and p = 0.263, respectively). Both groups showed statistically significant improvement in BCVA and CST (for all groups: p < 0.001). The mean number of anti VEGF given during follow-up period was statistically significantly lower in the "subretinal group" (p < 0.0001). CONCLUSION This study shows better management of the CNV, with a statistically significant lower need for anti-VEGF injections when treated with subretinal aflibercept compared to intravitreal application.
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Affiliation(s)
- Matias Iglicki
- Private Retina Office, University of Buenos Aires, Buenos Aires, Argentina.
| | - Marina Khoury
- Medical Investigation Institute "Alfredo Lanari", University of Buenos Aires, Buenos Aires, Argentina
| | - Javier Ignacio Melamud
- Medical Investigation Institute "Alfredo Lanari", University of Buenos Aires, Buenos Aires, Argentina
| | - Lucas Donato
- Ophthalmologic Institute, Buenos Aires, Argentina
| | - Adiel Barak
- Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Diego Jose Quispe
- Private Retina Office, University of Buenos Aires, Buenos Aires, Argentina
| | - Dinah Zur
- Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Loewenstein
- Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Townsend M, Khoury M, Koehl D, Cantor R, Kirklin J, Beasley G, Chen C, Boyle G, Parent J, Hernandez NB, Halnon N. Statin Use May Not Benefit Pediatric Heart Transplant Recipients: A PHTS Analysis. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Dirk K, Khoury M, Hartling L, Krysler A, Foshaug R. HIGH-INTENSITY INTERVAL TRAINING FOR HEART FAILURE AND POST-HEART TRANSPLANT: A SYSTEMATIC REVIEW AND META-ANALYSIS. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Court A, Letter AV, Parra E, Velarde F, García C, Ortoloff A, Luz-Crawford P, Khoury M, Figueroa F. Mesenchymal Stem/Stromal Cells: Late Breaking Abstract: INTRA-ARTICULAR INJECTION OF MSC-DERIVED MITOCHONDRIA LEADS TO CLINICAL IMPROVEMENT IN AN EXPERIMENTAL MODEL OF OSTEOARTHRITIS. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00244-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Villagómez A, Borja T, Pontón P, Ramos P, Robayo P, Arteaga M, Suquillo D, Barba D, Zambrano K, Karolys G, Barba P, Pavón D, Gomez X, Torres F, Khoury M, Luz-Crawford P, Maron T, Segnini G, Diaz R, Cabrera F, Caicedo A. Mesenchymal Stem/Stromal Cells: MSC AND THEIR ISOLATED MITOCHONDRIA IMPROVE THE REGENERATION OF MICE CUTANEOUS SURGICAL WOUNDS BY IN-SITU INJECTION. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00161-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ossendorff R, Walter SG, Schildberg FA, Khoury M, Salzmann GM. Controversies in regenerative medicine: should knee joint osteoarthritis be treated with mesenchymal stromal cells? Eur Cell Mater 2022; 43:98-111. [PMID: 35298024 DOI: 10.22203/ecm.v043a09] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Knee joint osteoarthritis is a complex immunological and degenerative disease. Current treatment strategies fail to alter its progression. Mesenchymal stromal cell (MSC) therapy for osteoarthritis has been object of research for more than 30 years. The aim of MSC therapy is intended to be holistic, with regeneration of all affected knee joint structures. The paracrine effect of the MSC secretome has been shown to be central for the regenerative capacity of MSCs. Activation of local knee-joint-specific MSCs leads to an immunomodulatory, anti-catabolic, anti-apoptotic and chondrogenic stimulus. Preclinical models have demonstrated the symptom- and disease-modifying effects of MSC therapy. At the bedside, there is evidence that autologous and allogeneic MSC therapy shows significant improvement in symptom-modifying and functional outcome. Despite this, a variety of contradictory clinical outcomes are available in the literature. The effectiveness of MSC therapy is still unclear, although there have been promising results. Regarding the diversity of cell sources, isolation, culture protocols and other factors, a comparison of different studies is difficult. Clinical translation of disease-modifying effects has not yet been shown. This narrative review presents a controversial overview of the current preclinical and clinical studies on MSC therapy in knee joint osteoarthritis.
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Affiliation(s)
- R Ossendorff
- Department for Orthopaedics and Trauma, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn,
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Khoury M, Hajihosseini M, Joffe A, Bond G, Dinu I, Makarchuk S, Robertson C, Atallah J. EVALUATING THE PREVALENCE AND FACTORS ASSOCIATED WITH AN OPTIMAL NEURODEVELOPMENTAL OUTCOME IN CHILDREN WITH FONTAN CIRCULATION. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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13
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Welle K, Khoury M, Prangenberg C, Täger S, Goost H, Kabir K. [Minimally invasive lumbopelvic stabilization of sacral fracture and sacroiliac injury]. Oper Orthop Traumatol 2021; 33:538-545. [PMID: 34468791 DOI: 10.1007/s00064-021-00730-x] [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] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 05/05/2019] [Accepted: 04/15/2020] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Rapid mobilization with full weight bearing by minimally invasive fixation of Os ilium to L5 in fractures of the sacrum and disruption of the sacroiliac joint (SIJ). INDICATIONS Unstable injuries of the posterior pelvic ring in fractures of the sacrum and disruption of the SIJ. CONTRAINDICATIONS Fracture of ilium and not injury related implants in the screw trajectory, neurological deficits regarding the fracture, decubitus in the area of surgical approach. SURGICAL TECHNIQUE Minimally invasive screw placement in the pedicles of L5, access of ilium screw via the posterior superior iliac spine. Radiological display for the iliacal screw bearing trajectory in Os Ilium as a drop-shaped/triangle canal. Insert a Jamshidi needle orthograde in the beam path, change to guide wire and placement of iliacal screw after resection of the bone in the screw head area. Submuscular insertion of the longitudinal rods, in case of double-sided instrumentation similar procedure on the opposite side, reduction of the fracture and fixation of the rods to screws. POSTOPERATIVE MANAGEMENT Postoperative mobilization with full weight bearing under physiotherapeutic guidance. RESULTS Patients treated with lumbopelvic stabilization in our facility between 2012 and 2017 were identified via the hospital database and retrospectively evaluated. In 24 patients with median age of 60.1 years and a follow-up-time of 11.8 months, we found no implant displacement, infection and no wound healing problems. Full weight bearing was permitted in 21 of 24 cases, in 3 cases partial load bearing due to other injuries. Three patients reported moderate mechanical irritation of iliacal screws; 1 patient reported severe irritability with removal of the implants after bony healing of fracture 1 year postoperatively.
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Affiliation(s)
- K Welle
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland
| | - M Khoury
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland
| | - C Prangenberg
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland
| | - S Täger
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland
| | - H Goost
- Abteilung für Orthopädie und Unfallchirurgie, Krankenhaus Wermelskirchen, Wermelskirchen, Deutschland
| | - K Kabir
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland.
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Horacio Rojas Mendiola R, Smurra M, Khoury M. [Clinical profile of patients suspected of sleep apnea]. Rev Fac Cien Med Univ Nac Cordoba 2021. [PMID: 34617716 PMCID: PMC8760919 DOI: 10.3105310.31053/1853.0605.v78.n3.25531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Obstructive Sleep Apnea Syndrome is a disease with a growing prevalence worldwide that significantly affects quality of life and increases cardiovascular morbidity and mortality. OBJECTIVES To describe symptoms, comorbidities and anthropometry of patients who were clinically evaluated and underwent sleep studies to identify variables associated with a Respiratory Disturbance Index (RDI) equal or greater than 15. MATERIAL AND METHODS We reviewed data from a self-administered questionary, anthropometry, comorbidities and sleep studies of patients who consulted for the first time at a sleep medicine practice from June 2012 through May 2016. RESULTS Among 366 patients included we found 47.5% with a RDI>30, 21.9% with a RDI 15 – 29.9, 22.1% with a RDI 5 – 14.9 and 8.5% with a RDI<5. A multivariate model was built using RDI≥15 as the dependent variable. It showed that snoring more than 3 nights per week (OR 2.89, 95%CI 1.66 – 5.05), BMI ≥ 35 Kg/m2 (OR 2.53, 95%CI 1.35 – 4.72), witnessed apneas almost every night or every night (OR 1.95, 95%CI 1.09 – 3.49), male sex (OR 1.81, 95%CI 1.10 – 2.97) and the presence of high blood pressure (OR 1.67, 95%CI 1.02 – 2.74) were the most significant clinical factors. CONCLUSIONS In our sample, the most significant predictors of a RDI >15 were: snoring more than 3 nights per week, BMI ≥ 35 Kg/m2, witnessed apneas almost every night or every night, male sex and the presence of high blood pressure.
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Affiliation(s)
| | | | - Marina Khoury
- Instituto de Investigaciones Médicas Alfredo LanariArgentina
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Gargiulo MDLÁ, Perez N, Khoury M, Buhl M, Suárez L, Sarano J, Montoya F, Bazzalo I, Navarro S, Pendón G, Molina MJ, Mamani M, Rivero M, Gómez G. Anti-RNA polymerase III antibodies in systemic sclerosis: Multicentric study from Argentina. ACTA ACUST UNITED AC 2021; 18:368-373. [PMID: 34366290 DOI: 10.1016/j.reumae.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 02/11/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe the frequency of anti-RNA polymerase III antibody in patients with Systemic Sclerosis (SSc) of a group of healthcare centres from Argentina and to explore differences among patients with positive and negative anti-RNA polymerase III antibody. PATIENTS AND METHODS Data from clinical records, anamnesis and physical examination were collected from 135 patients with SSc (ACR/EULAR 2013). A serum sample from each patient was obtained for the detection of anti-RNA polymerase III IgG antibodies by ELISA. RESULTS In all, 97.8% were women and the median age at diagnosis was 53 years (range 12-87), 77.7% had limited cutaneous SSc (lcSSC), 19,3% patients had diffuse cutaneous SSc (dcSSC) and 2.9% had scleroderma sine scleroderma. The 67.5% of the patients were from a Mestizos or Amerindian ethnic group. Anti-RNA polymerase III was positive in 5.9% of the patients. In 36 patients, the anticentromere (ACA) and anti-Scl70 antibodies were negative; anti-RNA polymerase III was positive in 16.7% of these 36 patients. Pitting scars and pulmonary artery hypertension were more frequent in anti-RNA polymerase III positive patients who were also older at diagnosis. No association with gastric antral vascular ectasia was found. The only patient with scleroderma renal crisis was anti-RNA polymerase III positive. CONCLUSIONS Anti-RNA polymerase III frequency found in this study was one of the lowest reported, which could be related to the predominance of the Amerindian and Mestizo ethnic group. It is possible that the detection of anti RNA polymerase III allows better classification of SSc patients, to know their prognosis and to improve their follow-up, therefore more studies are needed.
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Affiliation(s)
- María de Los Ángeles Gargiulo
- Servicio de Inmunología, Instituto de Investigaciones Médicas "Dr. Alfredo Lanari", UBA, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Nicolás Perez
- Servicio de Inmunología, Instituto de Investigaciones Médicas "Dr. Alfredo Lanari", UBA, Ciudad Autónoma de Buenos Aires, Argentina
| | - Marina Khoury
- Docencia e Investigación, Instituto de Investigaciones Médicas "Dr. Alfredo Lanari", UBA, Ciudad Autónoma de Buenos Aires, Argentina
| | - Manuel Buhl
- Servicio de Inmunología, Instituto de Investigaciones Médicas "Dr. Alfredo Lanari", UBA, Ciudad Autónoma de Buenos Aires, Argentina
| | - Lorena Suárez
- Servicio de Inmunología, Instituto de Investigaciones Médicas "Dr. Alfredo Lanari", UBA, Ciudad Autónoma de Buenos Aires, Argentina
| | - Judith Sarano
- Servicio de Inmunología, Instituto de Investigaciones Médicas "Dr. Alfredo Lanari", UBA, Ciudad Autónoma de Buenos Aires, Argentina
| | - Fabiana Montoya
- Servicio de Reumatología y Colagenopatías, Hospital General de Agudos José María Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | - Ignacio Bazzalo
- Servicio de Reumatología y Colagenopatías, Hospital General de Agudos José María Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | - Sandra Navarro
- Servicio de Reumatología, Hospital Provincial del Centenario, Rosario, Santa Fe, Argentina
| | - Gisela Pendón
- Unidad de Reumatología, Hospital "Dr. Ricardo Gutiérrez", La Plata, Buenos Aires, Argentina
| | - María Josefina Molina
- Consultorio de Reumatología, Hospital Central de San Isidro "Dr. Melchor A Posse", San Isidro, Buenos Aires, Argentina
| | - Marta Mamani
- Servicio de Reumatología, Hospital General de Agudos Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires. Argentina
| | - Mariano Rivero
- Servicio de Reumatología, Hospital Británico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Graciela Gómez
- Servicio de Inmunología, Instituto de Investigaciones Médicas "Dr. Alfredo Lanari", UBA, Ciudad Autónoma de Buenos Aires, Argentina
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Kurte M, Cuenca J, Martinez E, Carrion F, Khoury M, Coutihno-Maracaja V. Transcriptomic analysis of licensed mesenchymal stem cells reveals a molecular signature associated with an increase of IDO and SOCS3 expression. Cytotherapy 2021. [DOI: 10.1016/s1465324921004382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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de Carvalho L, Abreu S, Castro LD, Andrade L, Nogueira C, Braga C, Silva P, Vieira J, Trabach R, Cabral M, Coelho Teixeira-Pinheiro L, Nascimento-dos-Santosce G, Ferreira ES, Khoury M, Weiss D, Pacheco ML, Leme P, Cruz F, Rocco P. Mitochondria isolated from mesenchymal stromal cells reduce lung and distal organ injury in experimental sepsis. Cytotherapy 2021. [DOI: 10.1016/s1465324921003200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Gargiulo MDLÁ, Pérez N, Khoury M, Buhl M, Suárez L, Sarano J, Montoya F, Bazzalo I, Navarro S, Pendón G, Molina MJ, Mamani M, Rivero M, Gómez G. Anti-RNA Polymerase III Antibodies in Systemic Sclerosis: Multicentric Study from Argentina. Reumatol Clin (Engl Ed) 2021; 18:S1699-258X(21)00059-0. [PMID: 33933370 DOI: 10.1016/j.reuma.2021.02.005] [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] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 01/31/2021] [Accepted: 02/11/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To describe the frequency of anti-RNA polymerase III antibody in patients with Systemic Sclerosis (SSc) of a group of healthcare centres from Argentina and to explore differences among patients with positive and negative anti-RNA polymerase III antibody. PATIENTS AND METHODS Data from clinical records, anamnesis and physical examination were collected from 135 patients with SSc (ACR/EULAR 2013). A serum sample from each patient was obtained for the detection of anti-RNA polymerase III IgG antibodies by ELISA. RESULTS In all, 97.8% were women and the median age at diagnosis was 53 years (range: 12-87), 77.7% had limited cutaneous SSc (lcSSC), 19,3% patients had diffuse cutaneous SSc (dcSSC) and 2.9% had scleroderma sine scleroderma. The 67.5% of the patients were from a Mestizos or Amerindian ethnic group. Anti-RNA polymerase III was positive in 5.9% of the patients. In 36 patients, the anticentromere (ACA) and anti-Scl70 antibodies were negative; anti-RNA polymerase III was positive in 16.7% of these 36 patients. Pitting scars and pulmonary artery hypertension were more frequent in anti-RNA polymerase III positive patients who were also older at diagnosis. No association with gastric antral vascular ectasia was found. The only patient with scleroderma renal crisis was anti-RNA polymerase III positive. CONCLUSIONS Anti-RNA polymerase III frequency found in this study was one of the lowest reported, which could be related to the predominance of the Amerindian and Mestizo ethnic group. It is possible that the detection of anti-RNA polymerase III allows better classification of SSc patients, to know their prognosis and to improve their follow-up, therefore more studies are needed.
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Affiliation(s)
- María de Los Ángeles Gargiulo
- Servicio de Inmunología, Instituto de Investigaciones Médicas «Dr. Alfredo Lanari», UBA, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Nicolás Pérez
- Servicio de Inmunología, Instituto de Investigaciones Médicas «Dr. Alfredo Lanari», UBA, Ciudad Autónoma de Buenos Aires, Argentina
| | - Marina Khoury
- Docencia e Investigación, Instituto de Investigaciones Médicas «Dr. Alfredo Lanari», UBA, Ciudad Autónoma de Buenos Aires, Argentina
| | - Manuel Buhl
- Servicio de Inmunología, Instituto de Investigaciones Médicas «Dr. Alfredo Lanari», UBA, Ciudad Autónoma de Buenos Aires, Argentina
| | - Lorena Suárez
- Servicio de Inmunología, Instituto de Investigaciones Médicas «Dr. Alfredo Lanari», UBA, Ciudad Autónoma de Buenos Aires, Argentina
| | - Judith Sarano
- Servicio de Inmunología, Instituto de Investigaciones Médicas «Dr. Alfredo Lanari», UBA, Ciudad Autónoma de Buenos Aires, Argentina
| | - Fabiana Montoya
- Servicio de Reumatología y Colagenopatías, Hospital General de Agudos José María Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | - Ignacio Bazzalo
- Servicio de Reumatología y Colagenopatías, Hospital General de Agudos José María Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | - Sandra Navarro
- Servicio de Reumatología, Hospital Provincial del Centenario, Rosario, Santa Fe, Argentina
| | - Gisela Pendón
- Unidad de Reumatología, Hospital «Dr. Ricardo Gutiérrez», La Plata, Buenos Aires, Argentina
| | - María Josefina Molina
- Consultorio de Reumatología, Hospital Central de San Isidro «Dr. Melchor A Posse», San Isidro, Buenos Aires, Argentina
| | - Marta Mamani
- Servicio de Reumatología, Hospital General de Agudos Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariano Rivero
- Servicio de Reumatología, Hospital Británico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Graciela Gómez
- Servicio de Inmunología, Instituto de Investigaciones Médicas «Dr. Alfredo Lanari», UBA, Ciudad Autónoma de Buenos Aires, Argentina
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Heid C, Khoury M, Harirah O, Kalsbeek A, Maaraoui K, Ring W, Jessen M, Peltz M. Renal Decline Following Heart Transplant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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20
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Krauss A, West L, Conway J, Khoury M, Halpin A, Nahirniak S, Aklabi MA, Urschel S. ABO-Incompatible Heart Transplantation in Older Children Using Immune Modulation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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21
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Khoury M, Conway J, Gossett J, Edens E, Soto S, Cantor R, Koehl D, Barnes A, Exil V, Glass L, Kirklin J, Zuckerman W. Cardiac Allograft Vasculopathy in Pediatric Heart Transplant Recipients: Does Early Onset Portend a Worse Prognosis? J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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22
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D'Acunto JI, Khoury M, Parodi G, Estrada G. [Inpatient identification wristbands failures detection]. Medicina (B Aires) 2021; 81:597-601. [PMID: 34453802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Abstract
Medical attention is not free from committing mistakes that can increase mortality and costs. The International Goals for Patient Safety include correct patient identification. The use of wristbands reduces the number of adverse events. The rate of nonidentified patients at the moment of phlebotomy was investigated retrospectively during 2019. The annual rate of non-identified patients was 9.8% and higher rates were observed from April to September. Monday was the day with the highest rate of non-identified. There was statistically significant relationship between the month rate of non-identified patients and the number of discharges from operative unit per month (r=0.6465; p=0.0237) and the bed turnover rate (r=0.7776; p=0.0029). Other wristband identification errors are unknown. The investigation detected failures in patient identification that allowed to make recommendations. In order to reduce the number of missing wristbands it will be necessary to monitor the indicator, especially during the months with the highest number of discharges and bed turnover rate, to evaluate the adherence of the personnel to the current protocol and to carry out training programs.
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Affiliation(s)
- Javier I D'Acunto
- Departamento de Clínica Médica, Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina. E-mail:
| | - Marina Khoury
- Departamento de Docencia e Investigación, Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina
| | - Graciela Parodi
- Departamento de Gestión de Pacientes y Estadística, Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina
| | - Gabriela Estrada
- Departamento de Bioquímica Clínica, Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina
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Pérez N, Gargiulo MDLÁ, Suarez L, Khoury M, Gómez G. Clinical characteristics and prognostic factors in an Argentinian cohort with ANCA-associated vasculitis. Medicina (B Aires) 2021; 81:198-207. [PMID: 33906138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Abstract
ANCA-associated vasculitis is a heterogeneous group of rare autoimmune conditions of unknown cause. Clinical characteristics and prognostic factors were analyzed in 47 patients: 20 (42.5%) with granulomatosis with polyangiitis, 17 (36.2%) with microscopic polyangiitis, 6 (12.8%) with renal-limited vasculitis, and 4 (8.5%) with eosinophilic granulomatosis with polyangiitis. Mean age at diagnosis was 53.5 ± 16.5 years and the median of BVAS (Birmingham Vasculitis Activity Score) was 14 (4-42). The most frequent clinical manifestations were: general in 44 (93.6%), renal in 30 (63.8%) and respiratory in 28 (59.6%). All received corticosteroids at the beginning of treatment. Intravenous cyclophosphamide was associated in 20 (42.5%) and oral route in 14 (29.8%); azathioprine in 3 (6.4%) and rituximab in 2 (4.2%). At a median follow-up of 35.5 months (range 0.14-234), 21 relapses were recorded in 14 patients. Overall mortality was 3.5 deaths per 100 patient-year in the whole group. Those over 55 years old, the presence of alveolar hemorrhage, those with FFS (Five Factor Score) of 2, and patients with MPA had poor prognosis. Renal involvement, ANCA pattern and BVAS were not associated to a poorer prognosis.
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Affiliation(s)
- Nicolás Pérez
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina. E-mail:
| | - María de Los Ángeles Gargiulo
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina
| | - Lorena Suarez
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina
| | - Marina Khoury
- Dirección de Docencia e Investigación, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina
| | - Graciela Gómez
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina
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Toliopoulos D, Khoury M, Bouabdellaoui M, Granchi N, Claude JB, Benali A, Berbezier I, Hannani D, Ronda A, Wenger J, Bollani M, Gurioli M, Sanguinetti S, Intonti F, Abbarchi M. Fabrication of spectrally sharp Si-based dielectric resonators: combining etaloning with Mie resonances. Opt Express 2020; 28:37734-37742. [PMID: 33379602 DOI: 10.1364/oe.409001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/18/2020] [Indexed: 06/12/2023]
Abstract
We use low-resolution optical lithography joined with solid state dewetting of crystalline, ultra-thin silicon on insulator (c-UT-SOI) to form monocrystalline, atomically smooth, silicon-based Mie resonators in well-controlled large periodic arrays. The dewetted islands have a typical size in the 100 nm range, about one order of magnitude smaller than the etching resolution. Exploiting a 2 µm thick SiO2 layer separating the islands and the underlying bulk silicon wafer, we combine the resonant modes of the antennas with the etalon effect. This approach sets the resonance spectral position and improves the structural colorization and the contrast between scattering maxima and minima of individual resonant antennas. Our results demonstrate that templated dewetting enables the formation of defect-free, faceted islands that are much smaller than the nominal etching resolution and that an appropriate engineering of the substrate improves their scattering properties. These results are relevant to applications in spectral filtering, structural color and beam steering with all-dielectric photonic devices.
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25
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Caulley L, Sawada M, Crighton E, Khoury M, Kontorinis G. Association between socioeconomic indicators and geographic distribution of vestibular schwannomas in West Scotland: a 15-year review. J Laryngol Otol 2020; 134:1-9. [PMID: 33267923 DOI: 10.1017/s0022215120002212] [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: 11/07/2022]
Abstract
OBJECTIVE Socioeconomic risk factors may contribute to geographic variation in diseases, but studies are limited due to lack of large available cohorts. METHOD A geographic analysis was performed of the association between socioeconomic risk factors and the distribution of vestibular schwannomas in adults diagnosed with sporadic vestibular schwannomas through the National Health Services in the West of Scotland from 2000 to 2015. RESULTS A total of 511 sporadic vestibular schwannomas were identified in a population of over 3.1 million. Prevalence of vestibular schwannomas were lowest in cases with good health (-0.64, 95 per cent confidence interval: -0.93,-0.38; p = 0.002) and level 1 qualifications (-0.562, 95 per cent confidence interval: -0.882 to -0.26; p = 0.01). However, these risk factors did not demonstrate consistent linearity of correlations. Prevalence was lower in people originating from European Union accession countries from April 2001 to March 2011 (-0.63, 95 per cent confidence interval: -0.84 to -0.43; p = 0.002). No correlation between distribution of vestibular schwannomas and socioeconomic risk factors met our threshold criteria (± 0.7). CONCLUSION This study demonstrated that there is little variation in distribution of vestibular schwannomas by socioeconomic risk factors.
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Affiliation(s)
- L Caulley
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Canada
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, The Netherlands
- Ottawa Hospital Research Institute, Canada
| | - M Sawada
- Department of Geography, Environment and Geomatics, University of Ottawa, Canada
| | - E Crighton
- Department of Geography, Environment and Geomatics, University of Ottawa, Canada
| | - M Khoury
- Department of Undergraduate Medicine, University of Ottawa, Canada
| | - G Kontorinis
- Department of Otolaryngology-Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
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Laudanno O, Garrido J, Ahumarán G, Gollo P, Khoury M. Long-term follow-up after fetal radiation exposure during endoscopic retrograde cholangiopancreatography. Endosc Int Open 2020; 8:E1909-E1914. [PMID: 33269328 PMCID: PMC7695519 DOI: 10.1055/a-1293-7783] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 09/29/2020] [Indexed: 02/07/2023] Open
Abstract
Background and study aims The main concern about endoscopic retrograde cholangiopancreatography (ERCP) during pregnancy is the risk of radiation exposure to the fetus. The potential exists not only in the short-term, but also in the long-term and includes growth and development problems and the possibility of childhood cancer. Little is known about the long-term effects of fetal radiation exposure at the time of ERCP. The aim of the study was to report the long-term outcome of babies born after radiation exposure to mothers who underwent ERCP during pregnancy. Patients and methods This was a single-center retrospective cohort study. We included 24 consecutive pregnant patients who underwent ERCP due to choledocholithiasis and their children, between June 1997 and June 2015. All patients and their babies were followed up until birth to assess their short-term outcome. To assess long-term outcomes, from September 2014 to September 2015, a comprehensive medical interview was conducted with the mothers and their children. We also evaluated medical records, lab tests, school report cards, and the families completed a questionnaire inquiring about perceived health status of the children. Results Fifteen patients had full-term pregnancies. One patient had a preterm delivery (32 weeks) due to preeclampsia. There were no cases of miscarriage, stillbirth or fetal malformations. Long-term follow-up was performed at a mean age of 11.08 years (range 1-18) for the children, with no developmental delays, poor school performance, or malignancies found. Conclusions Long-term outcome in children born after radiation exposure during ERCP was unremarkable.
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Affiliation(s)
- Oscar Laudanno
- Instituto de Investigaciones Medicas Doctor Alfredo Lanari – Gastroenterology, Buenos Aires, Argentina
| | - Jose Garrido
- Hospital C. Boccalandro, Tres de Febrero, Gastroenterology, Buenos Aires, Argentina
| | - Gabrial Ahumarán
- Hospital C. Boccalandro, Tres de Febrero, Gastroenterology, Buenos Aires, Argentina
| | - Pablo Gollo
- Hospital C. Boccalandro, Tres de Febrero, Gastroenterology, Buenos Aires, Argentina
| | - Marina Khoury
- Instituto de Investigaciones Medicas Doctor Alfredo Lanari – Gastroenterology, Buenos Aires, Argentina
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27
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Laudanno O, Ahumarán G, Gollo P, Khoury M, Thomé M, González P. Tailored Helicobacter pylori eradication therapy in obese patients undergoing bariatric surgery. Rev Esp Enferm Dig 2020; 113:345-347. [PMID: 33244981 DOI: 10.17235/reed.2020.7433/2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES to compare the efficacy and safety of a tailored quadruple concomitant therapy based on body weight, with the same scheme but with fixed doses in obese patients undergoing bariatric surgery. METHODS a prospective study was performed of 104 obese patients. RESULTS the weight-based therapy group achieved significantly higher eradication rates in the intention-to-treat analysis; 86.3 % (95 % CI: 74.3-93.2) vs 66.1 % (95 % CI: 52.6-77.3), p < 0.05. Relative risk: 1.31 (95 % CI: 1.05-1.63). Discontinuations and adverse events were similar in both groups. CONCLUSIONS a tailored quadruple concomitant therapy based on body weight seems to be more effective than the standard quadruple concomitant therapy in obese patients.
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Affiliation(s)
- Oscar Laudanno
- Gastroenterología , Instituto de Investigaciones Médicas "Alfredo Lanari". Universidad de Buenos Aires, Argentina
| | | | - Pablo Gollo
- Gastroenterología, Hospital C. Bocalandro, Argentina
| | - Marina Khoury
- Docencia e Investigación , Instituto de Investigaciones Médicas "Alfredo Lanari". Universidad de Buenos Aires, Argentina
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28
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Khoury M, Phillips D, Wood P, Mott W, Stickland M, Boulanger P, Rempel G, Conway J, Mackie A, Khoo N. CARDIAC REHABILITATION IN THE PEDIATRIC FONTAN POPULATION: DEVELOPMENT OF A HOME-BASED HIGH-INTENSITY INTERVAL TRAINING PROGRAM. Can J Cardiol 2020. [DOI: 10.1016/j.cjca.2020.07.063] [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: 11/16/2022] Open
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29
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Rudzinski M, Pardini L, Bernstein M, Moré G, Khoury M, Duarte SC, Argüelles C, Reina S, Oubiña JR. Interferon-γ and IL-10 Release Assay for Patients with Ocular Toxoplasmosis. Am J Trop Med Hyg 2020; 103:2239-2243. [PMID: 32901605 DOI: 10.4269/ajtmh.20-0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Peripheral blood mononuclear cells (PBMC) from patients with ocular toxoplasmosis were challenged with total antigens from Toxoplasma gondii lysate (TATL) in a cytokine release assay (CRA), run during the inactive period of the disease. Increased interferon gamma (IFN-γ) levels were detected after PBMC stimulation with either ME49 reference strain (P = 0.0015) or local TgCkAr-11-9 isolate (P = 0.0012), as compared with those recorded under basal conditions. TATL from TgCkAr11-9 isolate induced a higher release of IFN-γ than ME49 strain in CRA from all tested patients (P = 0.02). The median value of IFN-γ release on TgCkAr-11-9 stimulation (26.03 pg/mL) allowed the classification of patients into high- or low-/non-IFN-γ releasers. Clinical correlations were established with both groups. The results obtained in this study suggest the need to include local strains when performing CRA with TATL.
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Affiliation(s)
- Marcelo Rudzinski
- Facultad de Ciencias de la Salud, Centro de Investigación, Universidad Católica de las Misiones (UCAMI), Posadas, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina.,Cátedra de Oftalmología, Universidad Católica de las Misiones (UCAMI), Posadas, Argentina
| | - Lais Pardini
- Facultad de Ciencias Veterinarias, Laboratorio de Inmunoparasitología, Universidad Nacional de La Plata (UNLP), Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Mariana Bernstein
- Facultad de Ciencias Veterinarias, Laboratorio de Inmunoparasitología, Universidad Nacional de La Plata (UNLP), Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Gastón Moré
- Facultad de Ciencias Veterinarias, Laboratorio de Inmunoparasitología, Universidad Nacional de La Plata (UNLP), Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Marina Khoury
- Dirección de Docencia e Investigación, Instituto de Investigaciones Médicas "Alfredo Lanari", Ciudad Autónoma de Buenos Aires, Argentina
| | - Silvana Carolina Duarte
- Facultad de Ciencias de la Salud, Centro de Investigación, Universidad Católica de las Misiones (UCAMI), Posadas, Argentina
| | - Carina Argüelles
- Cátedra de Biología Molecular, Universidad Católica de las Misiones (UCAMI), Posadas, Argentina
| | - Silvia Reina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina.,Facultad de Ciencias de la Salud, Centro de Investigación, Universidad Católica de las Misiones (UCAMI), Posadas, Argentina
| | - José Raúl Oubiña
- Instituto de Investigaciones en Microbiología y Parasitología Médica, Universidad de Buenos Aires - Consejo Nacional de Investigaciones Científicas y Técnicas (IMPaM, UBA-CONICET), Ciudad Autónoma de Buenos Aires, Argentina
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30
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Contreras-Lopez RA, Elizondo-Vega R, Torres MJ, Vega-Letter AM, Luque-Campos N, Paredes-Martinez MJ, Pradenas C, Tejedor G, Oyarce K, Salgado M, Jorgensen C, Khoury M, Kronke G, Garcia-Robles MA, Altamirano C, Luz-Crawford P, Djouad F. PPARβ/δ-dependent MSC metabolism determines their immunoregulatory properties. Sci Rep 2020; 10:11423. [PMID: 32651456 PMCID: PMC7351754 DOI: 10.1038/s41598-020-68347-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 06/19/2020] [Indexed: 01/01/2023] Open
Abstract
Mesenchymal stem cell (MSC)-based therapy is being increasingly considered a powerful opportunity for several disorders based on MSC immunoregulatory properties. Nonetheless, MSC are versatile and plastic cells that require an efficient control of their features and functions for their optimal use in clinic. Recently, we have shown that PPARβ/δ is pivotal for MSC immunoregulatory and therapeutic functions. However, the role of PPARβ/δ on MSC metabolic activity and the relevance of PPARβ/δ metabolic control on MSC immunosuppressive properties have never been addressed. Here, we demonstrate that PPARβ/δ deficiency forces MSC metabolic adaptation increasing their glycolytic activity required for their immunoregulatory functions on Th1 and Th17 cells. Additionally, we show that the inhibition of the mitochondrial production of ATP in MSC expressing PPARβ/δ, promotes their metabolic switch towards aerobic glycolysis to stably enhance their immunosuppressive capacities significantly. Altogether, these data demonstrate that PPARβ/δ governs the immunoregulatory potential of MSC by dictating their metabolic reprogramming and pave the way for enhancing MSC immunoregulatory properties and counteracting their versatility.
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Affiliation(s)
- R A Contreras-Lopez
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad de Los Andes, Santiago, Chile.,IRMB, Univ Montpellier, INSERM, CHU Montpellier, Inserm U 1183, IRMB, Hôpital Saint-Eloi, 80 Avenue Augustin Fliche, 34295, Montpellier Cedex 5, France
| | - R Elizondo-Vega
- Facultad de Ciencias Biológicas, Departamento de Biología Celular, Laboratorio de Biología Celular, Universidad de Concepción, Concepción, Chile
| | - M J Torres
- Escuela de Ingeniería Bioquímica, Pontificia Universidad Católica de Valparaiso, Valparaiso, Chile
| | - A M Vega-Letter
- Cells for Cells, Consorcio Regenero, Las Condes, Santiago, Chile.,Laboratory of Nano-Regenerative Medicine, Facultad de Medicina, Universidad de Los Andes, Santiago, Chile
| | - N Luque-Campos
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad de Los Andes, Santiago, Chile
| | - M J Paredes-Martinez
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad de Los Andes, Santiago, Chile
| | - C Pradenas
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad de Los Andes, Santiago, Chile
| | - G Tejedor
- IRMB, Univ Montpellier, INSERM, CHU Montpellier, Inserm U 1183, IRMB, Hôpital Saint-Eloi, 80 Avenue Augustin Fliche, 34295, Montpellier Cedex 5, France
| | - K Oyarce
- Facultad de Ciencias de la Salud, Universidad San Sebastián, Concepción, Chile
| | - M Salgado
- Facultad de Ciencias Biológicas, Departamento de Biología Celular, Laboratorio de Biología Celular, Universidad de Concepción, Concepción, Chile
| | - C Jorgensen
- IRMB, Univ Montpellier, INSERM, CHU Montpellier, Inserm U 1183, IRMB, Hôpital Saint-Eloi, 80 Avenue Augustin Fliche, 34295, Montpellier Cedex 5, France
| | - M Khoury
- Cells for Cells, Consorcio Regenero, Las Condes, Santiago, Chile.,Laboratory of Nano-Regenerative Medicine, Facultad de Medicina, Universidad de Los Andes, Santiago, Chile
| | - G Kronke
- Department of Internal Medicine 3, University of Erlangen-Nuremberg, 91054, Erlangen, Germany
| | - M A Garcia-Robles
- Facultad de Ciencias Biológicas, Departamento de Biología Celular, Laboratorio de Biología Celular, Universidad de Concepción, Concepción, Chile
| | - C Altamirano
- Escuela de Ingeniería Bioquímica, Pontificia Universidad Católica de Valparaiso, Valparaiso, Chile
| | - P Luz-Crawford
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad de Los Andes, Santiago, Chile.
| | - F Djouad
- IRMB, Univ Montpellier, INSERM, CHU Montpellier, Inserm U 1183, IRMB, Hôpital Saint-Eloi, 80 Avenue Augustin Fliche, 34295, Montpellier Cedex 5, France.
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31
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Court A, Velarde F, Parra E, Luz-Crawford P, Figueroa F, Khoury M. Mitochondria Transfer Elicits Articular Cartilage Protection. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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32
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Zavala G, González F, Hidalgo C, Kunze M, Khoury M, Acevedo J. Injectable functionalized-gelatin derived from cold-adapted species balances between arthroscopic extrudability prerequisite, chondrocompatibility and biomechanical requirements for precise arthroscopic restoration. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.357] [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: 10/24/2022]
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33
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Heid C, Khoury M, Vela R, Liu C, Maaraoui K, Pruszynski J, Walsh L, Ring W, Peltz M, Wait M, Huffman L. Pulse Dose Steroids are Not Associated with Wound Dehiscence Following Lung Transplant. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.499] [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: 10/24/2022] Open
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34
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Brizuela C, Meza G, Urrejola D, Quezada MA, Concha G, Ramírez V, Angelopoulos I, Cadiz MI, Tapia-Limonchi R, Khoury M. Cell-Based Regenerative Endodontics for Treatment of Periapical Lesions: A Randomized, Controlled Phase I/II Clinical Trial. J Dent Res 2020; 99:523-529. [PMID: 32202965 DOI: 10.1177/0022034520913242] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [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: 12/16/2022] Open
Abstract
A randomized controlled phase I/II clinical trial was designed to evaluate the safety and efficacy of encapsulated human umbilical cord mesenchymal stem cells in a plasma-derived biomaterial for regenerative endodontic procedures (REPs) in mature permanent teeth with apical lesions. The trial included 36 patients with mature incisors, canines, or mandibular premolars showing pulp necrosis and apical periodontitis. Patients were randomly and equally allocated between experimental (REP) or conventional root canal treatment (ENDO) groups. On the first visit, cavity access and mechanical preparation of the root canal were performed. Calcium hydroxide medication was used, and the cavity was sealed. Three weeks later, patients were treated following their assigned protocol of ENDO or REP. Clinical follow-up examinations were performed at 6 and 12 mo. Categorical variables were evaluated by Fisher's exact test. Quantitative variables were compared using the Mann-Whitney test. The evolution over time of the percentage of perfusion units and the dimensions of lesion and cortical compromise were explored. After the 12-mo follow-up, no adverse events were reported, and the patients showed 100% clinical efficacy in both groups. Interestingly, in the REP group, the perfusion unit percentage measured by laser Doppler flowmetry revealed an increase from 60.6% to 78.1% between baseline and 12-mo follow-up. Sensitivity tests revealed an increase of the positive pulp response in the REP group at 12-mo follow-up (from 6% to 56% on the cold test, from 0% to 28% on the hot test, and from 17% to 50% on the electrical test). We present the first clinical safety and efficacy evidence of the endodontic use of allogenic umbilical cord mesenchymal stem cells encapsulated in a plasma-derived biomaterial. The innovative approach, based on biological principles that promote dentin-pulp regeneration, presents a promising alternative for the treatment of periapical pathology (ClinicalTrials.gov NCT03102879).
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Affiliation(s)
- C Brizuela
- Centro "Activa Biosilicate Technology™" de Investigación en Biología y Regeneración Oral (CIBRO), Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
| | - G Meza
- Centro "Activa Biosilicate Technology™" de Investigación en Biología y Regeneración Oral (CIBRO), Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
| | - D Urrejola
- Centro "Activa Biosilicate Technology™" de Investigación en Biología y Regeneración Oral (CIBRO), Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
| | - M A Quezada
- Centro "Activa Biosilicate Technology™" de Investigación en Biología y Regeneración Oral (CIBRO), Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
| | - G Concha
- Centro "Activa Biosilicate Technology™" de Investigación en Biología y Regeneración Oral (CIBRO), Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
| | - V Ramírez
- Centro "Activa Biosilicate Technology™" de Investigación en Biología y Regeneración Oral (CIBRO), Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
| | - I Angelopoulos
- Laboratory of Nano-Regenerative Medicine, Faculty of Medicine, Universidad de los Andes, Santiago, Chile
| | - M I Cadiz
- Laboratory of Nano-Regenerative Medicine, Faculty of Medicine, Universidad de los Andes, Santiago, Chile.,Consorcio Regenero, Chilean Consortium for Regenerative Medicine, Santiago, Chile
| | - R Tapia-Limonchi
- Laboratory of Nano-Regenerative Medicine, Faculty of Medicine, Universidad de los Andes, Santiago, Chile.,Consorcio Regenero, Chilean Consortium for Regenerative Medicine, Santiago, Chile
| | - M Khoury
- Laboratory of Nano-Regenerative Medicine, Faculty of Medicine, Universidad de los Andes, Santiago, Chile.,Consorcio Regenero, Chilean Consortium for Regenerative Medicine, Santiago, Chile.,Cells for Cells, Santiago, Chile
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35
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Vamvakeridou-Lyroudia LS, Chen AS, Khoury M, Gibson MJ, Kostaridis A, Stewart D, Wood M, Djordjevic S, Savic DA. Assessing and visualising hazard impacts to enhance the resilience of Critical Infrastructures to urban flooding. Sci Total Environ 2020; 707:136078. [PMID: 31874400 DOI: 10.1016/j.scitotenv.2019.136078] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 12/08/2019] [Accepted: 12/09/2019] [Indexed: 06/10/2023]
Abstract
The design, construction and maintenance of Critical Infrastructures (CI) is commonly based on standards that are rigorous, so as to withstand any climate or weather-linked pressures. However, due to climate change, climate characteristics may shift, resulting in increased frequency/magnitude of potential failures, or exposure to new unknown risks. As vital components for the normal functioning of modern societies, the resilience of CIs under climate stressors encompasses their structural integrity, their operational elements, and their capacity to maximize business output. In this work, we propose an integrated and participatory methodological approach to enhance the resilience of interconnected CIs to urban flooding under climate change, by assessing the risk and introducing adaptation measures. The main objectives of the proposed methodology and approach are: (i) to provide scientific evidence for better understanding of how future climate regimes might affect normal operation of interconnected CI in urban areas during their lifespan; (ii) to assess the cost-effectiveness of different adaptation measures; (iii) to involve local stakeholders and operators in the co-design of the approach, as well as the assessment and the evaluation of adaptation measures; (iv) to combine computational modelling with advanced 3D visualisation techniques for effectively engaging stakeholders in decision making; (v) to include risk assessment and damage functions co-designed by end-users and local stakeholders; (vi) to integrate all of the aforementioned components in a specifically designed cloud platform as a Decision Support System for end-users, (vii) to validate the DSS by the end users and local stakeholders. The paper presents the computational background and tools. Additionally, it describes a Case Study in Torbay, UK, where the full methodology and the proposed participatory approach have been applied, with all the specifics, i.e., the scenarios of extreme flooding, the numerical and visualisation results, the response of the stakeholders and the evaluation of selected adaptation measures.
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Affiliation(s)
- L S Vamvakeridou-Lyroudia
- KWR Water Research Institute, Groningenhaven 7, P.O. Box 1072, 3430 BB Nieuwegein, the Netherlands; Centre for Water Systems, University of Exeter, North Park Road, Exeter EX4 4QF, UK.
| | - A S Chen
- Centre for Water Systems, University of Exeter, North Park Road, Exeter EX4 4QF, UK
| | - M Khoury
- Centre for Water Systems, University of Exeter, North Park Road, Exeter EX4 4QF, UK
| | - M J Gibson
- Centre for Water Systems, University of Exeter, North Park Road, Exeter EX4 4QF, UK
| | - A Kostaridis
- SATWAYS Ltd, 3 Christou Lada Street, 15233 Halandri, Athens, Greece
| | - D Stewart
- Torbay Council, Town Hall, Castle Circus, Torquay TQ1 3DR, UK
| | - M Wood
- Torbay Council, Town Hall, Castle Circus, Torquay TQ1 3DR, UK
| | - S Djordjevic
- Centre for Water Systems, University of Exeter, North Park Road, Exeter EX4 4QF, UK
| | - D A Savic
- KWR Water Research Institute, Groningenhaven 7, P.O. Box 1072, 3430 BB Nieuwegein, the Netherlands; Centre for Water Systems, University of Exeter, North Park Road, Exeter EX4 4QF, UK
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36
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Boim C, Khoury M, Storni M. [Adherence to a home-based pulmonary rehabilitation program]. Medicina (B Aires) 2020; 80:143-149. [PMID: 32282320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Abstract
Since 1996, the Hospital del Tórax Dr. Antonio A. Centrángolo conducts a pulmonary rehabilitation program that requires patients with chronic pulmonary disease to attend the hospital twice a week. In 2015 the home-based program (HBP) was developed for patients living more than either 10 km or 60 minutes away from the hospital, or with conflicting working schedules. A retrospective study was conducted to describe the adherence to the home-based program by patients with chronic pulmonary disease, and explore adherence-related factors. In 2017, 96 (75.6%) of 127 patients eligible for pulmonary rehabilitation were assigned to the home-based program; they were instructed to complete at least three exercise sessions a week -including aerobic and resistance, segmental strength of upper and lower limbs, and flexibility-; and attend hospital visits every 20 to 30 days; "adherence to the HBP" was determined for patients who attended their final assessment on the fifth visit. A 40.6% (n = 39) of the patients only attended the first visit; 23% (n = 22) adhered to the program. This latter group of patients had shown, at their first assessment, better FVCs (p = 0.013), lower dyspnea scores (p = 0.008), and less than two or more exacerbations during the previous 6 months (p = 0.032). Only one patient needed to take three or more different transportation services to reach the hospital (p = 0.006). The results suggest that adherence to the home-based program was associated to a better clinical status and better access to the hospital.
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Affiliation(s)
- Clarisa Boim
- Unidad de Rehabilitación Respiratoria, Hospital de Tórax Dr. Antonio A. Cetrángolo, Buenos Aires, Argentina. E-mail:
| | - Marina Khoury
- Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina
| | - Miguel Storni
- Unidad de Rehabilitación Respiratoria, Hospital de Tórax Dr. Antonio A. Cetrángolo, Buenos Aires, Argentina
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37
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Parra E, LeGatt A, Court A, Figueroa F, Khoury M. Artificial mitochondria transfer prevents staurosporine-induced apoptosis of human T lymphocytes. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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38
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Roughani RA, Elfadally H, Otaiby HA, Hasan A, Kawi ZA, Belahsen M, Zakaria M, Khoury M, Harb M, Sadi TA, Asmi AA. Real World Retrospective Study of Effectiveness and Safety of Fingolimod in Relapsing Remitting Multiple Sclerosis in the Middle East and North Africa (FINOMENA). Mult Scler Relat Disord 2018. [DOI: 10.1016/j.msard.2018.10.078] [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: 10/27/2022]
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39
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Khoury R, Dawood S, Khoury M, Khan F, Al Khatib F, Bello M, Hamadi A, Kazim H, Dhar A, Nasioulas G. Hereditary cancer syndromes and development of tele genetics program in the Asia-Pacific, Middle East region. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy441.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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40
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Akentjew T, Terraza C, Suazo C, Wilkens C, Blaker J, Garcia C, Valenzuela L, Khoury M, Acevedo J. Rapid, automated and bio-inspired fabrication of cell-patterned small diameter vascular graft with coronary artery mechanics. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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41
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Court A, LeGatt A, Luz-Crawford P, Kurte M, Ortuzar M, Contreras R, Parra E, Pino-Lagos K, Figueroa F, Khoury M. Mitochondrial transfer from MSC to human T cells: A first evidence of a stem cell-mediated reprogramming of multiple immune cell function. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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42
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Brizuela C, Urrejola D, Meza G, Angelopoulos I, Khoury M. Translational pathway of scalable, allogenic encapsulated Mesenchymal Stem Cells for Dental Pulp Regeneration. RanoKure a controlled Phase I/II clinical trial designed to evaluate the survival of mature permanent teeth with apical lesion following a regenerative endodontics procedure. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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43
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Acevedo J, Ros E, Encina M, González F, Khoury M. Rapid assessment of directed migration: A novel Microtechnology-based 3D device for therapeutic quality screening of stem cells (SC). Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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44
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Buhl MA, Gómez G, Collado MV, Oddo EM, Khoury M, Azurmendi PJ, Sarano J. [Genetic polymorphisms of thiopurine methyltransferase and incidence of adverse events in patients with medical indication of azathioprine]. Medicina (B Aires) 2018; 78:65-70. [PMID: 29659353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Azathioprine is a thiopurine which has a narrow therapeutic index and marked hematological and hepatic toxicity. Thiopurine s-methyltransferase is an enzyme involved in the metabolism of thiopurines. Mutations in the gene that encodes the enzyme may augment the risk of adverse events. For that reason, pharmacogenetic determinations prior to the initiation of therapy can provide useful information for the future therapeutic strategy. Nevertheless, its utility in the local environment is not completely established. Forty-five subjects (13 men) who had been prescribed azathioprine were included. The presence of *2, *3A, *3B and *3C mutations were determined by PCR-RFLP, and the relationship between genotype and incidence of adverse events related to the drug was analyzed. Nine carried at least one non-functional allele, one of them with *3A/*3A genotype. Among the eighteen patients who initiated treatment with azathioprine, toxicity was detected in 3 cases: 2 mild events were observed in patients with normal genotype, and the only serious event (bone marrow suppression) occurred in the individual with homozygous mutant genotype. The only homozygous mutant patient developed the most severe of the registered events, in spite of being under treatment with low doses of azathioprine. This is the reason why enzymatic determination could be of utility, even though it does not replace clinical and biochemical follow-up in patients under thiopurine treatment.
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Affiliation(s)
- Manuel A Buhl
- Servicio de Inmunología, Instituto de Investigaciones Médicas (IDIM) Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina. E-mail:
| | - Graciela Gómez
- Servicio de Inmunología, Instituto de Investigaciones Médicas (IDIM) Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - María Victoria Collado
- Servicio de Inmunología, Instituto de Investigaciones Médicas (IDIM) Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Elisabet M Oddo
- Laboratorio de Nefrología Experimental y Bioquímica Molecular, Instituto de Investigaciones Médicas (IDIM) Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Marina Khoury
- Estadística y Metodología de la Investigación, Instituto de Investigaciones Médicas (IDIM) Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Pablo J Azurmendi
- Laboratorio de Nefrología Experimental y Bioquímica Molecular, Instituto de Investigaciones Médicas (IDIM) Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Judith Sarano
- Servicio de Inmunología, Instituto de Investigaciones Médicas (IDIM) Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
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Gargiulo MDLÁ, Khoury M, Gómez G, Grimaudo S, Suárez L, Collado MV, Sarano J. Cut-off values of immunological tests to identify patients at high risk of severe lupus nephritis. Medicina (B Aires) 2018; 78:329-335. [PMID: 30285925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Cut-off values for anti-dsDNA, anti-nucleosome and anti-C1q antibodies tests and for complementmediated hemolytic activity (CH50) were explored to identify patients with high risk of developing severe lupus nephritis (LN). Forty-one patients with confirmed systemic lupus erythematosus (SLE) were identified; their levels for the three antibodies and complement had been measured on a same serum sample. These patients were classified based on the presence of renal involvem ent; sixteen had active proliferative LN. With the cut-off values accepted in the laboratory for SLE diagnosis (anti-dsDNA > 100 UI/ml, anti-nucleosome > 50 U/ml or CH50 < 190 UCH50%) no significant differences were found between patients with and without LN. Anti-C1q > 40 U/ml showed a statistically significant association with LN and had 80% of specificity. Cut-off values for LN identified by Receiver Operating Characteristic curves (ROC) were higher for anti-dsDNA (> 455 IU/ml) and antinucleosome (>107 U/ml), lower for CH50 (< 150 UCH50%) and, for anti-C1q (> 41 U/ml) coincided with the cut-off values accepted for SLE. Anti-C1q > 134 U/ml had a 92% of specificity, 56% of sensibility and was associated with a fifteen-fold increased risk of LN. The simultaneous presence of anti-nucleosome > 107 U/ml and anti-C1q > 134 U/ml was associated with a 27-fold higher probability for LN. According to these results, the cut-off values used to detect SLE activity could be inadequate to identify patients at high risk of severe LN.
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Affiliation(s)
- María De Los Ángeles Gargiulo
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Marina Khoury
- Estadística y Metodología de la Investigación, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Graciela Gómez
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Sebastián Grimaudo
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Lorena Suárez
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - María Victoria Collado
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Judith Sarano
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
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Khoury M, Stone J, Southern D, Wilton S, Galbraith D, Aggarwal S, Arena R, Martin B. UTILIZATION AND IMPACT OF CARDIAC REHABILITATION IN PREMATURE AND NON-PREMATURE CORONARY ARTERY DISEASE. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Akentjew T, Khoury M, Acevedo J, Wilkens C. Automated micro-fabrication of a vascular graft mimicking the structure of human coronary arteries based on layer deposition, nanofibers and dipping-spinning technologies. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.048] [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: 11/16/2022]
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Espinoza F, González F, Badilla A, Monckeberg G, Chea R, Pefaur J, Llanos C, Martinez M, Valenzuela O, Silva F, Areny R, Alamo M, Court A, Tapia R, Khoury M, Figueroa F. Randomized controlled clinical trial to assess dose-response and efficacy of umbilical cord derived mesenchymal stromal cells (MSC) in severe lupus nephritis. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.079] [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: 11/28/2022]
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Dorado E, Mouesca MV, Khoury M, Barreiro D, Lafós N, Rausch S. [Relation between severity of atherosclerosis and progression of renal disease in nephrectomized patients]. Medicina (B Aires) 2017; 77:95-99. [PMID: 28463213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
Radical nephrectomy is associated with a progressive decline in renal function. Clinical parameters in post-nephrectomy insufficiency were described but the impact of histopathologic vascular findings in the non-neoplastic kidney of nephrectomy specimen, has been poorly studied. Our aim was to evaluate whether the severity of atherosclerosis in non-neoplastic renal tissue predicts the evolution of glomerular filtration rate in patients undergoing total nephrectomy. Thirty-one non-donor patients with unilateral radical nephrectomy were included. Average age was 68.5 ± 11.8 years, 80% had a history of hypertension, 64% overweight and 51% were smokers. The glomerular filtration rate was estimated preoperatively, postoperatively and at 6, 12 and 24 months after surgery. Arteriolosclerosis was scored based on degree of narrowing of the vascular lumen (stage 0: no vascular narrowing; stage 1: less than 25%; stage 2: 25-50%; stage 3: more than 50%). Ten patients in stage 0 had higher basal glomerular filtration rate (75 ± 13 ml/min/1.73 m2) than eight patients in stage 2 or 3 (55 ± 22 ml/min/1.73 m2) (p 0.0886). At the last postoperative evaluation, the glomerular filtration rate was 60 ± 13 ml/min/1.73 m2 (stage 0) and 39 ± 11 ml/min/1.73 m2 (stage 2 or 3) (p = 0.05). The decrease in glomerular filtration rate was higher in patients with more severe degrees of atherosclerosis but the difference was not statistically significant. The histological evaluation of the severity of arteriosclerosis in the whole kidney allows the identification of patients with a greater risk of decreased glomerular filtration rate after a post radical nephrectomy.
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Affiliation(s)
- Enrique Dorado
- Departamento Nefrología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina. E-mail:
| | - María V Mouesca
- Departamento de Clínica Médica, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina
| | - Marina Khoury
- Epidemiología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina
| | - Diego Barreiro
- Sección Urología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina
| | - Norberto Lafós
- Sección Urología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina
| | - Silvia Rausch
- Departamento de Anatomía Patológica, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina
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